Palabras clave: Naltrexona, mantenimiento, dependencia opiáceos, efectividad.

ABSTRACT: We present the outcome of the 12 months follow-up after a outpatient treatment of naltrexona maintenance (juny 1992) and the appraisal of the program carried out during two years (may 89 until may 91). The sample was 47 heroin addicts, with a mean age of 25 years (range: 18-37) and 87% were men.
The main criterio for evaluation was the improvement in heroin taking, medical condition, employment and family relations in relation with the time spend in treatment. In the follow-up we use interviews and urine test. We get information from 93,6% of the initial sample. We found a significant decrease in opiate use in the subjects after three months in the naltrexone program; the treatment demands decreased and increased the employment time in post-treatment stage.

Palabras clave: Alcoholismo, urgencias psiquiátricas, doble diagnóstico.

ABSTRACT: The authors study a sample of 605 psychiatric emergencies attending to a general hospital psychiatric ward. The 12,5% of patients were alcohol related psychiatric emergencies. The results show a greater rate of men and age between 21-60. There were no significative differences in habitat, but profession showed significative in some occupations (sailor, worker and administrative and clerical workers). A 36,5% had a dual diagnosis: depression (9,2%) and personality disorder (9,2%) were the most frequent. The rate of previous suicidal attempt is 11,5%. The rate of hospitalization is 27, 6% and 64,5% were derivated to psychiatric outpatient services.

Palabras clave: Adicción, Personalidad, Tratamiento, Resultados, MMPI, 16PF

ABSTRACT: The authors make an study on personality characteristics of a group of heroin addicts admitted to treatment at one therapeutic community. Two instruments were used: the MMPI and 16PF. Both instruments show high rates of personality deviated traits and a recognisable pattern of personality disturbance, characterised by a combination of psychotic, neurotic, psychopathic elements ans Introversion indicators. Psychodiagnostic at six-month follow-uo shows evidence of improvement at psychological adjustement, with greater extroversion and socialisation, and less symptoms of anxiety and depression, although greater somatic symptoms are observed. Psychodiagnostic at follo-up showed more prognostic validity for retention than initial evaluation. Implications for treatment and diagnostic are discussed.

Palabras clave: Consumo de alcohol, población general, variables sociodemográficas.

SUMMARY: The Pattern of averace dily intake of alcohol in a representative sample of the general population of La Rioja aged between 15 and 65 y. o. is analyzed. The objective is to try to stablish the prevalence of alcoholism in the general population, to analyze which layers of the population are more affected, and to stablish a correlation between alcohol use and other sociodemographic variables. This is a nominative transversal design with aleatory sampling regarding age, sex and habitat. 60% of the population consume alcohol regularily, 75% of the men and 43% of the women. 8,8% of the men and 0,8% of the women drink more than 100cc of alcohol/24h. The period of life in which the highest concentration of excessive drinkers concentrate is 45-65 y.o. Men living in rural areas consume more alcohol than those living in urban areas.

Palabras clave: Naltrexona, Heroina, Evaluación

SUMMARY: This artcle describes the evolution of 90 opiate addicts in an outpatien Naltrexone programme and the differences in their situation, according to the duration of pharmacological treatment, at the end of the Follow-up (February 93). It is remarkable that 75,47% of the patients stay in treatment in a health programme at the end of the study. Patients undergoing pharmacological treatment for more than 6 months, remain longer in abstinence with very few relapses. Naltrexone use in long programme does not increase the side effects.

Palabras clave: Heroina, comunidad terapéutica, estudios de seguimiento, políticas sobre drogas.

ABSTRACT: When discussing the results of a retrospective longitudinal study of 166 drugaddicts who received treatment on the "Haize-Gain" Therapeutic Community program between 1982 and 1992, we have isolated five aspects which are considered especially relevant to treatment policies for heroin addicts.
These five aspects are: a) the high level of success in abstinence,
b) the normalization of social integration variables amongst survivors,
c) the emergence od a group of "chronic" consumers of treatment,
d) increased valuation of the "self-awareness, support and coexistence" factors as opposed to "consumption control and social integration" factors as indicators of satisfaction and
e) the existence of a more pessimistic attitude than the corresponding reality amongst therapists.

Palabras clave: Auto-concepto, sí mismos posibles, adicción, aspectos clínicos.

SUMMARY: The well-know relationship between self-esteem and addiction is beig changed because of the new theoretical approaches about the self-concept and the novel models of addiction. This paper is going to be focused on the possible selves conception within the cognitive paradigm: thus, the self-concept is now seen as a much more active element which has an overriding influence on subject's behaviour, motivation and feelings: we can say that it is a real catalyst of the whole human activity. We point at a main insistence on the potencial aspects of the subject (creative style), the need of having a wider therapeutic offer that makes feasible the greatest human potential growth, and the alwys present risk that the therapeutic intrvention may be harmful.

Key words: Self-concept, possible selves, addiction, clinical aspects

Palabras clave: prevención de la demanda, educación para la salud, toma de decisiones, implementación, evaluación del proceso, evaluación funcional.

SUMMARY: This article reports on the introduction and implementation of the preventive programma TU DECIDES in Barcelona. The Municipal Action Plan on Drugs Dependencies already disposes of a programme for the prevention of toxic habits in Primary School (PASE programme). For High School, we selected the present programme, created by Calafat et al. in 1985, which fits best to our theoretical setting out.
With previous permission of the authors, the test has been traslated into Catalan version - DECIDEIX! - in 1993/94. Data about centres, teachers and the application of the programme are provided. Almost every goal of the lessons have been achieved and 92,7% of the involved teachers are satisfied with the experience. Results have been elaborated and a crossing of some variables is attemted, although the item fragmentation and the irregular distribution of valid answers exclude a significative statistic processing. A former pilot experience,the current implantation and the future perspectives for the programme are exposed. Our aim is altogether to start an ongoing evaluation of the implementation process of the programme in Barcelona.

Palabras clave: variables, grupo control, grupo experimental, predicción, adicción, drogas, heroina.

SUMMARY: This is a study of the importance of the social, psychological and consumption variables in the prediction of the behaviour of the heroin addiction. In this article we are going to see the differences found in 59 different variables, when compared to a group of drugdependents whose main substance of abuse was heroin (experimental group), and another group of subjects without any problems of drug addiction (control group). The results of the differential analysis show the existence of significative differences in a great number of variables, specially in those of a social nature. The aim is to prove the probability with wich this kind of variables predict the appearing of addiction behaviour.
The results of the discriminating analysis show that such variables present a very high margin of confidence in the prediction of the addiction behaviour, and so the need that these, are be taken into account both elaborating the programmes of prevention and in the programmes of treatment.

Palabras clave: Adicción, Diagnóstico, Cognitivo-Conductual, Prevención de Recaidas.

ABSTRACT: This study describes 130 heroin addicts after 7 months of treatment in several professional therapeutic communities. A structured interview is used which collected two kinds of data: 1) sociodemographic data and history of heroin consumption, 2) retrospective information concerting the treatment period. The results show a high prevalence of craving episodes during the treatment period. ·7% of the sample experience weekly heroin craving after seven months in abstinence. Almost 70% suffered psychophysiological alterations associated with craving. Many subjects consumed substances against treatment rules, laid own selves open to paces related with heroin consumption or under social pressure towards heroin. Also deficits in coping with craving are frequent.
Heroin craving is associated with negative emotional states and inadapted cognitive responses, arises in a variety of stressful situations and a accompanied by a low level of cognitive surveillance. The authors conclude the need of behaviour modification programs guided toward the relapse prevention in these patients, and suggest some intervention strategies.

Palabras clave: Alcohol, Alcoholismo, Análisis Discriminante, Valores, Socialización Familiar.

ABSTRACT: 1.100 adolescents(15-19 years old) of both sexes, studying in Valencia private and public schools are studied to determine the relationship between alcohol consumption and a ser of psychosocial variables hypothetically tied to abuse consumption: family socialization, values, attitudes toward alcohol, level of information, and gropu pressure, through seven differnt scales. According to the scores obtained in consumption habits scale, subjets were assignes to two clusters: Abstemious/Moderate and Excessive. When the discriminant analysis are aplied, it was detected that the abusive consumption of alcohol on adolescence is related to:

• Permissive attitudes, based on: a) perception of normality about uses socially accepted; b) the conviction that alcoholic drinks ease social realtions; and c) the absence of conviction of disarrangement respected to the proper abusive behavior.
• Habitual consumption within the family and group of peers.
• Perception of incomprehension and dissatisfaction within the family system.
• Absence of consolidated internalization concerning social demands of self-control.

Palabras clave: Juego patológico, prevalencia, epidemiología.

SUMMARY: The purpose of this article is to offer a model of epidemiological study in general population given that in our contry, we need to improve the information on the reach of the problem. Since the game was legalized in Spain, the amount of money expend has grown progressively, until now that we are one of the countries that more spends in game and where more legalized games exist. It seems them logical to expect that there will be a number elevated of people with pathological gambling. For this purpose, we discuss in this paper the necessity to have good epidemilogical studies.

Palabras clave: Toxicómanos, pautas de crianza, vínculo, factores familiares.

SUMMARY: Particular styles of parenting have been related as etiological factors of the emotional problems, by many clinicians in the area of drugs addiction. This study focuses on the reception of a parental breeding styles assessed with the Parental Bonding Instrument in a sample of 96 subjets (60 drugs abusers and 36 normal controls). Drug-abusers perceive their parents as high in overinvolvemnt and low i-care, predominating a control bond without affect opposite the optimal bond of control group.
These results, as a well as previous research, suggest that these perceived behavior may be associated to a general risk factor for the development of psychological and psychiatric disorders. In the therapeutic level, would be interesting to include famili inteventions, in the programs of drugs abusers, to achieve a better bond between patient amd parents.

Palabras clave: Drogadicción, escolares, prevalencia, epidemiología.

SUMMARY: estimate the prevalence, reasons and the pattern of grug use among teenager students. Design: An observational cross-sectional study. Setting: Teenagers at high schools in Córdoba (N=11,28). Participants: 1103 subjects random selected by multietapic sampling. Interventions: A self-report questionnaire. Results: The smoker prevalence was 36,8% (95% Confidence Interval -CI-: 34,0-39,7%), that prevalence was higher among females (p=0,0085). The drinker prevalence was 64% (CI: 71,4-76,6%) and higher in males (p<0,01). The prevalence of use of illegal drugs was 7% (CI: 6,0-9,2%), haschish was the substance more frequently tried. The intake of sedatives was 6,8% (CI: 5,4-8,5%) and that of anphetamines 3% (CI:1,9-3,9%).
Conclusions: In general, the drug use prevalence we drawn are very close to those from other studies. We observed some particularities in the intake patterns that we haver detected as well as ther reasons why teenager scholars from our environment are attracted by drugs.

Key words: Drug abuse, students, prevalence, epidemiology.

Palabras clave: Alcohol, gamma-glutamiltranspeptidasa, volumen corpuscular medio, marineros, pescadores.

SUMMARY: The objective of this study is to analyze the prevalence of the heavy drinkers in the sailor and fisherman populations of the Region of Murcia and its relation with other worker populations, as well as to confirm the usefulness of the gamma-glutamyltranspeptidase (Y-GT) and the mean corpuscular volume (VCM) to the diagnosis of the high alcohol consumption. A total of 304 blood samples from the regular checkups werw studied. In our sample, 77% of the subjects reported alcohol consumption. We have found a direct significant statistical association between Y-GT and VCM values and alcohol consumption. In our study, we obtained different rates of prevalence according to the diagnosis index used (raised activities of serum Y-GT and high values of VCM). We concluded that our population shows a high prevalence of excessive alcohol consumers.

Palabras clave: DUSI (Drug Use Screening Inventory), adolescentes, cuestionario, validación, uso de drogas.

ABSTRACT: The aim of this study was to validate the Drug Use Screening Inventory for Costa Rican adolescent population. This will provide health professionals with a simple and precise instrument to be used in research, evaluation and intervention. It was administered in a sample of 1192 student adolescent from 10 to 18 years old, 97 adolescents from treatment services for drug abuse, 100 "street adolescents" identified as drug abusers, and 67 adolescent from juvenile correctional centers. The DUSI is a comprehensive instrument that evaluates the use of drugs and nine areas of adolescent general functioning affected by drugs. It has shown hihg levels of validity and reliability in different populations and ability to be used as a screening instrument in high risk addition, it can be used for program evaluation.

Palabras clave: Heroinómanos, abstinencia, seguimiento

ABSTRACT: We have here the results of a follow-up study involving a sample of heroin addicts that wew undergoing treatment in Asturias (Spain). The study was carried out in two phases. In the first phase a selection was made by mean of case register, of the new patients (n=334) that werw receiving assistance at drug free clinics (Mental Health Clinics) in Asturias from January to December 1987. The second phase was carried out on an average of 40 months after the first contact, and the patients was located and interviewed. It was found that those who had stopped taking heroin were in better shape psychologically and committed fewer crimes. There werw no significant differences in excessive alcohol abuse (more than 75 ml/day of ethanol) and the number of HIV+ cases between the heroin users and the heroin non-users.

Palabras clave: Drogodependencia, Contención, Comprensión, Reconstrucción.

SUMMARY: The objective of this article is to analyse the therapeutic approach to drug dependency considering the three phases of process: contention, understanding and reconstruction. The phase of contention involves the Institution's place and the therapeutic team as a generating forces of the therapeutic postulates that are the bases for interventions. Lastly, the phase of reconstruction assesses the therapeutic strategies.

Palabras clave: Test de Le Gô, diagnóstico, alcoholismo, tabaquismo, población laboral.

SUMMARY: In the first six months of 1994, a study has been carried out on 152 workers belonging to a transport company which consists of 405 workers, and it is placed in the southeast of Spain. Le Gô test for alcoholism screening was tested.
Thirteen workers (8,6%) showed a Le Gô test equal to or hugher than 12 (heavy drinker). Their ages were 45,2+8,7 (mean +S.D); their years of service 23,2 + 12,0 and their years in the same port 17,1+9,9. There exist significant statiscal differences (PÛ0,05) between the light and heavy drinkers for variables related to excessive alcohol intake: age, tobacco intake, systolic and diastolic blood pressure, weight, leucocytes, glucose, uric acid, and gamma-glutamyl transpeptidase.
Le GÔ test can be a useful method to detect people with alcohol problems in the working population during the periodical health check-up. In any case the must be completed by guided anamnesis and blood test results.

Palabras clave: Adolescentes, Uso de Drogas, Juego Patológico.

ABSTRACT: The paper being presented shows some new information about the problems of gambing drawn from a group of 105 adolescent students under the age of 18. The data, with 2,86% of the youths classiefied as "probable pathological gambler" and 6,7% as "having mild gambling problems", tend to confirm the earlier reported (Arbinaga, 1994; Custer 1982; Ladoucer and Mireault, 1988; Lesieur and cols., 1991). Information is offered about the relationship between gambling and the use of drugs, where it can be seen that 17% of dailly cigarette smokers have problems with gambling. With respect to the source of financiation it can be seen that it tends to come from the family as the problems grow. Finally, among the alleged motives are the influence of social imitation (36,19%), new sensations (18,09%) and the importance of glambing as a way of forgetting problems (21,9%).

Palabras clave: Conductas adictivas, Recaída, Impacto psicológico, Dinámica asistencial, Estrategias de afrontamiento.

ABSTRACT: In the addictive behaviours treatment area, the addicts' relapses represent a continuous and unavoidable challenge due to their high frequency. The aim of the present study is to show the outstanding relevance of the psychological impact that addicts' relapses have both on the course of the addictive disorder as well as on the therapists and on the care management dynamics. Likewise several coping strategies for minimizing such impact are presented and developed.

Palabras clave: dejar de fumar, programas conductuales, eficacia a largo plazo, seguimiento, abstinencia

ABSTRACT: In this article we review fourteen behavioral smoking cessation studies, that include follow-up data to 2-6 years and that have been conducted over the past 20 years. Short-term follow-up data for the majority of programs produce cessation rates higher than 50%. Long-term follow-up, at twelve months posttretment, the efficacy average is 35%. The efficacy of studies that include follow-up data to 24-72 months exceeded 24% of abstinence for all studies.
Some of these works haven't physiological measures, inadequate sample sizes, non-control group and/or not considered participants attrition when they reported cessation outcomes. Neevertheless, data note to which an important portion of subjects than had gone to smoking cessation programs, about one third of treated subjects, are abstinent and so the behavioural smoking cessation programs are effective both one year as larger length of time.

Key words: smoking cessation, behavioural interventions, long-term efficacy, follow-up, abstinence.

Palabras clave: Alcoholismo, Drogodependencias, Absentismo, Consecuencias sociolaborales, población laboral.

SUMMARY: Between 1988 and 1992 a creful examination was accomplished on 800 workers of a transport company, in the southeast of Spain, in order to determine drug-addiction consequences. A comparative study was carried out on the results obtained from check-ups on the 1357 employees that belong to the staff. Heavy drinkers were tested by means of anamnesis, drink alcohol survey, physical exploration and blood test results. We found 66 heavy drinkers (8,4%). Theri ages were 45,8+12,7 (mean +S.D). Illegal drug users were tested by means of analysing uirne samples by enzymeimmunotest. We found 21 drug users (3,6%). Theri ages were 27,6+8,3. No sign of drug addiction was found in female employees. By analysing the results of our study we can perceive a higher level of absenteeism on possible heavy drinkers. The utmost degree of abstenteeism was detected on illegal drug users, among which the accident rate is also the highest. Twelve workers (26,/%) didn't get a job because of their drug-addiction. Work-place changing was present at the 47,3% of our ills.

Palabras clave: Alcoholismo, mujeres, características, análisis descriptivo.

SUMMARY: It is accomplished a descriptive analysis of an alcoholic women sample (N=70), that they were attended, or outpatient or inpatient treatment, during a 10-year-old period, in the Alcoholism Unit of Salamanca, and is valued the influence of some variable in the characteristics of the alcoholic disease.
The profile of the alcoholic woman is the following: mean age of 37,7 years, married (58,7%), resides in the city, housewife (44,30%) and low socioculture level (78,6% have only a basic education). Alcohol consumption was initiated at 24,07 years. Other interesting findings are: 50% of the women had received, previously, treatment for their alcoholism; 38,80% of the sample had presented somatic diseases directly related to the alcohol consumption; the marital conflicts werw very frequent (88,9% of the sample); 25 women (40,3%) were presenting antecedents of alcoholism in their fathers; 13 women (25%) were married with alcoholic husband and 28,7% of the sample had personal psychopathological antecedents.

Palabras clave: Drogas de abuso, automedicación, estudiantes universitarios, encuesta.

ABSTRACT: A sample of 566 students at Las Palmas University was surveyed in 1990 to investigate the pattern and the extend of self-medication and drug consumption. Among responders, 66,5% self-medicated and 25,6% had taken some kind of illegal addictive drugs during their lifetimes. Of those who admitted to having consumed drugs, 17% did so daily, 20% at weekends, and the rest occasionally. The association between self-medication and drug consumption was significant for men (X2=10,8; p<0,01)

Palabras clave: Alcoholismo, delitos, embriaguez, conducción.

SUMMARY: We study the existence of criminal history in 162 outpatients alcoholics, the type of crimes and the characteristics of those with criminal history, 25% of them had some criminal history, and 85% of the crimes were commited under the effects of alcohol. The most common crimes are traffic offences (63%), assault (17%) and stealing (10%). These crimes werw associated with being younger, having a lower educational degree, the existence of previous antisocial behaviour in childhood and adolescence, drug abuse history, higher psychoticism marks, alcohol dependence before being 25, and comorbidity with antisocial personality.
We can conslude that our sample of alcoholics in outpatient treatment commit relatively few crimes; most of them are minor ones, and that unspecific factors, which tend to cluster in type II alcoholics, do contribute to crime committing.

Palabras clave: Historia familiar de alcoholismo. Estudio familiar. Dependencia a opiáceos. Dependencia al alcohol. Trastornos afectivos. Trastornos de personalidad antisocial.

SUMMARY: A family study on the siblings of a group of heroin addicts, selected by the presence or absence of a history of family alcoholism, is carried out. The objective of this work is to study the relationship between the prevalence of psychiatric disorders in the siblings of heroin addicts and the presence or absence of a history of family alcoholism.
METHODOLOGY: The family study method was employed in 94,9% of the subjects and the family history method in the remaining 5,1%. In the former a structured interview for DSM-III-R was used and in the second case the RDC-FH criteria. SAMPLE: This was comprised of 1,187 siblings of heroin addicts. The study groups were: 421 siblings of 115 heroin addicts with a family history of alcoholism in two previous generations; 494 siblings of 182 heroin addicts with a family history of alcoholism in one previous generation; 272 siblings of 96 heroin addicts with no family history of alcoholism.
RESULTS: Alcohol dependence was more prevalent in the groups with a positive family history of family alcoholism (21,4 HFA++ vs. 17,0 HFA+ vs. 1,1 HFA). Opiate dependence was more common in the sibling of the groups with a positive family history of alcoholism (23,3 HFA++ vs. 19,8 HFA+ vs. 9,9 HFA-). Antisocial personality disorders was significantly more common among the siblings of the group with a positive family history in two generations (5,2 HFA++ vs. 1,6 HFA+ vs. 0,4 HFA-).
CONCLUSIONS: These results support a relationship between a positive family history of alcoholism and the presence of other addictive bahaviours (opiates, alcohol) both in males and females and with affective disrders in females. Antisocial personality disorder is associated with the existence of two generations of family history of alcoholism.

Palabras clave: Dependencia de opiáceos, naltrexona, seguimiento.

ABSTRACT: The main objective of the study is to analyze the efficacy of naltrexone treatment in opioids dependents, and looking for predictors of favourable outcome of treatment. Eighty two subjects who met DSM-III-R criteria for opioid dependence, who entered consecutively the naltrexone program of the Ramon y Cajal Hospital of Madrid, were evaluated with the Structured Clinical Interview for DSM-III-R for axis I and II (SCID-I and II), Sensation Seeking Scale (SSS) and Addiction Severity Index (ASI) on the admission, one month and six month later. Retention in treatment was the main efficacy index. 51,2% of the addicts remained at six months of treatment. There was a significative reduction in the most areas of ASI, except in alcohol area which increased and medical area where no modification was observed.
The best prediction model of favourable retention by logistic regression analysis consisted of a high family involvement in treatment, non-intravenous use, a low score in ASI psychological area and a high one in disinhibition subscale of SSS. Naltrexone treatment was a effective alternative for opioid dependence.

Palabras clave: Alcohol, campañas de prevención, evaluación, jóvenes

ABSTRACT: The present work analyzes the effectiveness of the "¿Qué tomas?" ("What are you having?") campaign, designed to prevent alcoholic drinks consumption among youg people fom 16 to 20 years old and based on the reinforcement of the non-alcoholic drinks consumption.
Volunteer young people got in touch with the subjects in bars, pubs, etc. and those that didn't have alcoholic drinks and filled up a form received some presents and participated in a raffle. The sample consists of 2572 valid forms. 22,9% of those youngsters mentioned above declared their intention to have more non-alcoholic drinks in the future. However, this percentage reaching 40% when people drinking more often alcoholic drinks at present are concerned. Although the results are limited, they show that this campaign has been effective in modifying the intention to drink alcoholic drinks in the future.

Palabras clave: Actitudes hacia el SIDA, Estudiantes de Ciencias de la Salud, Estudiantes de Medicina, Estudiantes de Enfermería, Estudiantes de Fisioterapia

ABSTRACT: Attitudes of Health Science students toward acquired immunodeficiency syndrome (AIDS) will influence the assistance given to these patients. A survey of these attitudes was carried out on 602 Helath Science students of Medicine, Nursing and Physiotherapy at the University of Oviedo. More possitive attitudes werw found in females, and more negative attitudes were found in more mature students (male and female). When these results werw compared with the results of similat studies, more positive attitutdes werw found in our group.