12- and 18-month follow-up after residential treatment of methamphetamine dependence: Influence of treatment drop-out and different treatment concepts

This study investigates the effects of two different residential treatments and of treatment drop-out in a German methamphetamine (MA) dependent sample. 108 subjects from two addiction treatment concepts were recruited at treatment begin and followed-up at 12 (T2) and 18 (T3) months after treatment. Based on follow-up samples (n = 38 at T2, n = 25 at T3), 77.1% at T2 and 68.0% at T3 were MA abstinent. Classifying everyone, who did not participate at follow-ups as having had a relapse, showed MA-abstinence rates of 25.0% (at T2) and 15.7% (at T3). There was no difference in MA-use between treatment conditions nor between treatment completers and drop-outs. Having injected any substance predicted MA-use at T2 (p = .03). The median time of relapse was 1.5 days after hospital release. Depression scores at T2 predicted MA-use at T3 (p = .02). T2 participants that dropped out of treatment had higher craving scores at T2, than T2 subjects who completed treatment (p = .03). The results show positive effects of current inpatient treatment programs without differences between different concepts. More research is needed to clarify the impact of treatment drop-out. Attention should be paid to a successful transition from residential to outpatient services and to a reduction of study attrition.

Effectiveness of methamphetamine abuse treatment: Predictors of treatment completion and comparison of two residential treatment programs

BACKGROUND

There is an increasing demand of evidence-based treatment options for methamphetamine users, but research in this field is limited. This study therefore evaluates the efficacy of two residential treatment programs for methamphetamine users.

METHOD

A total of 108 patients with a history of methamphetamine abuse from two inpatient rehabilitation centers were studied for psychiatric symptoms, craving, psychosocial resources, and cognitive functioning at the start and end of therapy. Patients from one center ("amphetamine type stimulant group") received conventional group therapy plus an additional 10 h of group therapy focusing on stimulant use. Patients from the other center ("treatment as usual") received conventional group therapy only. Predictors of drop-out were estimated.

RESULTS

A drop-out rate of 40.7% was observed without a significant difference between both centers. Patients remained significantly longer in treatment as usual compared to amphetamine type stimulant treatment. Irrespective of treatment program, craving and psychiatric symptoms significantly decreased while psychosocial resources, processing speed, and cognitive flexibility improved over time. Other cognitive measures yielded mixed results. History of injection drug use was a significant predictor for treatment drop-out.

CONCLUSIONS

Existing treatments are effective in reducing craving and psychiatric symptoms. Additional stimulant specific groups do not appear to influence treatment completion and secondary outcome measures. Institutions should therefore offer treatment for methamphetamine users, even if they do not provide a therapy content focusing on methamphetamine. History of injection drug use should receive attention in treatment to prevent drop-out. Changes in cognitive functioning need to be further explored.

Esterase XXVII. Purification and characterization of esterase-9A of mouse kidney

Esterase-9A, which appears electrophoretically as a triplet of the bands III-50, III-40 and III-30, was isolated from the kidneys of male NMRI-mice by isoelectrofocusing and refocusing followed by repeated molecular sieve chromography. The overall purification was approx. 250 fold and each of the three bands was isolated separately. The band of the triplet nearest to the cathode, III-50, changed in vitro into the satellite bands III-40 and III-30 and, further, into the band III-22 not observed before in the homogenate. It is assumed that the band III-50 represents the original gene product. The molecular weight (45 000) of the band III-50 is identical with those of III-40 and III-30, as measured by analytical electrophoresis, whereas the molecular weight obtained by thin-layer chromatography was 51 000. There were no obvious signs that esterase-9 was composed of subunits. The Km constant for 4-nitrophenyl proprionate was identical for each of three bands. The esterase-9A is the first testosterone-dependent isozyme of the mouse carboxylesterase (carboxylicester hydrolase, EC 3.1.1.1) system which has been isolated.

Esterase XXV. On the induction of Es-9 esterase of mouse kidney by testosterone

The Es-9 esterase is expressed in the cortical zone of the NMRI mouse kidney only in the presence of testosterone. In disc electrophoresis, three esterase bands, absent in the control, emerge under the influence of exogenous testosterone, accompanied by the appearance of active sites, as shown by marking with [3H] diisopropyl fluorophosphate ([3H]DFP). It is suggested that the testosterone dependent appearance of Es-9 activity is due to true enzyme induction which requires the presence of an intact testosterone receptor.

[Esterase XX. Disc-electrophoretic investigations on the polymorphism of the esterases of the house mouse (author's transl)]

For the further clarification of the polymorphism of mouse-esterase and its hormonal control, which in part have not yet been fully comprehended, disc-electrophoretic analyses of eight organs were made, using a strain with the Tfm-mutation. In addition, quantitative assays of esterase activity as well as histochemical studies were performed. The individual organs are characterized by a specific banding pattern of esterase, which is essentially conditioned by the diverse activity of a limited number of bands. Partly these may be regarded as primary gene products, partly they seem to be secondary modifications. The few incidences of band-linkage justify the expectations, that further gene loci will be discovered. In four organs of Tfm-mutants a lower esterase activity was found than in the controls, which was especially distinct in the kidney. The behaviour of the testosterone-dependent bands in the kidneys of Tfm-mutants seems to indicate two different mechanisms of the effect of testosterone on these bands.

Effect of pregnancy on cytoplasmic and mitochondrial enzymes in human and animal myometrium

An investigation was made on the influence of pregnancy on the specific activities of cytoplasmic (lactate dehydrogenase2), cytoplasmic malate dehydrogenase) and mitochondrial enzymes (glutamate dehydrogenase, mitochondrial malate dehydrogenase, cytochrome-c-oxidase) in the human and animal myometrium. The activities were related to DNA.

The specific activities of all the investigated enzymes increased. This rise in activity depended on the cellular localisation of the enzyme. The activity of all enzymes in one cellular compartment changed to the same extent. This change varied according to species. With regard to the human tissue, the increase of the cytoplasmic enzymes was larger than that of the mitochondrial enzymes. In the rat, however, a significantly larger increase of the mitochondrial enzymes was found.

The increase in the specific activities of the cytoplasmic enzymes in the human and rat was proportional to the protein-content and to the hypertrophy of the cells.

It was concluded that the number of mitochondria or their enzymatic activity increased in both species during pregnancy – in each species, however, to a different extent.

The pattern of the LDH-isoenzymes in the myometrium changed in the same manner in the human myometrium as in the rat. The percentage of M subunits of LDH compared to H subunits rose in both cases during pregnancy.