RESUMEN
In this article the authors explore the experience of craving of methamphetamine users and seek to illuminate how differences in craving contribute to use patterns. Using in-depth interviewing, data were collected from 82 active methamphetamine users in the metropolitan Atlanta area. The constant comparison method common in grounded theory guided the data analysis. Narrative responses corresponded with three types of craving described in the literature: cue-, drug- and withdrawal-induced. However, the narratives also problematize this typological view as well as the characterization of craving as invariably leading to drug use. Types of craving cues were sometimes inseparable, and users indicated that the different types of craving could occur in the same situation. Further, many users described being able to overcome craving through personalized methods of control. This study complements the largely quantitative work on craving and highlights the importance of improving drug abuse treatment and harm reduction programs.
Asunto(s)
Trastornos Relacionados con Anfetaminas/psicología , Estimulantes del Sistema Nervioso Central , Metanfetamina , Adolescente , Adulto , Trastornos Relacionados con Anfetaminas/economía , Trastornos Relacionados con Anfetaminas/epidemiología , Estimulantes del Sistema Nervioso Central/efectos adversos , Señales (Psicología) , Recolección de Datos , Interpretación Estadística de Datos , Femenino , Humanos , Masculino , Metanfetamina/efectos adversos , Persona de Mediana Edad , Síndrome de Abstinencia a Sustancias/epidemiología , Síndrome de Abstinencia a Sustancias/psicologíaRESUMEN
This article discusses a two-phase demonstration project focused on the implementation of the Network for the Improvement of Addiction Treatment model of process improvement among substance abuse treatment providers in Los Angeles County, California. A total of 30 Change Teams from 12 county-contracted treatment agencies planned and executed one or more rapid-cycle change projects to reduce wait time to treatment, reduce no-shows to scheduled appointments, increase admissions, or improve continuation in treatment. The findings and lessons learned illustrate the importance of a concrete and straightforward methodology and consistent peer-to-peer interaction provided in a learning collaborative environment. In addition, both ongoing technical assistance and coaching are essential for successful implementation of this innovative, low-cost, evidence-based process improvement strategy.