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1994 We investigate constraint relaxation within a general constraint model. We claim that a key to relaxation is recognition that a constraint can be modified in a variety of ways and that each modification potentially carries a different impact for both the quality of the solution and the problem solving process. Our primary motivation is the application(More)
This expert consensus statement reviews evidence on the effectiveness of drug and alcohol self-help groups and presents potential implications for clinicians, treatment program managers and policymakers. Because longitudinal studies associate self-help group involvement with reduced substance use, improved psychosocial functioning, and lessened health care(More)
A novel VLSI implementation of the Viterbi algorithm based on a cascade architecture is presented. Survivor sequence memory management is implemented using a new single read pointer traceback technique. The overall design for a 16-qtate, rate 1/2 decoder requires about 26000 transistors and a core area of 8.5 mma in a 1.2 pm two-level metal CMOS technology.(More)
Psychiatrists may wonder why both addiction treatment and the 12-step programs recommend abstinence. In his 50-year follow-up of two groups of alcoholics, Vaillant compared those who established secure abstinence with those who continued to drink. Secure abstinence was associated with: Living longer Better mental health Better marriages Being more(More)
The authors describe a course in substance abuse given to sophomore medical students with the intention of positively influencing their attitudes toward substance-abusing patients and their treatment. Clinical problem solving and small group discussion were emphasized in addition to field trips. By pretest and posttest measures, significant positive changes(More)
Treatment of dual diagnosis patients requires simultaneous treatment of the addictive and the mental disorders. Available data suggest that this does not happen often. In a survey of several psychiatric services, the unit chiefs reported that dual diagnoses were underreported, no plans were present for combined treatment, families were infrequently(More)
Patients attempt, consciously or unconsciously, to minimize or disguise their substance use, in part to preserve shreds of self-respect, avoid guilt and shame, and avoid the real or imagined criticism of others. It is ironic that substance users not only use the substance to gain access to pleasant events or escape or avoid unpleasant events, but also to(More)
The history of medical education in treating and prescribing for additive disorders is primarily one of omission. This began to change in the 1970s, leading to positive developments in medical education; however, much still remains to be done. Training in writing prescriptions should cover four areas: (1) prescribing to prevent addiction; (2) prescribing(More)