This paper reports a qualitative intervention research that utilized narrative inquiry ... of substance abuse issues, disciplinary dilemmas and family involvement at a ... socialization theory, private university, qualitative research, intervention ...
Das, Jai K; Salam, Rehana A; Arshad, Ahmed; Finkelstein, Yaron; Bhutta, Zulfiqar A
Many unhealthy behaviors often begin during adolescence and represent major public health challenges. Substance abuse has a major impact on individuals, families, and communities, as its effects are cumulative, contributing to costly social, physical, and mental health problems. We conducted an overview of systematic reviews to evaluate the effectiveness of interventions to prevent substance abuse among adolescents. We report findings from a total of 46 systematic reviews focusing on interventions for smoking/tobacco use, alcohol use, drug use, and combined substance abuse. Our overview findings suggest that among smoking/tobacco interventions, school-based prevention programs and family-based intensive interventions typically addressing family functioning are effective in reducing smoking. Mass media campaigns are also effective given that these were of reasonable intensity over extensive periods of time. Among interventions for alcohol use, school-based alcohol prevention interventions have been associated with reduced frequency of drinking, while family-based interventions have a small but persistent effect on alcohol misuse among adolescents. For drug abuse, school-based interventions based on a combination of social competence and social influence approaches have shown protective effects against drugs and cannabis use. Among the interventions targeting combined substance abuse, school-based primary prevention programs are effective. Evidence from Internet-based interventions, policy initiatives, and incentives appears to be mixed and needs further research. Future research should focus on evaluating the effectiveness of specific interventions components with standardized intervention and outcome measures. Various delivery platforms, including digital platforms and policy initiative, have the potential to improve substance abuse outcomes among adolescents; however, these require further research. Copyright © 2016 Society for Adolescent Health and Medicine
Hernandez, Lynn; Rodriguez, Ana Maria; Spirito, Anthony
Synopsis Research has consistently shown that a lack of parental involvement in the activities of their children predicts initiation and escalation of substance use. Parental monitoring, as well as youth disclosure about their whereabouts, parent child communication, positive parenting and family management strategies, e.g., consistent limit setting, and parental communication about and disapproval of substance use, have all been shown to protect against adolescent substance abuse and substance problems. Given the empirical evidence, family and parenting approaches to preventing and intervening on adolescent substance misuse have received support in the literature. This article discusses the theoretical foundations as well as the application of the Family Check-up, a brief family-based intervention for adolescent substance use. PMID:26092741
Full Text Available Substance misuse and abuse among adolescents and young adults, especially students, remain a significant public health issue, often associated with serious academic, psychological and health problems. Theoretical models of social behaviour emphasize the importance of peer behaviour as a modelling or normative influence. The processes by which social influence factors contribute to substance misuse behaviour have been described in models derived from the social learning paradigm, including both socio-environmental (e.g. social modelling, perceived norms and coping skills and cognitive variables (e.g. self-efficacy, outcome expectancies. However, this growing body of the literature often reveals contradictory findings regarding the precise mechanisms of processes by which social and cognitive variables may influence substance misuse in youth populations. This review critically examines the literature on different forms of peer influence and accordingly provides suggestions for intervention strategies that take into consideration the relevant research findings on social learning constructs.
Full Text Available Drug use remains today one of the health problems of greatest concern to society. According to the most recent state epidemiological data, women's consumption continuously increases, becoming more and more similar to that of men. However, this same trend does not occur in terms of access to treatment, and when women seek treatment, there is a marked difficulty in adherence to treatment as abandoning it is often the case. Such is the importance of meeting the specific needs of substance-abusing women, that it is even highlighted as a priority and an integral element of the latest Action Plan on Drugs 2013-2016 (Plan Nacional Sobre Drogas, 2013a. In this sense, at the empirical level, researchers have started to study the possible differences men and women may present in drug treatment, as well as the development of a gender-specific treatment. The aim of this theoretical review paper is to analyze the elements that characterize drug dependent women, establishing what aspects should be taken into account in the intervention with women from previous research or from on-going research, suggesting its implementation and future research directions.
Kelly Peter J
Full Text Available Abstract Background A large proportion of people attending residential alcohol and other substance abuse treatment have a co-occurring mental illness. Empirical evidence suggests that it is important to treat both the substance abuse problem and co-occurring mental illness concurrently and in an integrated fashion. However, the majority of residential alcohol and other substance abuse services do not address mental illness in a systematic way. It is likely that computer delivered interventions could improve the ability of substance abuse services to address co-occurring mental illness. This protocol describes a study in which we will assess the effectiveness of adding a computer delivered depression and substance abuse intervention for people who are attending residential alcohol and other substance abuse treatment. Methods/Design Participants will be recruited from residential rehabilitation programs operated by the Australian Salvation Army. All participants who satisfy the diagnostic criteria for an alcohol or other substance dependence disorder will be asked to participate in the study. After completion of a baseline assessment, participants will be randomly assigned to either a computer delivered substance abuse and depression intervention (treatment condition or to a computer-delivered typing tutorial (active control condition. All participants will continue to complete The Salvation Army residential program, a predominantly 12-step based treatment facility. Randomisation will be stratified by gender (Male, Female, length of time the participant has been in the program at the commencement of the study (4 weeks or less, 4 weeks or more, and use of anti-depressant medication (currently prescribed medication, not prescribed medication. Participants in both conditions will complete computer sessions twice per week, over a five-week period. Research staff blind to treatment allocation will complete the assessments at baseline, and then 3, 6, 9
Roberts-Lewis, Amelia C.; Welch-Brewer, Chiquitia L.; Jackson, Mary S.; Kirk, Raymond; Pharr, O. Martin
The objective of this preliminary study was to determine the effectiveness of a female gender-specific substance abuse treatment intervention (Holistic Enrichment for At-Risk Teens, or HEART) in improving problems related to personal and social functioning. A quasi-experimental, 2-group pretest and posttest repeated measures design was used to…
Patchell, Beverly A; Robbins, Leslie K; Lowe, John A; Hoke, Mary M
To examine the effects of incorporating tribal specific cultural beliefs into a tailored substance abuse prevention intervention for at risk rural Oklahoma Native American Indian (NAI) Plains adolescents. The 10 hour Native American Talking Circle Intervention, a school-based, group substance abuse prevention program, was implemented over a 8.5 week period and evaluated using a one group, pretest-posttest design. Measurements were from the Native Self-Reliance Questionnaire and the Substance Problems Scale from Global Appraisal of Individual Needs-Quick (GAIN-Q). One-tailed, paired sample t-tests demonstrated significant increase in self-reliance, from 86.227 to 92.204 (t (43) = -2.580, p = .007) and a decrease in substance abuse/use, from 2.265 to 1.265 (t (33) = 1.844, p = .007). The Native Talking Circle Intervention based on tribal-specific values and beliefs was shown to be effective with substance abuse/use at-risk NAI Plains tribal adolescents.
There remains a long-standing argument regarding the need for money management strategies to control poor spending habits among people with substance use disorders. The objective was to review issues relevant to the design and implementation of money-management-based interventions for substance abuse. Using a comparative, cross-cultural framework of anthropology, this manuscript examines three challenges for the design and implementation of money management interventions for substance abuse: (i) clients may not trust mental health centers to manage their money, (ii) clients may have different economic perspectives from clinicians and researchers, and (iii) clients may obtain substances through informal networks of exchange. This article clarifies the inherently complex symbolic and social dimensions of money and addiction and illustrates the need for researchers and clinicians to be mindful of the cultural assumptions that underlie money management interventions for substance abuse. Using an anthropological approach toward understanding the issues surrounding money management for individuals struggling with addiction and mental illness has the potential to strengthen the design and implementation of money-management-based interventions in a manner that is acceptable and meaningful for this target population.
Acierno, Ron; Resnick, Heidi S; Flood, Amanda; Holmes, Melisa
The trauma of rape is routinely associated with extreme acute distress. Such peri-event anxiety increases risk of developing psychopathology and substance use or abuse post-rape, with the degree of initial distress positively predicting future problems. Unfortunately, the nature of post-rape forensic evidence collection procedures may exacerbate initial distress, thereby potentiating post-rape negative emotional sequelae. Consequently, substance use may increase in an effort to ameliorate this distress. To address this, a two-part video intervention was developed for use in acute post-rape time frames to (a) minimize anxiety during forensic rape examinations, thereby reducing risk of future emotional problems, and (b) prevent increased post-rape substance use and abuse. Pilot study data with 124 rape victims indicated that the low-cost, easily administered intervention was effective in reducing risk of marijuana abuse at 6 weeks. Nonstatistically significant trends also were evident for reduced marijuana use. Trends were also noted in favor of the intervention in the subgroup of women who were actively using substances pre-rape (among pre-rape alcohol users, 28% viewers vs. 43% nonviewers met criteria for post-rape alcohol abuse; among pre-rape marijuana users, the rates of post-marijuana use were 17% vs. 43%).
Nair, Prasanna; Schuler, Maureen E; Black, Maureen M; Kettinger, Laurie; Harrington, Donna
To assess the relationship between cumulative environmental risks and early intervention, parenting attitudes, potential for child abuse and child development in substance abusing mothers. We studied 161 substance-abusing women, from a randomized longitudinal study of a home based early intervention, who had custody of their children through 18 months. The intervention group received weekly home visits in the first 6 months and biweekly visits from 6 to 18 months. Parenting stress and child abuse potential were assessed at 6 and 18 months postpartum. Children's mental and motor development (Bayley MDI and PDI) and language development (REEL) were assessed at 6, 12, and 18 months postpartum. Ten maternal risk factors were assessed: maternal depression, domestic violence, nondomestic violence, family size, incarceration, no significant other in home, negative life events, psychiatric problems, homelessness, and severity of drug use. Level of risk was recoded into four categories (2 or less, 3, 4, and 5 or more), which had adequate cell sizes for repeated measures analysis. Repeated measures analyses were run to examine how level of risk and group (intervention or control) were related to parenting stress, child abuse potential, and children's mental, motor and language development over time. Parenting stress and child abuse potential were higher for women with five risks or more compared with women who had four or fewer risks; children's mental, motor, and language development were not related to level of risk. Children in the intervention group had significantly higher scores on the PDI at 6 and 18 months (107.4 vs. 103.6 and 101.1 vs. 97.2) and had marginally better scores on the MDI at 6 and 12 months (107.7 vs. 104.2 and 103.6 vs. 100.1), compared to the control group. Compared to drug-abusing women with fewer than five risks, women with five or more risks found parenting more stressful and indicated greater inclination towards abusive and neglectful behavior
Micol Parolin; Alessandra Simonelli
Children’s emotional and relational development can be negatively influenced by maternal substance abuse, particularly through a dysfunctional caregiving environment. Empirical evidence indicates that parenting is negatively influenced by maternal drug use and its associated adverse psychosocial conditions. As a consequence, many interventions have focused on enhancing parental skills, but they have often overlooked the emotional and relational features of the mother-infant bond. Instead, Att...
Moussas, G I; Papadopoulou, A G
. Specific components have been identified in tobacco, which are considered to be carcinogenic and responsible for tumor development in various sites. Moreover, complicated psychiatric problems arise due to substance abuse in cancer patients, either in the context of pain treatment, or under pre-existing dependence. The rational use of opioid analgesics, when it is medically required as suggested by the health professionals specialized in the treatment of acute pain in cancer patients, could be a therapeutic option. Substance abuse reduces treatment compliance, worsens cancer prognosis and seems to be a negative factor for the quality of life of these patients. Current literature highlights the importance of appropriate psychiatric interventions to address substance abuse in cancer patients.
VanDeMark Nancy R
Full Text Available Abstract Background The continuing gap between the number of people requiring treatment for substance use disorders and those receiving treatment suggests the need to develop new approaches to service delivery. Meanwhile, the use of technology to provide counseling and support in the substance abuse field is exploding. Despite the increase in the use of technology in treatment, little is known about the impact of technology-supported interventions on access to services for substance use disorders. The E-TREAT intervention brings together the evidence-based practice of Motivational Interviewing and theories of Persuasive Technology to sustain clients' motivation to change substance use behaviors, provide support for change, and facilitate continuity across treatment settings. Methods This study used descriptive statistics, tests of statistical significance, and logistic regression to explore the characteristics and perceptions of the first 157 people who agreed to participate in E-TREAT and the predictors of their active engagement in E-TREAT services. In addition, responses to open-ended questions about the participants' experiences with the intervention were analyzed. Results The data reveal that clients who engaged in E-TREAT were more likely than those who did not engage to be female, have children and report a positive relationship with their recovery coach, and were less likely to have completed treatment for a substance use disorder in the past. A majority of people engaging in E-TREAT reported that it was helpful to talk with others with similar problems and that the program assisted them in developing a sense of community. Conclusions The authors conclude that technology-assisted interventions hold promise in expanding access to treatment for substance use disorders especially for women and parents. Further, the characteristics of the relationship with a coach or helper may be critical to engagement in technology-supported interventions
Zarshenas, Ladan; Baneshi, Mehdi; Sharif, Farkhondeh; Moghimi Sarani, Ebrahim
Anger and aggression have been developing notably in societies, especially among patients depending on substance abuse. Therefore, this study aimed to investigate the effect of anger management based on group education among patients depending on substances according to Patrick Reilly's cognitive behavioral approach. In a quasi- experimental study, all patients who met the inclusion criteria were evaluated regarding their aggression level. The participants were assigned to 12 educational sessions based on group therapy and Patrick-Reilly's anger management by focusing on using a combination of cognitive intervention, relaxation, and communication skills. The data were analyzed using the SPSS statistical software, version 16. The findings showed a significant difference between the two groups regarding aggression level after the intervention (p = 0.001). No significant relationship was observed between aggression level and demographic variables (p > 0.05). The intervention of this study can be used for establishing self-management and decreasing anger among patients depending on substances. They can also be used as a therapeutic program in addition to pharmacotherapy. IRCT2016102030398N1 .
Paris, Ruth; Herriott, Anna; Holt, Melissa; Gould, Karen
This study examines the relationship between levels of psychological distress in substance-dependent mothers and their differential response to a dyadic parent-child intervention. A sample of 66 mothers who were receiving treatment for substance abuse, as well as a simultaneous parenting intervention, were interviewed pre and post-treatment on measures of psychological distress, adult and child trauma history, parental reflective functioning, and child social-emotional development. Additionally, clinicians provided assessments of the parent-child relationships. As anticipated, trauma histories for mothers and children, children's social emotional development, and parental reflective functioning were associated with aspects of maternal psychological distress. Kruskal-Wallis and subsequent Wilcoxson signed rank tests revealed that women with highest levels of baseline psychological distress showed significant improvements in psychological functioning post-treatment while women with moderately elevated levels of psychological distress did not. Women who were most distressed at baseline showed increased levels of parental reflective functioning post-treatment while women with moderate and lower levels of baseline psychological distress showed improvements on clinician-rated assessments of parent-child relationships. Chi Square analyses showed that parents who endorsed the highest levels of distress at baseline reported that their children's risk status regarding social-emotional development decreased post-treatment. Despite similarities in substance dependence, mothers in this sample had different needs and outcomes in the context of this parenting intervention due to variation in mental health. Given this variation, parenting interventions for substance-dependent mothers need to account for the individual differences in levels of psychological distress. Copyright © 2015 Elsevier Ltd. All rights reserved.
Stevens, Sally; Haynes, Patricia L.; Ruiz, Bridget; Bootzin, Richard R.
This study tested whether improvement in sleep by an integrative, behavioral sleep intervention was associated with improvement in traumatic stress (TS) symptoms in a sample of 20 adolescents who were recently treated for substance abuse. Sleep was measured throughout the intervention via daily sleep diaries, and traumatic stress symptoms were…
Becker, L R; Hall, M; Fisher, D A; Miller, T R
The authors describe methods for work in progress to evaluate four workplace prevention and/or early intervention programs designed to change occupational norms and reduce substance abuse at a major U.S. transportation company. The four programs are an employee assistance program, random drug testing, managed behavioral health care, and a peer-led intervention program. An elaborate mixed-methods evaluation combines data collection and analysis techniques from several traditions. A process-improvement evaluation focuses on the peer-led component to describe its evolution, document the implementation process for those interested in replicating it, and provide information for program improvement. An outcome-assessment evaluation examines impacts of the four programs on job performance measures (e.g., absenteeism, turnover, injury, and disability rates) and includes a cost-offset and employer cost-savings analysis. Issues related to using archival data, combining qualitative and quantitative designs, and working in a corporate environment are discussed.
Pestka, Elizabeth; Nash, Virginia; Evans, Michele; Cronin, Joan; Bee, Susan; King, Susan; Osborn, Kristine; Gehin, Jessica; Weis, Karen; Loukianova, Larissa
This quality improvement project demonstrates that RN Care Managers, in a chronic pain programme, can assess for a family history of substance abuse in 5-10 min. Information informs treatment based on specific high risk criteria. Benefits include heightened awareness of the genetic and environmental risks associated with a family history of substance abuse, an opportunity to participate in motivational interventions to prevent or minimize consequences of substance use disorders, and likely substantial overall health-care cost savings. © 2015 John Wiley & Sons Australia, Ltd.
Allahverdipour, Hamid; Bazargan, Mohsen; Farhadinasab, Abdollah; Hidarnia, Alireza; Bashirian, Saeed
The prevalence of substance abuse among adolescents from low- and middle-income countries is increasing drastically and requires immediate intervention. The objective of this longitudinal quasi-experimental panel study was to design and implement a skill-based intervention to prevent and reduce substance use among urban adolescents who attended 2 randomly selected high-schools in Tehran, Iran. One-year post intervention data show that substance abuse, knowledge, attitudes, peer resistance skills, level of self-control, self-efficacy, and perceived susceptibility among intervention group were significantly improved, whereas level of self control and attitudes against substance abuse among the control group deteriorated. To efficiently prevent substance abuse among youth primary preventive interventions should be implemented before onset of substance abuse to improve resistance skills and provide adolescents with information and skills needed to develop anti-drug norms.
Thorne, Craig R.; DeBlassie, Richard R.
Cummings (1979), citing evidence from the National Institute of Drug Abuse, reports that one of every eleven adult Americans suffers from a severe addictive problem. Drug addiction is epidemic among teenagers; one of every six teenagers suffers from a severe addictive problem. This paper focuses on adolescent drug/substance abuse. (Author)
Deck, Dennis D.
To directly address the state of Washington's concerns regarding student alcohol and other drug use, in 1989 the state Legislature passed the Omnibus Alcohol and Controlled Substances Act (ESSHB 1793). One part of this act called for the creation of a school-based alcohol and other dug abuse prevention and early intervention program. The Office of…
Full Text Available Children’s emotional and relational development can be negatively influenced by maternal substance abuse, particularly through a dysfunctional caregiving environment. Empirical evidence indicates that parenting is negatively influenced by maternal drug use and its associated adverse psychosocial conditions. As a consequence, many interventions have focused on enhancing parental skills, but they have often overlooked the emotional and relational features of the mother-infant bond. Instead, Attachment Theory offers a privileged framework to analyse how drug addiction can affect the quality of an adult’s attachment style, parenting attitudes and behaviours towards the child and can have a detrimental effect on the co-construction of the attachment bond by the mother and the infant. Several studies have also identified a prevalence of insecure patterns among drug-addicted mothers and their children, but a specific model of insecurity is still needed to be attested, requiring further investigations. In recent years, a number of protocols have been developed in order to strengthen the relationship between drug-abusing mothers and their children, drawing lessons from Attachment Theory. The present study reviews the literature on the adult and infant attachment style in the context of drug addiction, describing currently available treatment programs which address parenting and specifically focus on the mother-infant bond, relying on Attachment Theory.
Garcia-Guasch, Roser; Roigé, Jaume; Padrós, Jaume
Anaesthesiologists have a significantly higher frequency of substance abuse by a factor of nearly 3 when compared with other physicians. This is still a current problem that must be reviewed. Many hypotheses have been formulated to explain why anaesthesiologists appear to be more susceptible to substance abuse than other medical professionals (genetic differences in sensitivity to opioids, stress, the association between chemical dependence and other psychopathology or the second-hand exposure hypothesis). Environmental exposure and sensitization may be an important risk factor in physician addiction. There is a long debate about returning to work for an anaesthetist who has been depending on opioid drugs, and recent debates are discussed. Institutional efforts have been made in many countries and physician health programmes have been developed. As drug abuse among anaesthesiologists has continued, new studies have been conducted to know the theories about susceptibility. Written substance abuse policies and controls must be taken in place and in all countries.
Neger, Emily N; Prinz, Ronald J
Parental substance abuse is a serious problem affecting the well-being of children and families. The co-occurrence of parental substance abuse and problematic parenting is recognized as a major public health concern. This review focuses on 21 outcome studies that tested dual treatment of substance abuse and parenting. A summary of theoretical conceptualizations of the connections between substance abuse and parenting provides a backdrop for the review. Outcomes of the dual treatment studies were generally positive with respect to reduction of parental substance use and improvement of parenting. Research in this area varied in methodological rigor and needs to overcome challenges regarding design issues, sampling frame, and complexities inherent in such a high-risk population. This area of work can be strengthened by randomized controlled trials, use of mixed-methods outcome measures, consideration of parent involvement with child protective services, involvement of significant others in treatment, provision of concrete supports for treatment attendance and facilitative public policies. Copyright © 2015 Elsevier Ltd. All rights reserved.
Neger, Emily N.; Prinz, Ronald J.
Parental substance abuse is a serious problem affecting the well-being of children and families. The co-occurrence of parental substance abuse and problematic parenting is recognized as a major public health concern. This review focuses on 21 outcome studies that tested dual treatment of substance abuse and parenting. A summary of theoretical conceptualizations of the connections between substance abuse and parenting provides a backdrop for the review. Outcomes of the dual treatment studies were generally positive with respect to reduction of parental substance use and improvement of parenting. Research in this area varied in methodological rigor and needs to overcome challenges regarding design issues, sampling frame, and complexities inherent in such a high-risk population. This area of work can be strengthened by randomized controlled trials, use of mixed-methods outcome measures, consideration of parent involvement with child protective services, involvement of significant others in treatment, provision of concrete supports for treatment attendance and facilitative public policies. PMID:25939033
Hahm, Hyeouk Chris; Chang, Stephanie Tzu-Han; Tong, Hui Qi; Meneses, Michelle Ann; Yuzbasioglu, Rojda Filiz; Hien, Denise
The purpose of this paper is to provide a review of the current literature uncovering specific factors associated with self-harm and suicidality among young Asian American women, as well as to present the Fractured Identity Model as a framework for understanding these factors. This paper offers concrete suggestions for the development of culturally competent interventions to target suicidality, substance abuse, and mental illness among young Asian American women. Empirical studies and theory-based papers featured in peer-reviewed journals between 1990 and 2014 were identified through scholarly databases, such as PubMed, MEDLINE, PsycINFO, JSTOR, and Google Scholar. We identified several factors associated with suicidality among young Asian American women: (1) family dynamics, or having lived in a household where parents practice "disempowering parenting styles," (2) substance use/abuse, and (3) untreated mental illness(es), which are exacerbated by the stigma and shame attached to seeking out mental health services. The Fractured Identity Model by Hahm et al. (2014) is presented as a possible pathway from disempowering parenting to suicidal and self-harm behaviors among this population, with substance abuse playing a significant mediating role. Research limitations/implications - Our review focused on Asian American women, substance use among Asian Americans, and mental health among Asian Americans. Literature that focused on Asians living in Asia or elsewhere outside of the USA was excluded from this review; the review was limited to research conducted in the USA and written in the English language. The complex interplay among Asian American culture, family dynamics, gender roles/expectations, and mental health justifies the development of a suicide and substance abuse intervention that is tailored to the culture- and gender-specific needs of Asian Pacific Islander young women. It is imperative for professionals in the fields of public health, mental health
Ogle, Richard L; Baer, John S
Two personalized substance abuse assessment and feedback interventions were tested for effectiveness in engaging female domestic violence shelter residents in substance abuse treatment. One hundred forty-seven residents were assessed for quantity andfrequency of substance use, negative consequences due to use, motivation to change substance use behavior, and psychopathological symptoms related to substance abuse. Assessment identified (33) 22% of participants as heavy substance users. Twenty of the 33 heavy-using residents received one of two personalized substance use feedback interventions:face-to-face feedback or writtenfeedbackplaced in shelter mailboxes. Treatment engagement was defined as attending at least one substance abuse treatment session within 30 days after the intervention. Results showed a significant difference in treatment engagement rates in favor of the face-to-face feedback group (60% vs. 0%). The results provide preliminary data suggesting that substance abuse assessment can be effectively accomplished in the shelter environment and that the face-to-face feedback procedure may be an effective intervention to bridge the service linkage problem between domestic violence services and substance abuse treatment.
Pediatricians and other medical providers caring for children need to be aware of the dynamics in the significant relationship between substance abuse and child maltreatment. A caregiver's use and abuse of alcohol, marijuana, heroin, cocaine, methamphetamine, and other drugs place the child at risk in multiple ways. Members of the medical community need to understand these risks because the medical community plays a unique and important role in identifying and caring for these children. Substance abuse includes the abuse of legal drugs as well as the use of illegal drugs. The abuse of legal substances may be just as detrimental to parental functioning as abuse of illicit substances. Many substance abusers are also polysubstance users and the compounded effect of the abuse of multiple substances may be difficult to measure. Often other interrelated social features, such as untreated mental illness, trauma history, and domestic violence, affect these families.
Introduction: stroke in recreational substance users can be an indirect complication, like endocarditis and cardio embolism in parenteral drug users. With some drug like cocaine, stroke appear to be the result of a direct effect. In young subjects without other risk factors provide persuasive evidence for causality . OPIATES: Heroine is the most abused opiate drug, which is administered by injection, by snorting or by smoking. Stroke affects heroin users by diverse mechanisms,. Injec...
Ingersoll, Karen; Dillingham, Rebecca; Reynolds, George; Hettema, Jennifer; Freeman, Jason; Hosseinbor, Sharzad; Winstead-Derlega, Chris
We describe the development of a two-way text messaging intervention tool for substance users who are non-adherent with HIV medications, and examine message flow data for feasibility and acceptability. The assessment and intervention tool, TxText, is fully automated, sending participants mood, substance use, and medication adherence queries by text message. Participants respond, the tool recognizes the category of response, and sends the personalized intervention message that participants designed in return. In 10 months, the tool sent 16,547 messages (half initial, half follow-up) to 31 participants assigned to the TxText condition, who sent 6711 messages in response to the initial messages. Response rates to substance use (n=2370), medication (n=2918) and mood (n=4639) queries were 67%, 69%, and 64%, respectively. Responses indicating medication adherence, abstinence from substances, and good moods were more common than negative responses. The TxText tool can send messages daily over a 3 month period, receive responses, and decode them to deliver personalized affirming or intervention messages. While we await the outcomes of a pilot randomized trial, the process analysis shows that TxText is acceptable and feasible for substance abusers with HIV, and may serve as a complement to HIV medical care. PMID:24029625
Pihkala, Heljä; Dimova-Bränström, Neda; Sandlund, Mikael
Many children are affected by parental substance use disorder. Beardslee's family intervention (BFI) is a family-based psycho-educative method for children of mentally ill parents, used in psychiatric practise in several Nordic countries. The method has also been used to some extent when a parent suffers from substance use disorder. The aim of the study was to explore the family members' experiences of the BFI when a parent has a diagnosis of substance use disorder, to gain new knowledge about the process of the BFI in this area. Ten children and 14 parents were interviewed about their experiences 6 months after a BFI. The interviews were analyzed by qualitative content analysis. The children's psychological symptoms were measured by the Strengths and Difficulties Questionnaire at baseline and after 6 months. Increased openness about the substance use disorder in the families was a recurrent theme throughout the material and a central issue reported in the children's experiences. The children had a high level of psychological symptoms according to the SDQ at baseline, but the majority of them felt that the BFI made a positive difference in their families and for themselves. The parents reported improved wellbeing of their children. Positive experienced effects for children and parents are reported in families with parental substance use disorder, with possible connection to use of BFI. The present study suggests that Beardslee's family intervention is applicable as a preventive method for children in families with a parent suffering from substance use disorder.
Amaro, Hortensia; Larson, Mary Jo; Zhang, Annie; Acevedo, Andrea; Dai, Jianyu; Matsumoto, Atsushi
Women in substance abuse treatment often have co-occurring mental health disorders and a history of trauma; they are also at high risk for HIV infection and other sexually transmitted diseases via unprotected sex. A quasi-experimental study evaluated the effectiveness of trauma-enhanced substance abuse treatment combined with HIV/AIDS prevention…
David Bisetto Pons
Full Text Available The use of drugs among adolescents/youth often results in a high degree of distress for the family members who live with them. This in turn can lead to a deterioration of mental (psychological health, hindering any attempt to successfully cope with the situation. The goal of our research was to study the effect of the Community Reinforcement and Family Training (CRAFT program on parents of adolescents/young adult drug users. Study volunteers (n=50 were parents from Valencia (Spain that were divided into two groups. The experimental group (n=25 was made up of parents whose sons and daughters exhibited problems with drug use and the constructed noncausal baseline group (n=25 was made up of parents whose sons and daughters did not show any substance abuse problems. For both groups, self-esteem (Rosenberg Self-Esteem Scale, depression (BDI-II, anxiety (STAI, and anger (STAXI-II were evaluated before and after the application of the CRAFT program. Results show a significant improvement in the experimental group’s self-esteem, depression, and anger state and a decrease in negative moods. These changes in parents produce a positive effect on their substance-using sons and daughters: of the 25 participants, 15 contacted specialized addiction treatment resources for the first time.
Higgins, P G; Clough, D H; Wallerstedt, C
To explore patterns and levels of self-esteem of pregnant substance abusers. A descriptive prospective study to describe the self-esteem of pregnant substance abusers. Subjects (N = 31) were abusing and dependent on three or more legal and/or illegal substances. Subjects were asked one open-ended question regarding their self-esteem, then the Rosenberg Self-Esteem Inventory (RSI) was administered. Subjects gave 46 responses to the open-ended question. Overall, they used a single word to describe self-esteem. The most frequent response on the RSI was "low" for self-esteem, 23 subjects used positive terms, 20 used negative terms, and 3 reported a neutral term. The RSI confirmed the aspects of low self-esteem. Problems with low self-esteem were evident. Intervention strategies need to be developed to increase self-esteem in pregnant substance abusers.
Full Text Available Introduction: stroke in recreational substance users can be an indirect complication, like endocarditis and cardio embolism in parenteral drug users. With some drug like cocaine, stroke appear to be the result of a direct effect. In young subjects without other risk factors provide persuasive evidence for causality . OPIATES: Heroine is the most abused opiate drug, which is administered by injection, by snorting or by smoking. Stroke affects heroin users by diverse mechanisms,. Injectors are at risk of infections endocarditis, which carries risk for both ischemic and hemorrhagic stroke. Cerebral or subarachnoid hemorrhage usually occurs after rupture of a septic (mycotic aneurysm. Heroine users can are also at risk for hemorrhagic stroke secondary to liver failure with deranged clotting and to heroin nephropathy with uremia or malignant hypertension. In some heroin users the drug it self is directly causal due to vasculitis, hypersensitivity and immunologic changes. Embolization of foreign material to brain due to mixed of heroine with quinine can cause cerebral embolism. AMPHETAMINE AND other psychostimulants: In abuser of amphetamine hemorrhagic stroke can occur, oral, intravenous, nasal, and inhalational routes of administration have been reported. Most were chronic user, but in several patients, stroke followed a first exposure. Some of amphetamine induced intracranial hemorrhages are secondary to acute hypertension, some to cerebral vacuities, and some to a combination of two. Decongestants and diet pills: Phenylpropanolamine (PPA, an amphetamine – like drug, in decongestants and diet pills, induce acute hypertension, sever headache, psychiatric symptoms, seizures and hemorrhagic stroke. Ephedrine and pseudo ephedrine are present in decongestants and bronchodilators and induce headache, tachyarrhythmia, hypertensive emergency, and hemorrhagic and occlusive stroke. Ecstasy, 3,4 Methylenedioxymethamphetamin (MDMA with amphetamine like can
El Rasheed, Amany Haroun
Alexithymia is thought of as a trait that predisposes to drug abuse. Moreover, it is suggested to be related to type of the substance abused, with the worst-case scenario including a worse prognosis as well as tendency to relapse or even not to seek treatment at all. To address this important subject in Egyptian patients, a sample of 200 Egyptian substance abusers was randomly selected from inpatients in the Institute of Psychiatry, Ain Shams University, Egypt. The study also included 200 group-matched controls. DSM-IV criteria were used for assessment of substance use disorders, and toxicologic urine analysis was used to confirm the substances of abuse. Toronto Alexithymia Scale (TAS)-Arabic version was used for assessment of alexithymia. It was found that alexithymia was significantly more prevalent in the substance use disorders group as compared to healthy controls. It was also found that among the substance use disorders group, alexithymics reported more polysubstance abuse, more opiate use (other than heroin IV), lower numbers of hospitalizations, lower numbers of reported relapses, and a lower tendency to relapse as a result of internal cues compared to patients without alexithymia. Statistically significant associations were also found between alexithymia and more benzodiazepine abuse and nonpersistence in treatment. The results suggest that alexithymia should be targeted in a treatment setting for substance use disorders.
Tiburcio, Marcela; Lara, Ma Asunción; Aguilar Abrego, Araceli; Fernández, Morise; Martínez Vélez, Nora; Sánchez, Alejandro
The development of Web-based interventions for substance abuse in Latin America is a new field of interest with great potential for expansion to other Spanish-speaking countries. This paper describes a project aimed to develop and evaluate the usability of the Web-based Help Program for Drug Abuse and Depression (Programa de Ayuda para Abuso de Drogas y Depresión, PAADD, in Spanish) and also to construct a systematic frame of reference for the development of future Web-based programs. The PAADD aims to reduce substance use and depressive symptoms with cognitive behavioral techniques translated into Web applications, aided by the participation of a counselor to provide support and guidance. This Web-based intervention includes 4 steps: (1) My Starting Point, (2) Where Do I Want to Be? (3) Strategies for Change, and (4) Maintaining Change. The development of the program was an interactive multistage process. The first stage defined the core structure and contents, which were validated in stage 2 by a group of 8 experts in addiction treatment. Programming of the applications took place in stage 3, taking into account 3 types of end users: administrators, counselors, and substance users. Stage 4 consisted of functionality testing. In stage 5, a total of 9 health professionals and 20 drug users currently in treatment voluntarily interacted with the program in a usability test, providing feedback about adjustments needed to improve users' experience. The main finding of stage 2 was the consensus of the health professionals about the cognitive behavioral strategies and techniques included in PAADD being appropriate for changing substance use behaviors. In stage 5, the health professionals found the functionalities easy to learn; their suggestions were related to the page layout, inclusion of confirmation messages at the end of activities, avoiding "read more" links, and providing feedback about every activity. On the other hand, the users said the information presented
Full Text Available Substance abuse and dependence among the employed have massive cost implications for South Africa. Employers are legally obliged to provide opportunities for the treatment of substance dependence before dismissal is considered. Problem areas are the following: inadequate identification of employees with substance-abuse problems, infrequent treatment referrals, and overlooking of substance abuse in the workplace. This article attempts to address these issues by providing an overview of literature dealing with the problem of substance abuse and dependence in the workplace. Addressing this problem calls for specialist intervention measures, which are discussed in the article.
Full Text Available Jarrett M Burns, Edward W Boyer Division of Medical Toxicology, Department of Emergency Medicine, University of Massachusetts Medical School, Worcester, MA, USA Abstract: Abuse of antitussive preparations is a continuing problem in the United States and throughout the world. Illicit, exploratory, or recreational use of dextromethorphan and codeine/promethazine cough syrups is widely described. This review describes the pharmacology, clinical effects, and management of toxicity from commonly abused antitussive formulations. Keywords: dextromethorphan, purple drank, sizzurp, codeine/promethazine
Siegal, Harvey; Rudisill, John R.
A weekend program places medical students under supervision in close, intense contact with drug and alcohol abusers and strongly reinforces basic sciences and clinical instruction. Student reaction has been very positive. The program requires no new resources and is cost-effective. (Author/MSE)
Murphy, John P.
Examines the effect that a substance abuser may have on the family system and the maladaptive roles sometimes assumed by family members. Discusses dysfunctional family phases and therapeutic issues and presents 11 guidelines for counselors working with chemically dependent families. (JAC)
The past decade has witnessed revolutionary changes to the delivery of health services, ushered in to a great extent by the introduction of electronic health record systems. More recently, a new class of technological advancements-technology-based behavioral health interventions, which involve the delivery of evidence-informed practices via computers, web-based applications, mobile phones, wearable sensors, or other technological platforms-has emerged and is primed to once again radically shift current models for behavioral healthcare. Despite the promise and potential of these new therapeutic approaches, a greater understanding of the impact of technology-based interventions on cornerstone issues of mental health and addiction services-namely access, quality, and cost -is needed. The current review highlights 1) relevant conceptual frameworks that guide this area of research, 2) key studies that inform the relevance of technology-based interventions for behavioral healthcare access, quality, and cost, 3) pressing methodological issues that require attention, 4) unresolved questions that warrant further investigation, and 5) practical implications that underscore important new directions for this emerging area of research.
Full Text Available substance abuse' specially opiates and prescribed drugs are spreading among the older adults. Most of the time it begins as an attempt to medicate chronic pains, medical conditions and loneliness. In other instances, it simply is the continuation of a problem that begun in young adulthood. But scholars and specialists in both fields of Addiction and Gerontology, rather neglected this fast growing problem, to the extent that we almost have no data on the epidemiology, prevention and treatment modalities among the substance abusing old adults in Iran. This paper reflects the necessity of designing age specific programs to identify and treat this group. Besides, some of the most effictive methods of treatment in other countries are reviewed.
Jogerst, Gerald J; Daly, Jeanette M; Galloway, Lara J; Zheng, Shimin; Xu, Yinghui
Substance abuse by either victim or perpetrator has long been associated with violence and abuse. Sparse research is available regarding elder abuse and its association with substance abuse. The objective of this study was to evaluate the association of state-reported domestic elder abuse with regional levels of substance abuse. Census demographic and elder abuse data were sorted into substate regions to align with the substance use treatment-planning regions for 2269 US counties. From the 2269 US counties there were 229 substate regions in which there were 213,444 investigations of abuse. For the other Ns (reports and substantiations) there were fewer counties and regions. See first sentence of data analyses and first sentence of results. Elder abuse report rates ranged from .03 to .41% (80 regions), investigation rates .001 to .34% (229 regions), and substantiation rates 0 to .22% (184 regions). Elder abuse investigations and substantiations were associated with various forms of substance abuse. Higher investigation rates were significantly associated with a higher rate of any illicit drug use in the past month, a lower median household income, lower proportion of the population graduated high school, and higher population of Hispanics. Higher substantiation rates were significantly associated with higher rate of illicit drug use in the past month and higher population of Hispanics. It may be worthwhile for administrators of violence programs to pay particular attention to substance abuse among their clients and in their community's environment, especially if older persons are involved. Measures of documented elder abuse at the county level are minimal. To be able to associate substance abuse with elder abuse is a significant finding, realizing that the substance abuse can be by the victim or the perpetrator of elder abuse.
Hamid, Humera; El-Mallakh, Rif S; Vandeveir, Keith
Substance abuse is among one of the major problems plaguing our society. It has come to the attention of several healthcare professionals that a communication gap exists between themselves and substance abusers. Most of the time the substance abusers are only familiar with the slang terms of abused substances, a terminology that medical professionals are usually unaware of. This paper is an attempt to close that communication gap, allowing health care professionals to understand the slang terminology that their patients use, thus enabling them to make appropriate treatment decisions. In addition, the article presents some key features (including active ingredient, pharmacological classification, medical use, abuse form, usage method, combinations used, effects sought, long-term possible effects, and detectability in urine) of the most commonly abused substances.
Full Text Available Background and Objective: The previous research has demonstrated that addiction treatment services for women need to be based on knowledge of female psychological needs. Therefore, the aim of current study is to compare body image, quality of sleep and marital satisfaction among substance abuser and non-substance abuser women.Materials and Methods: This study is a descriptive comparative research. 200 women including 100 substance abuser women and 100 non-substance abuser women were chosen through convenience method in Arak in 2015. The measuring instruments were Fisher body image scale (1970, Pittsburgh Sleep Quality Index (1989 and Enrich Marital Satisfaction Scale (1989. Data was analyzed utilizing t independent.Results: The results showed that there is the significant difference between marital satisfaction (P=0.001 and quality of sleep (P=0.001 among substance abuser and non-substance abuser women. Additionally, the significant difference was not observed between body image (P= 0.31 among these two groups.Conclusion: These findings emphasized that substance use decreases the quality of sleep and marital satisfaction in women. Hence, it should be considered these factors in process of therapeutic intervention in substance abuser women.
Resiliency is the ability to cope in the face of adversity. One protective factor that promotes resiliency in substance-abusing dysfunctional families is family rituals and traditions. Social workers and substance abuse counselors can teach family members how to instill resiliency in their families and themselves through rituals and traditions. To…
Columbia Univ., New York, NY. National Center on Addiction and Substance Abuse.
The first comprehensive assessment of substance abuse and women, this report arose from an analysis of more than 1,700 scientific and technical articles, surveys, government reports and books. Results show that American women are closing the gap with men in that they are increasingly likely to abuse substances at the same rate as men. Findings…
The study investigated the factors influencing substance abuse amongundergraduate students in Osun State; Nigeria. A sample of 1, 200undergraduate students were randomly selected from three tertiaryinstitution in Osun State. Factors Influencing Substance Abuse Questionnaire (FISA) was developed by the researcher ...
Kane, Michael N.; Green, Diane
Human service students' (social work, criminal justice, public administration, psychology) were surveyed (N = 242). Their perceptions about older persons' resilience and recovery from substance abuse were investigated. Overall, respondents did not agree that treating older persons for a substance abuse problem was wasteful of resources or older…
Full Text Available Sharon C WilsnackDepartment of Clinical Neuroscience, University of North Dakota School of Medicine and Health Sciences, Grand Forks, ND, USAAbstract: Gender, Alcohol, and Culture: An International Study (GENACIS is a collaborative study of gender-related and cultural influences on alcohol use and alcohol-related problems of women and men. Members conduct comparative analyses of data from comparable general population surveys in 38 countries on five continents. This paper presents GENACIS findings that (1 age-related declines in drinking are uncommon outside North America and Europe; (2 groups of women at increased risk for hazardous drinking include women who cohabit, women with fewer social roles, more highly educated women in lower-income countries, and sexual minority women in North America; (3 heavier alcohol use shows strong and cross-culturally consistent associations with increased likelihood and severity of intimate partner violence; and (4 one effect or accompaniment of rapid social, economic, and gender-role change in traditional societies may be increased drinking among formerly abstinent women. These findings have potentially important implications for women-focused intervention and policy. Substance abuse services should include attention to middle-aged and older women, who may have different risk factors, symptoms, and treatment issues than their younger counterparts. Creative, targeted prevention is needed for high-risk groups of women. Programs to reduce violence between intimate partners must include attention to the pervasive role of alcohol use in intimate partner aggression. Social and economic empowerment of women, together with social marketing of norms of abstention or low-risk drinking, may help prevent increased hazardous alcohol use among women in countries undergoing rapid social change. Greater attention to effects of gender, culture, and their interactions can inform the design of more effective prevention
Lee, Young Sik; Han, Doug Hyun; Kim, Sun Mi; Renshaw, Perry F
The purpose of the current study was to evaluate possible overlapping substance abuse and internet addiction in a large, uniformly sampled population, ranging in age from 13 to 18 years. Participants (N=73,238) in the current study were drawn from the 6th Korea Youth Risk Behavior Web-based Survey (KYRBWS-V) for students from 400 middle schools and 400 high schools in 16 cities within South Korea. Of adolescent internet users, 85.2% were general users (GU), 11.9% were users with potential risk for internet addiction (PR), and 3.0% were users with high risk for internet addiction (HR). There was a difference in the number of students with alcohol drinking among the GU, PR, and HR groups (20.8% vs 23.1% vs 27.4%). There was a difference in the number of students who smoked among the GS, PR, and HR groups (11.7% vs 13.5% vs 20.4%). There was a difference in the number of students with drug use among the GU, PR, and HR groups (1.7% vs 2.0% vs 6.5%). After adjusting for sex, age, stress, depressed mood, and suicidal ideation, smoking may predict a high risk for internet addiction (OR=1.203, p=0.004). In addition, drug use may predict a high risk for internet addiction (OR=2.591, paddiction have vulnerability for addictive behaviors, co-morbid substance abuse should be evaluated and, if found, treated in adolescents with internet addiction. Copyright © 2013 Elsevier Ltd. All rights reserved.
Lacey, Krim K; Mouzon, Dawne M; Govia, Ishtar O; Matusko, Niki; Forsythe-Brown, Ivy; Abelson, Jamie M; Jackson, James S
Lower rates of substance abuse are found among Black Americans compared to Whites, but little is known about differences in substance abuse across ethnic groups within the black population. We examined prevalence rates of substance abuse among Blacks across three geographic regions (US, Jamaica, Guyana). The study also sought to ascertain whether length of time, national context and major depressive episodes (MDE) were associated with substance abuse. We utilized three different data sources based upon probability samples collected in three different countries. The samples included 3,570 African Americans and 1,621 US Caribbean Black adults from the 2001-2003 National Survey of American Life (NSAL). An additional 1,142 Guyanese Blacks and 1,176 Jamaican Blacks living in the Caribbean region were included from the 2005 NSAL replication extension study, Family Connections Across Generations and Nations (FCGN). Mental disorders were based upon DSM-IV criteria. For the analysis, we used descriptive statistics, chi-square, and multivariate logistic regression analytic procedures. Prevalence of substance abuse varied by national context, with higher rates among Blacks within the United States compared to the Caribbean region. Rates of substance abuse were lower overall for women, but differ across cohorts by nativity and length of time in the United States, and in association with major depressive episode. The study highlights the need for further examination of how substance abuse disparities between US-based and Caribbean-based populations may become manifested.
As for substance-related disorders, there were several differences between ICD-10 and DSM-IV, however, the concept of "dependence" had been essential for both criteria. DSM-5 published in 2013 had erased dependence. This confuses us. It is important to recognize dependence again. "Abuse" is the self-intake behavior of drug against the social norms. Repeated abuse results in dependence. Dependence is a state of loss of control against drug use due to craving. Abuse can produce "acute intoxication", and repeated abuse under dependence can produce "chronic intoxication". It is important to understand abuse, dependence and "intoxication" based on their relationship from the point of time course.
Africa: Insights from Brain and. Behavioural ... and neuro-psychology, and human genetics to economics and mathematics. As such, it represents an active cohort of researchers and practitioners working in the area of substance use and abuse.
Full Text Available Objective: This study investigated if there was a significant relationship between physical abuse during childhood and experiencing psychological distress and substance abuse among university students. Methods: This cross-sectional study utilized a questionnaire to collect retrospective data from 382 university students (103 males and 279 females about their substance use patterns, level of psychological distress and their exposure to physical abuse. The data were then analysed using bivariate statistics. Results: Most (61.8% participants met the criteria for being physically abused, however, only 27.2% recognized the experience as abuse. Another 38.9% of the students reported moderate to severe psychological distress. There was a significant relationship between being physically abused and experiencing higher levels of psychological distress (p < 0.001. Cannabis was the most frequently utilized illicit drug (10.3% while alcohol was the most frequently utilized licit drug (37.4%. Drug abuse was found to be significantly associated with being physically abused during childhood (p < 0.05. Conclusion: Even though the results obtained are not generalizable, this study has provided important preliminary information, that experiencing physical abuse increases the likelihood of having higher levels of psychological distress and becoming a substance abuser during adulthood; thereby identifying an overlooked area to target anti-drug use interventions.
Aarons, Gregory A; Ehrhart, Mark G; Moullin, Joanna C; Torres, Elisa M; Green, Amy E
Evidence-based practice (EBP) implementation represents a strategic change in organizations that requires effective leadership and alignment of leadership and organizational support across organizational levels. As such, there is a need for combining leadership development with organizational strategies to support organizational climate conducive to EBP implementation. The leadership and organizational change for implementation (LOCI) intervention includes leadership training for workgroup leaders, ongoing implementation leadership coaching, 360° assessment, and strategic planning with top and middle management regarding how they can support workgroup leaders in developing a positive EBP implementation climate. This test of the LOCI intervention will take place in conjunction with the implementation of motivational interviewing (MI) in 60 substance use disorder treatment programs in California, USA. Participants will include agency executives, 60 program leaders, and approximately 360 treatment staff. LOCI will be tested using a multiple cohort, cluster randomized trial that randomizes workgroups (i.e., programs) within agency to either LOCI or a webinar leadership training control condition in three consecutive cohorts. The LOCI intervention is 12 months, and the webinar control intervention takes place in months 1, 5, and 8, for each cohort. Web-based surveys of staff and supervisors will be used to collect data on leadership, implementation climate, provider attitudes, and citizenship. Audio recordings of counseling sessions will be coded for MI fidelity. The unit of analysis will be the workgroup, randomized by site within agency and with care taken that co-located workgroups are assigned to the same condition to avoid contamination. Hierarchical linear modeling (HLM) will be used to analyze the data to account for the nested data structure. LOCI has been developed to be a feasible and effective approach for organizations to create a positive climate and
Muckle, Wendy; Muckle, Jamie; Welch, Vivian; Tugwell, Peter
at high risk for alcohol abuse attending MAP, defined as a structured programme that provided clients with controlled amounts of alcohol on a daily schedule, comparing no treatment, moderate drinking, brief intervention or 12-step variants. All study citations were collated into a single database. Two review author independently screened titles and abstracts and selected references potentially relevant to the review. Differences between selection lists were resolved by discussion. Two review authors independently evaluated whether studies should be included or excluded according to the eligibility criteria. In the event of a disagreement, a third author was consulted. No studies were included in the review. This systematic review was intended to assess the effectiveness of a brief MAP on the reduction of incidence of harmful behaviour; however, no evidence was available to make this comparison; 22 articles were considered possibly relevant and all were excluded. Most articles were excluded because they failed to compare or consider managed alcohol as the experimental or control intervention, as well as one study (Baker 2010), which was also excluded because study participants were under 18 years of age. No study reviewed offered an intervention that was compared with managed alcohol or considered it as the intervention of interest, providing insufficient evidence to address the objectives of the review. Four studies (Aalto 2001; Baker 2010; Bertholet 2005; Tracy 2007) considered alcohol reduction as an outcome of interest, while four engaged interventions in a shelter setting or targeted vulnerable people (Baker 2010; Bradford 2005; Lapham 1993; McGlynn 1993); only one study (Kidd 2011) offered a qualitative assessment of a participant being admitted to MAP, but offered no analysis of the programme itself. These results accurately reflect the use of MAPs in current practice as existing programmes are ongoing only in a small number of sample pilot projects that target
Daley, Kathryn; Chamberlain, Chris
To help explain why some young people move from recreational drug use to substance abuse, twelve in-depth interviews were conducted with young people who had experienced problematic substance use. The data were supplemented by statistical data on 111 young people. The researchers found a variety of "structural" factors that help explain…
Baldwin, Jeffrey N.; And Others
American Association of Colleges of Pharmacy guidelines for required and elective instructional content concerning substance abuse for pharmacy students is presented. Recommended required content includes psychosocial aspects of drug use; pharmacology and toxicology; identification, intervention, and treatment of addiction; and legal issues.…
Kane, Michael N.; Green, Diane
Human service professionals regularly do not recognize the symptoms of substance abuse in older populations and are unlikely to provide intervention. In this study, human service students (N = 242) were given one of three vignettes in which the main character was an 80-year-old man, an 80-year-old woman, or they were asked to imagine themselves at…
Full Text Available Stacy Calhoun,1,2 Emma Conner,2 Melodi Miller,3 Nena Messina1 1UCLA Integrated Substance Abuse Programs, Los Angeles, CA, USA; 2Department of Criminology, Law and Society, University of California, Irvine, CA, USA; 3Social Solutions International, Inc., Silver Spring, MD, USA Abstract: Substance abuse is a major public health concern that impacts not just the user but also the user's family. The effect that parental substance abuse has on children has been given substantial attention over the years. Findings from the literature suggest that children of substance-abusing parents have a high risk of developing physical and mental health and behavioral problems. A number of intervention programs have been developed for parents who have a substance abuse problem. There have also been a number of interventions that have been developed for children who have at least one parent with a substance abuse problem. However, it remains unclear how we can best mitigate the negative effects that parental substance abuse has on children due to the scarcity of evaluations that utilize rigorous methodologies such as experimental designs. The purpose of this study is to review randomized controlled trials of intervention programs targeting parents with substance abuse problems and/or children with at least one parent with a substance abuse problem in order to identify programs that show some promise in improving the behavioral and mental health outcomes of children affected by parental substance abuse. Four randomized controlled trials that met our eligibility criteria were identified using major literature search engines. The findings from this review suggest that interventions that focus on improving parenting practices and family functioning may be effective in reducing problems in children affected by parental substance abuse. However, further research utilizing rigorous methodologies are needed in order to identify other successful interventions that can
Webber, Adrian; Clark, Jane; Kelly, David
Addressing the psychological distress of individuals experiencing substance use disorders has too often been relegated to the 'too hard basket', leaving those affected with little choice but to receive treatments aimed solely at addressing their drug and alcohol issues. Conversely, individuals receiving support for psychological issues are often underdiagnosed with regards to any comorbid substance misuse problems. In fact, to date, no definitive treatment model exists that gives equal focus to the treatment of both psychological well-being and substance-related addictions. This is not to suggest, however, that existing treatment programmes for substance misuse are not impacting positively on clients' mental health, rather that further research is needed in order to determine what it is that is supporting such improvements. The aim of this study, therefore, was to address this imbalance by examining the correlation between substance dependence and psychological well-being. Using a descriptive correlation design, the Severity of Dependence and Kessler 10 scales were administered to 37 inpatient and outpatient clients at a rural drug and alcohol rehabilitation service, at intake and 2 months into treatment. Data were analysed using descriptive statistics and paired-samples t-tests. Positive correlative factors of improvement between substance dependence and psychological well-being were found for both groups. In light of these findings, the authors recommend that future research be undertaken to investigate the causal factors for this correlation. © 2016 Australian College of Mental Health Nurses Inc.
Brande, M.C.; Zimmerman, A.M.
This book provides an overview of the effects of several abused drugs, including opiates, cannabinoids, alcohol, nicotine, and cocaine, with special emphasis on the actions of these substances at the molecular and cellular levels. The first half deals with genetic effects, including molecular genetics, biochemical genetics, pharmacogenetics, cytogenetics, and genetic toxicity. The second half focuses on perinatal effects and covers: drug abuse during pregnancy; biochemical aspects of marihuana on male reproduction; and long-term behavioral and neuroendocrine effects of perinatal alcohol exposure.
Examination of Life Satisfaction, Child Maltreatment Potential and Substance Use in Mothers Referred for Treatment by Child Protective Services for Child Neglect and Substance Abuse: Implications for Intervention Planning
Plant, Christopher P.; Donohue, Brad; Holland, Jason M.
There is evidence to suggest mothers who are served by child protective service agencies are relatively dissatisfied in their lives, leading some investigators to conclude life dissatisfaction may be associated with child maltreatment. To assist in better understanding this relationship the Life Satisfaction Scale for Caregivers (LSSC) was psychometrically developed in a sample of 72 mothers who were referred for behavioral treatment for child neglect and substance abuse by caseworkers from a local child protective service agency. The LSSC was developed to assess mothers’ happiness in nine domains (family, friendships, employment/work, spirituality/religion, safety, sex life/dating, ability to avoid drugs, ability to avoid alcohol, control over one’s own life). Results indicated two factors that appeared to be relevant to Social Satisfaction and Safety and Control Satisfaction. Higher satisfaction scores on both of these scales were negatively associated with child maltreatment potential and substance use at baseline (i.e., positive urinalysis test). Mothers who exposed their children to substances in utero or in infancy (a distinct type of child neglect) were found to report higher satisfaction scores on the LSSC than other types of child neglect. Hispanic-American, African-American, and Caucasian women reported similar levels of life satisfaction. Application of the LSSC as a non-stigmatizing, wellness-focused instrument is discussed within the context of intervention planning. PMID:27617042
Full Text Available Aims: The aim of this research was the study of the role of identity formation styles on substance abuse behavior of referred people to addiction withdrawal and DIC centers of Tehran city and its comparison with non addicted people. Method: The research design was causal effect research method, which 100 substance abusers compared with 100 non substance abusers. The sampling method was cluster random sampling and both groups were matched in consideration of age. Bersinesky’s identity making questionnaire administered in two samples. Results: The results showed that substance abusers were scored higher on normative and confused/avoidant identity formation also the non substance abusers were scored higher on information identity formation style. Conclusion: With different kind of intervention-training trials the parents and people who are effective on children’s identity formation can be mobilized, in order to prevention of identity formation styles which can planning teenagers’ substance abusing.
Zilberman, Monica L; Blume, Sheila B
Domestic violence and substance abuse are common in primary care patients. Although these problems are associated with severe physical and psychological sequelae, they are often undiagnosed. This article provides an overview of the prevalence of these problems, the health-related consequences for adults, children and elderly, as well as the challenges for clinicians in screening, assessment and referral.
Giordano, Amanda L.; Prosek, Elizabeth A.; Stamman, Julia; Callahan, Molly M.; Loseu, Sahar; Bevly, Cynthia M.; Cross, Kaitlin; Woehler, Elliott S.; Calzada, Richard-Michael R.; Chadwell, Katie
Trauma is prevalent among clients with substance abuse issues, yet addictions counselors' training in trauma approaches is limited. The purpose of the current article is to provide pertinent information regarding trauma treatment including the use of assessments, empirically supported clinical approaches, self-help groups and the risk of vicarious…
Objective: To study the prevalence of substance abuse among female secondary school students in Anambra State. Design: This is a cross sectional study. Materials and Methods: A pre-tested structured questionnaire was used to obtain information on smoking, use of sedatives and alcohol drinking habits from 725 ...
This study aims to examine options to increase the supportive power of parents, teachers, school administrators, and counselors who directly interact with children and adolescents and have a fundamental responsibility to protect them from the risks of substance abuse and evaluate the effectiveness of associated training programs. The study design…
Aggarwal, Atul; Vaish, Supriya; Sharma, D K; Sushil, C S; Usman, Nashat; Sudarsanan, S
The aim of the present study was to study the personality characteristics and criminal behavior in the substance abusers. The role of various sociodemographic variables in substance abusers, which affected their criminal behavior was also studied. Moreover, in the present study, the personality profile of substance users and nonusers was compared using psychoticism, extraversion, and neuroticism (PEN) inventory. A total of 50 consecutive subjects diagnosed as per International Classification of Diseases-10 criteria for substance abuse, fulfilling the inclusive and exclusive criteria were taken. A well-matched control was also assessed to compare the studied subject using a well-designed semi-structured proforma and PEN inventory. Most of the substance abusers were Hindus, married, belonged to 21-30 age group and urban domicile, and were presently unemployed, educated up to middle class, and belonged to lower socioeconomic status. Family history of substance use was significant in the subjects, and the chief substance of use was opioids. Scores for psychoticism and neuroticism, as well as the criminal behavior was significantly higher in studied subjects. Thus, conclusions drawn were that personality characteristics of the substance abusers differed significantly from the control group and second, the number of variables including occupational status, socioeconomic status, family history of substance use, and type of substance of abuse significantly correlated with the criminal behavior in the substance abusers. Identifying these variables can be the first step in the intervention in substance abusers in order to reduce their future criminal behavior.
Phillips, Lindsay A.
This qualitative analysis explores the role of substance abuse in reentry from prison to society. Participants who recidivated (N = 20) in an urban prison system identified substance abuse as their primary reason for recidivism. Treatment implications are discussed.
Potapchik, Elena; Popovich, Larisa
To summarize results of studies that estimate the social costs of alcohol, tobacco, and illicit drug abuse in Russia. The purpose of these studies was to inform policymakers about the real economic burden of risky behaviors and to provide conditions for evidence-based and well-informed decision making in this area. The cost-of-illness method was applied to estimate the social cost of substance abuse. The intangible cost was not included in estimation. A prevalence-based approach was applied to estimate the tangible cost. For the estimation of direct costs, a top-down method was used. Indirect costs were estimated using two methods: the human capital and the friction cost. In 2008, the social cost of substance abuse in Russia comprised 677.2 billion rubles if the friction cost method is applied and 1965.9 billion rubles if the human capital method is used. The social cost of substance abuse is defined to the greatest extent by alcohol consumption, comprising about 45% of the economic burden. Illicit drug use comprises about 30% of the economic burden and tobacco consumption 25%. The results of economic studies demonstrated that psychoactive substances impose a considerable economic burden on society. Analysis of the substance abuse social cost pattern shows that the main losses that society bears because of these behavioral risk factors fall outside the health care system and lay in other sectors of the economy such as social care, law enforcement, and productivity losses. Copyright © 2014 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.
Conway, Kevin P; Swendsen, Joel D; Dierker, Lisa; Canino, Glorisa; Merikangas, Kathleen R
Although acculturation to the United States has been associated with an increase in substance, mood, and anxiety disorders in Latino populations, few studies have examined this concept relative to comorbidity among these syndromes. This study compares the prevalence and patterns of psychiatric comorbidity among Puerto Ricans with substance use disorders living in San Juan (Puerto Rico) to those who have migrated to New Haven (Connecticut) and examines the association between acculturation-related stress and the prevalence and patterns of psychiatric comorbidity among those who have migrated to New Haven. Lifetime levels of nearly all comorbid psychiatric disorders among respondents with substance use disorders were generally similar across sites. However, the risk of any co-occurring psychiatric disorder was higher among substance use disorder cases in New Haven who reported high levels of total acculturation stress and family-specific acculturation stress. These findings were generally accounted for by associations between affective disorders and high scores on these indicators of acculturation stress. The overall prevalence and patterns of psychiatric comorbidity are remarkably similar among Puerto Rican substance abusers whether they live in San Juan or have migrated to New Haven, thereby demonstrating robustness to differences in geographic location. Nevertheless, the degree of acculturation-related family stress is positively associated with co-occurring substance and psychiatric disorders, particularly affective disorders. Intervention in family strain related to the acculturation process may diminish the development of comorbid mental disorders and assist in implementing successful treatment of substance abuse.
The notion of substance abuse is highly problematic. There is considerable disagreement amongst 'experts' as to the relative hazards and addictive properties of both legally and illegally available substances. There are also widely divergent sub-cultural attitudes to the harmfulness or benefit of drug use. One can assume no social consensus as to the nature of the contemporary 'drug problem', nor about the most appropriate means of dealing with it. There is, however, considerable evidence that criminalization of drug use, and harsh penalties against users and suppliers, are ineffective and counter-productive. Other models of control need to be considered, and in particular the merits and de-merits of the medicalization of drug abuse require examination. However, this is only one aspect of the problem. On the other side are the national and international corporations and syndicates, both legitimate and criminal, that earn vast profits from trade in toxic substances. Tobacco is legally available in every country in the world, and the industry is rarely subject to strict control. Thus the issue of substance abuse and control should be seen in a global context, in which account is taken of both legitimate and underworld operations. In attempts to control international trade in toxic substances, the limited success and the problems of already existing legal controls should be acknowledged. Local awareness and regulation of trade in substances is essential, but not sufficient. Amongst other avenues to be explored is the possibility of diverting presently illicitly grown narcotics into indigenous pharmaceutical industries in the Third World. Some problems with this strategy are noted.(ABSTRACT TRUNCATED AT 250 WORDS)
Kate Miriam Loewenthal
Full Text Available This article outlines a history of rulings and beliefs about addiction in Judaism, covering alcohol and substance use and addiction, in the context of a brief account of the development of the status of addiction. It examines the prevalence of alcohol and substance use and abuse among Jews, including a discussion of some of the difficulties in estimating prevalence and of factors involved in changing patterns of use and abuse. Community beliefs and attitudes are examined, using published material and interviews with community leaders and members. Some conclusions are suggested about the impact of religious rulings and of other factors on addiction among Jews. Attention is given to the phenomenon of denial. Therapeutic practices and organisations are described. The scope for further research is identified.
Knight, Danica K.; Broome, Kirk M.; Edwards, Jennifer R.; Flynn, Patrick M.
Staff turnover is a significant issue within substance abuse treatment, with implications for service delivery and organizational health. This study examined factors associated with turnover among supervisors in outpatient substance abuse treatment. Turnover was conceptualized as being an individual response to organizational-level influences, and predictors represent aggregate program measures. Participants included 532 staff (including 467 counselors and 65 clinical/program directors) from 90 programs in four regions of the USA. Using logistic regression, analyses of structural factors indicated that programs affiliated with a parent organization and those providing more counseling hours to clients had higher turnover rates. When measures of job attitudes were included, only parent affiliation and collective appraisal of satisfaction were related to turnover. Subsequent analyses identified a trend toward increased supervisory turnover when satisfaction was low following the departure of a previous supervisor. These findings suggest that organizational-level factors can be influential in supervisory turnover. PMID:19949883
Schippers, Gerard M; Schramade, Mark; Walburg, Jan A
The Dutch substance abuse treatment system is in the middle of a major reorganization. The goal is to improve outcomes by redesigning all major primary treatment processes and by implementing a system of regular monitoring and feedback of clinical outcome data. The new program includes implementing standardized psychosocial behavior-oriented treatment modalities and a stepped-care patient placement algorithm in a core-shell organizational model. This article outlines the new program and presents its objectives, developmental stages, and current status.
Abstract Background The rise of authorized marijuana use in the U.S. means that many individuals are using cannabis as they concurrently engage in other forms of treatment, such as substance abuse counseling and psychotherapy. Clinical and legal decisions may be influenced by findings that suggest marijuana use during treatment serves as an obstacle to treatment success, compromises treatment integrity, or increases the prevalence or severity of relapse. In this paper, the author reviews the ...
Dias, Philomena J
There are no gold-standard tests for evaluating a teen suspected of abusing substances. Awareness of the high prevalence of substance abuse in youth, a high index of suspicion, and a firm desire to be a part of the solution are all that is required to address the problem of substance abuse in youth. In an age of "dotcoms" and societal complexity that fosters an emotionally "disconnected" atmosphere by uniting adolescents only by what they buy, plug into, click on, or blast away, teens need trusted medical homes where caring pediatricians are available to give youth accurate and authoritative facts and care to help them build inner resilience and connect them to the pain and hurt of the people in their lives. Until now, the "three strikes and you're out" maxim has been applied in medical care. This maxim may work for baseball, Clintonomics, and practical office management strategies but is not recommended for addressing the needs of substance using or abusing youth who are prey to advertising strategies. The size of the marketing and advertising budgets of the alcohol and cigarette industries is an indication of the relentless marketing directed toward vulnerable youth. Pediatricians would be doing teens a disservice if they fail to countermand this marketing effect by not using the "rule of seven"--the "seven 'S' screen," seven education attempts, seven different ways over 7 years, and persistence over seven attempts of chemically dependent adolescents to quit. It has been said by Osler that "These are our methods--to carefully observe the phenomena of life in all its stages, to cultivate the reasoning of the faculty so as to be able to know the true from the false. This is our work--to prevent disease, to relieve suffering, to heal the sick," and provide HOPE always.
Gibbs, Deborah A
...: spouse abuse child abuse and substance abuse. By supporting the development of improved responses to troubled families findings from this study can potentially reduce mortality and morbidity among military personal and their family members...
Full Text Available Abstract Background The rise of authorized marijuana use in the U.S. means that many individuals are using cannabis as they concurrently engage in other forms of treatment, such as substance abuse counseling and psychotherapy. Clinical and legal decisions may be influenced by findings that suggest marijuana use during treatment serves as an obstacle to treatment success, compromises treatment integrity, or increases the prevalence or severity of relapse. In this paper, the author reviews the relationship between authorized marijuana use and substance abuse treatment utilizing data from a preliminary pilot study that, for the first time, uses a systematic methodology to collect data examining possible effects on treatment. Methods Data from the California Outcomes Measurement System (CalOMS were compared for medical (authorized marijuana users and non-marijuana users who were admitted to a public substance abuse treatment program in California. Behavioral and social treatment outcomes recorded by clinical staff at discharge and reported to the California Department of Alcohol and Drug Programs were assessed for both groups, which included a sample of 18 reported medical marijuana users. Results While the findings described here are preliminary and very limited due to the small sample size, the study demonstrates that questions about the relationship between medical marijuana use and involvement in drug treatment can be systematically evaluated. In this small sample, cannabis use did not seem to compromise substance abuse treatment amongst the medical marijuana using group, who (based on these preliminary data fared equal to or better than non-medical marijuana users in several important outcome categories (e.g., treatment completion, criminal justice involvement, medical concerns. Conclusions This exploratory study suggests that medical marijuana is consistent with participation in other forms of drug treatment and may not adversely affect
Fazel, Seena; Långström, Niklas; Hjern, Anders; Grann, Martin; Lichtenstein, Paul
Persons with schizophrenia are thought to be at increased risk of committing violent crime 4 to 6 times the level of general population individuals without this disorder. However, risk estimates vary substantially across studies, and considerable uncertainty exists as to what mediates this elevated risk. Despite this uncertainty, current guidelines recommend that violence risk assessment should be conducted for all patients with schizophrenia. To determine the risk of violent crime among patients diagnosed as having schizophrenia and the role of substance abuse in mediating this risk. Longitudinal designs were used to link data from nationwide Swedish registers of hospital admissions and criminal convictions in 1973-2006. Risk of violent crime in patients after diagnosis of schizophrenia (n = 8003) was compared with that among general population controls (n = 80 025). Potential confounders (age, sex, income, and marital and immigrant status) and mediators (substance abuse comorbidity) were measured at baseline. To study familial confounding, we also investigated risk of violence among unaffected siblings (n = 8123) of patients with schizophrenia. Information on treatment was not available. Violent crime (any criminal conviction for homicide, assault, robbery, arson, any sexual offense, illegal threats, or intimidation). In patients with schizophrenia, 1054 (13.2%) had at least 1 violent offense compared with 4276 (5.3%) of general population controls (adjusted odds ratio [OR], 2.0; 95% confidence interval [CI], 1.8-2.2). The risk was mostly confined to patients with substance abuse comorbidity (of whom 27.6% committed an offense), yielding an increased risk of violent crime among such patients (adjusted OR, 4.4; 95% CI, 3.9-5.0), whereas the risk increase was small in schizophrenia patients without substance abuse comorbidity (8.5% of whom had at least 1 violent offense; adjusted OR, 1.2; 95% CI, 1.1-1.4; Pgenetic or early environmental) confounding of the
Fisher, Dennis G; Reynolds, Grace L; D'Anna, Laura H; Hosmer, David W; Hardan-Khalil, Kholoud
Among substance abusers in the US, the discrepancy in the number who access substance abuse treatment and the number who need treatment is sizable. This results in a major public health problem of access to treatment. The purpose of this study was to examine characteristics of Persons Who Use Drugs (PWUDs) that either hinder or facilitate access to treatment. 2646 participants were administered the Risk Behavior Assessment (RBA) and the Barratt Impulsiveness Scale. The RBA included the dependent variable which was responses to the question "During the last year, have you ever tried, but been unable, to get into a drug treatment or detox program?" In multivariate analysis, factors associated with being unable to access treatment included: Previously been in drug treatment (OR=4.51), number of days taken amphetamines in the last 30days (OR=1.18), traded sex for drugs (OR=1.53), homeless (OR=1.73), Nonplanning subscale of the Barratt Impulsiveness Scale (OR=1.19), age at interview (OR=0.91), and sexual orientation, with bisexual men and women significantly more likely than heterosexuals to have tried but been unable to get into treatment. The answers to the question on "why were you unable to get into treatment" included: No room, waiting list; not enough money, did not qualify, got appointment but no follow through, still using drugs, and went to jail before program start. As expected, findings suggest that limiting organizational and financial obstacles to treatment may go a long way in increasing drug abuse treatment accessibility to individuals in need. Additionally, our study points to the importance of developing approaches for increasing personal planning skills/reducing Nonplanning impulsivity among PWUDs when they are in treatment as a key strategy to ensure access to additional substance abuse treatment in the future. Copyright © 2016 Elsevier Inc. All rights reserved.
Columbia Univ., New York, NY. National Center on Addiction and Substance Abuse.
This report follows an extensive survey of primary care physicians (N=400) about the problem of substance abuse in women over the age of 59. Research has shown that an individual who reaches the age of 21 without smoking, using drugs, or abusing alcohol is virtually never at risk to abuse these substances. The only exception occurs with mature…
Psychoactive substance use/abuse among students in Igbinedion University, Okada, Nigeria-new challenges. E Uwadiae ... (NPF), National Drug Law Enforcement Agency (NDLEA) must be sufficiently informed that substances of abuse have gone beyond the conventional substances like alcohol, cannabis, cigarette etc.
Ajeng Intan Nur Rahmawati
Full Text Available The purpose of this article to find out which variables are the causes and effects between substancial abuse and internet addiction through conceptual studies.Internet addiction and substance abuse are known to have correlation.But this becomes overlapping, which is the cause andthe result. The results of this conceptual study explain that adolescents who experience substance abuse will tend tobe the cause of increased prevalenceinternet addiction, because the use of addictive substances will determine how fast internet addiction develops. Conversely, adolescents who experience Internet addiction is not necessarily the cause of the emergence of substance abuse. It can be concluded that substance abuse is the cause of high levels of internet addiction in adolescents, likewisethe internet addiction has the potential to cause substance abuse
McConnell, K John; Hoffman, Kim A; Quanbeck, Andrew; McCarty, Dennis
Efforts to understand how to improve the delivery of substance abuse treatment have led to a recent call for studies on the "business of addiction treatment." This study adapts an innovative survey tool to collect baseline management practice data from 147 addiction treatment programs enrolled in the Network for the Improvement of Addiction Treatment 200 project. Measures of "good" management practice were strongly associated with days to treatment admission. Management practice scores were weakly associated with revenues per employee but were not correlated with operating margins. Better management practices were more prevalent among programs with a higher number of competitors in their catchment area.
Bryson, Ethan O; Silverstein, Jeffrey H
Despite substantial advances in our understanding of addiction and the technology and therapeutic approaches used to fight this disease, addiction still remains a major issue in the anesthesia workplace, and outcomes have not appreciably changed. Although alcoholism and other forms of impairment, such as addiction to other substances and mental illness, impact anesthesiologists at rates similar to those in other professions, as recently as 2005, the drug of choice for anesthesiologists entering treatment was still an opioid. There exists a considerable association between chemical dependence and other psychopathology, and successful treatment for addiction is less likely when comorbid psychopathology is not treated. Individuals under evaluation or treatment for substance abuse should have an evaluation with subsequent management of comorbid psychiatric conditions. Participation in self-help groups is still considered a vital component in the therapy of the impaired physician, along with regular monitoring if the anesthesiologist wishes to attempt reentry into clinical practice.
Striley, Catherine W.; Nattala, Prasanthi; Ben Abdallah, Arbi; Dennis, Michael L.; Cottler, Linda B.
This pilot study evaluated the effectiveness of enhanced case management for substance abusers with comorbid major depression, which was an integrated approach to care. One hundred and 20 participants admitted to drug treatment who also met Computerized Diagnostic Interview Schedule criteria for major depression at baseline were randomized to…
Scott, Melanie C; Easton, Caroline J
It is unclear whether racial differences in treatment effect exist for individuals in substance abuse and domestic violence programs. This study examined racial differences in treatment effect among substance dependent Caucasian and African-American male intimate partner violence (IPV) offenders court mandated to an integrated substance abuse and domestic violence treatment. From baseline to completion of treatment (week 12), 75 participants (39 Caucasian; 36 African-American) were assessed on demographics, substance use, legal characteristics, and use of violence (physical, verbal, and psychological). African-American men served more months incarcerated in their life than Caucasian men. Both groups showed decreases in their use of physical violence and alcohol abuse over treatment. Caucasian men also showed a decrease in their use of verbal abuse. At treatment completion, both groups showed a reduction in physical abuse and alcohol abuse. Caucasian men showed a reduction in their use of verbal abuse, but African-American men did not. Substance dependent African-American male IPV offenders may benefit from interventions that thoroughly target communication skills in addition to issues of substance abuse and IPV to reduce use of verbal abuse and improve treatment outcomes among African American men.
Chang, Zheng; Lichtenstein, Paul; Halldner, Linda; D'Onofrio, Brian; Serlachius, Eva; Fazel, Seena; Långström, Niklas; Larsson, Henrik
There are persistent concerns of long-term effects of stimulant ADHD medication on the development of substance abuse. Using Swedish national registers, we studied all individuals born between 1960 and 1998 and diagnosed with ADHD (26,249 men and 12,504 women). We investigated the association between stimulant ADHD medication in 2006 and substance abuse during 2009. Substance abuse was indexed by substance-related death, crime, or hospital visits. ADHD medication was not associated with increased rate of substance abuse. Actually, the rate during 2009 was 31% lower among those prescribed ADHD medication in 2006, even after controlling for medication in 2009 and other covariates (hazard ratio: 0.69; 95% confidence interval: 0.57-0.84). Also, the longer the duration of medication, the lower the rate of substance abuse. Similar risk reductions were suggested among children and when investigating the association between stimulant ADHD medication and concomitant short-term abuse. We found no indication of increased risks of substance abuse among individuals prescribed stimulant ADHD medication; if anything, the data suggested a long-term protective effect on substance abuse. Although stimulant ADHD medication does not seem to increase the risk for substance abuse, clinicians should remain alert to the potential problem of stimulant misuse and diversion in ADHD patients. © 2013 The Authors. Journal of Child Psychology and Psychiatry © 2013 Association for Child and Adolescent Mental Health.
Examination of Life Satisfaction, Child Maltreatment Potential and Substance Use in Mothers Referred for Treatment by Child Protective Services for Child Neglect and Substance Abuse: Implications for Intervention Planning
Plant, Christopher P.; Donohue, Brad; Holland, Jason M.
There is evidence to suggest mothers who are served by child protective service agencies are relatively dissatisfied in their lives, leading some investigators to conclude life dissatisfaction may be associated with child maltreatment. To assist in better understanding this relationship the Life Satisfaction Scale for Caregivers (LSSC) was psychometrically developed in a sample of 72 mothers who were referred for behavioral treatment for child neglect and substance abuse by caseworkers from a...
Full Text Available Background: It is clear that tobacco smoking and substance abuse have negative consequences on adolescent and youth′s health. Tobacco smoking especially hookah smoking has increased worldwide especially among university students. This study aimed to determine the prevalence of risk-taking behaviors such as cigarette smoking, hookah smoking, alcohol use, and drug abuse and its predictors in students of Karaj universities. Methods: This cross-sectional study took place in Karaj in January and February 2014. The randomly selected sample consisted of 1959 college students. A self-administered questionnaire was used to measure risk-taking behaviors as well as demographic and related risk factors. Logistic regression model was performed in data analysis. Results: The prevalence of cigarette smoking was 9.3%. The prevalence of hookah smoking was 9.3%. 7% of students used illegal drugs and 9.5% of students used alcohol at least once in last 30 days. After adjustment for other factors, being male, living without parents, having smoker friends, and presence any smoker in the family were factors associated with students′ risk-taking behaviors. The results showed the co-occurrence of risk-taking behaviors. Conclusions: The prevalence of tobacco smoking and substance abuse, particular in males, are high. It seems that planning preventive interventions for this part of the population are necessary. This study emphasized the co-occurrence of risky behaviors, so, it is better high-risk behaviors simultaneously targeted at reducing or preventing interventions.
McFarlane, J; Parker, B; Soeken, K
To establish the singular and combined occurrence of physical abuse, smoking, and substance use (i.e., alcohol and illicit drugs) during pregnancy and its effect on birth weight. Prospective cohort analysis. Urban public prenatal clinics. 414 African American, 412 Hispanic, and 377 white pregnant women. Occurrence of physical abuse was 16%; smoking, 29.5%; and alcohol/illicit drug use, 11.9%. Significant relationships existed between physical abuse and smoking for African American and white women. For African American women, 33.7% of women who were not abused smoked, versus 49.5% of women who were abused (chi 2 = 8.21; df = 1; p drug use was 20.8% for nonabused women compared with 42.1% for abused women (chi 2 = 18.18; df = 1; p abused smoked, versus 59.6% of those who were abused (chi 2 = 5.22; df = 1; p abuse, smoking, and alcohol/ illicit drug use were significantly related to birth weight (F[3, 1040] = 30.19, p abuse during pregnancy is common, readily detected with a five-question screen, and associated with significantly higher use of tobacco, alcohol, and illicit drugs. Clinical protocols that integrate assessment and intervention for physical abuse, smoking, and substance use are essential for preventing further abuse and improving smoking and substance cessation rates.
Full Text Available Aim: The aim of the present study was to study the personality characteristics and criminal behavior in the substance abusers. The role of various sociodemographic variables in substance abusers, which affected their criminal behavior was also studied. Moreover, in the present study, the personality profile of substance users and nonusers was compared using psychoticism, extraversion, and neuroticism (PEN inventory. Materials and Methods: A total of 50 consecutive subjects diagnosed as per International Classification of Diseases-10 criteria for substance abuse, fulfilling the inclusive and exclusive criteria were taken. A well-matched control was also assessed to compare the studied subject using a well-designed semi-structured proforma and PEN inventory. Results: Most of the substance abusers were Hindus, married, belonged to 21-30 age group and urban domicile, and were presently unemployed, educated up to middle class, and belonged to lower socioeconomic status. Family history of substance use was significant in the subjects, and the chief substance of use was opioids. Scores for psychoticism and neuroticism, as well as the criminal behavior was significantly higher in studied subjects. Conclusion: Thus, conclusions drawn were that personality characteristics of the substance abusers differed significantly from the control group and second, the number of variables including occupational status, socioeconomic status, family history of substance use, and type of substance of abuse significantly correlated with the criminal behavior in the substance abusers. Identifying these variables can be the first step in the intervention in substance abusers in order to reduce their future criminal behavior.
Becker, Sara J
The overall chasm between those who need treatment for mental health and substance abuse (M/SU) and those who receive effective treatment consists of two, interrelated gaps: the research-to-practice gap and the treatment gap. Prior efforts to disseminate evidence-based practice (EBP) for M/SU have predominantly targeted the research-to-practice gap, by focusing efforts toward treatment providers. This article introduces direct-to-consumer (DTC) marketing that targets patients and caregivers as a complementary approach to existing dissemination efforts. Specific issues discussed include: rationale for DTC marketing based on the concept of push versus pull marketing; overview of key stakeholders involved in DTC marketing; and description of the Marketing Mix planning framework. The applicability of these issues to the dissemination of EBP for M/SU is discussed.
Becker, Sara J.
The overall chasm between those who need treatment for mental health and substance abuse (M/SU) and those who receive effective treatment consists of two, interrelated gaps: the research-to-practice gap and the treatment gap. Prior efforts to disseminate evidence-based practice (EBP) for M/SU have predominantly targeted the research-to-practice gap, by focusing efforts toward treatment providers. This article introduces direct-to-consumer (DTC) marketing that targets patients and caregivers as a complementary approach to existing dissemination efforts. Specific issues discussed include: rationale for DTC marketing based on the concept of push versus pull marketing; overview of key stakeholders involved in DTC marketing; and description of the Marketing Mix planning framework. The applicability of these issues to the dissemination of EBP for M/SU is discussed. PMID:25937710
Scott, Cynthia G.; Ambroson, DeAnn L.
Examines college substance abuse prevention and intervention programs in the framework of the elaboration likelihood model. Discusses the role of persuasion and recommends careful analysis of the relevance, construction, and delivery of messages about substance use and subsequent program evaluation. Recommendations for increasing program…
Join Together, Boston, MA.
According to the United States Department of Labor, 73% of drug users in 1997 were employed. Numerous studies, reports, and surveys suggest that substance abuse is having a negative effect on the workplace in terms of decreased productivity; increased accidents; absenteeism; turnover; and medical costs. However, workplace substance abuse is a…
Wolk, James L.; Hartmann, David J.
Argues that process evaluation is needed to validate prison-based substance abuse treatment effectiveness. Five groups--inmates, treatment staff, prison staff, prison administration, and the parole board--should be a part of this process evaluation. Discusses these five groups relative to three stages of development of substance abuse treatment in…
This is a survey research study which investigated gender and peer influence on substance abuse among undergraduates in Lagos State University, Ojo, Lagos, Nigeria. 513 undergraduates were purposively selected for the study. The researchers designed the instrument, Gender and Peer Influence on Substance Abuse ...
Richardson, George B.; Montgomery, LaTrice; Brubaker, Michael D.
Only 7.6% of adolescents in need of substance abuse treatment actually receive it. Many adolescents are hesitant to seek treatment due to public stigma (i.e., negative attitudes and beliefs of the general public toward individuals who abuse substances). However, decades of research indicate that interpersonal contact with stigmatized groups helps…
Crozier, Mary K.
In the field of rehabilitation services, substance abuse counseling requires unique skills. Post-baccalaureate academic certificate programs offer professionals an opportunity to retool or expand their skills and meet licensure needs in this evolving field. East Carolina University's online Substance Abuse Counseling Certificate Program was…
It was also revealed that the above drugs and substances were the most used and abused. While snuffs and marijuana were the least abused substances. Based on the findings some counselling implications were highlighted and recommendations made.. The Nigerian Journal of Guidance Counselling Vol. 10 (1) 2005: pp ...
Gabany, Steve G.; Plummer, Portia
Studied 617 high school and college students prior to and after substance abuse instruction to determine relationship between perceptions and demographic characteristics, and to learn whether substance abuse instruction was related to changes in student's perception of relationships. Findings from Marihuana Perception Inventory showed five factors…
... 49 Transportation 7 2010-10-01 2010-10-01 false Substance abuse professional (SAP). 655.52 Section 655.52 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL TRANSIT... OPERATIONS Drug and Alcohol Testing Procedures § 655.52 Substance abuse professional (SAP). The SAP must...
Rienzi, Beth M.; And Others
To investigate gender differences in acceptance of substance abuse behavior among adolescents, 968 students were administered a questionnaire to assess their perceptions. Results show that both genders felt that boys would be more approving of teenage substance abuse. Most students were disapproving of a teenager driving after drinking. Other…
... treatment admission (“other female teen admissions”). Note that TEDS is a census of all admissions to treatment facilities reported to the Substance Abuse and Mental Health Services Administration (SAMHSA) by State substance abuse agencies. IN BRIEF X X Between 2007 and 2010, about 57,000 ...
Culbreth, John R.
Reports on a national survey of substance abuse counselors (N=134) to learn their current and preferred supervision practices. Results suggests that substance abuse counselor are receiving supervision similar to other counselors. No preference was indicated for the sex of the supervisor, nor for the 12-step recovery experience. Counselors did…
Bailey, Jennifer A.; McCloskey, Laura Ann
This study examined the link between childhood sexual abuse and adolescent substance use among girls, and evaluated depressive self-concept and behavioral under-control (BUC) as pathways to substance use for sexually abused girls. Participants (n = 150) were drawn from a longitudinal study of the impact of domestic violence on the lives of women…
State and Local Government Labor-Management Committee, Washington, DC.
This short booklet is a joint expression by public sector labor and management that recognizes that neither side has all the answers to the problems of employee substance abuse and that both share a common concern for a successful outcome. The booklet summarizes the dimension of substance abuse in today's workplace; and it tries to encourage…
Full Text Available Introduction & Objective: The prevalence of substance abuse among college students is increasing drastically and requires immediate skill-based substance abuse intervention such as assertive skills. The purpose of this study was to develope the healthy behavior to change the subjective norms of students in order to decrease their tendency towards substance abuse. Materials & Methods: A pre and post nonequivalent control group design study carried out on college students. A total number of 140 students were selected through randomized cluster sampling and randomly assigned to the intervention (n=70 and the control (n=70 groups. The data-gathering tool consisted of a self-report questionnaire assessing the variables of moral , descriptive , and injunctive norms. After the diagnostic evaluation, assertive skills promoting program was applied to persuade the participants against substances abuse. Respondents in the control and experimental groups completed questionnaires at baseline and 2 months after the intervention. Results: The result showed that educational manipulation had significant effect on intervention group’s average response for moral norms (t= -3.36, P<0.001, descriptive norms (t= -3.07, P<0.003, and injunctive norms for persuading substance abuse (t=-3.79, P<0.000.Conclusion: These findings suggest that assertive skills training would be an efficient tool in drug abuse prevention programs among adolescents that should also be included in the comprehensive school health programs. (Sci J Hamadan Univ Med Sci 2011;18(3:40-49
Full Text Available Child abuse and neglect is any interaction or lack of interaction between a caregiver and a child resulting in nonaccidental harm to the child′s physical and developmental state. Substance abuse is ingestion of any drug, which is capable of altering the mental functioning eventually leading to addiction. This paper presents a case report of a 12-year-old neglected girl with substance abuse for which she was physically abused by her mother.
Gil, Andrés G; Wagner, Eric F; Tubman, Jonathan G
This study presents preliminary analyses examining the effects of an alcohol and other drug use (AOD) intervention with minority juvenile offenders. Furthermore, the study investigates the impact of cultural factors on baseline AOD use among Hispanic and African American youth, as well as on treatment outcome. Participants were 213 juvenile offenders referred for treatment (mean age = 15.7 years), 97 of whom have completed treatment to date. The intervention was carried out in clinics placed within the neighborhoods in which the participants resided. Intervention Alcohol Treatment Targeting Adolescents in Need (ATTAIN) is a controlled clinical trial evaluating the effectiveness of a brief motivational, cognitive behavioral intervention, guided self-change (GSC). Participants are assigned randomly to the individual format of guided self-change (I-GSC), the family involved format of guided self-Change (F-GSC), choice of one of these two, or a waiting list control condition. Only participants involved in active intervention are included in the present report. Data were collected via structured face-to-face interviews. Alcohol and marijuana use measures were collected using the Time-line Follow-back interview (TLFB). There were significant reductions in alcohol and marijuana use for all ethnic groups from baseline to post-intervention. Cultural factors (discrimination, acculturation, ethnic pride and cultural mistrust) were associated with pre-intervention levels of alcohol and marijuana use. Among Hispanics, pre-intervention level of substance use were higher among foreign-born than US-born youth. Analyses conducted with the US-born Hispanic group showed that ethnic orientation and ethnic pride were associated positively with greater reductions in alcohol use. The intervention provided through ATTAIN appears to be effective with a multi-ethnic population of juvenile delinquents. Cultural factors, such as ethnic orientation and ethnic mistrust, appear to constitute
Clark, C Brendan; Reiland, Sarah; Thorne, Chris; Cropsey, Karen L
Past research showed a relationship between substance abuse and aggression and past trauma and aggression. The nature of the relationships between substance use, trauma, and aggression is inconclusive. The current research hypothesized greater aggression among those with a history of substance abuse and trauma compared with those without such a history and an additive relationship between substance abuse and trauma on aggression. Participants were 615 individuals in a substance abuse treatment program for individuals under criminal justice supervision. Data were collected from face-to-face interviews and self-report measures. Univariate and multivariate analyses assessed the relationships among substance use, trauma, and aggression. Participants with a history of trauma and regular substance use reported the highest rates of homicidal ideation, problem behaviors, and person offenses. Participants in this group also reported greater desire for help managing their stress and tension, dealing with problems in their intimate relationships, developing healthier relationships in general, and learning prosocial approaches to express their feelings. Substance abusing participants who experienced trauma reported more externalizing behaviors and a greater desire for coping- and social-skills training than participants who abused substances but did not report a history of trauma. This suggests that participants in substance abuse treatment programs may have improved outcomes with the addition of components to address these issues.
Snenghi, Rossella; Forza, Giovanni; Favretto, Donata; Sartore, Daniela; Rodinis, Silvia; Terranova, Claudio; Nalesso, Alessandro; Montisci, Massimo; Ferrara, Santo Davide
The aim of this study was to investigate polydrug use in drunk drivers. The experimental study was conducted on 2,072 drunk drivers undergoing a driving license reissue protocol at the Department of Legal Medicine of Padova University Hospital in the period between January 2011 and December 2012. The study protocol involved anamnesis, clinical examination, toxicological history, and toxicological analyses on multiple biological samples. One thousand eight hundred seventy-seven subjects (90.6%) were assessed as fit to drive, and 195 (9.5%) were declared unfit. Among those unfit, 32 subjects (1.6%) were declared unfit due to recent use of an illicit drug (time span drive after completeness of the protocol was established in 1.2% of cases for alcohol disorders and in 5.7% of cases for illicit drug abuse; only one subject was included in both subgroups. Cocaine was the most widely used substance, followed by cannabis, opiates, and psychotropic pharmaceutical drugs. The application of the protocol presented in this study allowed the identification of underlying polydrug use in drunk drivers. The study led to the identification of 6.8% unfit subjects on the basis of alcohol disorders and/or drug abuse, compared to 1.2% of identifiable unfitness if the protocol were limited to the mere assessment of alcohol consumption. The frequent association of alcohol and cocaine is different from other patterns of use in North Europe countries.
Phillips, Susan D.; Gleeson, James P.; Waites-Garrett, Melissa
The expansion of the criminal justice system over the last several decades helped to focus attention on children of incarcerated parents, many of whom have parents with substance abuse problems. Since the 1990's, a national grassroots campaign has been underway to make substance abuse treatment an alternative to incarceration for parents who…
Grunebaum, Michael F; Galfalvy, Hanga C; Nichols, C Matthew; Caldeira, Nathilee A; Sher, Leo; Dervic, Kanita; Burke, Ainsley K; Mann, J John; Oquendo, Maria A
The goal of this retrospective study was to examine factors differentiating persons with bipolar disorder who did or did not have comorbid lifetime substance use disorders (SUD) at an index assessment. We also explored the chronology of onset of mood and SUD. We studied 146 subjects with DSM-defined bipolar disorder. Subgroups with and without lifetime SUD were compared on demographic and clinical measures. Substance abuse disorders in this bipolar sample were associated with male sex, impulsive-aggressive traits, comorbid conduct and Cluster B personality disorders, number of suicide attempts and earlier age at onset of a first mood episode. In a multivariable logistic regression analysis, male sex and aggression and possibly earlier age at mood disorder onset were associated with SUD. In those with or without SUD, the first mood episode tended to be depressive and to precede the onset of SUD. In persons with bipolar disorder, an earlier age of onset and aggressive traits appear to be factors associated with later development of comorbid SUD.
Manchikanti, Laxmaiah; Brown, Keith R; Singh, Vijay
The National All Schedules Prescription Electronic Reporting Act, or NASPER, is a bill proposed by the American Society of Interventional Pain Physicians to provide and improve patient access with quality care, and protect patients and physicians from deleterious effects of controlled substance misuse, abuse and trafficking. Controlled prescription drugs, including narcotic analgesics, anxiolytics, anti-depressants, stimulants, and sedative-hypnotics play a significant and legitimate role in interventional pain management practices in managing chronic pain and related disorders. Based on the 1997 household survey on drug abuse it is estimated that 76.9 million Americans had used an illicit drug at least once in their life. In 1997, 4.2 million people used analgesics, 2.1 million used tranquillizers, and an additional 2.3 million people used various other drugs, including sedatives, tranquillizers, etc. The non-medical use of prescription drugs exceeds that of all illicit substances except for marijuana and hashish. The report on epidemiology trends in drug abuse, based on community epidemiology work group analysis showed continued increase of abuse of prescription drugs in urban, suburban, and rural areas. The most commonly abused drugs include oxycodone, hydrocodone, hydromorphone, morphine, codeine, clonazepam, alprazolam, lorazepam, diazepam and carisoprodol. The diversion of prescription controlled substances to illicit channels is a public health and safety issue. This review describes the role of controlled substances in chronic pain management, prevalence and economic impact of controlled substance abuse, prescription accountability, effectiveness of prescription monitoring programs, and rationale for national controlled substance electronic reporting system.
Spear, Suzanne Evelyn
The high cost of detoxification (detox) services and health risks associated with continued substance abuse make readmission to detox an important indicator of poor performance for substance abuse treatment systems. One major service gap in the continuum of care for substance use disorders associated with readmissions is not transitioning patients to rehabilitation after a detox service. This study examined the problem of detox readmissions from an interorganizational network perspective. The...
Yarvis, R M
A series of 100 murderers was examined to discern patterns of substance abuse and intoxication in relation to homicidal events. More than half of the study subjects were found to be actively abusing drugs at the time of their crime, and almost half were intoxicated. Alcohol was the drug most often abused. Demographic and other discriminating factors were utilized to examine the hypothesis that murderers do not constitute a homogeneous population and that subgroups differ in their abuse patterns. Cluster analytic techniques were applied to the study population. Utilizing a set of 13 proximate causal factors, a typology of seven distinct homicide profiles was created. Two of the seven profiles exhibited extremely high abuse and intoxication rates, three others intermediate rates, and two profiles very low rates. Moreover, different substances were prime offenders in different profiles. These findings demonstrate that substance abuse is an important etiological contributor in some types of murderer but not in all types.
Temitayo Serah Abijo
Full Text Available In spite of the fact that substance abuse remains a public health challenge and social problem of enormous magnitudes, with many adolescents and families involved and affected by substance abuse disarrays the issue of proper counselling still requires more attention. In view of this therefore, this study has explored and appraised conceptually the desirability as well as applicable integrated strategies for counselling of the children in the substance abused family. Based on the appraisal of existing strategies for counseling of substance abused family then this study has been able to establish that if people involved as well as the victims of the abused will be able to learn about concepts such as inner strength, self-praise, and group praise, which may prompt setting up of goals for positive decision on their addiction. Similarly, the strategies will encourage the target family to generate more and more positive self-portraits and, as these may inspire making positive lifestyle changes.
Gonzalez-Guarda, Rosa Maria; Vasquez, Elias P; Urrutia, Maria T; Villarruel, Antonia M; Peragallo, Nilda
Hispanic females are disproportionately affected by substance abuse, intimate partner violence, and HIV. Despite these disparities, research describing the cultural and gender-specific experiences of Hispanic women with regard to these conditions is lacking. Transplantadas en otro mundo (Uprooted in another world), El criador de abuso (The breeding ground of abuse), and Rompiendo el silencio (Breaking the silence). This study supports the importance of addressing substance abuse, violence, and risk for HIV in an integrated manner and stresses the importance of addressing associated cultural factors (e.g., acculturation, machismo ) in interventions targeting Hispanics.
Join Together, Boston, MA.
Substance abuse treatment has been demonstrated to be effective in reducing not only substance use, but also the economic, health, and social costs associated with substance abuse. This document examines how health care reform can preserve and enhance community substance abuse services. The cost effectiveness of funding substance abuse prevention…
Substance abuse and HIV risk behaviours amongst primary health care service users in Cape Town. ... African Journal of Psychiatry ... We assessed substance use with the Alcohol, Smoking and Substance Involvement Screening Test, and HIV risk with items addressing injection drug use, blood-sharing rituals, and sexual ...
Tompsett, Carolyn J.; Domoff, Sarah E.; Toro, Paul A.
Adolescents who experience homelessness are at higher risk for abusing substances, and for being exposed to substance-using peers. The current study used a longitudinal design to track substance abuse, affiliation with substance-using peers, and episodes of homelessness among a sample of 223 adolescents who were homeless at thebaseline data collection and 148 adolescents who were housed at baseline. Participants were interviewed at six waves over 6.5 years, covering an age rang...
Full Text Available Sally StevensSouthwest Institute for Research on Women (SIROW and Department of Gender and Women’s Studies (GWS, University of Arizona, Tucson, AZ, USAAbstract: Research on the incidence, etiology and substance abuse treatment needs of lesbian, bisexual and transgender (LBT women is limited. Most research indicates higher levels of alcohol and drug abuse among these populations compared to their heterosexual counterparts, with recent research indicating that substance abuse is a particular concern for transgender individuals and an increasing problem among younger LBT individuals. Risk factors and reasons for substance abuse among sexual minority women are similar to those of heterosexual women, yet are substantially complicated by issues of family rejection and lack of social support, stigma and minority stress, as well as abuse and harassment. Historically, substance abuse prevention, early intervention, and clinical treatment programs were designed to meet the needs of the sexual majority population with relatively few programs designed to incorporate the specific needs of sexual minorities. This article reviews findings from previous studies and utilizes new data collected from community-based and residential substance abuse treatment programs to (1 examine issues relevant to LBT women and substance use, and (2 make recommendations for tailoring substance abuse treatment programs to meet the needs of these populations.Keywords: lesbian, bisexual, transgender, substance abuse, family rejection, social support, stigma, minority stress, abuse, harassment
Lee, Kyoung Hag; Jun, Jung Sim; Kim, Yi Jin; Roh, Soonhee; Moon, Sung Seek; Bukonda, Ngoyi; Hines, Lisa
This study explored the role of mental health and substance abuse problems on the suicidal ideation and suicide attempts of 156 homeless adults. The logistic regression results indicated that homeless adults with anxiety were significantly more likely than those without anxiety to have both suicidal ideation and suicide attempts. Also, homeless adults with drug abuse were significantly more likely than those without drug abuse to have suicidal ideation. The study suggests that to reduce the suicide of the homeless, case managers need to screen mental health and substance abuse issues and to provide appropriate treatment services at homeless shelters.
Chang, Hsueh-Ling; Chen, Sue-Huei; Huang, Chien
The etiological factors and interrelations of juvenile delinquents, with psychiatric morbidity and substance abuse have been continuously debated. Cloninger's Tridimensional Theory of Temperament has been reported to predict patterns of substance abuse and comorbidity. In the current study, we aimed to examine the usability of the theory in predicting juvenile delinquency and substance abuse. Sixty consecutive and newly incarcerated male delinquents with history of substance abuse were recruited from a juvenile correctional facility in northwestern Taiwan from January 2002 through December 2003. All subjects were assessed of their temperament, behavioral problems, and psychiatric disorders on an individual base. The juvenile delinquent subjects with childhood history of attention deficit and hyperactivity disorder (ADHD) were significantly younger, consumed less betel nuts, and had more siblings with history of drug abuse. Consistent with the results of Cloninger's studies, novelty seeking positively correlated to the amount of substance abuse, while harm avoidance inversely correlated in juvenile delinquents. Endemic trend of choice of substance abuse needs to be taken into consideration in future research projects.
Full Text Available This is a case of a 22-year-old Hispanic male with a history of bipolar disorder and methamphetamine dependence who was admitted after presenting with suicidal ideations by slashing his throat with a machete. The patient had been smoking and inhaling “processed” pyrethroid for about eight weeks as an inexpensive methamphetamine substitute. He reported experiencing a “rush” similar to methamphetamine after using pyrethroid from liquid insecticide that had been heated (electrocuted or sprayed on hot metal sheets until it crystallized. The patient presented with no significant physical markings or findings but claimed to have his suicidal ideations precipitated by concerns of ill effects of pyrethroid on his health. He also had positive urine drug screen for methamphetamine, which he admitted to using on the day of admission. We conclude that it is important for physicians to maintain a high level of suspicion for alternate and uncommon substances of abuse as well as risks for suicidal tendencies in these patients.
Namat Sotodeh Asl
Full Text Available Introduction: Substance abuse is one of the most common disorders that exert a high impact on the life of patients and their families. There are many treatment methods for Addiction. The purpose of the present study was to determine the effects of narcotics anonymous (NA program on personality characters in substance abuse patients.Materials and Methods: This quasi experimental design was performed on 100 patients with substance abuse disorders that they had been randomly selected from those patients who were referred to psychiatric clinics and counseling centers in Esfehan in 2008. Then, the subjects were equally divided into two groups; experimental and control. All the patients carried out Eysenk test prior to any intervention and also a demographic questionnaire were filled out by all the subjects. Then, Eysenk test was performed on all the patients following the intervention. Changing in personality character in the experimental group (before and after the intervention was compared with those of the control group. Results: The findings showed that narcotic program has significant effects on personality characters of experimental group to substance abuse in post test, but these effects are not significant in control group.Conclusion: According to the findings of this work, we suggest the effectiveness of NA program in changing personality characters of the patients with substance abuse
Evans, Elizabeth; Grella, Christine E; Murphy, Debra A; Hser, Yih-Ing
The utilization of administrative data in substance abuse research has become more widespread than ever. This selective review synthesizes recent extant research from 31 articles to consider what has been learned from using administrative data to conduct longitudinal substance abuse research in four overlapping areas: (1) service access and utilization, (2) underrepresented populations, (3) treatment outcomes, and (4) cost analysis. Despite several notable limitations, administrative data contribute valuable information, particularly in the investigation of service system interactions and outcomes among substance abusers as they unfold and influence each other over the long term. This critical assessment of the advantages and disadvantages of using existing administrative data within a longitudinal framework should stimulate innovative thinking regarding future applications of administrative data for longitudinal substance abuse research purposes.
... Families - Vietnamese Substance Abuse Treatment For Children And Adolescents: Questions To Ask No. 41; Reviewed July 2013 Many children and adolescents use alcohol and other drugs. Some develop serious ...
Breda, Carolyn; Heflinger, Craig Anne
While interest in understanding the incentives to change among individuals with substance abuse disorders is growing, little is known about incentives among adolescents with substance abuse disorders who are participating in formal services. The present research assesses the degree and nature of motivation and treatment readiness among adolescents admitted to substance abuse services, and whether such factors vary across significant subgroups of youth based on their social, legal, or clinical profiles. Data are based on interviews with 249 youth between 12 and 18 years of age who have been admitted to either inpatient, residential, or outpatient substance abuse treatment. Measures are adapted from an instrument developed to assess multiple domains of motivation to change (e.g., intrinsic and extrinsic motivation, treatment readiness). Results suggest that the incentive to change among adolescents with substance-abusing behavior is modest at best, regardless of dimension. Nonetheless, ethnicity, type of substance use, and psychopathology significantly predict incentives to change, though the predictors depend on which dimension is considered. The most robust predictor of incentives is the severity of negative consequences associated with youth's substance use--the greater the severity, the greater the incentives. Findings underscore the need to examine the utility and dimensionality of incentive for treatment planning, while at the same time, they identify factors that treatment planners can consider as they seek ways to enhance incentives and help adolescents with substance use disorders attain positive outcomes.
King, M C; Ryan, J
Our society abounds with myths and misperceptions in relation to the battering of women. These myths impede the identification of women who are experiencing violence and abuse, and inhibit appropriate intervention. Abuse is not too private a matter to assess for, nor does abuse affect only poor black or Hispanic women. No woman deserves to be beaten. Women do not like or seek out abuse. Abused women are courageous, competent women; what abused women have in common is that they are threatened and controlled by a male partner and live under the constant fear of violence and abuse. Raising one's consciousness about the victimization and oppression of women in our society, and uncovering the myths which leave practitioners powerless and ineffective agents of change for women are important tasks for health care providers. By focusing attention on this enormous health problem, clinicians can provide a leadership role in using health care responses that actually empower women to take control of their own lives.
Kadkhodaei M.* MSc,
Full Text Available Aims Drug addiction is a mental, social, and economic problem that comes from abnormal and illicit consumption of substances such as alcohol, opium, hashish, and etc., making the addict psychologically and physiologically dependent to those substances. This study was designed and performed to evaluate the pattern of drug abuse change in the addicts visiting addiction treatment centers of Kashan City, Iran. Instrument & Methods This retrospective descriptive research was performed on 4066 persons referred to addiction treatment and harm reduction therapy centers, monitored by Kashan University of Medical Sciences, during 2004 to 2008. After coding, data were entered into the SPSS 16 software. Chi-square and one-way ANOVA was used to analyze the data. Findings The main reasons of the tendency to drugs were not having fun (72.5%, family problems (55% and not having knowledge (22.7%. The use of opium was the highest in all the years while the crack was used by 7.1% of drug addicts in 2004 and increased to 76% in 2007. 92.8% of drug abuses were through fumigation, 33.7% through injection, 48% orally and 8.6% through inhalants. Conclusion Youths are the most vulnerable age group to drug addiction. Easy access to illegal drugs, wrong friends, and curiosity are of the significant factors spreading drug addiction.
Solis, Jessica M.; Shadur, Julia M.; Burns, Alison R.; Hussong, Andrea M.
In this review, we consider the potential service needs of children of substance abusing parents based on what we know about the risk outcomes faced by these children and the parenting deficits often present in these families. Importantly, our review does not address the etiological role of parental substance abuse in children's negative outcomes but instead we discuss the complex inter-related risk factors that often co-occur with and exacerbate risk associated with parental alcohol and drug use. We first review studies showing the elevated risk that children of substance abusing parents face in general for poorer academic functioning; emotional, behavioral, and social problems; and an earlier onset of substance use, faster acceleration in substance use patterns, and higher rates of alcohol and drug use disorders. We then review studies showing contextual risk factors for children of substance abusing parents, including parenting deficits (less warmth, responsiveness, and physical and verbal engagement as well as harsher and more over-involved interaction styles), greater risk for child maltreatment, and less secure attachment patterns. We conclude with a discussion of future directions for research and guidelines for professionals working with children and their families where parental substance abuse is present. PMID:22455509
Full Text Available There has been an increase in the frequency of substance abuse among hospitalized burn injury patients. However, few studies have investigated substance abuse among burn patients. This study was aimed to identify the incidence of substance abuse in burn injury patients using the "Drug Abuse Screening Test" (DAST-20. We determined the validity of DAST-20 in spring 2010. Subsequently, this descriptive study was performed on 203 burn injury patients who fit the study's inclusion criteria. We chose a score of 6 as the cutoff and thus achieved a sensitivity of 89% and a specificity of 85% for the DAST-20. During the study, we gathered demographic data, burn features and DAST-20 results for all patients. Patients with scores of 6 or more were considered to be substances abusers. A statistical analysis was conducted using SPSS v16 software. According to the DAST-20 results, 33% of the patients were in the user group. The mean score of DAST-20 was significantly higher among users than it was among nonusers (P<0.05. The level of substance abuse was severe in 77% of users. No significant differences were found among the substances, with the exception of alcohol. Substance abuse is an important risk factor for burn patients. In addition, this study showed that DAST-20 is a valid screening measure for studies on burn patients.
Hojjat, Seyed Kaveh; Golmakani, Ebrahim; Norozi Khalili, Mina; Shakeri Chenarani, Maryam; Hamidi, Mahin; Akaberi, Arash; Rezaei Ardani, Amir
Parental substance abuse confronts children with a variety of psychological, social, and behavioral problems. Children of substance abusing parents show higher levels of psychiatric disorders including anxiety and depression and exert lower levels of communication skills. Weak social skills in this group of adolescents put them at a higher risk for substance abuse. Many studies showed school based interventions such as life skill training can effective on future substance abusing in these high risk adolescences. The participants consisted of 57 middles schools girls, all living in rural areas and having both parents with substance dependency. The participants were randomly assigned to intervention (n=28) and control (n=29) groups. The data were collected before and six weeks after training in both group. The intervention group received eight sessions of group assertiveness training. Participants were compared in terms of changes in scores on the Oxford Happiness Questionnaire and the Gambrills-Richey Assertion Inventory. The total score for happiness change from 43.68 ±17.62 to 51.57 ±16.35 and assertiveness score changed from 110.33±16.05 to 90.40±12.84. There was a significant difference in pretest-posttest change in scores for intervention (7.89±4.13) and control (-2.51±2.64) groups; t (55) =2.15, p = 0.049. These results suggest that intervention really does have an effect on happiness and assertiveness. Determining the effectiveness of these school based interventions on other life aspects such as substance abuse calls for further study on these rural adolescent girls.
Hayakawa, Momoko; Giovanelli, Alison; Englund, Michelle M; Reynolds, Arthur J
By the 12th grade, half of American adolescents have abused an illicit drug at least once (Johnston et al., 2015). Although many substance misuse prevention programs exist, we propose an alternative mechanism for reducing substance use. There is evidence that parent involvement is related to reductions in children's behavior problems which then predict later substance abuse. We examine the Child-Parent Center (CPC) program, an early childhood intervention, as a strategy to impact substance abuse. We conducted a path analysis from CPC to parent involvement through early adolescent problem behaviors and competencies to young adult substance abuse. Participants (N = 1,203; 51.5% female; 93.8% African-American) were assessed from age 3 to 26 years. CPC participation initiates a pathway to increased parent involvement and expectations, which positively impact adolescents' competencies and problem behaviors, lowering rates of substance abuse. Through early childhood education, increasing early parental involvement and expectations can alter life-course outcomes by providing children with a foundation for positive behaviors and encouraging adaptive functioning in adolescence. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.
Oshri, Assaf; Kogan, Steve M; Kwon, Josephine A; Wickrama, K A S; Vanderbroek, Lauren; Palmer, Abraham A; MacKillop, James
Emerging developmental perspectives suggest that adverse rearing environments promote neurocognitive adaptations that heighten impulsivity and increase vulnerability to risky behavior. Although studies document links between harsh rearing environments and impulsive behavior on substance use, the developmental hypothesis that impulsivity acts as mechanism linking adverse rearing environments to downstream substance use remains to be investigated. The present study investigated the role of impulsivity in linking child abuse and neglect with adult substance use using data from (a) a longitudinal sample of youth (Study 1, N = 9,421) and (b) a cross-sectional sample of adults (Study 2, N = 1,011). In Study 1, the links between child abuse and neglect and young adult smoking and marijuana use were mediated by increases in adolescent impulsivity. In Study 2, indirect links between child abuse and neglect and substance use were evidenced via delayed reward discounting and impulsivity traits. Among impulsivity subcomponents, robust indirect effects connecting childhood experiences to cigarette use emerged for negative urgency. Negative urgency, positive urgency, and sensation seeking mediated the effect of child abuse and neglect on cannabis and alcohol use. Results suggest that child abuse and neglect increases risk for substance use in part, due to effects on impulsivity. Individuals with adverse childhood experiences may benefit from substance use preventive intervention programs that target impulsive behaviors.
Rapp, Richard C.; Li, Li; Siegal, Harvey A.; DeLiberty, Richard N.
Examines the role of motivation in substance abusers' acceptance of treatment and its relation to treatment outcomes. Better motivation was consistently associated with severity of substance use. Motivation was not related to alcohol and drug use severity six months later. Severity associated with motivation at entry was not related to clients'…
Substance abuse in outpatients attending rural and urban health centres in Kenya. ... Objectives: To estimate the prevalence and pattern of substance use among patients attending primary health centres in urban and rural areas of Kenya. Design: A ... Socio-cultural factors might be responsible for the differences noted.
Nuttbrock, Larry A
Transgender individuals are misunderstood and inadequately treated in many conventional substance abuse treatment programs. This article reviews current concepts regarding the definition and diversity of transgenderism and summarizes the existing literature on the prevalence and correlates of substance use in transgendered populations. Examples of culturally competent and gender-sensitive treatment in specialized settings are cited, with a call to extend these initiatives throughout the gamut of service venues that engage transgender individuals. Cultural competence combined with gender sensitivity should improve the effectiveness of substance abuse treatment for transgender individuals and will contribute to the goal of providing effective services in an increasingly diverse society.
... is a term for when someone experiences a mental illness and a substance use disorder simultaneously. Either disorder—substance use or mental illness—can develop first. People experiencing a mental health ...
Ryan, Joseph P.; Marsh, Jeanne C.; Testa, Mark F.; Louderman, Richard
Alcohol and other drug abuse is a major problem for children and families involved with public child welfare. Substance abuse compromises appropriate parenting practices and increases the risk of child maltreatment. A substantial proportion of substantiated child abuse and neglect reports involve parental substance abuse. Once in the system,…
as the basic principle in social law. This does not mean, however, that the use of coercive measures is removed from social law. In this paper our focus is on two social groups who historically have been the target of comprehensive compulsory interventions – adult substance abusers and mentally disabled people...
Corvo, Kenneth; Williams, Kimberly
Study represents one of the first undertaken exclusively with students who brought weapons to school. Questions examined measures of student and family relationships, as well as attitudes and behavior among students caught with weapons at school. Findings support the need for substance abuse assessments and family interventions that strengthen…
Engle, Brett; Macgowan, Mark J.; Wagner, Eric F.; Amrhein, Paul C.
Objectives: Despite their popularity, little is known about what distinguishes effective from ineffective or even iatrogenic adolescent group interventions. Methods: Audio recordings and transcripts from 19, 8-10 session, school-based treatment groups comprised of 108, substance abusing 10- to 19-year olds were analyzed. "Group leader empathy" was…
Stevens, Sally J; Andrade, Rosi A C; Ruiz, Bridget S
Historically, data has shown that a smaller percentage of women use alcohol and illicit substances compared to men, and that frequency of use has been lower among women compared to use among men. Although this data on usage may be true, researchers also acknowledge that substance use among women has been a hidden issue, one not realistically acknowledged by society, especially prior to the mid-1960s. Along with this, more recent data indicates that rates of substance use among women are increasing. Factors contributing to this increase in substance abuse have begun to receive considerable attention, and recent research suggests that many issues exist that are unique to substance use among women. The purpose of this article is to discuss gender specific considerations in women's substance abuse by examining the history of substance use among women; analyzing gender-specific factors, including physiological factors, trauma-related factors, mental health issues, and cultural considerations that impact on women's substance use; articulating treatment approaches for working with substance abusing women and girls; and providing recommendations for further research in this area.
Mesic, Salih; Ramadani, Sokolj; Zunic, Lejla; Skopljak, Amira; Pasagic, Almir; Masic, Izet
Drug addiction is one of the most prominent problems in many countries in transition, including Bosnia and Herzegovina. Age limit of drug addiction is shifted to the younger age groups, especially is troubling the increase in number of injection drug users. Our study was aimed to investigate the habits, attitudes and practices related to drug use among young people from the area of Sarajevo city. We can still feel the effects of the war, among which are the most important life without closest relatives, banishment and various types of war and post-war trauma. To determine the frequency of substance abuse among adolescents; Identify potentially relevant biological, psychological and socio economic characteristics of the adolescents; To explore adolescents attitudes towards drug use; Examine the general level of knowledge of adolescents about drugs and their effects. The study was conducted on randomized sample of 502 students in two primary and three secondary schools in Sarajevo and Gracanica. To study used survey method. Survey instrument was a self-made questionnaire with the research variables. The obtained data were processed by a computer and statistically correlated. The study is of combined, retrospective, prospective and transversal type. To the question "How many times have you consumed cannabis in the last 30 days" about 6% of the respondents have tried once or twice, while 1.5% use it daily, ecstasy have tried one or two times 2.25%, while 0.5% have daily use. Based on the obtained results it can be concluded that students at schools in Sarajevo consumed drugs 50% more than the children in Gracanica. Analyzing the age at which the subjects consumed the drug for the first time, we came to the conclusion that in the third year of high school only 8% of adolescents have tried any drugs before they turned 15 years. This percentage among eighth graders is about three times higher. Presented research results clearly suggest a strong contamination of the living
Oct 17, 2010 ... family background, and knowledge of drugs and drug abuse. At the end of ... outside the school. This unfortunate, anti social behaviour therefore, calls for. Vol. .... This is necessary because knowledge is power. Information is ...
Full Text Available Abstract Background Completion of substance abuse treatment is a proximal indicator of positive treatment outcomes. To design interventions to improve outcomes, it is therefore important to unpack the factors contributing to treatment completion. To date, substance abuse research has not examined the factors associated with treatment completion among poor, disadvantaged communities in developing countries. This study aimed to address this gap by exploring client-level factors associated with treatment completion among poor communities in South Africa. Methods Secondary data analysis was conducted on cross-sectional survey data collected from 434 persons residing in poor communities in Cape Town, South Africa who had accessed substance abuse treatment in 2006. Results Multiple regression analyses revealed that therapeutic alliance, treatment perceptions, abstinence-specific social support, and depression were significant partial predictors of treatment completion. Conclusions Findings suggest that treatment completion rates of individuals from poor South African communities can be enhanced by i improving perceptions of substance abuse treatment through introducing quality improvement initiatives into substance abuse services, ii strengthening clients' abstinence-oriented social networks and, iii strengthening the counselor-client therapeutic alliance.
Dévieux, Jessy G; Jean-Gilles, Michèle; Rosenberg, Rhonda; Beck-Sagué, Consuelo; Attonito, Jennifer M; Saxena, Anshul; Stein, Judith A
Substance-abusing pregnant and postpartum women are less likely to maintain consistent condom use and drug and alcohol abstinence, which is particularly concerning in high HIV-prevalence areas. Data from 224 pregnant and postpartum women in substance abuse treatment were analyzed to examine effects of history of substance use, child abuse, and mental health problems on current substance use and condom-use barriers. Mediators were depression, relationship power and social support. Most participants (72.9 %) evidenced current depression. Less social support (-0.17, p power (-0.48, p power (0.15, p power limit highest-risk women's ability to negotiate condom use and abstain from substance use, increasing their risk of acute HIV infection and vertical transmission.
Heck, Nicholas C.; Sorensen, James L.
Little is known about the needs or characteristics of transgender individuals in substance abuse treatment settings. Transgender (n=199) and non-transgender (cisgender, n=13440) individuals were compared on psychosocial factors related to treatment, health risk behaviors, medical and mental health status and utilization, and substance use behaviors within a database that documented individuals entering substance abuse treatment in San Francisco, CA from 2007–2009 using logistic and linear regression analyses (run separately by identified gender). Transgender men (assigned birth sex of female) differed from cisgender men across many psychosocial factors, including having more recent employment, less legal system involvement, greater incidence of living with a substance abuser, and greater family conflict, while transgender women (assigned birth sex of male) were less likely to have minor children than cisgender women. Transgender women reported greater needle use and HIV testing rates were greater among transgender women. Transgender men and women reported higher rates of physical health problems, mental health diagnoses, and psychiatric medications but there were no differences in service utilization. There were no differences in substance use behaviors except that transgender women were more likely to endorse primary methamphetamine use. Transgender individuals evidence unique strengths and challenges that could inform targeted services in substance abuse treatment. PMID:24561017
Full Text Available The research aimed to investigate the phenomena of adolescent depressive symptomology, substance abuse and the relationship between the two phenomena in a South African context. The influence of moderator variables was also examined. Another objective was to determine risk factors for the before mentioned. This was done by using a questionnaire with a sample of 1298 conveniently selected adolescents in a South African high school. It was determined that adolescents become progressively unhappier from 13 to 17 years of age. Girls are more depressed than boys. This research also revealed that adolescent depressive symptomology is significantly and positively correlated with earlier age of onset of substance abuse as well as frequency of usage. There appear to be no gender differences in substance abuse but teenagers from different ethnic and language groups differ in their use of substances. Risk factors for depression and substance abuse included a conflict relationship with parents, the experience of major stressful events, dissatisfaction with school grades and friends’ use of substances.
Characteristics of substance abuse treatment programs providing services for HIV/AIDS, hepatitis C virus infection, and sexually transmitted infections: the National Drug Abuse Treatment Clinical Trials Network.
Brown, Lawrence S; Kritz, Steven Allan; Goldsmith, R Jeffrey; Bini, Edmund J; Rotrosen, John; Baker, Sherryl; Robinson, Jim; McAuliffe, Patrick
Illicit drug users sustain the epidemics of human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS), hepatitis C (HCV), and sexually transmitted infections (STIs). Substance abuse treatment programs present a major intervention point in stemming these epidemics. As a part of the "Infections and Substance Abuse" study, established by the National Drug Abuse Treatment Clinical Trials Network, sponsored by National Institute on Drug Abuse, three surveys were developed; for treatment program administrators, for clinicians, and for state and District of Columbia health and substance abuse department administrators, capturing service availability, government mandates, funding, and other key elements related to the three infection groups. Treatment programs varied in corporate structure, source of revenue, patient census, and medical and non-medical staffing; medical services, counseling services, and staff education targeted HIV/AIDS more often than HCV or STIs. The results from this study have the potential to generate hypotheses for further health services research to inform public policy.
Ducharme, Lori J; Chandler, Redonna K; Harris, Alex H S
The National Institute on Alcohol Abuse and Alcoholism (NIAAA), National Institute on Drug Abuse (NIDA), and Veterans Health Administration (VHA) share an interest in promoting high quality, rigorous health services research to improve the availability and utilization of evidence-based treatment for substance use disorders (SUD). Recent and continuing changes in the healthcare policy and funding environments prioritize the integration of evidence-based substance abuse treatments into primary care and general medical settings. This area is a prime candidate for implementation research. Recent and ongoing implementation projects funded by these agencies are reviewed. Research in five areas is highlighted: screening and brief intervention for risky drinking; screening and brief intervention for tobacco use; uptake of FDA-approved addiction pharmacotherapies; safe opioid prescribing; and disease management. Gaps in the portfolios, and priorities for future research, are described. Published by Elsevier Inc.
Full Text Available Objective:The aim of this study was to investigate the relationship between experiencing household dysfunction and substance abuse in adulthood among Jamaican university students. Methods: This was a cross-sectional study which consisted of university students who were 18 years or older. Systematic sampling techniques were utilized to identify participants spanning across all faculties of a single university. The questionnaire utilized for this study included questions from several standardized scales: Kessler Psychological Distress Scale (K10, the Inter-American Drug Abuse Control Commission/Organization of American States (CICAD/OAS drug use questionnaire and the household dysfunction scale from the Adverse Childhood Experiences (ACE questionnaire. Results:A total of 382 students participated in the study (279 females and 103 males. More than a third of the students (38.9% reported substance use, with 13.6% being substance abusers. Seven of every ten respondents were raised in a dysfunctional household. A significant positive relationship was observed between household dysfunction and substance abuse, where higher levels of household dysfunction were found to be associated with substance abuse: χ2 (2, n = 382 = 7.685, p < 0.05. Additionally, witnessing a mother or caregiver being violently treated, living with an alcoholic family member or a household member who attempted suicide was found to be associated with substance abuse during adulthood. Conclusion:These findings highlight the role of household dysfunction as a serious risk factor for adult drug abuse and can be used to help guide and inform drug prevention and intervention strategies.
Looman, Jan; Abracen, Jeffrey
There has been relatively little research on the degree to which measures of lifetime history of substance abuse add to the prediction of risk based on actuarial measures alone among sexual offenders. This issue is of relevance in that a history of substance abuse is related to relapse to substance using behavior. Furthermore, substance use has…
Riger, Stephanie; Bennett, Larry W; Sigurvinsdottir, Rannveig
Substance abuse commonly co-occurs with intimate partner violence among both perpetrators and survivors. Specialized courts that focus on intimate partner violence provide a unique opportunity to address both problems simultaneously, but research has yet to identify whether this happens. In this qualitative study of a domestic violence court in a large midwestern metropolitan area, key informants were interviewed to understand how the Court treats substance abuse. Results indicate that substance abuse typically is not identified among perpetrators or survivors going through the Court unless it is mentioned in a police report. Barriers to such identification are the organization of the Court, bounded definition of actors' roles in the Court, limited resources, and negative attitudes towards survivors. These results suggest that specialized courts that attend to only one problem may overlook the possibility of addressing issues that commonly co-occur.
Dual-diagnosis mentally ill patients, i.e. those characterized with substance abuse problems combined with mental health problems, are a challenge both for systems treating substance abusers and for mental health services. These patients are not easily integrated in either of these healthcare systems and/or are treated only for one aspect of their problem by each of these systems. For such patients it is necessary to create a separate treatment model, combining care of the problem of substance abuse and attention to the patient's mental pathology, according to his individual personality traits. For purposes of this programme a treatment setting operating on the model of a therapeutic community is proposed. This setting will open an affiliated treatment programme for dual-diagnosed patients in a separate treatment programme that is not part of the therapeutic community but will be affiliated with it and will accept dual-diagnosis patients.
Tompsett, Carolyn J; Domoff, Sarah E; Toro, Paul A
Adolescents who experience homelessness are at higher risk for abusing substances, and for being exposed to substance-using peers. The current study used a longitudinal design to track substance abuse, affiliation with substance-using peers, and episodes of homelessness among a sample of 223 adolescents who were housed at the baseline data collection and 148 adolescents who were housed at baseline. Participants were interviewed at six waves over 6.5 years, covering an age range from 13 to 25. Many participants experienced a recurrence of homelessness during follow-up, with 64.6 % of the baseline homeless group and 22.6 % of the baseline housed group reporting an additional episode of homelessness. Both alcohol abuse and other drug abuse symptoms showed an increase in adolescence followed by slowing in early adulthood. Recent homelessness and friend alcohol use predicted alcohol abuse symptoms, and the strength of the influence of friend use decreased over time. Recent homelessness and friend drug use predicted other drug abuse symptoms. Duration of the initial episode of adolescent homelessness showed no influence on substance abuse over time, or the effects of other predictors, highlighting the importance of conceptualizing the experience of homelessness as a recent stressor rather than an enduring personal characteristic.
Baker, Philip R A; Francis, Daniel P; Hairi, Noran N; Othman, Sajaratulnisah; Choo, Wan Yuen
Maltreatment of older people (elder abuse) includes psychological, physical, sexual abuse, neglect and financial exploitation. Evidence suggests that 10% of older adults experience some form of abuse, and only a fraction of cases are actually reported or referred to social services agencies. Elder abuse is associated with significant morbidity and premature mortality. Numerous interventions have been implemented to address the issue of elder maltreatment. It is, however, unclear which interventions best serve to prevent or reduce elder abuse. The objective of this review was to assess the effectiveness of primary, secondary and tertiary intervention programmes used to reduce or prevent abuse of the elderly in their own home, in organisational or institutional and community settings. The secondary objective was to investigate whether intervention effects are modified by types of abuse, types of participants, setting of intervention, or the cognitive status of older people. We searched 19 databases (AgeLine, CINAHL, Psycinfo, MEDLINE, Embase, Proquest Central, Social Services Abstracts, ASSIA, Sociological Abstracts, ProQuest Dissertations & Theses Global, Web of Science, LILACS, EPPI, InfoBase, CENTRAL, HMIC, Opengrey and Zetoc) on 12 platforms, including multidisciplinary disciplines covering medical, health, social sciences, social services, legal, finance and education. We also browsed related organisational websites, contacted authors of relevant articles and checked reference lists. Searches of databases were conducted between 30 August 2015 and 16 March 2016 and were not restricted by language. We included randomised controlled trials (RCTs), cluster-randomised trials, and quasi-RCTs, before-and-after studies, and interrupted time series. Only studies with at least 12 weeks of follow-up investigating the effect of interventions in preventing or reducing abuse of elderly people and those who interact with the elderly were included. Two review authors
Full Text Available Objectives: This paper describes the components of the Caribbean Institute on Alcoholism and Other Drug Problems (CARIAD, a long-standing substance abuse training programme. It seeks to explain how certain strategies and pedagogic techniques may be contributing to its success. Methods: Authors deconstruct the core elements of CARIAD to demonstrate how the programme effectively meets the characteristics of a community of practice. The processes used to develop the learning community and the specific pedagogic strategies and techniques that foster collaborative knowledge construction and sharing are described. Results: Caribbean Institute on Alcoholism and Other Drug Problems brings together a multi-disciplinary, multi-national group of individuals with interest in substance abuse. The programme provides a range of formal and informal learning activities which focus on sharing best practices and creating new sociocultural relevant knowledge to advance the domain of professional practice in substance abuse. The components of CARIAD promote interactivity, rapid bonding and a sense of identity. Caribbean Institute on Alcoholism and Other Drug Problems provides a unique platform for cultural sharing that gives participants an opportunity to reveal insights into local and regional expressions of substance abuse challenges. Participants, however, recognize the absence of structured continuity and the diminution of what could be accomplished by graduates over time. Conclusion: The success of CARIAD as a regional learning platform may be related to its success as a Caribbean community of practice for substance abuse. Caribbean Institute on Alcoholism and Other Drug Problems would do well to sustain the community of practice, generating and maintaining ongoing participation and collaboration among graduates. This can potentially serve to create new strategies for advancing the region in the area of substance abuse.
Columbia Univ., New York, NY. National Center on Addiction and Substance Abuse.
This report takes a comprehensive look at the connections between alcohol, drug use, and sex. Two national data sets on more than 34,000 teenagers and two sets on arrested and incarcerated sex offenders were analyzed. A review of the literature, interviews with experts, and an examination of programs aimed at prevention of abuse were included in…
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Martin, Sandra L; Moracco, Kathryn E; Chang, Judy C; Council, Carol L; Dulli, Lisa S
This article discusses the results of a survey of North Carolina domestic violence programs that found that substance abuse problems are common among program clients, yet only half of the programs had policies concerning substance-abusing clients, and one fourth had memoranda of agreement with substance abuse treatment providers. Most programs with shelters asked clients about substance use; however, one third of the shelters would not admit women if they were noticeably under the influence of substances while seeking shelter residence, instead referring them to substance abuse programs. Approximately one tenth of the domestic violence programs did not have any staff or volunteers with training in substance abuse issues. Implications are discussed.
Gonzalez-Guarda, Rosa Maria; Vasquez, Elias P.; Urrutia, Maria T.; Villarruel, Antonia M.; Peragallo, Nilda
Hispanic females are disproportionately affected by substance abuse, intimate partner violence, and HIV. Despite these disparities, research describing the cultural and gender-specific experiences of Hispanic women with regard to these conditions is lacking. The purpose of this study is to describe the experiences that Hispanic community-dwelling women have with regard to substance abuse, violence, and risky sexual behaviors. Eight focus groups with 81 women were conducted. A bilingual, bicultural moderator asked women open-ended questions regarding the experiences that Hispanic women have with these conditions. Focus groups were audiotaped, transcribed, translated, verified, and then analyzed using qualitative content analysis. Participants discussed substance abuse, violence, and risky sexual behaviors interchangeably, often identifying common risk factors associated with these. Nevertheless, intimate partner violence was the most salient of conditions discussed. Three major themes emerged from the analysis: Transplantadas en otro mundo (Uprooted in another world), El criador de abuso (The breeding ground of abuse), and Rompiendo el silencio (Breaking the silence). This study supports the importance of addressing substance abuse, violence, and risk for HIV in an integrated manner and stresses the importance of addressing associated cultural factors (e.g., acculturation, machismo) in interventions targeting Hispanics. PMID:21191036
Seyed Hadi Marjaei
Full Text Available This paper tries to study the status of tendency toward drug and alcohol abuse among university students and makes a comparison between native (from Tehran and non-native (from other parts of Iran who stay in dorms. This study is a secondary analysis which uses previous data from other grand researches that have been done among different universities in Tehran. According to the data based on these researches (Serajzade, 2002 and (Serajzade, ET, al. 2001 the eminence of native and non-native student are compared and analyzed. In this study the data is analyzed using SPSS through variety of tests such as T-test, Variation analysis, correlations and so on. The results show that among 28 indicators of different pathological problems relating to drug abuse, non-native students are more involved with drugs in 13 indicators while native students are more engage in 8 indicators and there are 7 indicators that engage both groups equally.
van den Bosch, L. M.; Verheul, R.; van den Brink, W.
This work examines differences between female borderline patients with and without substance abuse problems and between borderline patients from different treatment settings. A total of 64 female borderline patients were recruited from mental health services (n = 34) and addiction treatment services
Staton, Michele; Leukefeld, Carl; Logan, T. K.; Purvis, Rick
Presents findings from a process evaluation conducted in a prison-based substance abuse program in Kentucky. Discusses key components in the program, including a detailed program description, modifications in planned treatment strategies, program documentation, and perspectives of staff and clients. Findings suggest that prison-based programs have…
Rhemtulla, M.; Fried, E.I.; Aggen, S.H.; Tuerlinckx, F.; Kendler, K.S.; Borsboom, D.
Background: The DSM uses one set of abuse and dependence criteria to assess multiple substance use disorders (SUDs). Most SUD research aggregates across these symptoms to study the behavior of SUD as a static construct. We use an alternative approach that conceptualizes symptoms as directly
present study is to study some social factors of street children in Guwahati city and to ascertain ... substance abuse with duration of street life was found to be highly significant. Majority of .... According to the review by researchers from Moi University .... and personal social networks of the “on” the street, “of” the street, shelter ...
Goodwin, Lloyd R., Jr.; Sias, Shari M.
Students from a master's program in Substance Abuse and Clinical Counseling (SACC) at a midsize southeastern university were surveyed to determine personal characteristics and career goals. Sixty-two of the 68 students currently enrolled in the program volunteered to anonymously complete the questionnaire. The typical profile of the SACC student…
Vik, Peter W.; And Others
Examined social resource network characteristics of adolescent substance abusers (n=19). Perceived similarity to one's social network emerged as important moderator of whether social network provided support to remain abstinent or elevated risk for relapse. Increased perceived support predicted continued posttreatment abstinence when recovering…
... and mental health benefits for more than 60 million Americans. And beginning this month, those who... people, families, and neighborhoods free from drug and alcohol abuse. I encourage parents, schools... Proclamation Today, too many Americans face futures limited by substance use, which threatens health, safety...
Substance abuse is a major social problem and concern for counselors. It is the most prevalent mind disorder encompassing some 40% of the diagnoses in the DSM-IV, the number one continuing health problem, and the number one prison problem in the United States. Yet, school, rehabilitation, and mental health counselor education programs do not…
Salomonsen-Sautel, Stacy; Sakai, Joseph T.; Thurstone, Christian; Corley, Robin; Hopfer, Christian
Objective: To assess the prevalence and frequency of medical marijuana diversion and use among adolescents in substance abuse treatment and to identify factors related to their medical marijuana use. Method: This study calculated the prevalence and frequency of diverted medical marijuana use among adolescents (n = 164), ages 14-18 years (mean age…
Rieckmann, Traci; Fussell, Holly; Doyle, Kevin; Ford, Jay; Riley, Katherine J.; Henderson, Stuart
Substance abuse treatment agencies serving youth face unique barriers to providing quality care. Interviews with 17 adolescent programs found that family engagement, community involvement, and gender and diversity issues affected treatment delivery. Programs report organizational change efforts with implications for future process improvement…
Wolf, Barry M.
A phenomenological investigation was conducted to examine the causal factors of adolescent substance abuse. Results indicated the adolescent substance abuser sees life as a struggle, sees self as an outsider, feels powerless and uses drugs to cope with anxiety. (RC)
A sample of 50 (36 male and 14 female) street children currently in a remand home at Kabete in Nairobi, Kenya, were interviewed using a predesigned questionnaire in order to estimate prevalence rates for use of selected substances. The lifetime prevalence rates of the drugs most commonly used were volatile ...
Petersen, Lone; Jeppesen, Pia; Thorup, Anne
To evaluate whether integrated treatment (given by OPUS), in comparison with standard treatment, significantly reduced the number of patients with substance abuse and improved clinical and social outcome in the group of substance abusers after 2 years.......To evaluate whether integrated treatment (given by OPUS), in comparison with standard treatment, significantly reduced the number of patients with substance abuse and improved clinical and social outcome in the group of substance abusers after 2 years....
Yu, Jennifer W; Buka, Stephen L; Fitzmaurice, Garrett M; McCormick, Marie C
This paper assesses whether chemically dependent adolescents with comorbid learning disorders (LDs) derived less effective treatment results when compared to chemically dependent adolescents without LD and examines the moderating effects of prior treatments, treatment length, and treatment completion. Two hundred one adolescents were recruited between 1992 and 1993 from Massachusetts residential treatment centers and subsequently followed up 6 months after enrollment. Compared to chemically dependent teenagers without LD, those with LD were twice as likely to re-use substances at least once by follow-up. LD teenagers were more likely to attend Alcoholics/Narcotics Anonymous if they had prior admissions to treatment programs and longer treatment length. LD teenagers who completed treatment also experienced a greater decrease in current depression compared to LD teenagers not completing the treatment. This study is the first to consider outcomes of substance abuse treatment for adolescents with LD and contributes to the growing literature on comorbidity and substance abuse treatment.
Tashkin, D P
After tobacco, marijuana is the most widely smoked substance in our society. Studies conducted within the past 15 years in animals, isolated tissues, and humans indicate that marijuana smoke can injure the lungs. Habitual smoking of marijuana has been shown to be associated with chronic respiratory tract symptoms, an increased frequency of acute bronchitic episodes, extensive tracheobronchial epithelial disease, and abnormalities in the structure and function of alveolar macrophages, key cell...
Othman Mohamad Hashim
Full Text Available Urinalysis was used in previous studies among higher institution students (n=16252 in Malaysia to answer the question of whether university students are involved in drug abuse. However, the use of urinalysis had faced some problems. The problems were related to human rights issues and the cost to perform the urinalysis was expensive and quite impossible to be implemented to a large population of university students. To overcome this problem, this study was conducted to examine the effectiveness of psychometric measures in screening drug, alcohol and substance abuse. The Substance Abuse Subtle Screening Inventory A2 (SASSI-A2 was used for this purpose. SASSI-A2 is a brief screening tool designed to identify individuals who have a high probability of having a substance use disorder, including both substance abuse and substance dependence. SASSI-A2 comprises of 72 items that are rated on a two point scale with response; true and false. SASSI-A2 was translated into Malay language and it was refined through a back-translation technique and focus group approach. Psychometric testing was undertaken on a sample of 750 university students from five public universities in Malaysia. All participants were aged between 19 and 20 years. Internal consistency coefficients were calculated for the total scale and its subscales. Chronbach's alpha obtained for SASSI-A2 was 0.72. This relatively high level of Chronbach's alpha showed relatively high level of reliability. The results demonstrated that the whole SASSI-A2 meets the fundamental measurement properties and can discriminate groups of higher institution students from high to low on the substance dependency variable. The accuracy of the test has been found to be unaffected by gender, ethnicity, age and years of education. Although more rigorous validation studies are needed, it is recommended that SASSI-A2 be considered for usage to higher institution students populations when a brief, objective, and
Full Text Available Abstract Background Despite high levels of substance use disorders in Cape Town, substance abuse treatment utilization is low among people from disadvantaged communities in Cape Town, South Africa. To improve substance abuse treatment utilization, it is important to identify any potential barriers to treatment initiation so that interventions to reduce these barriers can be implemented. To date, substance abuse research has not examined the factors associated with substance abuse treatment utilization within developing countries. Using the Behavioural Model of Health Services Utilization as an analytic framework, this study aimed to redress this gap by examining whether access to substance abuse treatment is equitable and the profile of variables associated with treatment utilization for people from poor communities in Cape Town, South Africa. Methods This study used a case-control design to compare 434 individuals with substance use disorders from disadvantaged communities who had accessed treatment with 555 controls who had not accessed treatment on a range of predisposing, treatment need and enabling/restricting variables thought to be associated with treatment utilization. A hierarchical logistic regression was conducted to assess the unique contribution that the need for treatment, predisposing and enabling/restricting variable blocks made on substance abuse treatment utilization. Results Findings revealed that non-need enabling/restricting variables accounted for almost equal proportions of the variance in service utilization as the need for treatment variables. These enabling/restricting variables also attenuated the influence of the treatment need and predisposing variables domains on chances of treatment utilization. Several enabling/restricting variables emerged as powerful partial predictors of utilization including competing financial priorities, geographic access barriers and awareness of treatment services. Perceived severity of
... 29 Labor 3 2010-07-01 2010-07-01 false Leave for treatment of substance abuse. 825.119 Section 825... Leave for treatment of substance abuse. (a) Substance abuse may be a serious health condition if the conditions of §§ 825.113 through 825.115 are met. However, FMLA leave may only be taken for treatment for...
Substance Abuse and Mental Health Services Administration, 2011
This report uses data from the Treatment Episode Data Set (TEDS) for 2008 to provide information on the characteristics of youths aged 12 to 14 admitted to substance abuse treatment. In 2008, approximately 23,770 substance abuse treatment admissions were adolescents aged 12 to 14. The two most frequently reported primary substances of abuse among…
Goodrum, Sarah; Staton, Michele; Leukefeld, Carl; Webster, J. Matthew; Purvis, Richard T.
Almost 90% of all State and Federal prisons in the U.S. offer some form of substance abuse counseling, and one in eight prisoners have participated in a substance abuse treatment program while incarcerated. Evidence indicates that these programs can be successful in stopping prisoners' substance abuse. While some data are available about the…
Werner, Mark J.
The high prevalence of alcohol and substance abuse by adolescents poses a significant threat to the wellness of youth. Adolescents appear to use drugs for a variety of reasons. In addition to the multiple etiologic and risk factors present for substance abuse, there are many pathways teenagers may follow on their way to substance abuse. The…
Haynes, L. F.; Korte, J. E.; Holmes, B. E.; Gooden, L.; Matheson, T.; Feaster, D. J.; Leff, J. A.; Wilson, L.; Metsch, L. R.; Schackman, B. R.
The Substance Abuse Mental Health Services Administration has promoted HIV testing and counseling as an evidence-based practice. Nevertheless, adoption of HIV testing in substance abuse treatment programs has been slow. This article describes the experience of a substance abuse treatment agency where, following participation in a clinical trial,…
Badr, Lina Kurdahi; Taha, Asma; Dee, Vivien
It is estimated that the percentage of students using illicit substances by sixth grade has tripled over the last decade not only in developed countries but in developing countries as well probably due to the transition to a more Western society. Although much has been done to understand the mechanisms underlying substance abuse, few studies have been conducted with minority ethnic and religious groups such as Middle Eastern Youth. The primary goal of this study was to determine whether there are differences in factors contributing to substance abuse in adolescents from Lebanon versus the U.S.A. and to decipher the role of spirituality, religion, and culture among other factors that may influence substance abuse. A correlational cross-sectional design was used with adolescents living in two different countries: Los Angeles, California and Beirut, Lebanon. Muslim adolescents had significantly less rates of alcohol and substance use than Christians in both Lebanon and Los Angeles. More years lived in the U.S.A. increases the likelihood of abuse for both Muslims and Christians. Attachment to God and family was negatively associated with substance abuse. These results among others facilitate a better understanding of the influence of culture, religion, family and personal factors on substance abuse. Culturally sensitive interventions could benefit from the findings of this pilot study.
Ribas-Siñol, Maria; Del Prado-Sanchez, Noemi; Claramunt-Mendoza, Jaume; Civit-Ramirez, Monica; Canalias-Perez, Oriol; Ochoa, Susana
Many studies indicate the high prevalence of juvenile substance abuse. There is increasingly more dual diagnosis and mental illnesses in adolescents and many juvenile offenses are related to drug abuse. This is a descriptive study about the relationship between drug abuse and clinical, demographic and criminal characteristics in a sample of 144 youths seen in the Therapeutic Juvenile Justice Unit (UTJJ) of the Parc Sanitari Sant Joan de Deu. A total of 65.3% of the sample had a disorder on Axis I, 22.2% of which were related with the psychotic spectrum and 18.1% ADHD. Personality disorder occurred in 42.4%, the most frequent ones being antisocial disorder (16%), and borderline personality disorder (6.9%). Of the sample, 78.5% were drug consumers and 51.4% of the total only consumed 1 substance. There is a tendency among psychotic teenagers to consume cannabis and ADHD patients to consume cannabis and cocaine. A significant relationship is found between nationality and inhalants drugs, social and economic level and sedative drugs and alcohol, and parental death and alcohol (p<0.05-0.005). The level of drug use/abuse in juvenile justice is very high. Although there is no evidence about the relationship between the substance they consume and the profile of the young offender, some tendencies are observed.
Full Text Available Background: Substance abuse refers to a maladaptive pattern of use of a substance. The purpose of this study was to determine the prevalence of substance abuse in hostel boys in Hamadan medical university, 2008. Materials and Method: This research was a descriptive cross-sectional study. The method of sample was census report study and sample number was 430. The research objective data was gathered thorough questionnaire. Data processing and statistical analysis were performed using SPSS software, version 15.0.Results: Outcome showed that the majority of samples were 20 years old (21.9%, non married (92.8%, the number of family member were six members (21.9%, and they are the first children (85.4%.Also outcome showed that 27% of students did not consume any drug, and majority of light material drug abuse was narcotic (44.77%, cigarette (28.4%, alcohol (20.19% and heavy material was opium (5.25%, hashish (4.1%, ecstasy (1.64% and others (1.13%. Narcotic was in the first rank and cigarette was in the last. Conclusion: The screening of drug abuse and promoting primary prevention programs at the university were recommended
Kim, HyunSoo; Tracy, Elizabeth; Brown, Suzanne; Jun, MinKyoung; Park, Hyunyong; Min, Meeyoung; McCarty, Chris
This study compared compositional, social support, and structural characteristics of personal networks among women in residential (RT) and intensive outpatient (IOP) substance abuse treatment. The study sample included 377 women from inner-city substance use disorder treatment facilities. Respondents were asked about 25 personal network members known within the past 6 months, characteristics of each (relationship, substance use, types of support), and relationships between each network member. Differences between RT women and IOP women in personal network characteristics were identified using Chi-square and t -tests. Compared to IOP women, RT women had more substance users in their networks, more network members with whom they had used substances and fewer network members who provided social support. These findings suggest that women in residential treatment have specific network characteristics, not experienced by women in IOP, which may make them more vulnerable to relapse; they may therefore require interventions that target these specific network characteristics in order to reduce their vulnerability to relapse.
A cluster-randomized controlled trial evaluating the effects of delaying onset of adolescent substance abuse on cognitive development and addiction following a selective, personality-targeted intervention programme: the Co-Venture trial.
O'Leary-Barrett, Maeve; Mâsse, Benoit; Pihl, Robert O; Stewart, Sherry H; Séguin, Jean R; Conrod, Patricia J
Substance use and binge drinking during early adolescence are associated with neurocognitive abnormalities, mental health problems and an increased risk for future addiction. The trial aims to evaluate the protective effects of an evidence-based substance use prevention programme on the onset of alcohol and drug use in adolescence, as well as on cognitive, mental health and addiction outcomes over 5 years. Thirty-eight high schools will be recruited, with a final sample of 31 schools assigned to intervention or control conditions (3826 youth). Brief personality-targeted interventions will be delivered to high-risk youth attending intervention schools during the first year of the trial. Control school participants will receive no intervention above what is offered to them in the regular curriculum by their respective schools. Public/private French and English high schools in Montreal (Canada). All grade 7 students (12-13 years old) will be invited to participate. High-risk youth will be identified as those scoring one standard deviation or more above the school mean on one of the four personality subscales of the Substance Use Risk Profile Scale (40-45% youth). Self-reported substance use and mental health symptoms and cognitive functioning measured annually throughout 5 years. Primary outcomes are the onset of substance use disorders at 4 years post-intervention (year 5). Secondary intermediate outcomes are the onset of alcohol and substance use 2 years post-intervention and neuropsychological functions; namely, the protective effects of substance use prevention on cognitive functions generally, and executive functions and reward sensitivity specifically. This longitudinal, cluster-randomized controlled trial will investigate the impact of a brief personality-targeted intervention program on reducing the onset of addiction 4 years-post intervention. Results will tease apart the developmental sequences of uptake and growth in substance use and cognitive
Vungkhanching, Martha; Heinemann, Allen W; Langley, Mervin J; Ridgely, Mary; Kramer, Karen M
To demonstrate the feasibility of a skills-based substance abuse prevention counseling program in a community setting for adults who sustained traumatic brain injury. Convenience sample of 117 participants (mean age=35 years) with preinjury history of alcohol or other drug use. Intervention group participants (n=36) from 3 vocational rehabilitation programs; a no-intervention comparison group (n=81) from an outpatient rehabilitation service. 12 individual counseling sessions featuring skills-based intervention. Changes in self-reported alcohol and other drug use, coping skillfulness, affect, and employment status from baseline to 9 months postintervention. Significant differences were noted at baseline for the intervention and comparison groups on ethnicity, time postinjury, marital status, and employment (Pcoping skillfulness (Pskills-based intervention provides a promising approach to promoting abstinence from all substances and increasing readiness for employment for adults with traumatic brain injuries in outpatient settings.
Full Text Available In the last few decades, mental disorders resulting from substance abuse have become a frequent phenomenon, which features diverse forms and degrees of severity. In addition to being a medical and extremely harmful social phenomenon, substance abuse (commonly known as drug or narcotics abuse is frequently a subject matter of research in many sciences or scientific disciplines, such as medicine, psychology, sociology, legal science, etc. Drug abusers may develop diverse mental disorders, which largely depends on the type of psychoactive substance which is being abused and the method of taking narcotics (including frequency, daily dose, mode of administration, etc.. In this paper, the author provides an overview of different types of mental disorders according to the applicable International Classification of Mental and Behavioral Disorders. The disturbance of mental functions due to drug abuse (which may or may not result in the development of a mental disorder changes the perception and behaviour of drug users. The disturbance of mental functions becomes particularly prominent in the circumstances where substance abuse has turned into a drug addiction; the basic characteristic of the dependence syndrome is an irresistible urge (craving or even compulsion to take the substance in order to enjoy its effects again or to avoid/relieve the drug addiction crisis or the abstinence syndrome, which may be extremely painful and agonizing. As a consequence of these mental disturbances and other disorders arising from drug addiction, human behaviour may be disrupted to such an extent that a person may demonstrate some criminal conduct, which ultimately makes these mental disorders highly relevant in the field of criminal law. Given the fact that the criminal offender is a drug abuser who may have different forms of mental disorders, there is a need to consider the offender's mental capacity (sanity, which ultimately makes these mental disorders highly
Van Ammers, E C; Sellman, J D; Mulder, R T
The influence of temperament on substance abuse in schizophrenia is poorly understood, whereas it is known to play an important role in other clinical populations. In a sample of 28 male schizophrenics, Cloninger's dimensions of temperament were measured with the use of the Tridimensional Personality Questionnaire (TPQ). Levels of four commonly used substances were recorded. There was a significant correlation between the novelty-seeking dimension and past use of alcohol, cannabis, and caffeine and current use of caffeine and nicotine. There was no relationship between substance use and clinical symptoms or demographic variables. The possible implications of abnormal mean TPQ scores in the sample as well as a weak correlation between symptom patterns and TPQ scores are discussed. The findings suggest that novelty-seeking type behaviors contribute to substance use in schizophrenia.
Ulibarri, Monica D; Ulloa, Emilio C; Salazar, Marissa
This study examined self-reported sexually abusive experiences in childhood and adulthood as correlates of current drug use, alcohol abuse, and depression and posttraumatic stress disorder (PTSD) symptoms. Participants were 204 Latina women 18-34 years old. Results indicated significant relationships between history of sexual abuse (regardless of age of occurrence), depression symptoms, PTSD symptoms, alcohol abuse, and drug use. When examined separately, childhood sexual abuse was associated with symptoms of depression, PTSD, and substance use but not alcohol abuse behaviors. Experiencing sexual abuse in adulthood was associated with symptoms of depression, alcohol abuse behaviors, and substance use but not PTSD symptoms. Structural equation modeling showed that substance use partially mediated the relationship between sexual abuse and mental health outcomes. These findings suggest mental health and substance use services should incorporate treatment for trauma, which may be the root of comorbid mental health and substance use issues.
Hopwood, Christopher J; Schade, Nick; Matusiewicz, Alexis; Daughters, Stacey B; Lejuez, Carl W
Emotion regulation at treatment entry was evaluated among 115 patients in an inner-city substance use residential facility who either persisted (N = 94) or discontinued treatment (N = 21). Emotion regulation capacity including emotional clarity and the ability to engage in goal-directed behavior despite emotional distress, as well as lower scores on a measure of trait-negative emotionality, were associated with treatment persistence, whereas motivational variables were not. Findings indicate the importance of regulating negative emotions for treatment engagement among substance abusers.
Harrington, N G; Donohew, L
A substance abuse prevention and life skills program for economically disadvantaged, high sensation seeking African American teens was developed and tested in Cincinnati, Ohio. Formative research was conducted to determine program content and format. Over two implementations, 289 individuals in the target population were recruited as participants for the field test of the program. For the first implementation, participants were randomly selected from the city's summer youth employment program. For the second, a media campaign was designed to recruit participants. Process evaluation indicated that participants evaluated the program extremely positively. Outcome evaluation indicated that significant pretest differences between high and low sensation seekers were neutralized for liquor and marijuana in both years of the program and for attitude toward drugs in the first year of the program. These results suggest that sensation seeking is a useful message design and audience-targeting variable for substance abuse prevention program design. Implications and recommendations for future research are discussed.
Melnick, Gerald; Wexler, Harry K; Chaple, Michael; Cleland, Charles M
Previous studies demonstrated the relationship between consensus among both staff and clients with client engagement in treatment and between client consensus and 1-year treatment outcomes. The present article explores the correlates of staff consensus, defined as the level of agreement among staff as to the importance of treatment activities in their program, using a national sample of 80 residential substance abuse treatment programs. Constructive conflict resolution had the largest effect on consensus. Low client-to-staff ratios, staff education, and staff experience in substance abuse treatment were also significantly related to consensus. Frequency of training, an expected correlate of consensus, was negatively associated with consensus, whereas frequency of supervision was not a significant correlate. The implications of the findings for future research and program improvement are discussed.
formerly ORG 34517) in Veterans with Co-morbid PTSD/AUD” (Principal Investigator: Dewleen G. Baker, MD) The primary objective of this study is to...test the efficacy, safety, and tolerability of a novel GR antagonist PT150 (formerly ORG 34517) for AUD/PTSD dual diagnosis treatment in veterans. The...Pharmacotherapies for Alcohol and Substance Abuse (PASA) Consortium PI: Rick Williams, PhD & Thomas Kosten, MD Org : RTI International Study Research Planning
L.G. Blore; S. Schulze; A.C. Lessing
The research aimed to investigate the phenomena of adolescent depressive symptomology, substance abuse and the relationship between the two phenomena in a South African context. The influence of moderator variables was also examined. Another objective was to determine risk factors for the before mentioned. This was done by using a questionnaire with a sample of 1298 conveniently selected adolescents in a South African high school. It was determined that adolescents become progressively unhapp...
Tipps, Megan E; Raybuck, Jonathan D; Lattal, K Matthew
A large body of literature demonstrates the effects of abused substances on memory. These effects differ depending on the drug, the pattern of delivery (acute or chronic), and the drug state at the time of learning or assessment. Substance use disorders involving these drugs are often comorbid with anxiety disorders, such as post-traumatic stress disorder (PTSD). When the cognitive effects of these drugs are considered in the context of the treatment of these disorders, it becomes clear that these drugs may play a deleterious role in the development, maintenance, and treatment of PTSD. In this review, we examine the literature evaluating the cognitive effects of three commonly abused drugs: nicotine, cocaine, and alcohol. These three drugs operate through both common and distinct neurobiological mechanisms and alter learning and memory in multiple ways. We consider how the cognitive and affective effects of these drugs interact with the acquisition, consolidation, and extinction of learned fear, and we discuss the potential impediments that substance abuse creates for the treatment of PTSD. Copyright © 2013 Elsevier Inc. All rights reserved.
Full Text Available Abstract Background Previous research has indicated that aggressive behaviour and DSM-IV cluster B personality disorders (PD may be associated with professionals' emotional reactions to clients, and that cluster C PD may be associated with positive emotional reactions. Methods Staff members recruited from workshops completed a self-report inventory of emotional reactions to patients, the Feeling Word Checklist-58, and substance abusers completed a self-report of DSM-IV personality disorder, the DSM-IV and ICD-10 Personality Disorder Questionnaire. Correlational analysis and multiple regression analysis was used to assess the associations between personality disorders and emotional reations. Results Cluster B disorder features were associated with feeling distance to patients, and cluster C disorder features were associated with feeling helpful towards patients. Cluster A disorders had no significant impact on emotional reactions. Conclusion The findings confirm clinical experiences that personality disorder features in patients with substance abuse have an impact on staff members reactions to them. These reactions should be considered in supervision of staff, and in treatment models for patients with co-morbid personality disorders and substance abuse.
Link, Thomas W; Hefner, Jennifer L; Ford, Eric W; Huerta, Timothy R
Website development for health care has only been prevalent in the last two and a half decades. The first websites were electronic versions of brochures providing hardly any interaction with the consumer or potential consumer. The percentage of consumers that use the internet during the decision-making process for health care providers continues to rise. As a result, the websites of health care providers are becoming more of a representation of the facility and creating an organizational image rather than a brochure-like informational page. The purpose of this study was to analyze substance abuse treatment center's websites in the State of California with the goal of informing the management of substance abuse centers regarding an effective and inexpensive means to closing the marketing gaps in the industry. This brief research report presents the results of employing an automated web-crawler to assess website quality along five dimensions: accessibility, content, marketing, technology, and usability score. The sample mean scores for all dimensions were between 4 and 6 on a 10-point scale. On average larger facilities had higher quality websites. The low mean scores on these dimensions indicate that that substance abuse centers have significant room for improvement of their website's. Efficiently spending marketing funds to increase the effectiveness of a treatment center's website can be a low cost way for even small facilities to increase market competitiveness.
Full Text Available This case control study was conducted between January to June 2010 to determine the relationship between substance abuse and multidrug- resistant tuberculosis. A total of 73 cases were selected purposively, from culture- positive multidrug- resistant tuberculosis patients admitted in the National Institute of Diseases of the Chest and Hospital, Dhaka and compared with 81 un-matched controls, recruited from the cured patients of pulmonary tuberculosis who attended several DOTS centers of ‘Nagar Shastho Kendra’ under Urban Primary Health Care Project in Dhaka city. Data were collected by face to face interview and documents’ review, using a pre- tested structured questionnaire and a checklist. Multidrug- resistance was found to be associated with smoking status (χ2 = 11.76; p = 0.01 and panmasala use (χ2 = 8.28; p = 0.004. The study also revealed that alcohol consumption and other substance abuse such as jarda, sadapata, gul, snuff, heroine, cannabis, injectable drugs was not associated with the development of multidrug- resistant tuberculosis. Relationship between substance abuse and multidrug- resistant tuberculosis are more or less similar in the developing countries. Bangladesh is not out of this trend. The present study revealed the same fact, which warrants actions targeting specific factors. Further study is recommended to assess the magnitude and these factors related to the development of multidrug- resistant tuberculosis in different settings in our country. Ibrahim Med. Coll. J. 2012; 6(2: 50-54
Tedgård, Eva; Råstam, Maria; Wirtberg, Ingegerd
To add to our knowledge concerning the key elements involved in the individual's experience of growing up with substance abusing parents and the resulting challenges this involved for their own parenthood. In-depth interviews were conducted with 19 parents who had participated in a mental health intervention programme. All had experienced substance abusing parents in their family of origin. Qualitative content analysis was used to analyse the data. They also completed a self-report questionnaire assessing their attachment style. Participants reported a high incidence of emotional abuse and neglect coupled with inadequate support from the community. Their own parental role was influenced by high parental stress and a majority had an insecure attachment style. All participants had experienced a very difficult childhood which was reinforced by the fact that they received little support from society. Their childhood experience and the resulting challenges that this created in their own parenting role could negatively influence their own children's ability to form a secure psychosocial development. It is therefore important to develop instruments that can help to identify children who were raised in misuse families in order to accommodate the transgenerational effects of growing up with substance abusing parents.
Tedgård, Eva; Råstam, Maria; Wirtberg, Ingegerd
ABSTRACT Aim: To add to our knowledge concerning the key elements involved in the individual’s experience of growing up with substance abusing parents and the resulting challenges this involved for their own parenthood. Methods: In-depth interviews were conducted with 19 parents who had participated in a mental health intervention programme. All had experienced substance abusing parents in their family of origin. Qualitative content analysis was used to analyse the data. They also completed a self-report questionnaire assessing their attachment style. Result: Participants reported a high incidence of emotional abuse and neglect coupled with inadequate support from the community. Their own parental role was influenced by high parental stress and a majority had an insecure attachment style. Conclusions: All participants had experienced a very difficult childhood which was reinforced by the fact that they received little support from society. Their childhood experience and the resulting challenges that this created in their own parenting role could negatively influence their own children’s ability to form a secure psychosocial development. It is therefore important to develop instruments that can help to identify children who were raised in misuse families in order to accommodate the transgenerational effects of growing up with substance abusing parents. PMID:29482480
Full Text Available Introduction: Narcotic drug abuse and illicit use of drugs is a major, complicated multifactorial phenomenon affecting most of the societies today. Incidence of drug abuse among adolescents is very high. Adolescents become addicted to substances more quickly than adults. The aim of this study was to assess the pattern of drug abuse among male adolescents in Hamadan. Methods: This study was a descriptive study and samples (n=400 were collected on the basis of snowball sampling method. Information was collected individually through completion of a researcher-designed questionnaire including demographic and epidemiological indices, perceived familial support, religiosity, and locus of control. Results: The results showed that smoking (93%, alcohol (92.5%, marijuana (64.3%, and opium (57.8% use were very high, while LSD (4.8% and Cocaine(2.3% use was rare. 77.8 % of adolescents began drug abuse between 12 and 18 years of age. Moreover, sensation seeking (26.5%, individual interest (24.8%, and peer pressure (22%, were the main reasons for drug abuse. Conclusion: As initial smoking, alcohol and marijuana use play an important role in determining the future addiction of adolescents to narcotics, yearly surveillance programs in the country and evaluation of etiological factors of narcotic addiction need to be studied carefully. All of the preventive and school programs designed for the young should take into account environmental, demographic and policy factors in addition to personal factors so that the programs have a maximum effect.
Rosen, Daniel; Engel, Rafael J; Hunsaker, Amanda E; Engel, Yael; Detlefsen, Ellen Gay; Reynolds, Charles F
This article examines the extent to which studies of alcohol abuse, illicit drug use, and prescription drug abuse among older adults appear in the leading gerontological and substance abuse journals. The authors reviewed articles published in the 10 social science gerontological journals and the 10 social science substance abuse journals with the highest 5-year impact factors in PubMed from 2000 to 2010. Articles were selected that presented original research on alcohol, substance, or prescription abuse with older adults aged 50 and older; and were identified through aging and substance abuse-related Medical Subject Headings and word searches of titles and abstracts (N = 634). Full text of each article was reviewed by the authors, and consensus determined inclusion in the final sample. Of the 19,953 articles published respectively in the top 10 gerontological and substance abuse journals, 181 articles met the inclusion criteria of reporting findings related to substance use disorders among older adults. Specifically, 0.9% (102 of 11,700) of articles from the top 10 gerontology journals and 1.0% (79 of 8,253) of articles from the top 10 substance abuse journals met the criteria. Most published articles addressed alcohol misuse/abuse or polysubstance abuse with few articles addressing illicit drug use or the misuse of prescription medications. Less than 1% of articles published in the 10 gerontology journals and the 10 substance abuse journals with the highest 5-year impact scores addressed substance abuse in older adults. Practitioners treating health and/or mental health problems are at a disadvantage in accurately identifying and treating these conditions in older adult populations without a proper understanding of the role of comorbid substance use disorders.
Tsounis, Andreas; Niakas, Dimitris; Sarafis, Pavlos
Job satisfaction is an important predictor for management and clinical ratios. Although it is accepted that is affected by many aspects, the influence of social capital remains to be determined. The main purpose of the article is to examine the relationship between job satisfaction and individual social capital for employees offering services in the treatment of addiction. A cross-sectional study was conducted on 239 employees from 14 therapeutic programs at KETEA (Therapy Center for Dependent Individuals in Greece) (KETHEA). A revised Greek Version of the Social Capital Questionnaire (SCQ-G) for the individual social capital measurement, and of the Job Satisfaction Survey (JSS) for the job satisfaction measurement, were used. Individual Social Capital ranged in medium levels. We observed a significant positive association between social capital and its' different aspects and gender, age, place of residence and working experience. Men, older employees, those who lived in smaller places, and those working more years, reached higher levels of individual social capital. Concerning overall job satisfaction most of the participants were ambivalent (61.5%), while 21.8% were satisfied and 16.7% were dissatisfied. Concerning its separate aspects, 77% were least satisfied with pay, 69.9% were least satisfied with advancement opportunities, 60.3% were least satisfied with fringe benefits, 85.8% were most satisfied with the nature of their work, 80.8% with their relationship with colleagues, and 77.8% were satisfied with supervision. Total Job Satisfaction was positively associated with place of residence and monthly salary. A significant positive correlation between social capital and job satisfaction was also observed. Early evidence suggests that social capital is associated with job satisfaction of employees providing services in the treatment of substance abuse. Further research, regarding social capital on job satisfaction, is suggested. We need to design and implement
Strasburger, Victor C
The causes of adolescent substance use are multifactorial, but the media can play a key role. Tobacco and alcohol represent the 2 most significant drug threats to adolescents. More than $25 billion per year is spent on advertising for tobacco, alcohol, and prescription drugs, and such advertising has been shown to be effective. Digital media are increasingly being used to advertise drugs. In addition, exposure to PG-13- and R-rated movies at an early age may be a major factor in the onset of adolescent tobacco and alcohol use. The American Academy of Pediatrics recommends a ban on all tobacco advertising in all media, limitations on alcohol advertising, avoiding exposure of young children to substance-related (tobacco, alcohol, prescription drugs, illegal drugs) content on television and in PG-13- and R-rated movies, incorporating the topic of advertising and media into all substance abuse-prevention programs, and implementing media education programs in the classroom.
Sanchez, Rebecca Polley; Bartel, Chelsea M
The purpose of this study was to test the feasibility and acceptability of a novel online adolescent substance abuse relapse prevention tool, "Arise" (3C Institute, Cary, NC). The program uses an innovative platform including interactive instructional segments and skill-building games to help adolescents learn and practice coping skills training strategies. We conducted a pilot test with nine adolescents in substance abuse treatment (44 percent female) and a feasibility test with treatment providers (n=8; 50 percent female). Adolescents interacted with the program via a secure Web site for approximately 30 minutes for each of two instructional units. Treatment providers reviewed the same material at their own pace. All participants completed a questionnaire with items assessing usability, acceptability, understanding, and subjective experience of the program. Regarding feasibility, recruitment of this population within the study constraints proved challenging, but participant retention in the trial was high (no attrition). Adolescents and treatment providers completed the program with no reported problems, and overall we were able to collect data as planned. Regarding acceptability, the program received strong ratings from both adolescents and providers, who found the prototype informative, engaging, and appealing. Both groups strongly recommended continuing development. We were able to deliver the intervention as intended, and acceptability ratings were high, demonstrating the feasibility and acceptability of online delivery of engaging interactive interventions. This study contributes to our understanding of how interactive technologies, including games, can be used to modify behavior in substance abuse treatment and other health areas.
Tze, Virginia M. C.; Li, Johnson C.-H.; Pei, Jacqueline
Substance abuse, especially among adolescents, has long been an important issue in society. In light of the adverse impact of substance abuse, scholars, educators, and policy-makers have proposed different approaches to prevent and reduce such abuse. This paper investigates the effectiveness of the two prominent approaches--educational and…
Wallström, Rebecca; Persson, Renée Ståleborg; Salzmann-Erikson, Martin
Children who grow up in families with parental substance abuse are exposed to increased risk of developing a variety of disorders. As nurses encounter these children, it is important for them to be supportive. The aim of the current study was to describe nurses' experiences and reflections regarding their work with children in families with parental substance abuse. A qualitative descriptive approach was adopted. Seven nurses were interviewed, and data were analyzed using inductive content analysis. The results were presented in four categories: (a) nurses' responsibilities; (b) identification of children's social network; (c) ethical concerns; and (d) assessment and evaluation of children's behavior. Nurses' preventive work and intervention in dysfunctional families may have direct consequences on children's present and future development and well-being. [Journal of Psychosocial Nursing and Mental Health Services, 54(6), 38-44.]. Copyright 2016, SLACK Incorporated.
Full Text Available Few interventions have targeted perceived stress as a co-occurring construct central to substance use and subsequent HIV/AIDS risk reduction among African American urban young adults. The Color It Real Program was a seven session, weekly administered age-specific and culturally-tailored intervention designed to provide substance abuse and HIV education and reduce perceived stress among African Americans ages 18 to 24 in Atlanta, GA. Effectiveness was assessed through a quasi-experimental study design that consisted of intervention (n = 122 and comparison (n = 70 groups completing a pre- and post-intervention survey. A series of Analysis of Variance (ANOVA tests were used to assess pre- to post-intervention changes between study groups. For intervention participants, perceived stress levels were significantly reduced by the end of the intervention (t(70 = 2.38, p = 0.020, condom use at last sexual encounter significantly increased (F = 4.43, p = 0.0360, intervention participants were significantly less likely to drink five or more alcoholic drinks in one sitting (F = 5.10, p = 0.0245, and to use clean needles when injecting the drug (F = 36.99, p = 0.0001. This study is among the first of its kind to incorporate stress management as an integral approach to HIV/SA prevention. The program has implications for the design of other community-based, holistic approaches to addressing substance use and risky behaviors for young adults.
Zellner, Tiffany; Trotter, Jennie; Lenoir, Shelia; Walston, Kelvin; Men-Na'a, L'dia; Henry-Akintobi, Tabia; Miller, Assia
Few interventions have targeted perceived stress as a co-occurring construct central to substance use and subsequent HIV/AIDS risk reduction among African American urban young adults. The Color It Real Program was a seven session, weekly administered age-specific and culturally-tailored intervention designed to provide substance abuse and HIV education and reduce perceived stress among African Americans ages 18 to 24 in Atlanta, GA. Effectiveness was assessed through a quasi-experimental study design that consisted of intervention (n = 122) and comparison (n = 70) groups completing a pre- and post-intervention survey. A series of Analysis of Variance (ANOVA) tests were used to assess pre- to post-intervention changes between study groups. For intervention participants, perceived stress levels were significantly reduced by the end of the intervention (t(70) = 2.38, p = 0.020), condom use at last sexual encounter significantly increased (F = 4.43, p = 0.0360), intervention participants were significantly less likely to drink five or more alcoholic drinks in one sitting (F = 5.10, p = 0.0245), and to use clean needles when injecting the drug (F = 36.99, p = 0.0001). This study is among the first of its kind to incorporate stress management as an integral approach to HIV/SA prevention. The program has implications for the design of other community-based, holistic approaches to addressing substance use and risky behaviors for young adults.
Legha, Rupinder Kaur; Novins, Douglas
Culture figures prominently in discussions regarding the etiology of alcohol and substance abuse in American Indian and Alaska Native (AI/AN) communities, and a substantial body of literature suggests that it is critical to developing meaningful treatment interventions. However, no study has characterized how programs integrate culture into their services. Furthermore, reports regarding the associated challenges are limited. Twenty key informant interviews with administrators and 15 focus groups with clinicians were conducted in 18 alcohol and substance abuse treatment programs serving AI/AN communities. Transcripts were coded to identify relevant themes. Substance abuse treatment programs for AI/AN communities are integrating culture into their services in two discrete ways: by implementing specific cultural practices and by adapting Western treatment models. More important, however, are the fundamental principles that shape these programs and their interactions with the people and communities they serve. These foundational beliefs and values, defined in this study as the core cultural constructs that validate and incorporate AI/AN experience and world view, include an emphasis on community and family, meaningful relationships with and respect for clients, a homelike atmosphere within the program setting, and an “open door” policy for clients. The primary challenges for integrating these cultural practices include AI/AN communities' cultural diversity and limited socioeconomic resources to design and implement these practices. The prominence of foundational beliefs and values is striking and suggests a broader definition of culture when designing services. This definition of foundational beliefs and values should help other diverse communities culturally adapt their substance abuse interventions in more meaningful ways.
Lewin, Linda; Farkas, Kathleen; Niazi, Maryam
Mothers who abuse substances are likely to have insecure emotional attachment with their children, placing their children at risk for social-emotional and psychiatric conditions. Sobriety does not inevitably improve parenting. We tested recruitment methods, audiovisual (AV) recording procedures, the protocol for identifying child abuse risk, the coding of mother-child interactions, and retention of the sample for repeated measures as the first phase in examining mother-child relational quality of women in substance abuse treatment. This innovative study involved AV recordings to capture the in-vivo mother-child interactional behaviors that were later coded and analyzed for mean scores on the 64-item Parent-Child Relational Quality Assessment. Repeated measurement was planned during treatment and two months after discharge from treatment. The pilot involved a small sample (n = 11) of mother-child (interaction behaviors were identified. Mothers showed less enthusiasm and creativity but matched their child's emotional state. The children showed appropriate motor skill items and attachment behaviors. The dyad coding showed less mutual enjoyment between the mother and child. Eight of the participants could not be located for the second measurement despite multiple contact methods. AV recordings capture rich, descriptive information that can be coded for interactional quality analysis. Repeated measurement with this cohort was not feasible, thus needing to assess for additional/more frequent contacts to maintain the sample.
Chong, Jenny; Lopez, Darlene
The objective of this study was to describe the predictors of substance use relapse of American Indian (AI) women up to one year following substance abuse treatment. Relapse is defined as any use of alcohol or drugs in the past 30 days at the follow-up points. Data were collected from AI women in a 45-day residential substance abuse treatment…
Ersöğütçü, Filiz; Karakaş, Sibel Asi
This descriptive study was conducted to examine the levels of social functioning and self-esteem in individuals diagnosed with substance abuse. The study was conducted at the AMATEM (Alcohol and Substance Abuse Treatment Center) service of a psychiatry clinic in the Elazığ province in eastern Turkey between September 1, 2014 and February 1, 2015. The population is comprised of 249 patients being treated in this clinic, and the sample included 203 patients who comply with the research criteria and agreed to participate in the study. A Socia-Demographic Questionnaire, Coopersmith Self-esteem Scale (CSI) and Social Functioning Scale (SFS) were used for data collection. Percentages, averages, standard deviations and Pearson's correlation were used for data analysis. This study found that the patients' mean sore on the Self-esteem Scale is 50.97±18.01. Their score on the Social Functioning Scale is 115.76±22.41. A significant correlation between the patients' self-esteem and the age of first substance use was detected (p=0.001). A significant correlation was detected between their social functioning and the duration of their substance use (pself-esteem (pself-esteem and social functioning. A significant positive correlation between social functioning and self-esteem was found. It was also found that the age of first substance use and self-esteem are directly correlated. Counseling to increase patients' levels of self-esteem and improve their social functioning is recommended. Copyright © 2016 Elsevier Inc. All rights reserved.
Artists create their work in conditions of disequilibrium, states of creative chaos that may appear turbulent but are capable of bringing forth new order. By absorbing information from the environment and discharging it negentropically as new work, artists can be modeled as dissipative systems. A characteristic of chaotic systems is a heightened sensitivity to stimuli, which can generate either positive experiences or negative ones that can lead some artists to substance abuse and misguided searches for a creative chaos. Alcohol and drug use along with inadequately addressed co-occurring emotional disorders interfere with artists' quest for the nonlinearity of creativity. Instead, metaphorically modeled by a limit cycle of addiction and then a spiral to disorder, the joys of a creative chaos become an elusive chimera for them rather than a fulfilling experience. Untreated mental illness and addiction to substances have shortened the lives of artists such as Vincent Van Gogh, Frida Kahlo, Henri de Toulouse-Lautrec, and Jackson Pollock, all of whom committed suicide. In contrast Edvard Munch and John Callahan, who chose to address their emotional problems and substance abuse, continued to live and remain creative. Choosing to access previously avoided moments of pain can activate the nonlinear power of self-transformation.
Eames, S L; Westermeyer, J; Crosby, R D
This study determines the substance use and abuse patterns among patients with comorbid substance-related disorder (SRD) and dysthymia in SRD-dysthymia as compared with patients with SRD only. Differences in use and abuse patterns could be useful for (a) understanding motivations for use, such as self-treatment, and (b) assisting clinicians to identify cases of dysthymia among SRD patients. Retrospective and current data were obtained regarding history of substance use and current SRD diagnoses. Two university medical centers with alcohol-drug programs located within departments of psychiatry were the settings. A total of 642 patients was assessed. of whom 39 had SRD-dysthymia and 308 had SRD only. Data on past usc were collected by a research associate using a questionnaire. Current SRD and dysthymia diagnoses were made by psychiatrists specializing in addiction. The patients with SRD-dysthymia and SRD only did not differ with regard to use of alcohol, tobacco, and benzodiazepines. The patients with SRD-dysthymia started caffeine use at an earlier age, had shorter "use careers" of cocaine, amphetamines, and opiates, and had fewer days of cocaine and cannabis use in the last year. They also had a lower rate of cannabis abuse/dependence. This study indicated that patients with dysthymia and SRD have exposure to most substances of abuse that is comparable to patients with SRD only. However, they selectively use certain substances less often than patients with SRD only. Early use of caffeine may reflect self-treatment for depressive symptoms among patients with SRD-dysthymia.
Kinn, Michael; Holzbach, Rüdiger; Pajonk, Frank-Gerald Bernhard
For the first time since the year 2000 the number of death due to substance abuse of illegal drugs has increased in Germany in 2007 (+8 % compared to 2006). Emergency situations due to drug abuse are frequent, particular in big cities. They may be, however, difficult to diagnose and/or treat for an emergency physician on scene because of a lack of diagnostic tools, the local and personal surroundings, and the unknown number and nature of drugs. Many drug intoxications must be considered suicidal. On the other hand, drug intoxications may mask (other) life-threatening conditions. Emergency situations due to withdrawal offer the possibility to motivate patients to take advantage of specialist-guided abstinence programs.
Seth, Puja; Murray, Colleen C; Braxton, Nikia D; DiClemente, Ralph J
Substance use is prevalent among African American men living in urban communities. The impact of substance use on the social, psychological, and physical health of African American men has important public health implications for families, communities, and society. Given the adverse consequences of alcohol and drug abuse within communities of color, this study evaluated the relationship between city stress, alcohol consumption, and drug use among African American men. Eighty heterosexual, African American men, 18 to 29 years old, completed psychosocial risk assessments that assessed substance use and city stress. Multiple logistic regression analyses, controlling for age, indicated that participants reporting high levels of urban stress, relative to low levels of urban stress, were more likely to report a history of marijuana use (AOR = 5.19, p = .05), history of ecstasy and/or GHB use (AOR = 3.34, p = .04), having family/friends expressing strong concerns about their illicit drug use (AOR = 4.06, p = .02), and being unable to remember what happened the night before due to drinking (AOR = 4.98, p = .01). African American men living within the confines of a stressful urban environment are at increased risk for exposure to and utilization of illicit substances. Culturally competent public health interventions for substance use/abuse should address psychological factors, such as stress and neighborhood violence.
Bali, Vishal; Raisch, Dennis W; Moffett, Maurice L; Khan, Nasreen
Previous studies have found a negative association between health insurance and nonmedical use of prescription drugs (NMUPD), and abuse or dependence on prescription drugs (ADPD); and mixed associations between health insurance and use of substance abuse treatment (SAT). However, effect of health insurance in the specific subgroups of population is largely unknown. To estimate the relationship between health insurance and (1) NMUPD, (2) ADPD, and (3) use of SAT services among 12-64 years old, noninstitutionalized individuals and to see if these relationships are different in different subgroups of population. This study used cross-sectional survey data from 2007 National Survey on Drug Use and Health. Bivariate and multiple logistic regression analyses were conducted. In 2007, self-reported prevalence of NMUPD was approximately 10% (N=15,509,703). In multivariate analysis, NMUPD was negatively associated with health insurance, age, race other than non-Hispanic White, education, marital status, and income ($40,000-$74,999). Past year use of tobacco and alcohol were positively associated with NMUPD. Among those with private health insurance, Hispanics and individuals with family income less than $20,000 and $40,000-$74,999 were more likely prone to NMUPD than others. High school graduates with public health insurance were less likely prone to NMUPD. Approximately, 13% of nonmedical users reported ADPD (N=2,011,229). Health insurance and age were negatively associated with ADPD. However, people who were unmarried, reported fair/poor health, and used tobacco were more likely to report ADPD. Lastly, the use of substance abuse treatment programs was approximately 73% and 76% between NMUPD and ADPD population, respectively. Health insurance was not associated with use of substance abuse treatment. Individuals with high school education were 2.6 times more likely to use substance abuse treatment than the college graduates. Additionally, no significant interaction effects
Lane, Katherine E.
The paper analyzes the problem of alcohol and drug abuse among the deaf population focusing on: precipitating factors leading to substance abuse; barriers to recovery; and descriptions of several treatment centers, programs, and services. (JDD)
Mailloux, Allan T; Cummings, Stephen W; Mugdh, Mrinal
Our objective was to use Wisconsin's Medicaid Evaluation and Decision Support (MEDS) data warehouse to develop and validate a decision support tool (DST) that (1) identifies Wisconsin Medicaid fee-for-service recipients who are abusing controlled substances, (2) effectively replicates clinical pharmacist recommendations for interventions intended to curb abuse of physician and pharmacy services, and (3) automates data extraction, profile generation and tracking of recommendations and interventions. From pharmacist manual reviews of medication profiles, seven measures of overutilization of controlled substances were developed, including (1-2) 6-month and 2-month "shopping" scores, (3-4) 6-month and 2-month forgery scores, (5) duplicate/same day prescriptions, (6) count of controlled substance claims, and the (7) shopping 6-month score for the individual therapeutic class with the highest score. The pattern analysis logic for the measures was encoded into SQL and applied to the medication profiles of 190 recipients who had already undergone manual review. The scores for each measure and numbers of providers were analyzed by exhaustive chi-squared automatic interaction detection (CHAID) to determine significant thresholds and combinations of predictors of pharmacist recommendations, resulting in a decision tree to classify recipients by pharmacist recommendations. The overall correct classification rate of the decision tree was 95.3%, with a 2.4% false positive rate and 4.0% false negative rate for lock-in versus prescriber-alert letter recommendations. Measures used by the decision tree include the 2-month and 6-month shopping scores, and the number of pharmacies and prescribers. The number of pharmacies was the best predictor of abuse of controlled substances. When a Medicaid recipient receives prescriptions for controlled substances at 8 or more pharmacies, the likelihood of a lock-in recommendation is 90%. The availability of the Wisconsin MEDS data warehouse has
Morton, Cory M.; Simmel, Cassandra; Peterson, N. Andrew
This study investigates the relationship between concentrations of on- and off-premises alcohol outlets and rates of child abuse and neglect. Additionally, the study seeks to locate protective features of a neighborhood's built environment by investigating the potentially moderating role that access to substance abuse treatment and prevention services plays in the relationship between alcohol outlet density and child maltreatment. Using a cross-sectional design, this ecological study utilized data from 163 census tracts in Bergen County, New Jersey, on reports of child abuse and neglect, alcohol outlets, substance abuse treatment and prevention facilities, and the United States Census to investigate the linkages between socioeconomic structure, alcohol availability, and access to substance abuse service facilities on rates of child abuse and neglect. Findings indicate areas with a greater concentration of on-premises alcohol outlets (i.e., bars) had higher rates of child neglect, and those with easier access to substance abuse services had lower rates of neglect, controlling for neighborhood demographic and socioeconomic structure. Additionally, the relationship between on-premises alcohol outlet density and rates of child neglect was moderated by the presence of substance abuse service facilities. A greater concentration of off-premises outlets (i.e., liquor stores) was associated with lower rates of physical abuse. Findings suggest that the built environment and socioeconomic structure of neighborhoods have important consequences for child well-being. The implications for future research on the structural features of neighborhoods that are associated with child well-being are discussed. PMID:24529493
Richter Kimber P
Full Text Available Abstract Most persons in drug treatment smoke cigarettes. Until drug treatment facilities systematically treat their patients' tobacco use, millions will flow through the drug treatment system, overcome their primary drug of abuse, but die prematurely from tobacco-related illnesses. This paper reviews the literature on the health benefits of quitting smoking for drug treatment patients, whether smoking causes relapse to other drug or alcohol abuse, the treatment of tobacco dependence, and good and bad times for quitting smoking among drug treatment patients. It also presents a conceptual model and recommendations for treating tobacco in substance abuse treatment, and provides references to internet and paper-copy tools and information for treating tobacco dependence. At present, research on tobacco treatment in drug treatment is in its infancy. Although few drug treatment programs currently offer formal services, many more will likely begin to treat nicotine dependence as external forces and patient demand for these services increases. In the absence of clear guidelines and attention to quality of care, drug treatment programs may adopt smoking cessation services based on cost, convenience, or selection criteria other than efficacy. Because research in this field is relatively new, substance abuse treatment professionals should adhere to the standards of care for the general population, but be prepared to update their practices with emerging interventions that have proven to be effective for patients in drug treatment.
Birtel, Michèle; Wood, Lisa; Kempa, Nancy J.
Individuals with substance abuse may suffer from severe public and internalized stigma. Little is known about how social support can reduce stigma and improve mental health and well-being for them. This research examined how perceived stigma influences individuals in treatment for substance abuse, and whether internalized stigma and shame are mechanisms which link social support with better mental health and well-being. Sixty-four participants in treatment for substance abuse (alcohol, drugs)...
Frarid Ahmadi; Ebrahim Taghipoor; Anahita Khodabakhshi, K
Aims: The aim of this research was the study of the role of identity formation styles on substance abuse behavior of referred people to addiction withdrawal and DIC centers of Tehran city and its comparison with non addicted people. Method: The research design was causal effect research method, which 100 substance abusers compared with 100 non substance abusers. The sampling method was cluster random sampling and both groups were matched in consideration of age. Bersinesky’s identity making q...
Kramer, R M
Employee Assistance Programs (EAPs) are cost-effective strategies for employers to contain the substantial direct and indirect costs of substance abuse in the workplace. EAPs offer prevention, early detection, assessment of referral, and after-care programs to help stem the enormous costs of substance abuse in the workplace. Most effective employer substance abuse programs integrate drug-testing and EAP services to ensure a well coordinated, cost-effective program.
Slesnick, Natasha; Guo, Xiamei; Brakenhoff, Brittany; Feng, Xin
Given high levels of health and psychological costs associated with the family disruption of homelessness, identifying predictors of runaway and homeless episodes is an important goal. The current study followed 179 substance abusing, shelter-recruited adolescents who participated in a randomized clinical trial. Predictors of runaway and homeless episodes were examined over a two year period. Results from the hierarchical linear modeling analysis showed that family cohesion and substance use, but not family conflict or depressive symptoms, delinquency, or school enrollment predicted future runaway and homeless episodes. Findings suggest that increasing family support, care and connection and reducing substance use are important targets of intervention efforts in preventing future runaway and homeless episodes amongst a high risk sample of adolescents. Copyright © 2013 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.
McClure, Erin A; Acquavita, Shauna P; Harding, Emily; Stitzer, Maxine L
Technology-based applications represent a promising method for providing efficacious, widely available interventions to substance abuse treatment patients. However, limited access to communication technology (i.e., mobile phones, computers, internet, and e-mail) could significantly impact the feasibility of these efforts, and little is known regarding technology utilization in substance abusing populations. A survey was conducted to characterize utilization of communication technology in 266 urban, substance abuse treatment patients enrolled at eight drug-free, psychosocial or opioid-replacement therapy clinics. Survey participants averaged 41 years of age and 57% had a yearly household income of less than $15,000. The vast majority reported access to a mobile phone (91%), and to SMS text messaging (79%). Keeping a consistent mobile phone number and yearly mobile contract was higher for White participants, and also for those with higher education, and enrolled in drug-free, psychosocial treatment. Internet, e-mail, and computer use was much lower (39-45%), with younger age, higher education and income predicting greater use. No such differences existed for the use of mobile phones however. Concern regarding the digital divide for marginalized populations appears to be disappearing with respect to mobile phones, but still exists for computer, internet, and e-mail access and use. Results suggest that mobile phone and texting applications may be feasibly applied for use in program-client interactions in substance abuse treatment. Careful consideration should be given to frequent phone number changes, access to technology, and motivation to engage with communication technology for treatment purposes. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.
Gustavo Manoel Schier Dória
Full Text Available Objective: to determine the incidence and associations of attention deficit-hyperactivity disorder (ADHD, conduct disorder (CD, and substance abuse disorder (SAD in adolescents in conflict with the law in a Brazilian cohort. Methods: the Brazilian version of the Schedule for Affective Disorders and Schizophrenia for School Aged-Children (K-SADS-PL was administered to 69 adolescent boys who were incarcerated for 45 days in the city of Curitiba, Brazil. Results: mean age was 15.5 years (range, 12-16.9 years and most adolescents originated from disadvantaged social classes (87%. They resided in neighborhoods on the outskirts of the city or towns in the greater metropolitan area. Truancy and low educational achievement were common, with 73.9% not currently attending school and 43.4% not having finished the 5th grade. The great majority lived in single-parent families and many had relatives who themselves had problems with the law. Psychiatric disorders were apparent in 81.1% of the subjects, with the most common disorders being CD (59.4%, SAD (53.6%, and ADHD (43.5%. Both ADHD (p <0.001 and CD (p <0.01 had significant associations with substance abuse. Conclusion: in male adolescents in conflict with the law, ADHD, CD, and SAD were all found to be associated with delinquency.
Myra Siv Merete
Full Text Available BACKGROUND – Use of coercion against pregnant women who misuse substances was legalised in Norway in 1996. The background for the law was that substance abuse during pregnancy represents a significant health problem for the child.
Chan, Lai Fong; Maniam, T; Saini, Suriati Mohamed; Shah, Shamsul Azhar; Loh, Sit Fong; Sinniah, Aishvarya; Idris, Zawaha Haji; Che Rus, Sulaiman; Hassan Nudin, Siti Sa'adiah; Tan, Susan Mooi Koon
The aim of this study was to determine the association between sexual abuse, substance abuse and socio-demographic factors with suicidal ideation (SI), plans (SP) and deliberate self-harm (DSH) and propose steps to prevent youth suicidal behavior. This was a cross-sectional study of 6786 adolescents aged 17-18 years, selected randomly from all Malaysian adolescents to undergo compulsory youth camps located in Selangor, Malaysia (2008-2009). Participants were assessed using self-administered questionnaires developed to reflect the local cultural setting. However, only 4581 subjects were analyzed after excluding incomplete data. The rates of SI, SP and DSH were 7.6%, 3.2% and 6.3%, respectively. The multivariable-adjusted odds ratio showed that sexual abuse was associated with SI 1.99 (95% CI: 1.56-2.55), SP 1.57 (95% CI: 1.09-2.27) and DSH 2.26 (95% CI: 1.75-2.94); illicit drug use was associated with SI 4.05 (95% CI: 2.14-7.67), SP 2.62 (95% CI: 1.05-6.53) and DSH 2.06, (95% CI: 1.05-4.04); for alcohol use DSH was 1.34 (95% CI: 1.00-1.79). Being female was associated with all suicidal behaviors: SI 2.51 (95% CI: 1.91-3.30), SP 2.07 (95% CI: 1.39-3.08) and DSH 1.59 (95% CI: 1.19-2.11). Given the well-founded concern of increasing risk of suicidal behavior among youth, preventive efforts should adopt a more comprehensive approach in dealing with sexual abuse and substance abuse, and their sequelae, especially in girls. Copyright © 2013 Wiley Publishing Asia Pty Ltd.
Lavender, Jason M; Happel, Kate; Anestis, Michael D; Tull, Matthew T; Gratz, Kim L
Difficulties tolerating distress and the expectancy that eating will relieve negative affect have been linked with bulimic symptoms, which commonly co-occur with other forms of psychopathology characterized by emotion dysregulation (e.g., substance abuse). Indeed, problems with emotional functioning may be of particular relevance to bulimic symptoms in at-risk populations with heightened emotion dysregulation (such as substance use disorder patients). This study examined the interactive role of two emotion-related constructs (distress tolerance and the expectancy that eating relieves negative affect) in relation to bulimic symptoms among patients (N=93) recruited from a residential substance abuse treatment facility. Participants completed the Bulimia Test-Revised, the Positive and Negative Affect Schedule, the Distress Tolerance Scale, and the Eating Expectancy Inventory. A hierarchical multiple regression analysis was conducted to examine the main effects and interaction of distress tolerance and negative affect eating expectancies in relation to bulimic symptoms, controlling for participant gender and overall negative affect. Significant main effects were found for both distress tolerance and negative affect eating expectancies, and these two constructs were found to significantly interact in the prediction of bulimic symptoms. Interventions that address these constructs may be useful in treating those with bulimic symptoms, as well as those with co-occurring bulimic symptoms and substance use disorders. Copyright © 2014 Elsevier Ltd. All rights reserved.
Full Text Available Introduction: Children from substance-affected families show an elevated risk for developing own substance-related or other mental disorders. Frequently, they experience violence, abuse and neglect in their families. Therefore, they are an important target group for preventive efforts. In Germany it is estimated that approx. 2.65 million children are affected by parental substance abuse or dependence. Only ten percent of them receive treatment when parents are treated. To date, no evaluated program for children from substance-affected families exists in Germany. Methods: A new group intervention for children from substance-affected families was developed and is currently being evaluated in a randomized-controlled multicenter study funded by the German Ministry of Health. The development process was simultaneously guided by theory, existing research knowledge and expert opinion. Promoting resilience in children affected by parental substance abuse is a key goal of the program. Results: The TRAMPOLINE manual describes a 9-session addiction-focused, modular group program for children aged 8 to 12 years with at least one substance-using parent. Weekly sessions last for 90 minutes and combine psychoeducational elements with exercises and role play. A two-session parent intervention component is also integrated in the program. Content, structure and theoretical background of the intervention are described. Discussion: TRAMPOLINE is a new interventive effort targeting children from substance-affected families. It is grounded in theory and practice. The results of the research in progress will provide fundamental information on the effectiveness of a structured group prevention program for German children from substance-abusing families. Thus, the study will contribute to creating a broader and more effective system of preventive help for this high-risk target group.
Crosas, Josep M; Cobo, Jesus; Ahuir, Maribel; Hernández, Carla; García, Rebeca; Pousa, Esther; Oliva, Joan-Carles; Monreal, José-Antonio; Palao, Diego J
There have been controversial results in the study of gender differences in first episode psychosis (FEP). Substance abuse is the main existing comorbidity in FEP, and has been associated with worse prognosis and greater symptom severity. To explore gender differences in FEP in relation to drug abuse, and their relationship with hospital readmissions. Descriptive and prospective study (18 months). We included 141 patients (31.2% women), aged 26.1 years on average, mostly diagnosed with schizophreniform disorder (32.6%). A percentage of 58.9 had problematic use of drugs. Gender significant differences were found in age of onset, age at entry to the programme, marital status and cohabitation, and percentage differences were revealed in current drug abuse and frequency of consumption. Gender, duration of untreated psychosis, psychiatric history, age of onset and previous drug use were not predictors of re-entry. Hospital readmission rate was 24.8%, with no gender differences. The most common reasons for admission were abandonment of treatment (66.7%) and drug abuse (44.4%). Drug abuse was higher in the men than in the women as a reason for re-admission. There are gender differences in FEP. Men have an earlier onset of symptoms and have worse functional outcomes. Drug abuse in men is higher and represents a major cause of hospital readmission. Therapeutic interventions to prevent the effects of drug abuse are necessary from the early stages of the illness. Copyright © 2017 SEP y SEPB. Publicado por Elsevier España, S.L.U. All rights reserved.
Kelley, Michelle L; Bravo, Adrian J; Braitman, Abby L; Lawless, Adrienne K; Lawrence, Hannah R
Risk for child abuse was examined prior to and after behavioral couples treatment (BCT) among 61 couples in which one or both parents were diagnosed with substance use disorder (SUD). All couples were residing with one or more school-age children. Mothers and fathers completed pretreatment, post-intervention, and 6-month post-intervention follow-up assessments. Results of piecewise latent growth models tested whether the number of BCT sessions attended and number of days abstinent from drugs and alcohol influenced relationship satisfaction and its growth over time, and in turn if relationship satisfaction and change in relationship satisfaction influenced risk for child abuse. For both mothers and fathers, attending more BCT sessions lead to a direct increase in relationship satisfaction, which in turn led to stronger reductions in risk for child abuse. This effect was maintained from the post-intervention through the 6-month post-intervention follow-up. For fathers, number of days abstinent significantly influenced reduction in child abuse potential at post-intervention via relationship satisfaction. This indirect effect was not present for mothers. The overall benefits of BCT on mothers' and fathers' risk for child abuse suggest that BCT may have promise in reducing risk for child abuse among couples in which one or both parents have SUD. Copyright © 2015 Elsevier Inc. All rights reserved.
Snyder, Susan M; Smith, Rachel E
To date studies have not explored patterns of substance use exclusively among youth in the child welfare system. Consequently, little is known about polysubstance use among child welfare-involved youth. This study aimed to explore whether physical abuse, parental substance use, depression, and demographic characteristics predict distinct patterns of substance use among child welfare-involved youth using latent class analysis (LCA). The sample included 822 11-17 year olds who participated in the National Survey of Child and Adolescent Well-being (NSCAW II) study between March 2008 and September 2009. We found the following three classes: (1) polysubstance use, (2) alcohol and marijuana use, and (3) low use. Older youth and youth who experienced physical abuse were at greater risk of being in the polysubstance use class, while living with a biological parent reduced the likelihood of polysubstance use class membership. Youth in the alcohol and marijuana use class were more likely to be older and depressed. Results from this study illuminate important targets for interventions.
Full Text Available Substance abuse is widely regarded as a major health and social problem in South Africa, and particularly in the Western Cape (Corrigall, Ward, Stinson, Struthers, Frantz, Lund, Flisher & Joska, 2007; Myers, Fakier & Louw, 2009. The complex nature of patterns of substance abuse, as well as the particular problems associated with this abuse, has implications for the development and implementation of treatment interventions. The most common primary drug of abuse in the Western Cape amongst patients admitted to treatment programmes is methamphetamine (known locally as “tik” (Dada, Plüddemann, Parry, Vawda & Fourie, 2012. The previous decade saw a dramatic rise in methamphetamine (hereafter indicated as MA use, particularly among youths, with over half the patients in treatment for MA abuse being younger than 25 years (Plüddemann, Parry, Dada, Bhana, Bachoo & Fourie, 2010. MA is also often used in combination with other drugs, and this prevalence of poly-substance abuse needs to be taken into account in the planning of services (Harker, Kader, Myers, Falkier, Parry, Flisher, Peltzer, Ramlagan & Davids, 2008.
Pinto, S M; Dodd, S; Walkinshaw, S A; Siney, C; Kakkar, P; Mousa, H A
To determine the contribution of drug use to maternal and perinatal complications, controlling for social confounders. This is a retrospective cohort study of 247 drug-using women and 741 controls over a 4-year period from 1997 to 2000. Cases were identified from the drug dependency register. Three controls for each woman with substance abuse were selected from the delivery suite records, with calliper matching by year of delivery (any control patient who delivered within 6 months before or after the date of delivery of a drug-using woman was considered as a potential match) and district of residence (post code). The primary outcomes of interest were preterm birth, abruption, pre-eclampsia, intrauterine growth restriction and low birth weight. There were statistically significantly more preterm births amongst drug-using women (relative risk (RR) 2.5, 95% confidence interval (CI) 1.6-3.8), with preterm births complicating 25% of births amongst drug users. The incidence of low birth weight was 30.8% amongst drug-using women compared to 8% in control women (RR 3.6, CI 2.4-5.4), and the incidence of growth restriction was 25%, significantly higher than the control group (RR 3.82, CI 2.4-6.1). The risk of abruption was also higher (RR 2.74, CI 1.1-7.0). Of note is the extremely low incidence of pre-eclampsia among drug users, even after controlling for the confounder effects of parity and smoking. Despite multidisciplinary co-ordinated antenatal care, women with substance abuse during pregnancy are at significant risk of adverse obstetric and perinatal outcome, controlling for social confounders. A limitation of the study is that the sample size was not large enough to clearly assess individual drugs. This is the first study to highlight low incidence of pre-eclampsia among drug users over and above the effect of smoking. Further research is needed to elucidate the underlying biological reason for the lack of pre-eclampsia in women with substance abuse during pregnancy
Shepard, Donald S; Daley, Marilyn; Ritter, Grant A; Hodgkin, Dominic; Beinecke, Richard H
In the US, the spiraling costs of substance abuse and mental health treatment caused many state Medicaid agencies to adopt managed behavioral health care (MBHC) plans during the 1990s. Although research suggests that these plans have successfully reduced public sector spending, their impact on the quality of substance abuse treatment has not been established. The Massachusetts Medicaid program started a risk-sharing contract with MHMA, a private, for-profit specialty managed behavioral health care (MBHC) carve-out vendor on July 1, 1992. This paper evaluates the carve-out s impact on spending per inpatient episode and three proxy measures of quality: (i) access to inpatient treatment (ii) 30-day re-admissions and (iii) continuity of care. Medicaid claims for inpatient treatment were collapsed into episodes. Clients were tracked across the five-year period and an interrupted time series design was used to compare the three quality outcomes and spending in the year prior to (FY1992) and the four years during MHMA (FY1993-FY1996). Logistic and linear regression models were used to control for race, disability status, age, gender and primary diagnosis. Despite a 99% reduction in the use of hospital-based settings, access to 24-hour services overall increased by 38%, largely due to an expansion in the use of freestanding detoxification and acute residential services. Continuity improved by 73%. Nevertheless, rates of 7-day (58%) and 30-day (24%) readmission increased significantly, even after controlling for increases in disability status. Per episode spending decreased by 76% ($2,773), characterized by a dramatic spending reduction in FY1993 that was maintained but not augmented in subsequent years. The carve-out had mixed effects on the quality of substance abuse treatment. While one of the three measures (readmission rates) deteriorated, two improved (access and continuity). Rapid re-admissions were strongly associated with shorter lengths of stay, suggesting that
Scheidell, Joy D; Kumar, Pritika C; Campion, Taylor; Quinn, Kelly; Beharie, Nisha; McGorray, Susan P; Khan, Maria R
Child sexual abuse is associated with substance use and sexual risk behaviors during adolescence and adulthood, but no known studies have documented associations across the life course in a nationally representative U.S. We used the National Longitudinal Study of Adolescent to Adult Health to measure associations between child sexual abuse and substance use and sexual risk behaviors during adolescence, young adulthood, and adulthood among males and females (n = 11,820). Approximately 10% of females and 7% of males reported child sexual abuse. Associations with substance use were strongest during adolescence and lessened over time. Increased odds of sexual risk among those with a history of child sexual abuse remained consistent through the life course. Significant gender differences existed for some associations (e.g., adulthood multiple partners: males adjusted odds ratio (AOR) = 1.73, 95%CI:1.18, 2.53; females AOR = 1.11, 95%CI:0.79, 1.56). Trauma-informed prevention interventions should address child sexual abuse among both males and females to prevent substance use and sexual risk behavior throughout the life course.
... OFFICE OF NATIONAL DRUG CONTROL POLICY Technology Innovations for Substance Abuse and Mental... National Drug Control Policy. ACTION: Notice. Location: Eisenhower Executive Office Building, South Court....m.-1:00 p.m. SUMMARY: The Office of National Drug Control Policy (ONDCP) and the Substance Abuse and...
Watson, Donnie W.; Rawson, Richard R.; Rataemane, Solomon; Shafer, Michael S.; Obert, Jeanne; Bisesi, Lorrie; Tanamly, Susie
This paper presents a rationale for the use of a distance education approach in the clinical training of community substance abuse treatment providers. Developing and testing new approaches to the clinical training and supervision of providers is important in the substance abuse treatment field where new information is always available. A…
Diaz, Naelys; Horton, Eloise G.; McIlveen, John; Weiner, Michael; Nelson, Jenniffer
The purpose of this study was to examine the individual characteristics and mental health factors of dysthymic and nondysthymic substance abusers. Out of a total of 1,209 medical records reviewed to select cases of dysthymic and nondysthymic substance abusers attending a community drug treatment program, 183 medical records were selected, 48% of…
Stice, Eric; Presnell, Katherine; Bearman, Sarah Kate
Used interview data from a community study to test whether early menarche partially accounts for increased depression, eating pathology, substance abuse, and comorbid psychopathology among adolescent girls. Found that menarche prior to 11.6 years related to elevated depression and substance abuse. Findings support assertion that early menarche is…
Stephens, Peggy C.; Sloboda, Zili; Grey, Scott; Stephens, Richard; Hammond, Augustine; Hawthorne, Richard; Teasdale, Brent; Williams, Joseph
Drawing on the elaboration likelihood model of persuasive communication, the authors examine the impact of the perceptions of the instructor or source on students' receptivity to a new substance abuse prevention curriculum. Using survey data from a cohort of students participating in the Adolescent Substance Abuse Prevention Study, the authors use…
Bright, Charlotte Lyn; Osborne, Victoria A; Greif, Geoffrey L
Women and men have different histories, presentations, and behaviors in substance abuse groups. Twelve considerations are offered for the beginning group leader when encountering women with substance abuse issues. These include understanding sexism, what brings women to treatment, and how women behave in group treatment. Implications for clinical practice with women in single-gender and mixed-gender groups are included.
Columbia Univ., New York, NY. National Center on Addiction and Substance Abuse.
The National Center on Addiction and Substance Abuses surveys have consistently found that the family is fundamental to keeping children away from tobacco, alcohol and illegal drugs. This 2002 survey keeps the focus on family and seeks to assess the impact of siblings on the likelihood of teen substance abuse. This year 1,000 teens ages 12 to 17…
Goodwin, Lloyd R., Jr.
East Carolina University has one of the few comprehensive substance abuse counselor education (SACE) programs in the nation that offers an undergraduate, master's, and doctoral level of preparation in substance abuse counseling. This article describes the evolution of this SACE from its beginning in 1972 to its current status. This comprehensive…
Timko, Christine; Valenstein, Helen; Stuart, Gregory L; Moos, Rudolf H
The association between substance abuse and intimate partner violence is quite robust. A promising area to improve treatment for the dual problems of substance abuse and violence perpetration is the identification of client characteristics and organisational and programme factors as predictors of health outcomes. Therefore, we examined associations of client, organisational and programme factors with outcomes in community health settings. Directors of 241 substance use disorder programmes (SUDPs) and 235 batterer intervention programmes (BIPs) reported outcomes of programme completion and substance use and violence perpetration rates at discharge; data collection and processing were completed in 2012. SUDPs having more female, non-white, younger, uneducated, unemployed and lower income clients reported lower completion rates. In SUDPs, private, for-profit programmes reported higher completion rates than public or private, non-profit programmes. SUDPs with lower proportions of their budgets from government sources, and higher proportions from client fees, reported better outcomes. Larger SUDPs had poorer programme completion and higher substance use rates. Completion rates in SUDPs were higher when clients could obtain substance- and violence-related help at one location, and programmes integrated violence-prevention contracting into care. In BIPs, few client, organisational and programme factors were associated with outcomes, but the significant factors associated with programme completion were consistent with those for SUDPs. Publicly owned and larger programmes, and SUDPs lacking staff to integrate violence-related treatment, may be at risk of poorer client outcomes, but could learn from programmes that perform well to yield better outcomes. © 2014 John Wiley & Sons Ltd.
Lynch, Wendy J; Nicholson, Katherine L; Dance, Mario E; Morgan, Richard W; Foley, Patricia L
Substance abuse and addiction are well recognized public health concerns, with 2 NIH institutes (the National Institute on Drug Abuse and the National Institute on Alcohol Abuse and Alcoholism) specifically targeting this societal problem. As such, this is an important area of research for which animal experiments play a critical role. This overview presents the importance of substance abuse and addiction in society; reviews the development and refinement of animal models that address crucial areas of biology, pathophysiology, clinical treatments, and drug screening for abuse liability; and discusses some of the unique veterinary, husbandry, and IACUC challenges associated with these models.
Harris, John M; Sun, Huaping
To compare the educational effectiveness of two virtual patient (VP)-based e-learning strategies, versus no training, in improving physicians' substance abuse management knowledge, attitudes, self-reported behaviors, and decision making. The 2011-2012 study was a posttest-only, three-arm, randomized controlled trial in 90 resident and 30 faculty physicians from five adult medicine primary care training programs. The intervention was one of two 2-hour VP-based e-learning programs, designed by national experts to teach structured screening, brief interventions, referral, and treatment skills. One used traditional problem solving with feedback (unworked example), and the other incorporated an expert demonstration first, followed by problem solving with feedback (worked example). The main outcome measure was performance on the Physicians' Competence in Substance Abuse Test (P-CSAT, maximum score = 315), a self-administered, previously validated measure of physicians' competence in managing substance abuse. The survey was completed at the outset of the study and two months later. Overall P-CSAT scores were virtually identical (202-211, P > .05) between both intervention groups and the no-training control group at both times. Average faculty P-CSAT scores (221.9, 224.6) were significantly higher (P study did not provide evidence that a brief, worked example, VP-based e-learning program or a traditional, unworked, VP-based e-learning program was superior to no training in improving physicians' substance abuse management skills. The study did provide additional evidence that the P-CSAT distinguishes between physicians who should possess different levels of substance abuse management skills.
Background Several aspects linked to social are involved in the onset of depressive feelings. We aimed to find out if social adaptability and substance abuse predict depression among end-stage renal disease (ESRD) patients undergoing hemodialysis (HD). Methods We included 145 ESRD patients undergoing HD. Social adaptability was estimated by the Social Adaptability Index (SAI). Substance abuse was defined according to SAI. We screened for depression by applying the 20-item version of the Center for Epidemiologic Studies Depression Scale. A score ≥ 24 classified the patients as depressed. Comparisons between depressed and non-depressed patients were carried out and logistic regression was performed to test gender, age, total SAI, SAI without the substance abuse item, only the substance abuse score and substance abuse as a categorical variable (yes/no) as predictors of depression. Results There were 36 (24.8%) depressed patients. There were no differences regarding demographic and laboratory data between the depressed and non-depressed patients. Mean SAI among depressed and non-depressed patients was, respectively, 6.1 ± 1.6 vs. 6.2 ± 1.9 (p=0.901). The percentage of patients with or without substance abuse among depressed patients was, respectively, 13.8% vs. 13.9% (p=1.000). Gender, age, total SAI, SAI without the substance abuse item, only the substance abuse score and substance abuse as a categorical variable did not predict depression. Conclusions Social adaptability and substance abuse did not predict depression in HD patients. We propose that aspects related to socioeconomic status not comprised in SAI items should be ruled out as predictors of depression. PMID:23320829
McCauley, Jenna L; Kilpatrick, Dean G; Walsh, Kate; Resnick, Heidi S
To examine post-rape substance use, associated post rape medical and social concern variables, and past year substance abuse among women reporting having received medical care following a most recent or only lifetime incident of rape. Using a subsample of women who received post-rape medical care following a most recent or only rape incident (n=104) drawn from a national household probability sample of U.S. women, the current study described the extent of peritraumatic substance use, past year substance misuse behaviors, post-rape HIV and pregnancy concerns, and lifetime mental health service utilization as a function of substance use at time of incident. One-third (33%) of women seeking post-rape medical attention reported consuming alcohol or drugs at the time of their rape incident. Nearly one in four (24.7%) and one in seven (15%) women seeking medical attention following their most recent rape incident endorsed drug (marijuana, illicit, non-medical use of prescription drugs, or club drug) use or met substance abuse criteria, respectively, in the past year. One in twelve (8.4%) women reported at least monthly binge drinking in the past year. Approximately two-thirds of women reported seeking services for mental health needs in their lifetime. Post-rape concerns among women reporting peritraumatic substance use were not significantly different from those of women not reporting such use. Substance use was reported by approximately one-third of women and past year substance abuse was common among those seeking post-rape medical care. Implications for service delivery, intervention implementation, and future research are discussed. Copyright © 2012 Elsevier Ltd. All rights reserved.
Gallimberti, Luigi; Buja, Alessandra; Chindamo, Sonia; Rabensteiner, Andrea; Terraneo, Alberto; Marini, Elena; Pérez, Luis Javier Gómez; Baldo, Vincenzo
Problematic use of video games (PUVG) is associated with substance use in middle school students. The aim of our study was to examine the association between PUVG and substance abuse in children and young adolescents. A survey was conducted during the 2014-2015 school year in Padua (northeastern Italy). The sample consisted of 1156 students in grades 6 to 8. A multivariate logistic regression model was applied to seek associations between PUVG (dependent variable) and independent variables. Logistic regression showed that lifetime drunkenness, combined energy drink and alcohol consumption (lifetime), reading comics, and disrespect for rules increased the odds of PUVG, whereas playing competitive sport, eating fruit and/or vegetables daily, finding it easy to talk with fathers and being female lowered the odds of PUVG in early adolescence. Our findings show that PUVG is more likely in young adolescents at risk of substance abuse. Prevention schemes focusing on early adolescence should be based on a multicomponent intervention strategy that takes PUVG into account.
Banducci, Anne N; Hoffman, Elana; Lejuez, C W; Koenen, Karestan C
Adults with substance use disorders (SUDs) report higher rates of child abuse than adults without SUDs. Prior work suggests that this abuse is associated with higher rates of psychosis, posttraumatic stress disorder, physical health problems, alcohol dependence, and cannabis dependence among substance users. Little is known about other problems associated with child abuse experienced by substance users. We hypothesized that among adults with SUDs, child abuse would be associated with elevated rates of all Diagnostic and Statistical Manual (DSM-IV-TR) psychiatric disorders, substance dependencies, and comorbidities assessed. We assessed 280 inpatients in substance use treatment with the Structured Clinical Interview for the DSM-IV-TR, the Diagnostic Instrument for Personality Disorders, and Childhood Trauma Questionnaire (CTQ). We used chi-square and regression analyses to establish whether rates of psychiatric disorders, substance dependencies, and comorbidities differed as a function of child abuse. Consistent with our hypotheses, higher scores on the CTQ were associated with elevated rates of psychiatric disorders (mood disorders, anxiety disorders, psychotic symptoms, and personality disorders) and substance dependencies (alcohol dependence and cocaine dependence). Moreover, higher rates of all comorbidity patterns (e.g. comorbid alcohol dependence and anxiety) were observed among individuals who reported experiencing child abuse. Across all substance dependencies examined, individuals who had been abused had significantly higher rates of all psychiatric disorders assessed. Individuals with substance use disorders who have been abused have particularly elevated rates of psychiatric and substance use disorders as a function of their abuse experiences. These findings have important treatment implications for individuals in residential substance use treatment settings. Copyright © 2014 Elsevier Ltd. All rights reserved.
Mathew, R J; Mathew, V G; Wilson, W H; Georgi, J M
A modified version of an instrument called the Mathew Materialism-Spiritualism Scale (MMSS), originally developed in India, was evaluated for possible use in substance abuse research in the U.S. The scale was administered to 62 individuals recovering from substance use, 20 clergy people and 61 general controls. Test-retest reliability for the MMSS was verified by administering it to 18 control subjects on two separate occasions, 7 days apart. The Pearson correlation for the MMSS total scores was 0.83 (p < .0001). Internal consistency was examined with Cronbach's alpha in the entire sample of 143 subjects; the result for the total score was .93. Factor analysis showed a factor structure compatible with the subscales proposed by the developer. Women, in general, obtained higher spirituality scores. Members of the recovering group obtained significantly higher scores on "character" and "mysticism" than the general controls. When general controls were divided into MAST positive and MAST negative individuals, the MAST positive group obtained lower scores than the recovering group for "God," "mysticism" and "character." MAST negative individuals had lower scores on "mysticism" than the recovering group. Christians had higher scores on "God" and "religion" subscales than did nonChristians and agnostics. The results of this study need confirmation using an improved methodology and larger sample sizes. However, they suggest that the scale may be useful for the study of spirituality in the U.S.
Full Text Available Objective: This study aimed to examine the effect of dialectic behavior therapy on the reduction of impulsiveness in women with comorbidity of borderline personality disorders and substance abuse. Method: An experimental single system research design using multiple baselines was employed for this study. Based on the structured diagnostic interview and entry criteria, four participants among female patients with borderline personality disorders and substance abuse were selected via purposive sampling method. All four subjects received twelve dialectic behavior therapy sessions. Then, Impulsiveness Bart Scale (IBS was used to measure impulsiveness. Results: Dialectic behavior therapy led to the significant reduction of impulsiveness scores in women with borderline personality disorders and substance abuse. Graphs pertaining to the effectiveness and effect size indicate a significant decrease in participants’ impulsiveness. Conclusion: Dialectic behavior therapy interventions can contribute to the decrease of impulsiveness and bring about desired practical implications in the treatment and prevention of substance abuse.
Urbanoski, Karen A; Cairney, John; Adlaf, Edward; Rush, Brian
Evidence suggests that substance abuse negatively affects both psychiatric symptom severity and quality of life (QOL) in people with severe mental illness (SMI). However, these relationships have not been examined simultaneously, nor have they been characterized over time. Thus, it is difficult to appreciate the extent to which substance abuse exerts an enduring effect on psychiatric symptoms and distress and/or QOL in this population. The purpose of this study is to test a conceptual model linking these factors together. Subjects were participants in a longitudinal evaluation of community mental healthcare in Ontario (n = 133). Comprehensive consumer assessments were conducted at treatment entry, and at 9 and 18 months. Subjects were receiving intensive case management or assertive community treatment throughout the 18-month study period. Structural equation modelling was used to examine the concurrent and longitudinal relationships between substance abuse, symptoms and distress, and QOL. The prevalence of substance abuse was 55.0%. The SEM analysis suggested that substance abuse at baseline was associated with elevated symptomatology and distress and lower QOL, and that these effects endured after 18 months of treatment. Psychiatric symptoms and distress mediated the negative relationship between substance abuse and QOL. The mediating role played by symptom and distress levels in the relationship between substance abuse and QOL suggests the importance of closely monitoring changes in these factors among SMI patients with substance problems. Tracking symptom severity and distress levels over time will allow service providers to intervene and potentially improve the QOL of individuals with SMI.
Eby, Lillian T.; Curtis, Sara L.
This longitudinal study investigated the extent to which substance abuse (SA) clinician turnover is associated with SA-specific knowledge loss due to change in professions (professional turnover) versus SA-specific knowledge transfer due to movement from one SA clinical setting to another (treatment program turnover). For this study, clinicians had to voluntarily leave their current treatment program. Eligible clinicians completed a quantitative survey while employed and a qualitative post-employment exit interview 1 year later. Compared to those that exited the SA profession (N = 99), clinicians who changed treatment programs (N = 120) had greater SA-specific formal knowledge and were more likely to be personally in recovery. No differences were found between the two groups in terms of SA-specific practical knowledge. PMID:25115318
Thibodeau, Eric L; August, Gerald J; Cicchetti, Dante; Symons, Frank J
Preventive interventions that target high-risk youth, via one-size-fits-all approaches, have demonstrated modest effects in reducing rates of substance use. Recently, substance use researchers have recommended personalized intervention strategies. Central to these approaches is matching preventatives to characteristics of an individual that have been shown to predict outcomes. One compelling body of literature on person × environment interactions is that of environmental sensitivity theories, including differential susceptibility theory and vantage sensitivity. Recent experimental evidence has demonstrated that environmental sensitivity (ES) factors moderate substance abuse outcomes. We propose that ES factors may augment current personalization strategies such as matching based on risk factors/severity of problem behaviors (risk severity (RS)). Specifically, individuals most sensitive to environmental influence may be those most responsive to intervention in general and thus need only a brief-type or lower-intensity program to show gains, while those least sensitive may require more comprehensive or intensive programming for optimal responsiveness. We provide an example from ongoing research to illustrate how ES factors can be incorporated into prevention trials aimed at high-risk adolescents.
Morton, Cory M; Simmel, Cassandra; Peterson, N Andrew
This study investigates the relationship between concentrations of on- and off-premises alcohol outlets and rates of child abuse and neglect. Additionally, the study seeks to locate protective features of a neighborhood's built environment by investigating the potentially moderating role that access to substance abuse treatment and prevention services plays in the relationship between alcohol outlet density and child maltreatment. Using a cross-sectional design, this ecological study utilized data from 163 census tracts in Bergen County, New Jersey, on reports of child abuse and neglect, alcohol outlets, substance abuse treatment and prevention facilities, and the United States Census to investigate the linkages between socioeconomic structure, alcohol availability, and access to substance abuse service facilities on rates of child abuse and neglect. Findings indicate areas with a greater concentration of on-premises alcohol outlets (i.e., bars) had higher rates of child neglect, and those with easier access to substance abuse services had lower rates of neglect, controlling for neighborhood demographic and socioeconomic structure. Additionally, the relationship between on-premises alcohol outlet density and rates of child neglect was moderated by the presence of substance abuse service facilities. A greater concentration of off-premises outlets (i.e., liquor stores) was associated with lower rates of physical abuse. Findings suggest that the built environment and socioeconomic structure of neighborhoods have important consequences for child well-being. The implications for future research on the structural features of neighborhoods that are associated with child well-being are discussed. Copyright © 2014 Elsevier Ltd. All rights reserved.
McCarty, Dennis; Braude, Lisa; Dougherty, Richard H.; Daniels, Allen S.; Ghose, Sushmita Shoma; Delphin-Rittmon, Miriam E.
Objective Substance abuse intensive outpatient programs (IOPs) are direct services for people with substance use disorders or co-occurring mental and substance use disorders who do not require medical detoxification or 24-hour supervision. IOPs are alternatives to inpatient and residential treatment. They are designed to establish psychosocial supports and facilitate relapse management and coping strategies. This article assesses their evidence base. Methods Authors searched major databases: PubMed, PsycINFO, Applied Social Sciences Index and Abstracts, Sociological Abstracts, Social Services Abstracts, Published International Literature on Traumatic Stress, the Educational Resources Information Center, and the Cumulative Index to Nursing and Allied Health Literature. They identified 12 individual studies and one review published between 1995 and 2012. They chose from three levels of research evidence (high, moderate, and low) based on benchmarks for the number of studies and quality of their methodology. They also described the evidence of service effectiveness. Results Based on the quality of trials, diversity of settings, and consistency of outcomes, the level of evidence for IOP research was considered high. Multiple randomized trials and naturalistic analyses compared IOPs with inpatient or residential care; these types of services had comparable outcomes. All studies reported substantial reductions in alcohol and drug use between baseline and follow-up. However, substantial variability in the operationalization of IOPs and outcome measures was apparent. Conclusions IOPs are an important part of the continuum of care for alcohol and drug use disorders. They are as effective as inpatient treatment for most individuals seeking care. Public and commercial health plans should consider IOP treatment as a covered health benefit. Standardization of the elements included in IOPs may improve their quality and effectiveness. PMID:24445620
Frielink, N.; Schuengel, C.; Kroon, A.; Embregts, P.J.C.M.
Background Despite a lack of consensus regarding prevalence rates of substance abuse, people with intellectual disabilities (ID) on average use substances slightly less often than their non-disabled peers. However, their use of substances is more often problematic. Avoidance of treatment is a
Frielink, N.; Schuengel, C.; Kroon, A.; Embregts, P.C.J.M.
Background: Despite a lack of consensus regarding prevalence rates of substance abuse, people with intellectual disabilities (ID) on average use substances slightly less often than their non-disabled peers. However, their use of substances is more often problematic. Avoidance of treatment is a
Edwards, Jessica M; Stein-Seroussi, Al; Flewelling, Robert L; Orwin, Robert G; Zhang, Lei
Recent national substance abuse prevention efforts that have been disseminated at the state level have provided fertile ground for addressing the dearth of systematic research on state-level substance abuse prevention infrastructure. The Strategic Prevention Framework State Incentive Grant Program (SPF SIG), a national public health initiative sponsored by the US Substance Abuse and Mental Health Services Administration and its Center for Substance Abuse Prevention, is one such effort, providing an opportunity to examine state-level substance abuse prevention infrastructure across the country. The aims of the SPF SIG initiative include reducing substance abuse and its related problems, as well as enhancing state and local prevention infrastructure and capacity. In this article, we describe the status of state-level substance abuse prevention infrastructure and capacity 1 year after the first 26 funded states ended their projects, based on follow-up interviews with state prevention decision-makers. We found that, in five of the six prevention domains we measured, prevention infrastructure capacity increased during the 12-month period after the grants ended. The evidence for further SPF capacity development even after the conclusion of the grants suggests that states recognized the benefits of using the SPF and took deliberate steps to sustain and enhance the integration of this framework into their state prevention systems. In addition, the findings suggest that state agencies and organizations can benefit from time-limited resources aimed at increasing their capacity and that such efforts can have a lasting impact on measures of state prevention system capacity.
Using electronic health record data for substance use Screening, Brief Intervention, and Referral to Treatment among adults with type 2 diabetes: Design of a National Drug Abuse Treatment Clinical Trials Network study.
Wu, Li-Tzy; Brady, Kathleen T; Spratt, Susan E; Dunham, Ashley A; Heidenfelder, Brooke; Batch, Bryan C; Lindblad, Robert; VanVeldhuisen, Paul; Rusincovitch, Shelley A; Killeen, Therese K; Ghitza, Udi E
The Affordable Care Act encourages healthcare systems to integrate behavioral and medical healthcare, as well as to employ electronic health records (EHRs) for health information exchange and quality improvement. Pragmatic research paradigms that employ EHRs in research are needed to produce clinical evidence in real-world medical settings for informing learning healthcare systems. Adults with comorbid diabetes and substance use disorders (SUDs) tend to use costly inpatient treatments; however, there is a lack of empirical data on implementing behavioral healthcare to reduce health risk in adults with high-risk diabetes. Given the complexity of high-risk patients' medical problems and the cost of conducting randomized trials, a feasibility project is warranted to guide practical study designs. We describe the study design, which explores the feasibility of implementing substance use Screening, Brief Intervention, and Referral to Treatment (SBIRT) among adults with high-risk type 2 diabetes mellitus (T2DM) within a home-based primary care setting. Our study includes the development of an integrated EHR datamart to identify eligible patients and collect diabetes healthcare data, and the use of a geographic health information system to understand the social context in patients' communities. Analysis will examine recruitment, proportion of patients receiving brief intervention and/or referrals, substance use, SUD treatment use, diabetes outcomes, and retention. By capitalizing on an existing T2DM project that uses home-based primary care, our study results will provide timely clinical information to inform the designs and implementation of future SBIRT studies among adults with multiple medical conditions. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.
Using Electronic Health Records Data for Substance Use Screening, Brief Intervention, and Referral to Treatment among Adults with Type 2 Diabetes: Design of a National Drug Abuse Treatment Clinical Trials Network Study
Wu, Li-Tzy; Brady, Kathleen T.; Spratt, Susan E.; Dunham, Ashley A.; Heidenfelder, Brooke; Batch, Bryan C.; Lindblad, Robert; VanVeldhuisen, Paul; Rusincovitch, Shelley A.; Killeen, Therese K.; Ghitza, Udi E.
Background The Affordable Care Act encourages healthcare systems to integrate behavioral and medical healthcare, as well as to employ electronic health records (EHRs) for health information exchange and quality improvement. Pragmatic research paradigms that employ EHRs in research are needed to produce clinical evidence in real-world medical settings for informing learning healthcare systems. Adults with comorbid diabetes and substance use disorders (SUDs) tend to use costly inpatient treatments; however, there is a lack of empirical data on implementing behavioral healthcare to reduce health risk in adults with high-risk diabetes. Given the complexity of high-risk patients' medical problems and the cost of conducting randomized trials, a feasibility project is warranted to guide practical study designs. Methods We describe the study design, which explores the feasibility of implementing substance use Screening, Brief Intervention, and Referral to Treatment (SBIRT) among adults with high-risk type 2 diabetes mellitus (T2DM) within a home-based primary care setting. Our study includes the development of an integrated EHR datamart to identify eligible patients and collect diabetes healthcare data, and the use of a geographic health information system to understand the social context in patients' communities. Analysis will examine recruitment, proportion of patients receiving brief intervention and/or referrals, substance use, SUD treatment use, diabetes outcomes, and retention. Discussion By capitalizing on an existing T2DM project that uses home-based primary care, our study results will provide timely clinical information to inform the designs and implementation of future SBIRT studies among adults with multiple medical conditions. PMID:26563446
Saxena, Vartika; Saxena, Yogesh; Kishore, Gaurav; Kumar, Pratap
Adolescent boys are recognized as a vulnerable group to substance abuse. The present study has the objective to study the biosocial profile and habit pattern of substance abusers. The study was conducted on 511 male adolescents, students of 10 th to 12 th class from the four intermediate schools of the Doiwala block of Dehradun district. 46.9% students accepted substance abuse. In 75.5% cases, friends were providing the substances. 80.2% substance abusers expressed their desire to quit the habit. The study is indicative of need for developing a supportive environment involving both parents and teachers so that adolescent can decide and sustain with the right choices for healthy life.
Papachristou, Ec; Anagnostopoulos, Dk
normal intelligence adolescents with behavioral disorders. Risk factors that increase the chances of developing either simple or more complicated types of psychopathology in adolescents with mental retardation have been found to be based on individual, family and social levels. On the other hand, the individual characteristics of adolescents (intellectual level, attention capacity, understandable linguistic expression, overall progress until adolescence), the existence of a supportive family environment and the presence of social support and awareness through the creation of special counseling, education and medical services, are the most important protective factors which contribute to the prevention of several forms of psychopathology in adolescents with mental retardation. For the writing of the literature review, the following electronic databases were used: PubMed, Scopus, Psycinfo, Cochrane Library, Web of Science and Google Scholar. The key words used were: Intellectual Disability, Behavioral disorders, Adolescents, Mental Retardation, Learning disabilities, Developmental Disabilities, Disruptive behaviour disorders, Conduct disorder, Substance Abuse, Substance Misuse, Oppositional defiant disorder, Alcohol and illicit drug use, Smoking Use, Young people, Teenagers, Youths.
Full Text Available Impaired mucociliary clearance (MCC is a hallmark of acquired chronic airway diseases like chronic bronchitis associated with chronic obstructive pulmonary disease (COPD and asthma. This manifests as microbial colonization of the lung consequently leading to recurrent respiratory infections. People living with HIV demonstrate increased incidence of these chronic airway diseases. Bacterial pneumonia continues to be an important comorbidity in people living with HIV even though anti-retroviral therapy has succeeded in restoring CD4+ cell counts. People living with HIV demonstrate increased microbial colonization of the lower airways. The microbial flora is similar to that observed in diseases like cystic fibrosis and COPD suggesting that mucociliary dysfunction could be a contributing factor to the increased incidence of chronic airway diseases in people living with HIV. The three principal components of the MCC apparatus are, a mucus layer, ciliary beating and a periciliary airway surface liquid (ASL layer that facilitates ciliary beating. Cystic fibrosis transmembrane conductance regulator (CFTR plays a pivotal role in regulating the periciliary airway surface liquid. HIV proteins can suppress all the components of the MCC apparatus by increasing mucus secretion and suppressing CFTR function. This can decrease ASL height leading to suppressed ciliary beating. The effects of HIV on MCC are exacerbated when combined with other aggravating factors like smoking or inhaled substance abuse, which by themselves can suppress one or more components of the MCC system. This review discusses the pathophysiological mechanisms that lead to MCC suppression in people living with HIV who also smoke tobacco or abuse illicit drugs.
Ray, Dee C; Lilly, J P; Gallina, Nancy; MacIan, Paula; Wilson, Brittany
Children who have experienced physical abuse benefit from a multitude of community interventions including support programs to address emotional and behavioral stability. This pilot study evaluated the services of Bikers Against Child Abuse (BACA), a community of bikers lending intervention to abused children, using a pre/post exploratory design. Participants (N=154) were children who had been referred by parents/guardians for current or past physical and/or sexual abuse. Parents/guardians of children were interviewed four times over a course of one year. Results indicated children demonstrated substantial improvements in their overall levels of emotional distress, conduct concerns, hyperactivity, and behavioral and emotional functioning. Overall, results support the premise that services provided by BACA may serve as a unique intervention for children who have experienced abuse. Copyright © 2017 Elsevier Ltd. All rights reserved.
Cheng, Z; Dai, M M; Cao, X B
Methadone maintenance treatment (MMT) greatly contributed to the successful outcomes of prevention and control on both AIDS and drug abuse in China. However, the features on drug abuse changed in the past decades, and the prevalence of new psychoactive substances abuse potentially somehow offset the achievement of MMT. This paper concised the information on research and surveys of this issue that targeting on the current situation, characteristics, related factors and relevant public health problem on new psychoactive substances abuse, among patients who have been on MMT, in China.
Mattoo, Surendra K; Singh, Shubh M; Bhardwaj, Rahul; Kumar, Suresh; Basu, Debasish; Kulhara, Parmanand
Life-time prevalence of epileptic seizures was assessed in 626 consecutive patients treated for substance abuse. Seizures were reported in 8.63% (9.2% in alcohol abusers, 12.5% in opioid abusers). A total of 64.8% of the seizures were associated with substance use. These occurred during withdrawal in the alcohol cohort and during intoxication with dextropropoxyphene and withdrawal from heroin or poppy husk in the opioid cohort. Results indicate that seizures may be more common in older patients with longer duration of dependence among those abusing alcohol.
Glover, N M
This article discusses the use of play therapy and art therapy treatment techniques for persons in substance abuse treatment who have a history of incest victimization. While substance abuse treatment focuses on substance abuse, neglecting to address issues related to past incest contact may increase the potential for relapse. This population displays unique characteristics that may prevent them from participating in, or benefitting from, traditional treatment modalities (which are highly dependent upon the verbal interactions between clients and therapists). Play therapy and art therapy are discussed in terms of history, rationale, and benefits to clients.
Haynes, Patricia L; Bootzin, Richard R; Smith, Leisha; Cousins, Jennifer; Cameron, Michael; Stevens, Sally
To examine whether change in total sleep time during an integrative, behavioral sleep intervention is associated with aggression. Specifically, we tested whether adolescents who reported experiencing aggressive thoughts or actions after treatment had worse treatment trajectories (e.g., less total sleep time across treatment) than adolescents with no aggressive thoughts or actions after treatment. Nonpharmacologic open trial with 9 weeks of weekly assessment. University of Arizona Sleep Research Laboratory Twenty-three adolescents recently treated for substance abuse in outpatient community centers. Six-week integrative, behavioral sleep intervention. Weekly sleep-summary indexes were calculated from daily sleep diaries and entered as dependent variables in a series of growth-curve analyses. Statistically significant Session x Post-treatment Aggressive Ideation interactions emerged when predicting changes in total sleep time, gamma13 = 9.76 (SE = 4.12), p aggressive ideation and the frequency of substance use, as assessed at baseline. A similar pattern of results was seen for self-reported aggressive actions occurring during conflicts. These pilot data suggest that inadequate sleep in substance-abusing adolescents may contribute to the experiencing of aggressive thoughts and actions. Limitations include a small sample size and a restricted assessment of aggression. Nonetheless, these findings lend preliminary support to the breadth of therapeutic effectiveness of an integrative, behavioral sleep-therapy program for adolescents with a history of substance abuse and related behaviors.
Bandyopadhyay, Dipankar; DeSantis, Stacia M; Korte, Jeffrey E; Brady, Kathleen T
Count data collected in substance abuse research often come with an excess of "zeroes," which are typically handled using zero-inflated regression models. However, there is a need to consider the design aspects of those studies before using such a statistical model to ascertain the sources of zeroes. We sought to illustrate hurdle models as alternatives to zero-inflated models to validate a two-stage decision-making process in situations of "excess zeroes." We use data from a study of 45 cocaine-dependent subjects where the primary scientific question was to evaluate whether study participation influences drug-seeking behavior. The outcome, "the frequency (count) of cocaine use days per week," is bounded (ranging from 0 to 7). We fit and compare binomial, Poisson, negative binomial, and the hurdle version of these models to study the effect of gender, age, time, and study participation on cocaine use. The hurdle binomial model provides the best fit. Gender and time are not predictive of use. Higher odds of use versus no use are associated with age; however once use is experienced, odds of further use decrease with increase in age. Participation was associated with higher odds of no-cocaine use; once there is use, participation reduced the odds of further use. Age and study participation are significantly predictive of cocaine-use behavior. The two-stage decision process as modeled by a hurdle binomial model (appropriate for bounded count data with excess zeroes) provides interesting insights into the study of covariate effects on count responses of substance use, when all enrolled subjects are believed to be "at-risk" of use.
Jester, Jennifer M; Nigg, Joel T; Buu, Anne; Puttler, Leon I; Glass, Jennifer M; Heitzeg, Mary M; Fitzgerald, Hiram E; Zucker, Robert A
Aggression and hyperactivity/inattention each are linked to risk of alcohol use disorder (AUD), but their unique contributions remain ambiguous. The present study disaggregated these two domains developmentally and examined the relation between childhood behavior trajectories and adolescent substance use. A total of 335 children of alcoholic and nonalcoholic fathers were studied prospectively. Parallel process latent trajectory class analysis was developed with behavioral ratings by parents and teachers of aggression and inattention/hyperactivity across ages 7 to 16. Membership in the four latent classes was used as a predictor for problem adolescence alcohol use and substance onset. Youths in the four latent trajectory classes differed in number of alcohol problems at age 16: healthy class (39% of sample, mean 2.1 alcohol-related problems), inattentive/hyperactive but not aggressive (33%; mean 2.7 problems), aggressive but not inattentive/hyperactive (4%, mean 5.0 problems), and comorbid (24%; mean 4.0 problems). Survival analysis revealed that the aggressive, comorbid, and inattentive/hyperactive classes had significantly earlier onsets of drinking, drunkenness, and marijuana use than the healthy class. Illicit drug use was also significantly increased in the comorbid, aggressive, and inattentive/hyperactive classes compared to the healthy class. Three levels of behavioral risk of substance abuse exist, the highest having trajectories of increased aggressive and inattentive/hyperactive problems throughout childhood, the next involving only an increased inattentive/hyperactive behavioral trajectory, and the lowest involving those with neither type of problem. Children with both inattention/hyperactivity and aggression have the greatest need for childhood intervention to prevent substance abuse in adolescence.
Igwe Wilson C
Full Text Available Abstract Background Association between psychiatric morbidity and substance abuse among adolescent has been reported. However prevalence and pattern of such dysfunctions are unknown in our environment. Aims To determine the prevalence of psychosocial dysfunction and depressive symptoms among adolescents who abuse substance and also note the influence of socio-demographic factors and type of substance on the pattern of dysfuction. Method A cross-sectional study was carried out among 900 adolescents selected from 29 secondary schools in Enugu metropolis. A multi-stage sampling procedure was used to select the students. The student drug use questionnaire was used to screen respondents for substance abuse. Those who were abusing substance and matched controls (non substance abusers were assessed for psychiatric symptoms using the 35-item Paediatric Symptom Checklist (PSC and the Zung Self-rating Depression Scale (SDS. Social classification was done using the parental educational attainment and occupation. Result A total of 290 students were current substance abusers. The substances most commonly abused were alcohol (31.6%, cola nitida (kola nut (20.7% and coffee (15.7%. Using the PSC scale, 70 (24.1% subjects compared to 29 (10.7% of the controls had scores in the morbidity range of ≥ 28 for psychosocial dysfuction. This was statistically significant (χ2 = 17.57 p = 0.001. Fifty-four subjects (18.6% had scores in the morbidity range of ≥ 50 for depressive symptoms using the Zung SDS compared to 21 (7.7% of controls. This was statistically significant (χ2 = 14.43, p = 0.001. Prevalence of dysfunction was not significantly related to age in both subjects and controls (χ2 = 4.62, p = 0.010, χ2 = 4.8, p = 0.10 respectively. Also using both scales, there was no significant relationship between psychosocial dysfunction and gender or social class in both subjects and control. The prevalence of dysfuction using both scales was significantly higher
MacKinnon, David P.; Lockwood, Chondra M.
The paper describes advances in statistical methods for prevention research with a particular focus on substance abuse prevention. Standard analysis methods are extended to the typical research designs and characteristics of the data collected in prevention research. Prevention research often includes longitudinal measurement, clustering of data in units such as schools or clinics, missing data, and categorical as well as continuous outcome variables. Statistical methods to handle these features of prevention data are outlined. Developments in mediation, moderation, and implementation analysis allow for the extraction of more detailed information from a prevention study. Advancements in the interpretation of prevention research results include more widespread calculation of effect size and statistical power, the use of confidence intervals as well as hypothesis testing, detailed causal analysis of research findings, and meta-analysis. The increased availability of statistical software has contributed greatly to the use of new methods in prevention research. It is likely that the Internet will continue to stimulate the development and application of new methods. PMID:12940467
Groman, Stephanie M; James, Alex S; Jentsch, J David
The co-morbidity between attention deficit hyperactivity disorder (ADHD) and substance abuse and dependence disorders may have multiple causes and consequences. In this review, we will describe neurobehavioral, genetic and animal model studies that support the notion that a common, genetically determined failure of response inhibition function is an endophenotype for both disorders. Through an impairment in the ability to cognitively control pre-potent behaviors, subjects can exhibit a collection of ADHD-like traits (impulsivity and hyperactivity), as well as susceptibility for the initiation of drug taking and its ultimate progression to an inflexible, uncontrollable form. At the neural level, dysfunction within circuitry that includes the ventrolateral frontal and cingulate cortices, as well as in associated basal ganglia zones, contributes to a common pattern of behavioral impairment, explaining aspects of co-morbidity. Animal models of substance abuse/dependence and ADHD that exhibit deficits in response inhibition have substantiated the role of this endophenotype in both disorders and their co-morbidity and should provide a testing ground for interventions targeting it. New directions for research that will further explore this hypothesis and begin to reveal the underlying biological mechanisms will be proposed.
Salah Adin Karimi
Full Text Available Background: Many researches have been done on the addiction process, but few studies have examined the process of resiliency against addiction. This study was aimed to identify the facilitating and inhibiting factors in the young people’s resiliency process by analyzing their living experiences. Methodology: This qualitative study was based on grounded theory with Strauss and Corbin’s approach. The data underwent open, axial and selective coding. The study focused on Darvaze Ghar neighborhood of Tehran. Data were collected through open unstructured interviews and focus group discussion. In total, 21 interviews were conducted with 12 respondents and a focus group discussion was held with 7 participants. Lincoln and Guba (1985 scales were used to ensure the trustworthiness of the study. Results: The obtained codes were classified into 19 categories, including personal characteristics, family support, culture, spirituality, spiritual beliefs, environment, and social interventions. According to their nature, these categories were facilitating or inhibiting the process of resiliency against substance abuse. Conclusion: The youth with more religious beliefs, awareness, self-confidence, optimism and hatred towards drugs are more resilient against substance abuse. Moreover, the families with a higher sense of responsibility trust and monitor their children’s activities, talk to them about different issues and provide them with good trainings from the very childhood; therefore their children will be more resilient against addiction.
Jerome, Lisa; Schuster, Shira; Yazar-Klosinski, B Berra
A wider array of treatments are needed for people with substance abuse disorders. Some psychedelic compounds have been assessed as potential substance abuse treatments with promising results. MDMA may also help treat substance abuse based on shared features with psychedelic compounds and recent reports indicating that MDMAassisted psychotherapy can reduce symptoms of PTSD. Narrative reports and data from early investigations found that some people reduced or eliminated their substance use after receiving MDMA, especially in a therapeutic setting. MDMA is a potent monoamine releaser with sympathomimetic effects that may indirectly activate 5-HT2A receptors. It increases interpersonal closeness and prosocial feelings, potentially through oxytocin release. Findings suggest that ecstasy, material represented as containing MDMA, is associated with deleterious long-term effects after heavy lifetime use, including fewer serotonin transporter sites and impaired verbal memory. Animal and human studies demonstrate moderate abuse liability for MDMA, and this effect may be of most concern to those treating substance abuse disorders. However, subjects who received MDMA-assisted psychotherapy in two recent clinical studies were not motivated to seek out ecstasy, and tested negative in random drug tests during follow-up in one study. MDMA could either directly treat neuropharmacological abnormalities associated with addiction, or it could indirectly assist with the therapeutic process or reduce symptoms of comorbid psychiatric conditions, providing a greater opportunity to address problematic substance use. Studies directly testing MDMA-assisted psychotherapy in people with active substance abuse disorder may be warranted.
Smedema, Susan Miller; Ebener, Deborah
To analyse the current state of the literature with respect to substance abuse and psychosocial adjustment in persons with disabilities. The two primary databases containing the literature related to rehabilitation and disability issues (PsychINFO and MedLine) were searched to identify articles addressing the psychosocial impact of substance abuse in persons with disabilities. Eleven empirical articles specifically measuring the strength of the relationship between substance use and psychosocial outcomes in persons with disabilities were selected for analysis. Of the studies identified, five were related to spinal cord injury, three were related to traumatic brain injury, one was related to chronic back pain, one was related to HIV/AIDS, and one was related to persons with any type of disability. Each of the studies used different methodologies, measured substance abuse in different ways, and examined different psychosocial outcome variables. Examination of trends suggested that pre-injury substance abuse appears to be unrelated to acceptance of disability in persons with spinal cord injury and negatively associated with satisfaction in persons with traumatic brain injury. Recent substance abuse tends to have a detrimental effect on psychosocial outcomes across all disability groups. Future research, combined with appropriate pre-service and continuing education related to substance abuse and disability for rehabilitation practitioners, has the potential to lead to improved psychosocial outcomes in persons with disabilities.
Evans, Elizabeth A; Glover, Dawn L; Washington, Donna L; Hamilton, Alison B
Women Veterans who use the Veterans Health Administration (VA) have high rates of substance abuse and poorer health than non-Veteran women. Less is known about the psychosocial needs of women Veterans who seek care in non-VA settings. We provide a grounded description of factors that impact substance abuse, mental health, and related quality of life of women Veterans who use non-VA community-based health and social services. Utilizing a mixed methods design, we conducted semi-structured in-person interviews with 22 women Veterans in Los Angeles in 2013-2015. The current health of these women Veterans was shaped by substance abuse and several other factors, including: histories of trauma (in childhood, during military service) and discrimination, and associated mental health conditions; post-military socio-economic stressors; shifting social roles and adverse social support; and lost personal identity after military service. Psychosocial factors collectively underscore areas in which delivery of health and social services to women Veterans being treated in non-VA settings could be improved: (1) diffuse, implement, and sustain evidence-based gender-sensitive substance abuse treatment; (2) address traumas contributing to poor health; (3) recognize stress proliferation processes erode women's capacity to access healthcare or cope with stressors in healthy ways; (4) champion women Veterans who embody resilience and thereby can help others to form empowered personal identities of health and wellness. Findings can inform interventions and services that ameliorate vulnerability to substance abuse and other health risks among women Veterans.
Waldman, H Barry; Perlman, Steven P
The rapidly evolving demographic base of our communities intensifies the need for an awareness which in the past seemed beyond the traditional concerns of pediatric dentists; in this case, substance abuse by teenagers. A review was carried out regarding evolving demographics, the proportion of teenagers involved with substance abuse, the rationale for the use of varying elicit substances and the associated symptoms. A series of options for action are considered given the potential for pediatric dentists to be involved in the care of teenagers using elicit substances.
Fernanda Jorge Guimarães
Full Text Available Alcohol is the most consumed drug in the world, which could generate social and health problems, affecting users, people living with them and the society in general. The aim was to identify the best evidence of interventions to reduce alcohol abuse. An integrative review of the literature, conducted on LILACS, CINAHL, PUBMED and SCOPUS, through the descriptors “intervention studies” and “alcoholism”. Nineteen articles were selected, most of them classified as two regarding level of evidence. They involved interventions with alcohol users, the most efficient were short interventions, internet-based interventions and counselling. Although cessation of alcohol use was not proved through the interventions, results point to a significant reduction in consumption, increase of the availability to change drinking habit and effective impact of short interventions when compared to usual treatments. Short interventions constitute the best interventions to reduce alcohol abuse.
U.S. Department of Health & Human Services — The National Survey of Substance Abuse Treatment Services (N-SSATS) is designed to collect information from all facilities in the United States, both public and...
U.S. Department of Health & Human Services — The National Survey of Substance Abuse Treatment Services (N-SSATS) is designed to collect information from all facilities in the United States, both public and...
U.S. Department of Health & Human Services — The National Survey of Substance Abuse Treatment Services (N-SSATS) is designed to collect information from all facilities in the United States, both public and...
Chartas, Nicole D.; Culbreth, John R.
This study explored the philosophical issues hindering the linkage of substance abuse and domestic violence treatment. Results suggest that counselors tend to use treatment models that could not concurrently assign responsibility and address either present or past victimization. (Author)
To elucidate the role of child sexual abuse in the etiology of substance-related disorders, a systematic review of the several articles on the childhood sexual abuse-related risk for developing substance problems in adolescence or adulthood is provided. Seven databases were searched, supplemented with hand-search of reference lists. Six reviews, including 200 studies, were included. Results indicate that child sexual abuse is a statistically significant, although general and nonspecific, risk factor for substance problems. Other biological and psychosocial variables contribute to substance-related disorders, with sexual abuse conferring additional risk, either as a distal, indirect cause or as a proximal, direct cause. Recommendations for future research are provided.
Liebetrau, G; Prasa, D; Hentschel, H; Deters, M
Because of their importance for clinical toxicology, developments of sub-stance abuse reported to the Poisons Information Centre (PIC) Erfurt were investigated and compared to other reasons of human exposures. A retrospective analysis of all human exposures (exposures of humans to substances in abuse, accidental and unknown circumstances, and suicide attempts) (n=125,130) from the beginning of 2002 to the end of 2011 was undertaken according to substance classes, reasons of exposures, symptom severity, age groups, and gender. Cases of substance abuse (3,760, 3.0% of all exposures) continuously increased from 252 (92 with one and 160 with multiple substances) in 2002 to 507 in 2011 (239 with one and 268 with multiple substances). In relation to all exposures, only the abuse of multiple substances rose significantly (pabuse significantly (pabuse significantly (pabuse significantly (psuicide attempts (9.6%; 4.4%). First legal highs exposures were registered in 2010 and led significantly (pabuse is shown by the fact that it resulted more often in moderate and severe symptoms than suicide attempts. Data on substance abuse from PICs could supplement official annual drug reports in aspects of clinical toxicology. © Georg Thieme Verlag KG Stuttgart · New York.
Full Text Available Abstract Background The substance abuse prevention goal of the theatre production "TUNNELS" was to provide community education on substance abuse to an audience in Durham, NC and surrounding communities. The education effort intended to increase awareness and understanding of the risk and protective factors associated with alcohol and other drug use, and to promote pro-active behaviors in substance abuse prevention within the adult community. It was hypothesized that community-based education via drama would change attitudes toward alcohol and substance abuse, and increase participation in family and community activities aimed at substance abuse prevention. Methods A focus group comprised of educators, substance abuse researchers and local substance abuse counselors developed "life stories" of users of alcohol and other drugs and a local playwright incorporated these and other experiences into a series of six vignettes. The production was publicized throughout the Durham area, and 700 adults attending the play signed a consent form and completed the pre-play survey. The participant pool was restricted to those adults who completed both the time-1 and time-2 surveys and resided within Durham and surrounding communities. Paired comparisons of mean responses were analyzed using a paired sample two-tailed t-test. A telephone survey three months after the play assessed attitudes toward substance abuse as a disease, and whether the respondents had increased their participation in prevention activities including discussions of the play with others. Results Viewing the play increased the knowledge base of participants regarding substance abuse as a disease, even though the audience demonstrated an appreciation of risk and protective factors prior to attending the performance. In the pre-play survey, participants indicated a strong opinion that parental involvement in teen life was important, and therefore this was not increased as a result of viewing
Davis, Dana; Hawk, Mary
This study explored trauma centers social workers' beliefs regarding four evidence-based interventions for patients presenting with substance abuse issues. Previous research has indicated that health care providers' beliefs have prevented them from implementing non-abstinence based interventions. Study results indicated that the majority of social workers believed in the 12-step approach and were least comfortable with the harm reduction approach. However, results showed that in some cases, social workers may have negative personal beliefs regarding non-abstinence based interventions, but do not let their personal beliefs get in the way of utilizing these interventions if they are viewed as appropriate for the client's situation.
Chaple, Michael; Sacks, Stanley; McKendrick, Karen; Marsch, Lisa A; Belenko, Steven; Leukefeld, Carl; Prendergast, Michael; French, Michael
Despite evidence that treatment is effective in reducing recidivism among inmates with substance use problems, scarce resources mean that few of those in need of treatment actually receive it. Computerized substance abuse interventions could be used to expand access to treatment in prisons without placing an undue burden on resources. The major aim of the study was to compare treatment conditions in terms of their service utilization, skills acquisition, and treatment satisfaction. The study recruited men and women with substance use disorders from 10 prisons in 4 states. In an open label clinical trial, 494 subjects were randomly assigned either to the Experimental condition, a computerized drug treatment intervention, the Therapeutic Education System (TES; n = 249), or to the Control condition, Standard Care ( n = 245). Chi-square tests compared groups on categorical variables and independent samples t tests were used for interval level continuous variables. Initial evidence demonstrated: (1) comparable group rates of session attendance and high rates of TES module completion for experimental subjects; (2) comparable group gains in the development of coping skills; and (3) a more favorable view of TES than of Standard Care . Collectively, these results show that a computerized intervention, such as TES, can be implemented successfully in prison. Given the barriers to the delivery of substance abuse treatment typically encountered in correctional settings, computerized interventions have the potential to fill a significant treatment gap and are particularly well suited to inmates with mild to moderate substance use disorders who often are not treated.
Richard G. Frank; Thomas G. McGuire
Background: Parity in insurance coverage for mental health and substance abuse has been a key goal of mental health and substance abuse care advocates in the United States during most of the past 20 years. The push for parity began during the era of indemnity insurance and fee for service payment when benefit design was the main rationing device in health care. The central economic argument for enacting legislation aimed at regulating the insurance benefit was to address market failure stemmi...
Horigian, Viviana E.; Espinal, Paula S.; Alonso, Elizabeth; Verdeja, Rosa E.; Duan, Rui; Usaga, Ingrid M.; Pérez-López, Alejandro; Marín-Navarrete, Rodrigo; Feaster, Daniel J.
ABSTRACT: Introduction: Evidence shows a lag in adoption of evidence-based practices (EBPs) for substance abuse treatment and supports the need for studying the factors involved in this worldwide problem. Objective: This study aimed to assess the readiness and barriers to adopt EBPs for substance abuse in a sample of outpatient treatment centers of a newly created Mexican Clinical Trials Network. Method: An online survey was administered to directors (n = 8) and clinicians (n = 40) from se...
Full Text Available Abstract Background Substance abuse during pregnancy may harm the foetus and can cause neonatal abstinence syndrome. Exposure to alcohol and other substances can influence the child for the rest of its life. A special child welfare clinic was set up in 1994 in Kristiansand, Norway, targeting pregnant women with substance abuse problems in the county of Vest-Agder. Pregnancy is not an indication for opioid replacement therapy in Norway, and one of the clinic's aims was to support the drug dependent women through their pregnancy without any replacements. The object of this paper is to describe concurrent health and social problems, as well as the predictors for stopping drug abuse, in the clinic's user group. Methods Retrospective cohort study. Data was gathered from the medical records of all 102 women seen in the clinic in the period between 1992 and 2002. The study includes 59 out of 60 women that were followed until their children were two years old or placed in alternative care, and a comparison group of twice the size. Both groups were presented with a questionnaire concerning both the pregnancy and health and socio-economic issues. Results Four (4.5 percent of the women that completed their pregnancies did not manage to reduce their substance abuse. All the others reduced their substance abuse considerably. The odds ratio for stopping substance abuse within the first trimester was significantly associated with stopping smoking (O.R. 9.7 or being victims of rape (O.R. 5.3. Conclusion A low cost and low threshold initiative organised as a child welfare clinic may support women with substance abuse problems in their efforts to stop or reduce their substance abuse during pregnancy.
Osama Hasan Gaber
This study aimed to examine the relationship between Personality Disorders and Relapses among Sample of 75 Substance Abuse Patients (personality disorder scale (prepared by the researchers) were used Pearson Correlation Coefficient showed that there are statistically significant relationship between Antisocial personality disorder(ASPD), Borderline personality disorder (BPD, Avoidant personality disorder (AVPD) and Dependent personality disorder (DPD) and substance abuse relapses (P≤=0.00)...
Raney, Valerie K.; Magaletta, Philip; Hubbert, Timothy A.
The purpose of the current study was to determine the extent to which an early prison release incentive impacted inmates' perceptions of substance abuse treatment helpfulness, overall satisfaction and focus on treatment issues. Three groups of inmates participating in their first, third or sixth month of residential drug abuse treatment were…
Slesnick, Natasha; Bartle-Haring, Suzanne; Gangamma, Rashmi
There is a dearth of research that examines the impact of family systems therapy on problems among sexually and/or physically abused youth. Given this void, differential outcome and predictors of substance use change were evaluated for abused, as compared with nonabused, runaway adolescents who were randomly assigned to family therapy or treatment…
Pike, William R.
This text attempts to "put a face" on the statistics surrounding drug abuse. It presents real problems, real people, and real dilemmas through the use of plays or skits that tell the story of substance abuse. It attempts to challenge readers--both teachers and students--with hard questions and asks them to look at their own behaviors and to…
Despite the enormous personal and social cost Of substance abuse, there is very little knowledge with respect to the mechanisms by which these drugs produce addiction as well as to the mechanisms of toxicity. Similarly, there is a lack of effective therapeutic intervention to treat the drug abusers. In this respect, nuclear medicine could contribute significantly by helping to gather information using brain imaging techniques about mechanisms of drug addiction which, in turn, could help design better therapeutic interventions, and by helping in the evaluation and diagnosis of organ toxicity from the use of drugs of abuse. This volume contains six short descriptions of presentations made at the 18th Meeting of the American College of Nuclear Physicians -- DOE Day: Substance Abuse and Nuclear Medicine.
Despite the enormous personal and social cost Of substance abuse, there is very little knowledge with respect to the mechanisms by which these drugs produce addiction as well as to the mechanisms of toxicity. Similarly, there is a lack of effective therapeutic intervention to treat the drug abusers. In this respect, nuclear medicine could contribute significantly by helping to gather information using brain imaging techniques about mechanisms of drug addiction which, in turn, could help design better therapeutic interventions, and by helping in the evaluation and diagnosis of organ toxicity from the use of drugs of abuse. This volume contains six short descriptions of presentations made at the 18th Meeting of the American College of Nuclear Physicians -- DOE Day: Substance Abuse and Nuclear Medicine
Appleyard, Karen; Berlin, Lisa J.; Rosanbalm, Katherine D.; Dodge, Kenneth A.
In the interest of improving child maltreatment prevention science, this longitudinal, community based study of 499 mothers and their infants tested the hypothesis that mothers’ childhood history of maltreatment would predict maternal substance use problems, which in turn would predict offspring victimization. Mothers (35% White/non-Latina, 34% Black/non-Latina, 23% Latina, 7% other) were recruited and interviewed during pregnancy, and child protective services records were reviewed for the presence of the participants’ target infants between birth and age 26 months. Mediating pathways were examined through structural equation modeling and tested using the products of the coefficients approach. The mediated pathway from maternal history of sexual abuse to substance use problems to offspring victimization was significant (standardized mediated path [ab]=.07, 95% CI [.02, .14]; effect size=.26), as was the mediated pathway from maternal history of physical abuse to substance use problems to offspring victimization (standardized mediated path [ab]=.05, 95% CI [.01, .11]; effect size =.19). There was no significant mediated pathway from maternal history of neglect. Findings are discussed in terms of specific implications for child maltreatment prevention, including the importance of assessment and early intervention for maternal history of maltreatment and substance use problems, targeting women with maltreatment histories for substance use services, and integrating child welfare and parenting programs with substance use treatment. PMID:21240556
Full Text Available Introduction: Individuals with substance abuse show signs of negative emotion regulation strategies and impaired interpersonal behaviors. The aim of the present research was to determine the relationship between emotion regulation strategies and interpersonal behavior among substance abusers. Method: The research design was a correlation study. The research sample consisted of 100 who were selected of the substance abusers that referred to clinical of addiction withdrawal by random sample method in Ardabil city. To collect the data, Emotion regulation Scale and Interpersonal Reactivity Index were used. Results: The results showed that positive and negative emotion regulation strategies were correlated to interpersonal behavior in substance abusers. The results of multiple regression analysis showed positive and negative emotion regulation strategies explained 16 percent of interpersonal behavior variance. Also the results showed that “putting into perspective“ was found to be the best predictor for interpersonal behavior. Conclusion: These results have important implications in psychopathological of substance abuse. On the basis of these results, clinicians can use emotion regulation strategies in order to cope substance abuse.
Otiniano Verissimo, Angie Denisse; Gee, Gilbert C; Ford, Chandra L; Iguchi, Martin Y
This study investigates the relationship between discrimination and substance abuse among Latina/os, and further examines whether this relationship differs by gender and type of discrimination. Analyses focus on the Latina/o respondents (n = 1,039 men; n = 1,273 women) from the National Latino and Asian American Study carried out from 2002-2003. Outcomes were alcohol abuse and drug abuse measured using DSM-IV definitions and criteria. Additional covariates included immigrant characteristics and demographics. Analyses were completed using gender-stratified multinomial logistic regression. Men reported more discrimination (39.6% vs. 30.3%) and had higher prevalence of alcohol abuse (16.5% vs. 4.5%) and drug abuse (9.5% vs. 2.3%) than women. Discrimination was significantly associated with increased risk of alcohol abuse for women and increased risk of drug abuse for men. Men and women also varied in the types of discrimination (e.g., racial vs. gender) reported, and in the associations between these types of discrimination and substance abuse. These data indicate that discrimination is associated with different substance abuse outcomes between genders. Future research should consider the mechanisms that explain these differences.
Piehler, Timothy F; Winters, Ken C
Adolescent decision making has been previously identified as risk factor for substance abuse as well as a proximal intervention target. The study sought to extend this research by evaluating the role of decision-making style in response to parent involvement in brief substance abuse interventions. Adolescents (aged 12 to 18 years; n = 259) identified in a school setting as abusing alcohol and marijuana were randomly assigned to complete 1 of 2 brief interventions (BIs), either a 2-session adolescent-only program (BI-A) or the 2-session adolescent program with an additional parent session (BI-AP). Interventions were manualized and delivered in a school setting by trained counselors. Adolescent decision-making style was evaluated at intake, and alcohol and marijuana use were evaluated at intake and at a 6-month follow-up assessment. Supporting past research with these interventions, BI-AP demonstrated overall stronger outcomes for marijuana when compared with BI-A. Across both intervention models, an adaptive decision-making style (i.e., constructive, rational) assessed at intake predicted greater reductions in marijuana use. A significant moderation effect emerged for alcohol outcomes. Adolescents with maladaptive decision-making tendencies (i.e., impulsive/careless, avoidant) demonstrated the largest benefit from the parental involvement in BI-AP, whereas those with a less impulsive style derived little additional benefit from parental involvement in regard to alcohol use outcomes. Implications for the tailoring of brief interventions for adolescent substance abuse are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved).
Full Text Available Introduction: Unsafe sexual behaviors as important risky behaviors can expose individuals and society to dangerous infectious disease such as AIDS and viral hepatitis. Considering the high prevalence of unsafe sexual behaviors, this study aimed to determine the effect of educational programs to encourage safe sexual behaviors among substance abusers referred to substance abuse treatment centers in Hamadan, Western Iran by applying the theory of planned behavior. Materials & Methods: This quasi-experimental study was performed on 104 men substance abusers (52 participants in each of the control and intervention groups referred to substance abuse treatment centers in Hamadan. Data collection tool was a questionnaire containing demographic information and the theory of planned behavior constructs. Before the educational program, questionnaires were completed by both groups. After the pretest in both groups, participants in the intervention group participated in four educational sessions designed based on the theory of planned behavior. Two months after the end of program, posttest was performed. Data was analyzed using independent T-test, chi-square, fisher exact test, McNemar’s test and multiple linear regressions using SPSS-16. Results: After educational intervention, the mean scores of the theory constructs (attitude toward behavior, subjective norms, behavioral control, behavioral intention and behaviors, in the intervention group increased significantly (P<0.05, despite the fact, changes were not significant in the control group. Conclusion: Implementation of educational courses to encourage safe sexual behaviors based on the theory of planned behavior can be beneficial for substance abusers referred to substance abuse treatment centers.
Larsen, Tor K; Melle, Ingrid; Auestad, Bjørn
Abuse of alcohol and drugs is an important and clinically challenging aspect of first-episode psychosis. Only a few studies have been carried out on large-sized and reliably characterized samples. These are reviewed, and the results are compared with a sample of 300 first-episode psychosis patients...... recruited for the TIPS (Early Treatment and Identification of Psychosis) study from Norway and Denmark. Prevalence rates from the literature vary from 6% to 44% for drugs and 3% to 35% for alcohol. In our sample, 23% abused drugs and 15% abused alcohol during the last 6 months. When compared to non......-abusers, the drug-abusing group is characterized by the following: male gender, younger age, better premorbid social, poor premorbid academic functioning, and more contact with friends in the last year before onset. Alcohol abusers were the oldest group and they had the least contact with friends. A group...
Stein, Judith A; Dixon, Elizabeth L; Nyamathi, Adeline M
Finding direct and indirect influences of salient psychosocial and situational variables on problem substance use among homeless people is important in designing evidence-based, effective, and relevant interventions for this special population. A stress-coping paradigm in conjunction with situational items specialized for homeless people was used to explore predictive relationships in a sample of homeless adults (N = 664) among (a) psychosocial variables of self-esteem, social support, positive and negative coping, and emotional distress, (b) situational variables of homelessness history and quality of recent housing, and (c) outcomes of alcohol use, injection drug use (IDU), and non-IDU. Lower self-esteem predicted greater emotional distress, lower positive coping, greater negative coping, and more alcohol use. Social support predicted less emotional distress and more positive coping. Chronic homelessness predicted more emotional distress, less positive coping, greater alcohol use, and IDU. Poor housing was associated with more alcohol use and IDU. Substance abuse interventions among the homeless should have a dual focus that includes attention to psychological issues and negative coping patterns while also addressing situational, environmental factors, including encouraging provision of permanent supportive housing. (c) 2008 APA, all rights reserved.
Laux, John M.; Piazza, Nick J.; Salyers, Kathleen; Roseman, Christopher P.
The sensitivity of the Substance Abuse Subtle Screening Inventory-3 (SASSI-3) was examined among substance-dependent adults enrolled in a family drug court. The SASSI-3 had a high sensitivity rate with this population, even across varying levels of motivation to change. (Contains 2 tables.)
... 42 Public Health 1 2010-10-01 2010-10-01 false Model Notice of Individuals Receiving Substance... ORGANIZATIONS RECEIVING DISCRETIONARY FUNDING UNDER TITLE V OF THE PUBLIC HEALTH SERVICE ACT, 42 U.S.C. 290aa...—Model Notice of Individuals Receiving Substance Abuse Services Model Notice to Individuals Receiving...
Tyler, Kimberly A.; Melander, Lisa A.
Although previous research documents high rates of child abuse, street victimization, and substance use among homeless youth, few studies have investigated these three constructs simultaneously, and thus little is known about how various forms of victimization are uniquely associated with substance use among this population. The purpose of this…
Camp, J M; Krakow, M; McCarty, D; Argeriou, M
There is increased interest in documenting the characteristics and treatment outcomes of clients served with Alcohol, Drug Abuse, and Mental Health Block Grant funds. The evolution of federal client-based management systems for substance abuse treatment services demonstrates that data collection systems are important but require continued support. A review of the Massachusetts substance abuse management information system illustrates the utility of a client-based data set. The development and implementation of a comprehensive information system require overcoming organizational barriers and project delays, fostering collaborative efforts among staff from diverse agencies, and employing considerable resources. In addition, the need to develop mechanisms for increasing the reliability of the data and ongoing training for the users is presented. Finally, three applications of the management information system's role in shaping policy are reviewed: developing services for special populations (communities of color, women, and pregnant substance abusers, and injection drug users), utilizing MIS data for evaluation purposes, and determining funding allocations.
Stein, L. A. R.; Graham, John R.
The ability of respondents to underreport successfully on substance abuse and validity scales of the Minnesota Multiphasic Personality Inventory-Adolescent was evaluated. Incarcerated teens (67 substance abusing, 59 non-substance abusing) completed the MMPI-A twice: once under standard instructions (SI) and once under instructions to fake good (FG). Under SI, substance scales correctly classified about 60% to 85% of adolescents. Under FG, substance- and non-substance-abusing juveniles produced lower scores on substance scales. However, the Lie Scale (L) was able to detect more than 75% of deceptive profiles and about 77% of honest profiles. When scale L and the best substance scale were used in combination, only about 18% of faking substance abusers were not identified as either substance abusers or as underreporting. For feigning substance abusers, only about 10% of substance abusers were detected, with about 72% being categorized as faking and needing further assessment. PMID:15695741
Chuang, Emmeline; Wells, Rebecca; Bellettiere, John; Cross, Theodore P
Parental substance use significantly increases risk of child maltreatment, but is often under-identified by child protective services. This study examined how agency use of standardized substance use assessments and child welfare investigative caseworker education, experience, and caseload affected caseworkers' identification of parental substance abuse treatment needs. Data are from a national probability sample of permanent, primary caregivers involved with child protective services whose children initially remained at home and whose confidential responses on two validated instruments indicated harmful substance use or dependence. Investigative caseworkers reported use of a formal assessment in over two thirds of cases in which substance use was accurately identified. However, weighted logistic regression indicated that agency provision of standardized assessment instruments was not associated with caseworker identification of caregiver needs. Caseworkers were also less likely to identify substance abuse when their caseloads were high and when caregivers were fathers. Implications for agency practice are discussed. Copyright © 2013 Elsevier Inc. All rights reserved.
The analysis trends observed in this study demonstrate global patterns of drug abuse emerging in the Western Cape. The medical and social effects of drug abuse impose a grave responsibility on policymakers to ensure that adequate funding is available for analytical laboratories. Only in such a way can these patients be ...
Full Text Available There is an increased prevalence of maternal substance abuse during pregnancy in younger women in all socioeconomic classes and races. Our aim was to determine the prevalence and correlates of self-reported substance abuse among pregnant women and obstetric complications or neonatal outcomes in Iran. This retrospective cohort study is covering a five year period on medical records of pregnant women attending the maternity unit of four major hospitals (Mahdieh, Taleghani, Imam Hossein and Akbarabadi Hospitals. Women who reported using opium, heroin, crack, cannabis or methamphetamine were compared with women with no reported history of drug abuse for obstetric complications and prenatal morbidity and neonatal mortality. From 100,620 deliveries substance abuse was recorded for 519 women giving a prevalence of 0.5%. Opium was the most prevalent substance abused followed by crack (a mix of heroin and amphetamines. The exposed group had significantly more obstetric complications including preterm low birth weight and postpartum hemorrhage than the non-exposed group. The exposed group had significantly worse prenatal outcomes including more admissions to intensive care unit and higher infant mortality than the non-exposed group. None of the women in the exposed group was on methadone treatment at time of delivery. Risks of maternal and neonatal complications were increased in substance using pregnant women, especially preterm birth and low birth weight. We recommend a multidisciplinary team to provide methadone maintenance therapy for substance using pregnant women and urinary screen of all pregnant women presenting to hospital.
Derakhshanpour, Firoozeh; Hajebi, Ahmad; Panaghi, Leili; Ahmadabadi, Zohre
Background: Child abuse is a significant public health and social problem worldwide. It can be described as a failure to provide care and protection for children by the parents or other caregivers. This study aimed at evaluating the effectiveness of psychosocial interventions in abused children and their families. Methods: This quasi-experimental study was conducted in the psychosocial support unit of a pediatric hospital in Bandar Abbas, Iran, from 2012 to 2013. The participants consisted of child abuse cases and their parents who referred to the psychosocial support unit to receive services. Services delivered in this unit included parenting skills training, psychiatric treatments, and supportive services. The effectiveness of the interventions was assessed with Child Abuse Questionnaire, General Health Questionnaire (GHQ), and Strengths and Difficulties Questionnaires (SDQ). Participants were assessed at baseline, at 3, and 6 months follow-ups. ANOVA with repeated measures and Friedman test were used to evaluate the effect of the interventions. Results: A total of 68 children and their parents enrolled in this study, of whom 53% were males. Post-intervention follow-ups revealed significant changes in mothers' general health questionnaire (pchildren's conduct problem (pabuses significantly decreased (p<0.001). Conclusion: Our findings revealed that psychosocial interventions effectively improved child-parents interaction and mental health of parents. The effectiveness of interventions based on subgroup analysis and implications of the results have been discussed for further development of psychosocial interventions in the health system.
Horton, Gail; Diaz, Naelys; McIlveen, John; Weiner, Michael; Mullaney, Donald
The purpose of this study was to explore the prevalence rates of co-occurring mental health problems among 70 flight attendants in substance abuse treatment. Results indicated that flight attendants in treatment were more likely to experience alcohol dependency than drug dependency. A high proportion of participants reported clinical levels of…
preventive services and evidence-based treatments for substance use disorders with diabetes care in community-based medical settings. These laws also offer emerging areas for research.Keywords: addiction, illicit drug use, substance use disorder, substance abuse treatment, alcohol use, diabetes care, primary care, screening, brief intervention
Toumbourou, J W; Hemphill, S A; Tresidder, J; Humphreys, C; Edwards, J; Murray, D
Mental health promotion aimed at populations with low socio-economic status (SES) may benefit by investigating prevention strategies that effectively address related child and adolescent problems. Evidence from a number of literature reviews and program evaluations was synthesised. First, the impact of SES on development from childhood to adulthood is considered in light of research on substance abuse, violence, crime, and child development problems. Second, evaluations of interventions are reviewed to identify those that have shown outcomes in research studies (efficacy) or in real-world settings (effectiveness) in reducing developmental problems associated with low SES. Low SES is measured in different ways including low levels of education and/or income or definitions that combine several variables into a new indicator of low SES. Factors associated with low SES are also associated to varying extent with the development of violence and crime, substance abuse and child health problems. Interventions that address underlying determinants of low SES show strong efficacy in decreasing adolescent crime and violence and effectiveness in improving child health outcomes. Although there is limited efficacy evidence that substance abuse prevention can be effectively addressed by targeting low SES, programs designed to improve educational pathways show some efficacy in reducing aspects of adolescent substance use. Mental health promotion strategies can draw on the approaches outlined here that are associated with the prevention of child and adolescent problems within low SES communities. Alternatively, such interventions could be supported in mental health promotion policy as they may assist in preventing related problems that undermine mental health.
Schwartz, I M
It has been estimated that as many as 12%-15% of the nations 63 million children are in need of mental health treatment. We have a responsibility to do everything we can to see to it that these children receive the services they need. Unfortunately, there is mounting evidence that a significant proportion of our health care resources are being misspent on the unnecessary and inappropriate hospitalization of children and youths in psychiatric and substance abuse treatment programs. More alarming is the evidence of poor quality programs, abusive practices, and greed. The intense competition to capture a "share of the market" and turn a profit or keep a nonprofit hospital from closing its doors is contributing to unprofessional and unethical advertising and public relations practices. In the end these practices will reflect poorly on the broader mental health and health care community. Hopefully, the stakeholders in the system will recognize these problems and assume a leadership role in turning the situation around. If not, we can expect intervention from forces outside the system (e.g., courts, elected public officials, public interest groups, the business community, and child advocates).
Foote, A; Erfurt, J C
Clients entering an employee assistance program (EAP) of a large manufacturing plant in 1985 who were assessed as having an alcohol or drug abuse problem (N = 325) were randomized into an experimental "special follow-up" group and a control "regular care" group. The regular care group received follow-up only as needed (following the usual practice of the EAP), while a follow-up counselor was hired to make routine contacts with the special follow-up group. Study intake continued through 1985, and follow-up continued through the end of 1986. Data collected on study subjects included EAP participation data, absenteeism, number of hospitalizations, health care claims paid and disability claims paid. The major study hypothesis was that EAP clients randomly allocated to special follow-up would show better results than regular care clients (i.e., would have fewer relapses, better job attendance and lower health benefit utilization during the follow-up year). The follow-up intervention was incompletely implemented due to a variety of organizational problems. Differences between the two groups on the six outcome measures were not statistically significant, although clients in the special follow-up group did show better results than clients in the regular care group on the three measures related to substance abuse. Differences on these three measures were marginally significant in regression analyses after controlling for the effects of number of follow-up visits, age, race and chronicity.
Ondersma, Steven J; Winhusen, Theresa; Erickson, Sarah J; Stine, Susan M; Wang, Yun
Some evidence suggests that motivational approaches are less efficacious--or even counter-productive--with persons who are relatively motivated at baseline. The present study was conducted to examine whether disordinal moderation by baseline motivation could partially explain negative findings in a previous study [Winhusen, T., Kropp, F., Babcock, D., Hague, D., Erickson, S.J., Renz, C., Rau, L., Lewis, D., Leimberger, J., Somoza, E., 2008. Motivational enhancement therapy to improve treatment utilization and outcome in pregnant substance users. J. Subst. Abuse Treat. 35, 161-173]. Analyses also focused on the relative utility of the University of Rhode Island Change Assessment (URICA) scale, vs. a single goal question as potential moderators of Motivation Enhancement Therapy (MET). Participants were 200 pregnant women presenting for substance abuse treatment at one of four sites. Women were randomly assigned to either a three-session MET condition or treatment as usual (TAU). Generalized Estimating Equations (GEE) revealed no significant moderation effects on drug use at post-treatment. At follow-up, contrary to expectations, participants who had not set a clear quit goal at baseline were less likely to be drug-free if randomized to MET (OR=0.48); participants who did set a clear quit goal were more likely to be drug-free if randomized to MET (OR=2.53). No moderating effects were identified via the URICA. Disordinal moderation of MET efficacy by baseline motivation may have contributed somewhat to the negative results of the [Winhusen, T., Kropp, F., Babcock, D., Hague, D., Erickson, S.J., Renz, C., Rau, L., Lewis, D., Leimberger, J., Somoza, E., 2008. Motivational enhancement therapy to improve treatment utilization and outcome in pregnant substance users. J. Subst. Abuse Treat. 35, 161-173] study, but in the opposite direction expected. A simple question regarding intent to quit may be useful in identifying persons who may differentially respond to motivational
Substances known as psychedelics, hallucinogens and entheogens have been employed in ethnomedical traditions for thousands of years, but after promising uses in the 1950's and 1960's they were largely prohibited in medical treatment and human research starting in the 1970's as part of the fallout from the war on drugs. Nonetheless, there are a number of studies which suggest that these substances have potential applications in the treatment of addictions. While these substances are generally classified as Schedule I, alleging no established medical uses and a high drug abuse potential, there is nonetheless evidence indicating they might be safe and effective tools for short term interventions in addictions treatment. Evidence suggests that the psychedelics have a much greater safety profile than the major addictive drugs, having extremely low levels of mortality, and producing little if any physical dependence. This paper reviews studies evaluating the use of LSD, peyote, ibogaine and ayahuasca in the treatment of dependencies and the possible mechanisms underlying the indications of effectiveness. Evidence suggests that these substances help assist recovery from drug dependency through a variety of therapeutic mechanisms, including a notable "after-glow" effect that in part reflects their action on the serotonin neurotransmitter system. Serotonin has been long recognized as central to the psychedelics' well-known phenomenological, physical, emotional and cognitive dynamics. These serotonin-based dynamics are directly relevant to treatment of addiction because of depressed serotonin levels found in addict populations, as well as the role of serotonin as a neuromodulators affecting many other neurotransmitter systems.
Pan, I-Jen; Yi, Hsiao-ye
Objective To describe prevalence trends in hospitalized live births affected by placental transmission of alcohol and drugs, as well as prevalence trends among parturient women hospitalized for liveborn delivery and diagnosed with substance abuse problems in the United States from 1999 to 2008. Comparison of the two sets of trends helps determine whether the observed changes in neonatal problems over time were caused by shifts in maternal substance abuse problems. Methods This study independently identified hospitalized live births and maternal live born deliveries from discharge records in the Nationwide Inpatient Sample, one of the largest hospital administrative databases. Substance-related diagnosis codes on the records were used to identify live births affected by alcohol and drugs and parturient women with substance abuse problems. The analysis calculated prevalence differences and percentage changes over the 10 years, with Loess curves fitted to 10-year prevalence estimates to depict trend patterns. Linear and quadratic trends in prevalence were simultaneously tested using logistic regression analyses. The study also examined data on costs, primary expected payer, and length of hospital stays. Results From 1999 to 2008, prevalence increased for narcotic- and hallucinogen-affected live births and neonatal drug withdrawal syndrome but decreased for alcohol- and cocaine-affected live births. Maternal substance abuse at delivery showed similar trends, but prevalence of alcohol abuse remained relatively stable. Substance-affected live births required longer hospital stays and higher medical expenses, mostly billable to Medicaid. Conclusions The findings highlight the urgent need for behavioral intervention and early treatment for substance-abusing pregnant women to reduce the number of substance-affected live births. PMID:22688539
Pan, I-Jen; Yi, Hsiao-ye
To describe prevalence trends in hospitalized live births affected by placental transmission of alcohol and drugs, as well as prevalence trends among parturient women hospitalized for liveborn delivery and diagnosed with substance abuse problems in the United States from 1999 to 2008. Comparison of the two sets of trends helps determine whether the observed changes in neonatal problems over time were caused by shifts in maternal substance abuse problems. This study independently identified hospitalized live births and maternal live born deliveries from discharge records in the Nationwide Inpatient Sample, one of the largest hospital administrative databases. Substance-related diagnosis codes on the records were used to identify live births affected by alcohol and drugs and parturient women with substance abuse problems. The analysis calculated prevalence differences and percentage changes over the 10 years, with Loess curves fitted to 10-year prevalence estimates to depict trend patterns. Linear and quadratic trends in prevalence were simultaneously tested using logistic regression analyses. The study also examined data on costs, primary expected payer, and length of hospital stays. From 1999 to 2008, prevalence increased for narcotic- and hallucinogen-affected live births and neonatal drug withdrawal syndrome but decreased for alcohol- and cocaine-affected live births. Maternal substance abuse at delivery showed similar trends, but prevalence of alcohol abuse remained relatively stable. Substance-affected live births required longer hospital stays and higher medical expenses, mostly billable to Medicaid. The findings highlight the urgent need for behavioral intervention and early treatment for substance-abusing pregnant women to reduce the number of substance-affected live births.
Substance abusers often face substantial systematic and personal barriers to receiving required substance abuse treatment services as well as other services; hence, various linkage mechanisms have been proposed for drug abuse treatment programs to overcome such barriers. Although there is a growing interest in the use of case management with a substance abuse background, its effectiveness in child welfare has yet to be explored. In this study the author attempts to investigate the effectiveness of case management in service utilization by systematically evaluating the five-year Alcohol and Other Drug Abuse (AODA) waiver demonstration project with Recovery Coaches in Illinois. A classic experimental design with a control group was used. Random assignment occurs at the agency level. Parents in the experimental group (N = 1562) received recovery coaches in addition to traditional child welfare services while parents in the control group (N = 598) only received traditional child welfare services. Bivariate and multivariate analyses (Ordinary Last Square regressions) were used. Compared to parents in the control group, parents in the experimental group were more likely to utilize substance abuse treatment. The results suggest that gender, education level, employment status, and the number of service needs were significantly associated with service utilization. Controlling other factors, recovery coaches improved overall service utilization. Because the outcome of child welfare often depends on the improvement of risks or resolution, it is important for parents to utilize the needed services. Future studies need to address what aspects of recovery coaches facilitate the services utilization.
Soeker, Shaheed; Matimba, Tandokazi; Machingura, Last; Msimango, Henry; Moswaane, Bobo; Tom, Sinazo
Employee assistance programs (EAPs) are responsible for helping employees cope with problems such as: mental distress, alcoholism and other drug dependencies, marital and financial difficulties--in short, the whole host of personal and family troubles endemic to the human condition. The study explored the challenges that employees who abuse substances experience when returning to work after the completion of an employee assistance program. The study used a qualitative exploratory descriptive research design. Three male participants and two key informants participated in the study. One semi structured interview was conducted with each one of the participants and one semi structured interview with the key informants. Four themes emerged: 1) Loss of one's worker role identity, 2) Negative influences of the community continues to effect the success of EAP, 3) EAP as a vehicle for change and, 4) Healthy occupations strengthen EAP. This study portrayed the following: how substance abuse effect the worker role of individuals employed in the open labor market, the challenges and facilitators experienced by employees who abuse substances when returning to their previous work roles and how occupation based interventions can be incorporated in EAP programs. Occupational therapists could use the health promotion approach, work simplification, energy conservation techniques and ergonomic analysis techniques.
Jun 1, 2018 ... so on to feel high and enhance social performance to their own ... Nigerian society, and that drug abuse could lead to reduction in academic achievement or ..... depression, frustration and sometimes to build-up self-esteem.
Walters, Glenn D
The purpose of this study was to determine (a) which of 2 dimensions of criminal thinking (proactive and/or reactive) correlates with prior substance abuse; (b) whether criminal thinking mediates the relationship between prior substance abuse and recidivism; (c) if a direct relationship exists between specific drugs of abuse and specific criminal thinking styles. First, the reconstructed Proactive (Prc) and Reactive (Rrc) Criminal Thinking scores from the Psychological Inventory of Criminal Thinking Styles (PICTS; Walters, 1995) were correlated with a dichotomous measure of prior substance abuse and a continuous measure of the number of substances abused in a sample of 2877 male federal prisoners (age: M = 34.96, SD = 9.89, range = 18-84; race: 63.6% Black, 17.3% White, 17.6% Hispanic, 1.4% other). The results indicated that only the Rrc score correlated significantly with prior substance abuse when the effect of the alternative measure (Prc in the case of Rrc and Rrc in the case of the Prc) was controlled through partial correlations. Second, reactive criminal thinking was found to mediate the relationship between a history of prior substance abuse and subsequent recidivism in a subsample of 1101 inmates who were released from prison during a 1- to 76-month follow-up. Third, both specific (alcohol with cutoff; marijuana with cognitive indolence) and global (heroin, cocaine, and amphetamine with cutoff, cognitive indolence, and discontinuity) drug-criminal thinking correlations were obtained. These results suggest that reactive criminal thinking plays a potentially important role in the drug-crime relationship.
Horn, Brady P; Crandall, Cameron; Forcehimes, Alyssa; French, Michael T; Bogenschutz, Michael
Screening, brief intervention, and referral to treatment (SBIRT) has been widely implemented as a method to address substance use disorders in general medical settings, and some evidence suggests that its use is associated with decreased societal costs. In this paper, we investigated the economic impact of SBIRT using data from Screening, Motivational Assessment, Referral, and Treatment in Emergency Departments (SMART-ED), a multisite, randomized controlled trial. Utilizing self-reported information on medical status, health services utilization, employment, and crime, we conduct a benefit-cost analysis. Findings indicate that neither of the SMART-ED interventions resulted in any significant changes to the main economic outcomes, nor had any significant impact on total economic benefit. Thus, while SBIRT interventions for substance abuse in Emergency Departments may be appealing from a clinical perspective, evidence from this economic study suggests resources could be better utilized supporting other health interventions. Copyright © 2017 Elsevier Inc. All rights reserved.
Chinman, Matthew; Hunter, Sarah B; Ebener, Patricia
This article aims to describe continuous quality improvement (CQI) for substance abuse prevention and treatment programs in a community-based organization setting. CQI (e.g., plan-do-study-act cycles (PDSA)) applied in healthcare and industry was adapted for substance abuse prevention and treatment programs in a community setting. The authors assessed the resources needed, acceptability and CQI feasibility for ten programs by evaluating CQI training workshops with program staff and a series of three qualitative interviews over a nine-month implementation period with program participants. The CQI activities, PDSA cycle progress, effort, enthusiasm, benefits and challenges were examined. Results indicated that CQI was feasible and acceptable for community-based substance abuse prevention and treatment programs; however, some notable resource challenges remain. Future studies should examine CQI impact on service quality and intended program outcomes. The study was conducted on a small number of programs. It did not assess CQI impact on service quality and intended program outcomes. Practical implications- This project shows that it is feasible to adapt CQI techniques and processes for community-based programs substance abuse prevention and treatment programs. These techniques may help community-based program managers to improve service quality and achieve program outcomes. This is one of the first studies to adapt traditional CQI techniques for community-based settings delivering substance abuse prevention and treatment programs.
Barahmand, Usha; Khazaee, Ali; Hashjin, Goudarz Sadeghi
The purpose of this study is to assess the relative mediating effects of impulsivity and emotion dysregulation in the relationship between childhood maltreatment and motives for opiate use. Seventy four adolescent users of Tramadol, a synthetic opiate, were recruited from a boot camp for de-addiction and rehabilitation services for the study. Data were collected between May, 2014 and November, 2014. Participants completed assessments of childhood abuse history, difficulties regulating emotions, impulsiveness and motives for substance use as well as a socio-demographic information sheet. The results of the current study indicate that types of abuse may be associated with particular outcomes and can inform treatment planning for substance users. Findings from bootstrap mediator analyses indicated that emotion dysregulation, but not impulsiveness, mediated the relationship between childhood emotional abuse and expansion and enhancement motives for substance use. The current study provides preliminary evidence that difficulties regulating emotions may function as a mechanism linking prior childhood experiences of emotional abuse to subsequent motives for substance use. Clinical implications of these findings suggest that targeting emotion dysregulation problems may be an effective adjunct in the treatment of childhood emotional abuse adolescent victims at risk for substance use. Published by Elsevier Inc.
Cuomo, Chiara; Sarchiapone, Marco; Giannantonio, Massimo Di; Mancini, Michele; Roy, Alec
The aim of our study is then to analyze psychological and judicial features of a subgroup of inmates with substance abuse. Prisoners with substance abuse (n = 312) were compared to prisoners without substance abuse (n = 591). Recruited inmates completed a semistructured interview for collection of sociodemographic and judicial data and a battery of psychometric tests for assessement of aggression, impulsivity, depression, personality traits, hostility, resilience, and childhood trauma. Substance abusers had on average multiple incarcerations (78.8%), more juvenile convictions (60.2%), more violent behaviors during detention (29.8%), and a history of one or more suicide attempts (20.8%). They also had higher scores on subscales for childhood trauma, higher scores for psychoticism and neuroticism, higher impulsivity levels, worse resilience, increased hostility, and prevalent suicidal ideation. Prisoners with substance abuse constitute a subgroup with increased judiciary and psychiatric issues, possibly due to early life history and psychological characteristics, such as high impulsivity and aggressiveness, poor resilience, and higher suicidal risk.
Lee A James
Full Text Available Abstract This short report investigates scale effects in family substance abuse treatment programs. In Massachusetts, the family substance abuse treatment programs were much more costly than other adult residential treatment models. State officials were concerned that the "scale" or size of these programs (averaging just eight families was too small to be economical. Although the sample size (just nine programs was too small to permit reliable inference, the data clearly signalled the importance of "scale effects" in these family substance abuse treatment programs. To further investigate scale effects in family substance abuse treatment programs, data from the Center for Substance Abuse Treatment's (CSAT's Residential Women and Children and Pregnant and Postpartum Women (RWC-PPW Demonstration were re-analyzed, focusing on the relationship between cost per family-day and the estimated average family census. This analysis indicates strong economies of scale up until an average family census of about 14, and less apparent scale effects beyond that point. In consideration of these and other study findings, a multidisciplinary interagency team redesigned the Massachusetts' family treatment program model. The new programs are larger than the former family treatment programs, with each new program having capacity to treat 11 to 15 families depending on family makeup.
Goyal, Shrigopal; Deb, Koushik Sinha; Elawadhi, Deeksha; Kaw, Nanaji
Persons suffering from gender identity disorder (GID) are often severely marginalized in India and mostly live outside the society as a part of a minority community called the Hijras. Although substance abuse is considered a way of life in them, such patients rarely seek treatment because of the stigma and fear of discrimination. We report a case of GID presenting to tertiary care centre for treatment of multiple substance use dependence (SUD). The case is the first to highlight the use and dependence of multiple substances in the Hijra community of India. Further, the case emphasizes that SUD treatment might be a worthwhile intervention to bring such marginalized population under treatment, when further complicated issues on gender identity can be addressed. Copyright © 2014. Published by Elsevier B.V.
Full Text Available Abstract Background Attachment theory allows specific predictions about the role of attachment representations in organizing behavior. Insecure attachment is hypothesized to predict maladaptive emotional regulation whereas secure attachment is hypothesized to predict adaptive emotional regulation. In this paper, we test specific hypotheses about the role of attachment representations in substance abuse/dependence and treatment participation. Based on theory, we expect divergence between levels of maladaptive functioning and adaptive methods of regulating negative emotions. Methods Participants for this study consist of a sample of adoptees participating in an ongoing longitudinal adoption study (n = 208. The Semi-Structured Assessment of the Genetics of Alcohol-II 41 was used to determine lifetime substance abuse/dependence and treatment participation. Attachment representations were derived by the Adult Attachment Interview [AAI; 16]. We constructed a prior contrasts reflecting theoretical predictions for the association between attachment representations, substance abuse/dependence and treatment participation. Results Logistic regression was used to test our hypotheses. As predicted, individuals classified as dismissing, preoccupied or earned-secure reported the highest rates of substance abuse/dependence. Individuals classified as dismissing reported significantly lower rates of treatment participation despite their high rates of substance abuse/dependence. As expected, the continuous-secure group reported lowest rates of both substance abuse/dependence and treatment participation. Conclusion The findings from this study identify attachment representations as an influential factor in understanding the divergence between problematic substance use and treatment utilization. The findings further imply that treatment may need to take attachment representations into account to promote successful recovery.
Sanja Tatalović Vorkapić
Full Text Available AIM: In this study, burnout and its internal and external factors were investigated among substance abuse counsellors (no. = 68 who worked in centres for Prevention and Substance Abuse Treatment (no. = 18 in Croatia. METHODS: Maslach Burnout Inventory was used which measured three burnout dimensions: emotional exhaustion, depersonalization and personal accomplishment; and questionnaire of internal and external burnout factors. RESULTS: The higher levels of emotional exhaustion and depersonalization, and the higher level of personal accomplishment were determined. Factors such as work conditions, emotions about us and work, work organization and certain personality traits showed significant relationship with three burnout dimensions. CONCLUSIONS: Overall, findings implicated a certain specificity of professional burnout in substance abuse counsellors, and the need for specific design of mental health care for them.
Tatalović Vorkapić, Sanja; Mustapić, Jelena
In this study, burnout and its internal and external factors were investigated among substance abuse counsellors (no. = 68) who worked in Centres for Prevention and Substance Abuse Treatment (no. = 18) in Croatia. Maslach Burnout Inventory was used which measured three burnout dimensions: emotional exhaustion, depersonalization and personal accomplishment; and questionnaire of internal and external burnout factors. The higher levels of emotional exhaustion and depersonalization, and the higher level of personal accomplishment were determined. Factors such as work conditions, emotions about us and work, work organization and certain personality traits showed significant relationship with three burnout dimensions. Overall, findings implicated a certain specificity of professional burnout in substance abuse counsellors, and the need for specific design of mental health care for them.
Tucker, Joan S; Wenzel, Suzanne L; Golinelli, Daniela; Zhou, Annie; Green, Harold D
Many homeless women do not receive needed treatment for substance abuse. This study identified social network and other predisposing factors associated with perceived need for and receipt of substance abuse treatment among 273 homeless women who screened positive for past-year substance abuse. Perceived treatment need was more likely among women with drug-using sex partners, a denser network, and an arrest history but less likely for those with a minor child and a longer history of homelessness. Receiving treatment was more likely among women who received informational support from their sex partners and who had an arrest history but less likely among those who had a more street-based social network, had a minor child, considered themselves homeless, and recently needed mental health treatment. Treatment services researchers should attend more closely to social contextual factors, as well as the more traditional individual factors, to understand access and barriers to treatment. Copyright © 2011 Elsevier Inc. All rights reserved.
Sanja Tatalovic Vorkapic
Full Text Available One of the most important factors of successful substance abuse treatment is the early start of the same treatment. Recent selection method for identification of Croatian adolescents in the substance abuse risk that has been using drug tests from urine samples, has been simple and exact on the one hand, but on the other, has been very rare and usually guided by the pressure of parents or the court. Besides, such method presented the source of legal and ethical questions. So, the proposal of application of standardized psychological tests during systematic medical exams of Croatian adolescents at the age range of 15-22 years could help with the early detection of those adolescents who were in the substance abuse risk or already had the developed addiction problem.
Substance use disorder - prescription drugs; Substance abuse - prescription drugs; Drug abuse - prescription drugs; Drug use - prescription drugs; Narcotics - substance use; Opioid - substance use; Sedative - substance ...
Miller, Mark W.; Reardon, Annemarie F.; Wolf, Erika J.; Prince, Lauren B.; Hein, Christina L.
This study examined the relative influences of PTSD, other psychopathology, and intimate partner alcohol and drug use on substance-related problems in U.S. veterans (242 couples, N = 484). Hierarchical regression analyses revealed that partner alcohol and drug use severity explained more variance in veteran alcohol use and drug use (20% and 13%, respectively) than did veteran PTSD, adult antisocial behavior, or depression symptoms combined (6% for veteran alcohol use; 7% for veteran drug use). Findings shed new light on the influence of relationship factors on veteran alcohol and drug use and underscore the importance of couples-oriented approaches to treating veterans with comorbid PTSD and substance abuse. PMID:23325433
Hawkins, J. David; And Others
A test was conducted of a supplemental skills training and social-network-development aftercare program with 130 drug abusers from four residential therapeutic communities. The intervention produced positive effects on subjects' performance at the conclusion of treatment. Performance improved in situations involving avoidance of drug use, coping…
Gradus, Jaimie L; Leatherman, Sarah; Curreri, Andrew; Myers, Lisa G; Ferguson, Ryan; Miller, Matthew
Epidemiologic studies have reported substance abuse and posttraumatic stress disorder (PTSD) diagnoses as risk factors for suicide among Veterans Health Administration (VHA) patients. Research on risk factors for suicide may not generalize to our understanding of non-fatal intentional self-harm (ISH), given the evidence that these outcomes have unique risk factors. The aims of this study were to examine (1) gender-stratified rates of non-fatal ISH in VHA patients with alcohol abuse/dependence, drug abuse/dependence, and PTSD and (2) gender-stratified interaction between alcohol abuse and dependence and drug abuse and dependence and PTSD in predicting non-fatal ISH. Participants include all VHA care users who received a PTSD diagnosis in Massachusetts from 2000 to 2008 (n=16,004) and an age- and gender-matched comparison group (n=52,502). Data were obtained from the VHA administrative registries. We found evidence of stronger interactions between substance abuse diagnoses and PTSD in predicting non-fatal ISH for females than for males. The interaction contrast (IC) for alcohol abuse and dependence and PTSD in predicting non-fatal ISH among female VHA patients was 62.35/100,000 person-years; for male VHA patients the comparable IC was 21.49/100,000 person-years. For female VHA patients the IC for drug abuse and dependence and PTSD predicting ISH was 256.33/100,000 person-years; no interaction was observed for male VHA patients. This study contributes to the scant literature on gender differences in substance abuse and PTSD among VHA patients. The findings highlight comorbid diagnoses as particularly important risk factors for non-fatal ISH among female VHA patients. Published by Elsevier B.V.
Wilkinson, Samuel T; van Schalkwyk, Gerrit I; Davidson, Larry; D'Souza, Deepak C
Risk perception has been shown to be protective with regard to marijuana use. Notably, the risk perception of marijuana in individuals with substance abuse problems varies significantly from that of the general public. Understanding how risk perception is formed in substance users could explain these differences and help predict the consequences of policy changes. Using this framework, we explored risk perception and its formation in a sample of substance abusing veterans. Semi-structured interviews were conducted with veterans who were receiving treatment for substance abuse. Interviews were recorded digitally, transcribed verbatim, and analyzed using inductive thematic analysis. A prominent perspective among the 31 participants was that marijuana is significantly different from other drugs because it is safe, not addictive, not associated with physical withdrawal, and has less overt behavioral effects than other substances. Many of these participants drew upon their own innocuous experiences with the drug in developing this perspective, more so than information from any other source. A contrasting narrative emphasized marijuana's capacity to cause negative social consequences, act as a gateway to the use of other, more harmful substances, and cause paranoia or worsen psychosis. In conclusion, individual experience with marijuana featured more prominently in informing risk perception than any other source of information. Our results and previous literature suggest that the significant disconnect between the individual experiences of substance users and the current clinical and legal policy towards marijuana may weaken the legitimacy of public policy or the authority of the medical community.
Goodman, Daisy J; Wolff, Kristina B
Alcohol and drug use is a significant public health problem with particular implications for the health and safety of women. Women who abuse these substances are more likely to have untreated depression and anxiety and are at higher risk for intimate partner violence, homelessness, incarceration, infectious disease, and unplanned pregnancy. Substance abuse during pregnancy places both mother and fetus at risk for adverse perinatal outcomes. Data regarding the prevalence of substance abuse in women are conflicting and difficult to interpret. On the clinical level, strong arguments exist against routine urine drug testing and in favor of the use of validated instruments to screen women for drug and alcohol use both in primary women's health care and during pregnancy. A number of sex-specific screening tools are available for clinicians, some of which have also been validated for use during pregnancy. Given the risks associated with untreated substance abuse and dependence in women, the integration of drug and alcohol screening into daily clinical practice is imperative. This article reviews screening tools available to providers in both the prenatal and primary women's health care settings and addresses some of the challenges raised when women screen positive for drug and alcohol abuse. © 2013 by the American College of Nurse-Midwives.
Dimaggio, Giancarlo; D'Urzo, Maddalena; Pasinetti, Manuela; Salvatore, Giampaolo; Lysaker, Paul H; Catania, Dario; Popolo, Raffaele
Many patients with substance abuse problems present with co-occurrent cluster C personality disorders. Focusing on both disorders disrupts the maintenance mechanisms and the vicious cycle between the 2 conditions; however, treatment teams often neglect this issue. In this work, we describe the features of metacognitive interpersonal therapy as applied to a man with avoidant and depressive personality disorders and heroin, cocaine, and alcohol abuse. Psychotherapy proceeded through the following steps: (a) conducting drug therapy to deal with symptoms of abstinence from heroin; (b) forming a therapeutic bond to overcome the patient's severe emotional withdrawal; (c) fostering basic metacognitive capacities such as awareness of emotions and their triggers; (d) sharing formulations of maladaptive interpersonal schemas and descriptions of the associated states of mind; (e) conveying an understanding of the link between interpersonal events (recent ones and traumatic memories) and substance abuse; (f) facilitating the acquisition of critical distance from maladaptive schemas; and (g) promoting the use of adaptive coping skills instead of resorting to substance abuse. Implications for generalizing these procedures to the treatment of other patients with co-occurrent personality disorders and substance abuse are described. © 2014 Wiley Periodicals, Inc.
Hamid Tavakoli Ghouchani
Full Text Available Background and Objectives: The world population has reached over seven billion people. Of these, 230 million individuals abuse substances. Therefore, substance abuse prevention and treatment programs have received increasing attention during the past two decades. Understanding people’s motivations for quitting drug abuse is essential to the success of treatment. This study hence sought to identify major motivations for quitting and to compare them with the constructs of health education models. Materials and Methods: In the present study, qualitative content analysis was used to determine the main motivations for quitting substance abuse. Overall, 22 patients, physicians, and psychotherapists were selected from several addiction treatment clinics in Bojnord (Iran during 2014. Purposeful sampling method was applied and continued until data saturation was achieved. Data were collected through semi-structured, face-to-face interviews and field notes. All interviews were recorded and transcribed. Results: Content analysis revealed 33 sub-categories and nine categories including economic problems, drug-related concerns, individual problems, family and social problems, family expectations, attention to social status, beliefs about drug addiction, and valuing the quitting behavior. Accordingly, four themes, i.e. perceived threat, perceived barriers, attitude toward the behavior, and subjective norms, were extracted. Conclusion: Reasons for quitting substance abuse match the constructs of different behavioral models (e.g. the health belief model and the theory of planned behavior.
Matto, Holly C; Miller, Keith; Spera, Christopher
A newly developed instrument that assesses a client's orientation to addiction or recovery communities using social context referents was pilot tested with a sample of 103 adults seeking treatment for substance abuse at outpatient and residential treatment facilities on the East Coast. Preliminary findings show promising subscale reliabilities, and suggest that drug- and recovery-related social identities are related to drug-use severity and drug-use concern; and drug-related attitudinal congruence between the treatment-seeker and family and treatment-seeker and other significant persons are related to intention to make behavioral changes in reducing substance abuse.
This article explores the meanings of substance-abusing clients attach to friendships during motivational treatment sessions in Probation Service. Sessions (98) were videotaped in 12 probation service offices in Finland in 2007 to 2009. By using semiotic framework, this qualitative study examines client's change talk utterance about friendships as a symbolic sign. The findings indicate that the friendships play an important role in the substance-abusing clients' motivation to change and in their treatment outcome. The study suggests that the personal meanings of clients' utterances in motivational treatment sessions could be seen as potential predictors of their future behavior.
Badariah Mohd Saad
Full Text Available Drug and substance abuse create a social disorder that would destruct the society. This study examines factors leading to drug abuse among youth in a rehab center located in Kuala Lumpur. Out of 61 respondents surveyed, 71% was Malay, 13% was Chinese, and 10% was Indian and majority of them 80% were male. The study found that there were no significant differences in the mean of social environment, income, law enforcement and peer influence scores among the three ethnic groups. The multiple regression analysis revealed that peer influence was a significant factor leading to drug abuse among the youth.
Black, Rebecca; Mayer, Joseph
Research on the role of alcoholism and opiate addiction in child abuse and neglect is reviewed, and a study of the adequacy of child care in families of 200 alcohol or opiate addicted parents is reported. Demographic data is included, and incidence and characteristics of physical and sexual abuse and neglect are reported. Sex of the addicted…
... licensed or certified employee assistance professional; or (5) An alcohol and drug abuse counselor..., rule changes, and other information about developments in SAE practice pertaining to this part, since... activities must include documented assessment tools to assist in determining that the SAE has learned the...
... in our schools, to greater risks on our roads and in our communities, to the heartache of lives cut... approach that advances evidence-based public health and safety reforms. We have invested in outreach... tide of prescription drug abuse through education, monitoring, proper disposal, and enforcement. We...
risks and are more likely to face physical, emotional and sexual abuse, especially at night. ... They often fall sick owing to the harsh cold weather, poor hygiene and sanitation ..... streets. Other studies in Nigeria and India also reported that >70% of street ... behaviours by street children can lead to health and social problems.
Newcomb, Michael D.; Bentler, Peter M.
Although child or teenage drug use is an individual behavior, it is embedded in a sociocultural context that strongly determines its character and manifestations. Examines drug use and abuse from a multidimensional perspective that includes aspects of the stimulus, organism, response, and consequences. Discusses epidemiology, etiology, prevention,…
Tartakovsky, Eugene; Kovardinsky, Slava
This study investigates the therapeutic orientations of substance abuse social workers and the relationship between these orientations and burnout. Ninety-two social workers who provided outpatient treatment to people suffering from substance-related disorders in Israel participated in the study. The results obtained demonstrated that the substance abuse social workers adhere more to the psychodynamic and ecosystemic therapeutic orientations than to the cognitive-behavioral orientation. A greater adherence to the cognitive-behavioral orientation was associated with a higher sense of professional efficacy; a greater adherence to the psychodynamic orientation was associated with a higher level of exhaustion; and greater adherence to the ecosystemic orientation was associated with lower levels of exhaustion and cynicism. Female social workers reported lower levels of exhaustion and cynicism. The cognitive-behavioral orientation mediated the connection between the social workers' experience in the field of substance abuse and two dimensions of burnout-exhaustion and professional efficacy. Significance of the findings for improving the well-being of substance abuse social workers and for the advancement of psychosocial services is discussed. Copyright © 2013 Elsevier Inc. All rights reserved.
Full Text Available Background: Studies of the prevalence of substance abuse in rural and urban population in different countries revealed variable results regarding to the study method, study population, age group and measuring tools. The purpose of this research is to compare the patterns of substance abuse disorders in urban and rural population in Mashhad.Materials and Method: Two groups consecutively admitted patients who referred to substance treatment clinics of Mashhad, were selected (110 urban and 100 rural patients. Samples were evaluated with structured demographic questionnaire and Structured Clinical Interview (SCID for DSM-IV. Data were analyzed by χ2 and independent t-test.Results: This study showed statistically significant differences between two groups in marital status, education level, monthly income and job. Also the samples were differed in substance type, history of injection and quit, abuse of nicotine, cannabis and alcohol in long life. Conclusion: Rural and urban societies have differences in patterns of substance abuse that can be originated from social-context differences
with individuals who need help tending to deny or hide their condition for fear ..... Centers for Disease Control and Prevention, Atlanta, Georgia, U. S. A,. 2004. 19. Strauss ... Community based organizations for substance users in Cape Town,.
Secades-Álvarez, Adrián; Fernández-Rodríguez, Concepción
The aim of this study was to provide a descriptive overview of different psychological and pharmacological interventions used in the treatment of patients with bipolar disorder and substance abuse, in order to determine their efficacy. A review of the current literature was performed using the databases Medline and PsycINFO (2005-2015). A total of 30 experimental studies were grouped according to the type of therapeutic modality described (pharmacological 19; psychological 11). Quetiapine and valproate have demonstrated superiority on psychiatric symptoms and a reduction in alcohol consumption, respectively. Group psychological therapies with education, relapse prevention and family inclusion have also been shown to reduce the symptomatology and prevent alcohol consumption and dropouts. Although there seems to be some recommended interventions, the multicomponent base, the lack of information related to participants during treatment, experimental control or the number of dropouts of these studies suggest that it would be irresponsible to assume that there are well established treatments. Copyright © 2016. Publicado por Elsevier España, S.L.U.
Nielsen, S M; Toftdahl, N G; Nordentoft, M; Hjorthøj, C
Several studies have examined whether use of substances can cause schizophrenia. However, due to methodological limitations in the existing literature (e.g. selection bias and lack of adjustment of co-abuse) uncertainties still remain. We aimed to investigate whether substance abuse increases the risk of developing schizophrenia, addressing some of these limitations. The longitudinal, nationwide Danish registers were linked to establish a cohort of 3 133 968 individuals (105 178 673 person-years at risk), identifying 204 505 individuals diagnosed with substance abuse and 21 305 diagnosed with schizophrenia. Information regarding substance abuse was extracted from several registers and did not include psychotic symptoms caused by substance abuse in the definition. This resulted in a large, generalizable sample of exposed individuals. The data was analysed using Cox regression analyses, and adjusted for calendar year, gender, urbanicity, co-abuse, other psychiatric diagnosis, parental substance abuse, psychiatric history, immigration and socioeconomic status. A diagnosis of substance abuse increased the overall risk of developing schizophrenia [hazard ratio (HR) 6.04, 95% confidence interval (CI) 5.84-6.26]. Cannabis (HR 5.20, 95% CI 4.86-5.57) and alcohol (HR 3.38, 95% CI 3.24-3.53) presented the strongest associations. Abuse of hallucinogens (HR 1.86, 95% CI 1.43-2.41), sedatives (HR 1.68, 95% CI 1.49-1.90), and other substances (HR 2.85, 95% CI 2.58-3.15) also increased the risk significantly. The risk was found to be significant even 10-15 years subsequent to a diagnosis of substance abuse. Our results illustrate robust associations between almost any type of substance abuse and an increased risk of developing schizophrenia later in life.
Banducci, Anne N; Hoffman, Elana M; Lejuez, C W; Koenen, Karestan C
Adults with substance use disorders (SUDs) report a high prevalence of childhood abuse. Research in the general population suggests specific types of abuse lead to particular negative outcomes; it is not known whether this pattern holds for adults with SUDs. We hypothesized that specific types of abuse would be associated with particular behavioral and emotional outcomes among substance users. That is, childhood sexual abuse would be associated with risky sex behaviors, childhood physical abuse with aggression, and childhood emotional abuse with emotion dysregulation. 280 inpatients (M age=43.3; 69.7% male; 88.4% African American) in substance use treatment completed the Childhood Trauma Questionnaire (CTQ), HIV Risk-Taking Behavior Scale, Addiction Severity Index, Difficulties with Emotion Regulation Scale (DERS), Distress Tolerance Scale (DTS), and Affect Intensity and Dimensions of Affiliation Motivation (AIM). Consistent with our hypotheses, the CTQ sexual abuse subscale uniquely predicted exchanging sex for cocaine and heroin, number of arrests for prostitution, engaging in unprotected sex with a casual partner during the prior year, and experiencing low sexual arousal when sober. The physical abuse subscale uniquely predicted number of arrests for assault and weapons offenses. The emotional abuse subscale uniquely predicted the DERS total score, AIM score, and DTS score. Among substance users, different types of abuse are uniquely associated with specific negative effects. Assessment of specific abuse types among substance users may be informative in treatment planning and relapse prevention. Copyright © 2014 Elsevier Ltd. All rights reserved.
Relative contributions of parent substance use and childhood maltreatment to chronic homelessness, depression, and substance abuse problems among homeless women: mediating roles of self-esteem and abuse in adulthood.
Stein, Judith A; Leslie, Michelle Burden; Nyamathi, Adeline
This study, using latent variable methodology, explores simultaneously the relative effects of childhood abuse and early parental substance abuse on later chronic homelessness, depression, and substance abuse problems in a sample of homeless women. We also examine whether self-esteem and recent violence can serve as mediators between the childhood predictors and the dysfunctional outcomes. The sample consists of 581 homeless women residing in shelters or sober living centers in Los Angeles (54% African-American, 23% Latina, 22% White, mean age=33.5 years). Multiple-indicator latent variables served as predictors and outcomes in structural models. Childhood abuse was indicated by sexual, physical, and verbal abuse. Childhood abuse directly predicted later physical abuse, chronic homelessness, depression, and less self-esteem. Parent substance use directly predicted later substance use problems among the women. Recent physical abuse predicted chronic homelessness, depression, and substance use problems. Greater self-esteem predicted less depression and fewer substance use problems. Childhood abuse also had significant indirect effects on depression, chronic homelessness, and drug and alcohol problems mediated through later physical abuse and self-esteem. Although there was a strong relationship between childhood abuse and parent drug use, childhood abuse was the more pervasive and devastating predictor of dysfunctional outcomes. Childhood abuse predicted a wider range of problems including lower self-esteem, more victimization, more depression, and chronic homelessness, and indirectly predicted drug and alcohol problems. The mediating roles of recent physical abuse and self-esteem suggest salient leverage points for change through empowerment training and self-esteem enhancement in homeless women.
Blome, Wendy Whiting; Shields, Joseph; Verdieck, Mary Jeanne
The child welfare and substance abuse systems are integrally linked through the children and families they both serve. There is a dearth of knowledge, however, on how children who have experienced foster care fare when they are treated for substance abuse issues as adults. This article presents an exploratory study using the Alcohol and Drug…
Druss, Benjamin G.; Bornemann, Thomas; Fry-Johnson, Yvonne W.; McCombs, Harriet G.; Politzer, Robert M.; Rust, George
Objective. We examined trends in delivery of mental health and substance abuse services at the nation’s community health centers. Methods. Analyses used data from the Health Resources and Services Administration (HRSA), Bureau of Primary Care’s (BPHC) 1998 and 2003 Uniform Data System, merged with county-level data. Results. Between 1998 and 2003, the number of patients diagnosed with a mental health/substance abuse disorder in community health centers increased from 210 000 to 800 000. There was an increase in the number of patients per specialty mental health/substance abuse treatment provider and a decline in the mean number of patient visits, from 7.3 visits per patient to 3.5 by 2003. Although most community health centers had some on-site mental health/substance abuse services, centers without on-site services were more likely to be located in counties with fewer mental health/substance abuse clinicians, psychiatric emergency rooms, and inpatient hospitals. Conclusions. Community health centers are playing an increasingly central role in providing mental health/substance abuse treatment services in the United States. It is critical both to ensure that these centers have adequate resources for providing mental health/substance abuse care and that they develop effective linkages with mental health/substance abuse clinicians in the communities they serve. PMID:17008573
Reilly, Patrick M.; Shopshire, Michael S.; Durazzo, Timothy C.; Campbell, Torri A.
This manual and workbook set focuses on anger management. The manual was designed for use by qualified substance abuse and mental health clinicians who work with substance abuse and mental health clients with concurrent anger programs. The manual describes a 12-week cognitive behavioral anger management group treatment. Each of the 12 90-minute…
Full Text Available Background: The comorbidity of substance abuse and mental disorder is known to exist and may cause many diagnostic, prognostic, and management difficulties. Indian data are sparse in this area. Objectives: The aim of the study was to identify the prevalence and pattern of substance abuse in psychiatric outpatients and to examine the relation between demographic variables and drug abuse pattern. Materials and Methods: Medical records of the patients attending psychiatry outpatient clinic at a tertiary care general hospital over a 3-month period were reviewed. Information was obtained from medical chart and Drug Abuse Monitoring Scale pro forma about substance abuse. Psychiatric diagnosis made by a qualified psychiatrist according to the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition diagnostic criteria, as recorded in the case record form, was used. Observation: The results revealed that 50.8% (half of all psychiatry outpatients were using one or more substances including tobacco in the last month prior to registration (1 month prevalence and 28.35% were using substances at any time in their life prior to the last month (lifetime prevalence. Male patients had 6 to 8 times higher substance abuse than female patients. Tobacco and alcohol were found to be the most common substances of abuse, followed by cannabis. Part-time and full-time employed male patients consumed more alcohol and tobacco than unemployed patients. Conclusions: Substance abuse was common among mentally ill outpatients and could be the cause of various health hazards and hence requires due attention.
Polcin, Douglas L.; Korcha, Rachael
Social support and psychiatric severity are known to influence substance abuse. However, little is known about how their influences vary under different conditions. We aimed to study how different types of social support were associated with substance abuse outcomes among persons with low and moderate psychiatric severity who entered Sober Living…
Mathias, Ana Carolina R.; Vargens, Renata W.; Kessler, Felix H.; Cruz, Marcelo S.
There is a strong association between pathological gambling and substance abuse. The objective of this study is to identify the differences between substance abusers with and without gambling problems. A cross sectional study was conducted interviewing with Addiction Severity Index (ASI) and South Oaks Gambling Screen (SOGS), alcohol and drug…
Oudejans, S C C; Schippers, G M; Spits, M E; Stollenga, M; van den Brink, W
Three substance abuse treatment centres set up a benchmarking project for routine outcome management (ROM) of structured cognitive behavioral treatments for outpatients with a substance use disorder. To present the results of five years benchmarking. All patients were included at intake and the follow-up assessment was performed by a call-center nine months later. Twice a year aggregated data were fed back to management and treatment teams. Since 2005, clinical outcome data, including substance abuse data, have been collected for more than half of all 15.786 treated patients. At follow-up, nine months after intake, 23% was abstinent, 28% reported moderate substance use and 49% reported excessive substance use. The Dutch centres for the treatment of substance abuse were successful in setting up ROM projects to monitor and compare the development and the effects of outpatient addiction treatments. The clinical results are acceptable and correspond to the results of the American project called match. It is not yet clear whether the biannual feedback of aggregated outcomes to management and treatment teams has contributed to the creation of learning organisations, but it has provided transparency and has made it possible for teams to learn from the outcomes.
Substance use was considered to be primarily a male problem, and many substance abuse studies are conducted with a predominance of male participants. However, recent substance abuse research indicates significant gender differences in the substance-related epidemiology, social factors and characteristics, biological responses, progressions to dependence, medical consequences, co-occurring psychiatric disorders, and barriers to treatment entry, retention, and completion. The epidemiology of women's drug use presents challenges separate from those raised by men's drug use. A convergence of evidence suggests that women with substance use disorders are more likely than men to face multiple barriers affecting access and entry to substance abuse treatment. Gender-specific medical problems as a result of the interplay of gender-specific drug use patterns and sex-related risk behaviors create an environment in which women are more vulnerable than men to human immunodeficiency virus. Individual characteristics and treatment approaches can differentially affect outcomes by gender. All of these differences have important clinical, treatment, and research implications.
David, Daryn H; McMahon, Thomas J; Luthar, Suniya L; Suchman, Nancy E
Ego development, the capacity to derive coherent, nuanced meaning from one's life experiences, often has significant impact on psychosocial adjustment during adulthood. Research with nonclinical populations has indicated links between higher ego development and healthy emotional coping and interpersonal relationships. Emerging research with substance-abusing mothers suggests that higher levels of ego development are associated with improved parenting but also with increased rates of psychopathology. Less is known about how ego development is related to other psychosocial factors important for substance-abusing mothers' functioning and capacity to parent, including the proclivity to engage in risky behaviors, adaptive coping behaviors, and readiness to engage in psychotherapy. The present study examines these links. Participants included 182 methadonemaintained women who expressed interest in a randomized clinical trial testing the efficacy of a relational parenting intervention for substance-abusing mothers (Luthar, Suchman, & Altomare, 2007). Data were analyzed using a series of MANCOVAs and ANCOVAs controlling for maternal IQ and depression. Mothers with higher levels of ego development reported more adaptive coping techniques and greater readiness to engage in psychotherapy but also reported a heightened desire for strong sensations. Findings are discussed in light of mothers' psychological processes and parenting capacities. The significance of findings for developing parenting interventions for substance-abusing mothers is also discussed. © 2012 American Orthopsychiatric Association.
Spiller, Henry A
Volatile substance abuse (VSA) is believed to be widespread. The Toxic Exposure Surveillance System (TESS) of the American Association of Poison Control Systems offers an opportunity to evaluate the epidemiology of volatile substance abuse using a data set that captures data from a large geographic area covering a wide-ranging group of socioeconomic strata, ethnic groups, and demographics. To utilize this potential we analyzed a data set of TESS for the 6-year period of 1996 through 2001 involving all cases of intentional inhalational abuse of nonpharmaceutical substances. Over the study period there was a mean annual decline of 9% of reported VSA with an overall decline of 37% from 1996 to 2001. Volatile substance abuse was reported primarily in children, with 6358 cases (54%) in children 13-19 yr and 1803 (15%) cases in children 6-12 yr. Fifty-two cases were reported in children air fresheners (6%), and formalin (5%). Three categories were responsible for the majority of deaths: gasoline (45%), air fresheners (26%), and propane/butane (11%). While there was a decline in reported cases, there was no decline in major outcomes or fatalities. Volatile substance abuse was reported in all 50 states, with case distribution similar to population distribution. However, seven states had > 2 times the expected rate based on their population; three western states, two midwestern states, and two Appalachian states. The role of urban vs. rural population may possibly explain the difference in numbers, with a greater incidence of VSA cases reported in states with large rural populations. The mean monthly occurrence rate was 162 VSA cases/month (S.D. +/- 10.85). There were 4 months that were > 2 standard deviations from the mean, with two peak months (May, 192/month and March, 187/month) and two trough months (December, 126/month and January, 137/month). This report presents a broad picture of VSA in the United States. Volatile substance abuse, as reported to U.S. poison centers
) avec 52,08% de sujets âgés de 26 à 33 ans. La polytoxicomanie a représenté 41,03% suivi de l'usage du cannabis (26,54%) et de cocaïne (14,74%). Le syndrome déficitaire a été plus fréquent dans l'abus d'amphétamines (61,64%), de ...
Danielson, Carla Kmett; Amstadter, Ananda B.; Dangelmaier, Ruth E.; Resnick, Heidi S.; Saunders, Benjamin E.; Kilpatrick, Dean G.
We investigated the link between child maltreatment, including child sexual assault (CSA) and child physical assault (CPA), and addiction-related symptomatology in a subsample of adolescents from the National Survey of Adolescents, all of whom met DSM-IV criteria for substance abuse or dependence (N = 281). More than 60% of the sample reported a…
Substance Abuse and Mental Health Services Administration (DHHS/PHS), Rockville, MD. Center for Substance Abuse Treatment.
This report is the result of five expert panels and six regional public hearings around the country that focused on key persistent issues that have characterized discussions of substance abuse over the years: closing the treatment gap; reducing stigma and changing attitudes; improving and strengthening treatment systems; connecting services and…
Lehman, Wayne E. K.; Greener, Jack M.; Rowan-Szal, Grace A.; Flynn, Patrick M.
Significant needs exist for increased and better substance abuse treatment services in our nation's prisons. The TCU Organizational Readiness for Change (ORC) survey has been widely used in community-based treatment programs and evidence is accumulating for relationships between readiness for change and implementation of new clinical practices.…
Pelissier, Bernadette; Motivans, Mark; Rounds-Bryant, Jennifer L.
The present study examined whether there were program differences with respect to post-release outcomes in 20 federal in-prison substance abuse programs which used a cognitive-behavioral treatment approach. Recidivism and post-release drug use were examined for a sample of 1,343 individuals--1,065 men and 278 women. Discrete time proportional…
Daley, Marilyn; Love, Craig T.; Shepard, Donald S.; Petersen, Cheryl B.; White, Karen L.; Hall, Frank B.
Over the past two decades, the criminal justice population in the US has grown by over 200%, most of this due to an increase in drug-involved offenders. Although there is good evidence that prison-based substance abuse treatment programs can be effective in reducing rearrest, few cost-effectiveness studies have been conducted. Using data from the…
Lo, Celia C.; Cheng, Tyrone C.
Using data from the 2007 National Survey on Drug Use and Health, this study examines whether several social exclusion and psychological factors affect adolescents' receipt of substance abuse treatment. Multinomial logistic regression techniques were used to analyze data. The study asked how the specified factors provide pathways to receipt of…
Workowski, Eric J.
This study examined the relationship between criminal violence and type of substance abuse among 184 current and former residents of an inpatient non-hospital drug and alcohol treatment facility. The criminal justice system functioned as the source of referral into the program for 89% of the subjects studied while only 11% came to treatment…
This research was carried out to assess the role of dysfunctional attitudes, outcomes of psychology in substance abuse behaviors of subject were referred to addiction treatment center in the city of Bandar Abbas, and to compare the with the control group. Methods: This is a retrospective study in which 100 subject substance abusers were compared with 100 subject s of control group who were selected using convenience sampling and were also demographically matched. Data were gathered using a demographic questionnaire, clinical interview, dysfunctional attitudes scale (DAS, Depression Anxiety Stress Scale (DASS. The data were analyzed via descriptive statistic method, T- Test and chi-square and variance analysis. Findings: Findings indicated that in comparison with control group, subject of substance abusers had experienced more stress, anxiety, depression, had shown a cognitively more percent of them dysfunctional attitudes in comparison with control group. Results: The results suggested that the dysfunctional attitudes could be as a Vulnerability Factor that increase abuse of substance consequently use of cognitive therapy could be helpful and effective in prevention and treatment of the addicts.
O'Connor-Merrigan, Mary L.
The continued prevalence of mental health conditions and substance abuse among students enrolled in institutions of higher education is a significant and progressing concern, with marked impact on retention, academic success, graduation rate, and alarming personal consequences. Yet, many institutions struggle with successfully addressing these…
Robbins, Cynthia A.; Martin, Steven S.; Surratt, Hilary L.
This article reports analyses of recidivism and relapse experiences of substance-abusing women inmates as they reenter the community. Outcomes are compared for women who completed a work-release therapeutic community program, women who entered but did not complete the program, and those who did not receive work-release therapeutic community…
... referral to treatment for patients who abuse substances. The overall goal of this project is to assess the... provide significant services directly to the public to survey customers to determine the kind and quality of services they want and their level of satisfaction with existing services. The project will...
Polansky, Joan M.; Buki, Lydia P.; Horan, John J.; Ceperich, Sherry Dyche; Burows, Deborah Dyer
The effectiveness of three substance-abuse-prevention videotapes derived from contrasting theoretical frameworks was evaluated using 312 rural Mexican-American students in grades seven through eight. The assertion-training video produced higher levels of assertiveness among ninth-graders; the others had no impact. Discusses the importance of…
Candler, Ann C.; And Others
Substance abuse is pervasive in both rural and urban settings. Previous attempts to educate America's youth as to its dangers have not reduced the numbers of adolescents involved in the drug culture. The assertiveness-based "Just Say No" campaign attempts to counter peer pressure to use drugs, but is hampered by our society's…
... alcohol in the workplace? Please provide evidence to support your answers. 10. The use of alcohol, even in... Information Regarding Workplace Substance Abuse Programs for Department of Energy Contractors AGENCY: Office... Department of Energy (DOE or the Department) requests information and comments on issues related to workplace...
Birtel, Michèle D; Wood, Lisa; Kempa, Nancy J
Individuals with substance abuse may suffer from severe public and internalized stigma. Little is known about how social support can reduce stigma and improve mental health and well-being for them. This research examined how perceived stigma influences individuals in treatment for substance abuse, and whether internalized stigma and shame are mechanisms which link social support with better mental health and well-being. Sixty-four participants in treatment for substance abuse (alcohol, drugs), aged between 18 and 64, completed an online survey measuring perceived stigma, internalized stigma, shame, perceived social support, and mental health and well-being (self-esteem, depression and anxiety, sleep). We found that perceived stigma was associated with lower self-esteem, higher depression and anxiety, and poorer sleep. Furthermore, perceived social support followed the opposite pattern, and was associated with higher self-esteem, lower depression and anxiety, and better sleep. The effects of perceived stigma and of perceived social support on our outcome measures were mediated by internalized stigma and by internalized shame. Helping individuals with substance abuse to utilize their social support may be fruitful for combatting the negative impact of internalized stigma and shame on mental health and well-being. Copyright © 2017. Published by Elsevier B.V.
Thiel, Thelma King
This guide provides information for teachers to use in teaching about liver wellness, hepatitis B, and substance abuse. The guide includes effective motivational techniques to help students understand how valuable their liver is to their health and well being. It also provides basic information to help students avoid liver damaging behaviors, such…
Bay-Borelli, Michael; And Others
This manual is designed to help school district personnel assess the extent of substance abuse and to develop policies and procedures for dealing with the problem through the cooperation of schools, parents and communities. The effect of social change on adolescents is discussed and trends in developmental distress are noted. Roles and…
Bowles, Steven; Louw, Johann; Myers, Bronwyn
Directors' and treatment staff's perceptions of organizational functioning within substance abuse treatment facilities in four provinces in South Africa were examined via the Texas Christian University's Organizational Readiness for Change instrument. Forty-four treatment facilities (out of 89) participated in the study. Results indicated that…
Jeffrey Platter, Amanda
Many family members are adversely affected by their loved ones drinking or drug problem. The aim of the present study was to explore changes in coping and enabling behaviors among family members who attended a community educational and psychosocial group for friends and family of a substance abuser, and to examine the concerns of these family…
Roscoe, Joseph N; Lery, Bridgette; Chambers, Jaclyn E
Among children investigated for maltreatment, those with parents experiencing mental illness or substance abuse are more likely to be placed out-of-home; however, little is known about why these children are at greater risk. Using a sample of 2488 Structured Decision Making ® assessments administered in San Francisco county from 2011 to 2015, we identified a profile of safety threats that accounts for why workers are more likely to determine children of parents with mental illness and/or substance abuse unsafe in the home. Eight percent of assessments in our sample involved parents with current mental illness only and 10% had comorbid substance abuse. The odds of an unsafe determination more than doubled among parents with mental illness (OR = 2.52, p mental illness on safety determination: caretaking impairment due to emotional stability/developmental status/cognitive deficiency (57%), failure to meet a child's immediate needs (30%), and threats of harm (14%). Three safety threats accounted for 55% of the effect of comorbid mental illness and substance abuse on safety determination: failure to meet a child's immediate needs (21%), presence of a drug-exposed infant (21%), and caretaking impairment due to emotional stability/developmental status/cognitive deficiency (14%). Results suggest that sustained linkage to effective mental health services and material resources at the outset of a child welfare case may help to promote faster and more likely reunification, and prevent future maltreatment. Copyright © 2018 Elsevier Ltd. All rights reserved.
Abbey, Antonia; Pilgrim, Colleen; Hendrickson, Peggy; Buresl, Sue
Evaluates family-based substance abuse prevention program implemented in a rural community for families with middle school students. In comparison with nonparticipants, students had higher family cohesion, less family fighting, greater school attachment, higher self-esteem, and believed alcohol should be consumed at an older age, at one-year…
Elliott, Karen; Shelley, Kyna
Businesses have dealt with substance abuse in different ways. Some organizations have established Employee Assistance Programs (EAPs) to address these problems. One large national company chose to fire employees with positive drug screens, offer them EAP services, and then consider them for rehire after treatment. A study of performance records…
Cook, Paddy; Gartner, Constance Grant; Markl, Lise; Henderson, Randi; Brooks, Margaret K.; Wesson, Donald; Dogoloff, Mary Lou; Vitzthum, Virginia; Hayes, Elizabeth
The major goal of this TIP, on the best practice guidelines to improve the treatment of substance abuse, is to provide clinicians, educators, and paraprofessionals with the latest findings concerning domestic violence. The information is intended to educate providers about the needs and behaviors of batterers and survivors, and how to tailor…
Steinhardt, Sarah J; Clark, John E; Kelly, William N; Hill, Angela M
Objective. To implement active-learning strategies to engage students in learning, applying, and teaching legal and substance abuse topics. Design. Medication Safety course student groups created films on a National Patient Safety Goal (NPSG) using a movie genre and presented them in film festival format. Pharmacogenomics course student groups taught ethical, legal, and social implications (ELSI) topics through presentation of short stories about comic book characters with genetic mutations. Students in the Drugs of Abuse course composed and performed dances depicting the mechanism of action of a drug in an in-class rave dance format. Assessment. Course evaluations revealed student engagement with subject material and enjoyment of the creative applications, critical thinking, and collaborative aspects of the activities. Students performed well on examination questions and graded assignments. Conclusion. These active-learning strategies facilitated students' abilities to learn, apply, and teach material in medication safety, pharmacogenomics, and substance abuse courses.
Dalsgaard, Søren; Madsen, Anders G.; Bikic, Aida
This paper presents an overview of the history of the studies of mental health problems and substance use disorder (SUD) and the neurobiology and etiology of attention-deficit hyperactivity disorder (ADHD) and SUD. Additionally, we review the literature on the associations between ADHD and SUD...
Although forensic index and substance use are crucial issues in clinical work among mentally ill patients, studies emanating from psychiatric facilities in nonwestern cultures have been relatively scarce. This paper examines this issue in a tertiary health institution. Participants were 259 mentally ill patients (124 inpatients ...
They were also further assessed with the Treatnet Addiction Severity Index (ASI), MMPI-2™ and had urine toxicology carried out to determine the type of substances used as well as other laboratory investigations. The diagnosis was made from information gathered from interview and clinical investigations throughout the ...
Conclusion: It is recommended that there should always be proper screening of patients on personality and behavioural traits before admission or placement in public institutions in the same way that governments and families should help to restrict the use of psychoactive substances. The paper concluded that there should ...
Slesnick, N.; Prestopnik, J.L.
Runaway youth report a broader range and higher severity of substance-related, mental health and family problems relative to non-runaway youth. Most studies to date have collected self-report data on the family and social history; virtually no research has examined treatment effectiveness with this population. This study is a treatment development…
Rosenthal, M Zachary; Kutlu, Munir G
Despite experimental findings and some treatment research supporting the use of cues as a means to induce and extinguish cravings, interventions using cue exposure have not been well integrated into contemporary substance abuse treatments. A primary problem with exposure-based interventions for addiction is that after learning not to use substances in the presence of addiction cues inside the clinic (i.e., extinction), stimuli in the naturalistic setting outside the clinic may continue to elicit craving, drug use, or other maladaptive conditioned responses. For exposure-based substance use interventions to be efficacious, new approaches are needed that can prevent relapse by directly generalizing learning from the therapeutic setting into naturalistic settings associated with a high risk for relapse. Basic research suggests that extinction reminders (ERs) can be paired with the context of learning new and more adaptive conditioned responses to substance abuse cues in exposure therapies for addiction. Using mobile phones and automated dialing and data collection software, ERs can be delivered in everyday high-risk settings to inhibit conditioned responses to substance-use-related stimuli. In this review, we describe how associative learning mechanisms (e.g., conditioned inhibition) can inform how ERs are conceptualized, learned, and implemented to prevent substance use when delivered via mobile phones. This approach, exposure with portable reminders of extinction, is introduced as an adjunctive intervention that uses brief automated ERs between clinic visits when individuals are in high-risk settings for drug use.
Full Text Available Abstract Background Inmates on preventive detention are a small and select group sentenced to an indefinite term of imprisonment. Mood disorders and substance abuse are risk factors for inmate violence and recidivism, so the prevalence of depression, anxiety, and substance abuse was examined in this cohort using psychometric tests. Methods Completion of self-report questionnaires was followed by face-to-face clinical interviews with 26 of the 56 male inmates on preventive detention in Norway's Ila Prison. Substance abuse histories and information about the type of psychiatric treatment received were compiled. To assess anxiety and depression, the Hospital Anxiety and Depression Scale (HADS, the Clinical Anxiety Scale (CAS, and the Montgomery Asberg Depression Rating Scale (MADRS were used. Results Scores on the MADRS revealed that 46.1% of inmates had symptoms of mild depression. The HADS depression subscale showed that 19.2% scored above the cut-off for depression (κ = 0.57. The CAS anxiety score was above the cut-off for 30.7% of the subjects, while 34.6% also scored above the cut-off on the HADS anxiety subscale (κ = 0.61. Almost 70% of all these inmates, and more than 80% of those convicted of sex crimes, had a history of alcohol and/or drug abuse. Conclusions Mild anxiety and depression was found frequently among inmates on preventive detention. Likewise, the majority of the inmates had a history of alcohol and drug abuse. Mood disorders and substance abuse may enhance recidivism, so rehabilitation programs should be tailored to address these problems.
Sekulic, Damir; Ostojic, Marko; Ostojic, Zdenko; Hajdarevic, Braco; Ostojic, Ljerka
and 9% of the girls. In both genders, substance abuse was negatively correlated with educational achievement, and half of those students who failed educationally reported daily smoking. Among the girls who experienced education failure, 33% were smokers, and 22% practiced harmful drinking. Sport factors were weakly correlated with substance abuse in boys; thus, we could not support the hypothesis that sports are a protective factor against substance abuse among male adolescents. In girls, participation in team sports was related with a higher incidence of smoking, but there was no evidence of sport factors having an influence on the consumption of alcohol. In this study, the incidence of smoking and the consumption of alcohol were alarmingly high. These findings demonstrate the need for intervention programs to address these issues. These problems are particularly important, considering that substance abuse has a negative impact on educational achievement among boys and girls, and sport factors have not been found to be protective factors against substance abuse.
identified in 20% of the boys and 9% of the girls. In both genders, substance abuse was negatively correlated with educational achievement, and half of those students who failed educationally reported daily smoking. Among the girls who experienced education failure, 33% were smokers, and 22% practiced harmful drinking. Sport factors were weakly correlated with substance abuse in boys; thus, we could not support the hypothesis that sports are a protective factor against substance abuse among male adolescents. In girls, participation in team sports was related with a higher incidence of smoking, but there was no evidence of sport factors having an influence on the consumption of alcohol. Conclusion In this study, the incidence of smoking and the consumption of alcohol were alarmingly high. These findings demonstrate the need for intervention programs to address these issues. These problems are particularly important, considering that substance abuse has a negative impact on educational achievement among boys and girls, and sport factors have not been found to be protective factors against substance abuse. PMID:22480230
Mejía, Bertha; Zea, Paloma; Romero, Martha; Saldívar, Gabriela
In the past decade, several studies have focused on the treatment needs of female inmates with substance abuse problems. An important finding has been that these women are more likely to report histories of sexual, physical, and emotional abuse-at rates varying from 77% to 90%. The trauma resulting from this kind of abuse is a key contributing factor in behavioral problems in adolescence and subsequent delinquency, substance abuse, and criminality in adulthood. This was a retrospective clinical study. A convenience sample of 112 women who entered the program's treatment groups consecutively for one year form part of the study. Information on traumatic events was obtained using some questions from the Initial Trauma Review. It explores whether the participant experienced physical abuse, sexual abuse, disasters, automobile accidents, or witnessed violence under the age of 18. It also examines experiences as an adult, including sexual and physical abuse, attacks by others who are not intimate partners, and abuse by authorities. Revictimization in sexual abuse was found in 78.1% of participants. Significant differences were identified between women who had experienced a traumatic sexual event from a person five years their senior before the age of 18 and then suffered from sexual violence as an adult, and women who had never undergone either of these events (x(2) = 11.3, df 112/1, p = abuse, the figure was 82.17%. Differences were observed between women who were revictimized through physical abuse before and after the age of 18 (x(2) = 5.91, df 112/1, p = child and subsequently physical violence from their parents, and women who had not undergone either of these events (x(2) = 3.48, df 112/1, p = <.05). Investment in treatment in these areas during the prison sentence and after release may contribute to preventing these women from become repeat offenders. Creating sources of work and halfway houses that continue the program to prevent relapses
Fish, Jessica N; Maier, Candice A; Priest, Jacob B
Latino Americans report underutilization of treatment and poor treatment response for substance use and abuse compared to other racial/ethnic groups; thus, it is important to assess factors that contribute to these disparities. The current study objective was to assess the influence of family conflict on substance abuse treatment response in a sample of Latino Americans using two different yet complementary analyses. First, ordinary least squares regression was used to assess the association between overall family conflict and pre- and post-treatment substance use. Second, repeated measures latent class analysis was used to identify groups based on family member conflict and timing of conflict during treatment. Findings indicated that family conflict contributed unique variance to concurrent substance use; however pre-treatment family conflict was not related to post-treatment outcomes. Results also identified three distinct family conflict groups: no/low conflict, pre-treatment conflict, and post-treatment conflict who differed in pre- and post-treatment substance use. Post hoc investigation revealed that those who experienced pre-treatment conflict but low post-treatment conflict showed the greatest decrease in substance use. Findings highlight the importance of considering family conflict during all stages of treatment for Latino American substance users. Copyright © 2015 Elsevier Inc. All rights reserved.
Full Text Available Abstract Background Despite the importance of identifying co-occurring psychiatric disorders in substance abuse treatment programs, there are few appropriate and validated instruments available to substance abuse treatment staff to conduct brief screen for these conditions. This paper describes the development, implementation and validation of a brief screening instrument for mental health diagnoses and trauma among a diverse sample of Black, Hispanic and White women in substance abuse treatment. With input from clinicians and consumers, we adapted longer existing validated instruments into a 14 question screen covering demographics, mental health symptoms and physical and sexual violence exposure. All women entering treatment (methadone, residential and out-patient at five treatment sites were screened at intake (N = 374. Results Eighty nine percent reported a history of interpersonal violence, and 70% reported a history of sexual assault. Eighty-eight percent reported mental health symptoms in the last 30 days. The screening questions administered to 88 female clients were validated against in-depth psychiatric diagnostic assessments by trained mental health clinicians. We estimated measures of predictive validity, including sensitivity, specificity and predictive values positive and negative. Screening items were examined multiple ways to assess utility. The screen is a useful and valid proxy for PTSD but not for other mental illness. Conclusion Substance abuse treatment programs should incorporate violence exposure questions into clinical use as a matter of policy. More work is needed to develop brief screening tools measures for front-line treatment staff to accurately assess other mental health needs of women entering substance abuse treatment
Norton, E C; Zarkin, G A; Calingaert, B; Bradley, C J
This study addresses the effect of maternal substance abuse on the cost of neonatal care in a sample of all singleton live births in Maryland in 1991. Most other cost studies have analyzed data from only one hospital; we analyzed data from 54 hospitals and therefore can control for individual hospital effects and correlation of observations within hospitals. We find that maternal drug abuse has a significant positive effect on total hospital charges, length of stay, and average daily charges, with the increase in length of stay being proportionally greater than the increase in average daily charges. Maternal alcohol abuse also has a positive effect on hospital charges and length of stay, but the effects are not statistically significant. About half the effect of drug abuse on total charges works indirectly through premature birth and other comorbidities.
Nielson, Elizabeth M.
Purpose The purpose of this paper is to better understand the relationship between substance abuse counselors’ personal recovery status, self-schemas, and willingness to use empirically supported treatments for substance use disorders. Methods A phenomenological qualitative study enrolled 12 practicing substance abuse counselors. Results Within this sample, recovering counselors tended to see those who suffer from addiction as qualitatively different from those who do not and hence themselves as similar to their patients, while nonrecovering counselors tended to see patients as experiencing a specific variety of the same basic human struggles everyone experiences, and hence also felt able to relate to their patients’ struggles. Discussion Since empirically supported treatments may fit more or less neatly within one or the other of these viewpoints, this finding suggests that counselors’ recovery status and corresponding self-schemas may be related to counselor willingness to learn and practice specific treatments. PMID:28626597
Nielson, Elizabeth M
The purpose of this paper is to better understand the relationship between substance abuse counselors' personal recovery status, self-schemas, and willingness to use empirically supported treatments for substance use disorders. A phenomenological qualitative study enrolled 12 practicing substance abuse counselors. Within this sample, recovering counselors tended to see those who suffer from addiction as qualitatively different from those who do not and hence themselves as similar to their patients, while nonrecovering counselors tended to see patients as experiencing a specific variety of the same basic human struggles everyone experiences, and hence also felt able to relate to their patients' struggles. Since empirically supported treatments may fit more or less neatly within one or the other of these viewpoints, this finding suggests that counselors' recovery status and corresponding self-schemas may be related to counselor willingness to learn and practice specific treatments.
Barritt, A Sidney; Lee, Brian; Runge, Thomas; Schmidt, Monica; Jhaveri, Ravi
To evaluate the impact of substance abuse on pediatric hepatitis C virus (HCV) prevalence, we examined geographic and demographic data on inpatient hospitalizations in children with HCV. We examined hospitalizations in children using the Kids' Inpatient Database, a part of the Healthcare Cost and Utilization Project. We identified cases using the International Classification of Diseases, 9th edition, codes for HCV infection during 2006, 2009, and 2012. Nonparametric tests for trend were used to calculate trend statistics. From 2006 to 2012 nationally, the number of hospitalizations of children with HCV increased 37% (2.69 to 3.69 per 10 000 admissions; P substance use among children with HCV increased from 25% in 2006 to 41% in 2012 (P teenagers, highly associated with substance abuse, and concentrated in Northeast and Southern states. These results strongly suggest that public health efforts to prevent and treat HCV will also need to include adolescents. Copyright © 2017 Elsevier Inc. All rights reserved.
Full Text Available There is no empirical research exploring how substance abuse therapists perceive and manage their professional role or privacy boundaries. This study explores their attitudes associated with self-disclosure and dual relationships. Ten therapists, five who had recovered (neophytes and five who had never been substance dependent, shared their work experiences during semi-structured, in-depth interviews, which have been subjected to interpretative phenomenological analysis. While nonneophytes were generally reluctant to share personal information or establish alternative forms of relationship with current or former clients, neophytes were more open to using self-disclosure and admitted changing professional relationships into friendships. These findings are discussed in relation to ethical codes, training and supervision in substance abuse treatment.
Esbec, Enrique; Echeburúa, Enrique
There is a strong link between drug use and crime, but this relationship is complex. Drug use does not necessarily lead to an increase in crimes, such as theft, rape or assault, even among regular users or addicts. However, in cases of individuals who consume drugs excessively and commit crimes, both factors are linked. Poverty, personality disorders, social and cultural variables, relationships with other users and previous incarceration or drug use are all factors. These issues play an important role in understanding the risk of crime and drug use. Most addicts should be held liable for most criminal behaviour motivated by addiction, but that addiction can, in some cases, affect one's capacity for self-control over one's actions. This paper examines the current response of the Spanish Criminal Justice System to various aspects of drug abuse, focusing on court decisions related with the nature and enforcement of drug laws. It also addresses aspects of criminal responsibility for drug abuse and drug-related crimes and suggests legislation on drugs, sentencing alternatives for drug offenses, and drug treatment options. Expert evidence plays a crucial role in this area in the court.
Full Text Available Background and Objective: Adolescence is the most critical period of life as regards commencing drug abuse. The social cost and damage caused by drug abuse in adolescence are enormous, necessitating interventional programs to prevent this behavior. The theory of planned behavior (TPB is perhaps the most influential theory for the prediction of social and health behaviors such as drug abuse.Materials and Methods: In this descriptive analytical study, samples were collected from male students in four high schools in different regions of Hamedan. The survey was carried out via random cluster sampling of 650 students. Data were collected using the standard self-report questionnaires and were analyzed using SPSS16, chi-squared test, correlation coefficient, and logistic regression analysis.Results: Among the adolescents participating in this study, 11.1% had the experience of cigarette smoking, 3.4% had the experience of drug abuse, and 12% had the experience of intention to abuse drugs. There was a significant relationship between drug abuse and the following variables: smoking experience (p value =0.001, OR=27.238; having drug user parents (p value =0.001, OR=8.630; having friends who had experienced drug abuse (p value =0.001, OR=11.060; having best friends who had experienced drug abuse (p value = 0.001, OR=11.931; family with drug abuse (p value = 0.001, OR=4.311; and having a sibling who abused drugs (p value=0.001, OR=15.815. According to the logistic regression analysis, attitude, subjective norms, and perceived behavior control were the most influential predictors of intention to abuse drugs.Conclusion: The use of TPB is beneficial in the predicting and planning for high-risk behaviors. TPB can be used for planning and implementing drug abuse prevention programs in adolescents.
Chérrez-Bermejo, C; Alás-Brun, R
To obtain data on substance abuse and mental disorders amongst a population of inmates imprisoned for gender violence. 106 intimate partner violence offenders were recruited in our study, all of whom were prison inmates. The study is descriptive and statistical comparison of percentages was used. the percentage of substance abuse was 61.3%; most of which consisted of alcohol and cocaine. According to DSM-IV R, 25.5% of the inmates had at least one psychiatric diagnosis at the time when entering prison: 11.3% adjustment disorder with depressed mood, 6.6% personality disorders, 2.8% psychosis, 1.9% major depressive disorder, 1.9% bipolar disorder and 1.9% psycho-organic disorder were encountered. The average age of the men of the sample was forty years old. The most common nationality was Spanish. The percentage of immigrants was significant greater than the global percentage of the general population. The percentage of global substance consumption and psychopathologic problems is greater than data obtained in IPV from other populations, like samples of men charged by their partners with gender violence. depressive symptoms, personality disorders, alcohol and cocaine consumption need to be investigated as gender violence risk markers in Spain. Attention should be paid to the role of consumption prevention when entering prison.
Nagar, Vittal R; Springer, Joe E; Salles, Sara
To investigate the incidence of spinal abscess and substance abuse in a tertiary care hospital after state legislation titled "House Bill 1" (HB1) mandated stricter regulation of prescription drugs of abuse in Kentucky in 2012. A retrospective case series study design was used to review the incidence of spinal abscess and drug abuse diagnoses admissions from 2010 to 2014. Variances in the incidence of spinal abscess and substance abuse were plotted across this time frame. The incidence of intraspinal abscess increased 1.56-fold in 2011 (n = 26) and 2012 (n = 25) relative to 2010 (n = 16). However, in 2013, the year following implementation of HB1 legislation, the incidence of intraspinal abscess increased 2.38-fold (n = 38) and then 4.19-fold (n = 67) in 2014. The incidence of intraspinal abscess in subjects with drug abuse diagnosis remained constant between 2010 (n = 3) and 2012 (n = 3). However, it increased twofold (n = 7) in 2013 and then ninefold (n = 27) in 2014. A correlation coefficient (rSAD ) of 0.775 revealed a strong association between the increase incidence of intraspinal abscess and diagnosis of drug abuse. The results of this retrospective study demonstrate an increased incidence of intraspinal abscess associated with drug abuse after passage of HB1 legislation regulating prescriptions of controlled medications in Kentucky. This increased incidence may be related to individuals relying on nonprescription drugs of abuse due to more highly regulated access to controlled prescription medications. However, additional factors unrelated to HB1 legislation must be taken into account. Wiley Periodicals, Inc.
Full Text Available Substance use disorder is the second most common psychiatric disorders and is far more prevalent among young adults (ages;18-34y/0. Because of its importance and main effect in society, this study performed for evaluation of association fourteen childhood and adoleseence pathologic factors with substance use disorder among a group of abuser (20-30/0that referred to five addiction center in Tehran . The sample consist 100 patient: including 50 case and 50 control who were selected by DSM- IV based semi-structured diagnostic interviews for decrease memory biases in this retrospective cohart study. The patient’s parents also evaluated by DSM- IV based Semi-structured diagnostic interviews. The analysis showed significant relation between: parents control on the siblings, addiction in relatives of pt (except parents, addicted peers and friends, to be affected with the peers and friends and substance use disorder at the ages (20-30y/o. There wasn’t any association between: Disruptive childhood behaviors (under 11y/o, diagnosed medical illness (under 11y/o diagnosed Psychiatric illness (under 6 mo , family size, socio economic state and substance use disorder at the age(20-30y/0 . Finally some childhood and adolescence pathologic factors has association with Substance use disorder at the ages ( 20-30y/5 that these can be used for education all planning , prevention , design high risk group and remedical plans.
Mokma, Taylor R; Eshelman, Lee R; Messman-Moore, Terri L
Child sexual abuse and adult sexual assault have been linked to increased self-blame, posttraumatic stress symptoms, and alcohol use. The current study aims to examine (a) whether these constructs explain women's risk for later adult sexual assault and revictimization, (b) whether such factors differentially confer risk for specific types of adult sexual assault (i.e., substance-facilitated and forcible), and (c) if self-blame confers risk indirectly through other risk factors. Multiple types of self-blame, posttraumatic stress, and alcohol use were examined among 929 female college students as serial mediators of the relationship between child sexual abuse and adult sexual assault and as risk factors for sexual revictimization among child sexual abuse survivors. In the model predicting risk for substance-facilitated adult sexual assault, child sexual abuse indirectly predicted greater risk for substance-facilitated adult sexual assault mediated through two separate paths: global blame-to-posttraumatic-stress and global blame-to-alcohol use. In the model predicting risk for forcible adult sexual assault, child sexual abuse directly predicted greater risk for forcible adult sexual assault, and this relation was mediated by the global blame-to-posttraumatic-stress path. Among child sexual abuse survivors, child sexual abuse specific characterological and behavioral self-blame directly predicted greater risk for forcible and substance-facilitated revictimization, but the pathways were not mediated by posttraumatic stress or alcohol use. Results emphasize the importance of assessing different types of self-blame in predicting posttraumatic stress symptoms as well as examining risk for sexual victimization and revictimization. Findings did not support hypotheses that increased posttraumatic stress would predict increased alcohol use but did indicate that heightened self-blame is consistently associated with heightened posttraumatic stress and that heightened global self
Johnson, Kimberly; Quanbeck, Andrew; Maus, Adam; Gustafson, David H; Dearing, James W
Understanding influence networks among substance abuse treatment clinics may speed the diffusion of innovations. The purpose of this study was to describe influence networks in Massachusetts, Michigan, New York, Oregon, and Washington and test two expectations, using social network analysis: (1) Social network measures can identify influential clinics; and (2) Within a network, some weakly connected clinics access out-of-network sources of innovative evidence-based practices and can spread these innovations through the network. A survey of 201 clinics in a parent study on quality improvement provided the data. Network measures and sociograms were obtained from adjacency matrixes created by UCINet. We used regression analysis to determine whether network status relates to clinics' adopting innovations. Findings suggest that influential clinics can be identified and that loosely linked clinics were likely to join the study sooner than more influential clinics but were not more likely to have improved outcomes than other organizations. Findings identify the structure of influence networks for SUD treatment organizations and have mixed results on how those structures impacted diffusion of the intervention under study. Further study is necessary to test whether use of knowledge of the network structure will have an effect on the pace and breadth of dissemination of innovations.
Inchausti, Felix; Ortuño-Sierra, Javier; García-Poveda, Nancy V; Ballesteros-Prados, Alejandro
The term metacognition reflects a spectrum of psychological activities that allows people to form and integrate representations about their own mental states and those of others. The main goal of this study was to examine whether people with substance abuse disorders (SUDs), and treated in therapeutic community regime, displayed specific patterns of metacognitive deficits on Self-reflectivity, Understanding others’ mind, Decentration, and Mastery, comparing their scores with two clinical groups of patients with schizophrenia spectrum disorders (SSDs) and anxiety disorders. A mixed-methods (qualitative-quantitative) study was designed. Two hundred and sixteen adults aged 18-65 with principal diagnoses of SUDs (n = 52), SSDs (n = 49), and anxiety disorders (n = 115) were recruited. Qualitative data were obtained with the Metacognition Assessment Interview, which was then rated using a quantitative scale, the Metacognition Assessment Scale-Abbreviated (MAS-A). The anxiety disorders group had significantly higher MAS-A total scores than the SUDs group, and the SUDs group obtained significantly higher MAS-A total scores than the SSDs group. Concerning the MAS-A subscale scores, the SUDs group displayed significantly lower scores only on the Mastery subscale compared to the anxiety disorders group, with the SUDs and SSDs groups obtaining equivalent Mastery scores. According to these findings, current interventions for addiction should focus more specifically on improving metacognitive Mastery.
Stein, L. A. R.; Graham, John R.
The ability of respondents to underreport successfully on substance abuse and validity scales of the Minnesota Multiphasic Personality Inventory-Adolescent (MMPI-A; Butcher et al., 1992) was evaluated. Incarcerated teens (67 substance abusing, 59 non-substance abusing) completed the MMPI-A twice: once under standard instructions (SI) and once…
Lind, Kimberly E; Gutierrez, Eric J; Yamamoto, Dorothy J; Regner, Michael F; McKee, Sherry A; Tanabe, Jody
Sex differences in brain structure and clinical course of substance use disorders underscores the need to include women in structural brain imaging studies. The NIH has supported the need for research to address sex differences. We evaluated female enrollment in substance abuse structural brain imaging research and the methods used to study sex differences in substance effects. Structural brain imaging studies published through 2016 (n=230) were evaluated for number of participants by sex and substance use status and methods used to evaluate sex differences. Temporal trends in the numbers of participants by sex and substance use status were analyzed. We evaluated how often sex effects were appropriately analyzed and the proportion of studies that found sex by substance interactions on volumetric measures. Female enrollment increased over time, but remained significantly lower than male enrollment (p=0.01), with the greatest bias for alcohol and opiate studies. 79% of studies included both sexes; however, 74% did not evaluate sex effects or used an analytic approach that precluded detection of sex by substance use interactions. 85% of studies that stratified by sex reported different substance effects on brain volumes. Only 33% of studies examining two-way interactions found significant interactions, highlighting that many studies were underpowered to detect interactions. Although female participation in substance use studies of brain morphometry has increased, sex disparity persists. Studying adequate numbers of both sexes and employing correct analytic approaches is critical for understanding sex differences in brain morphometric changes in substance abuse. Copyright © 2017 Elsevier B.V. All rights reserved.
S C Tiwari
Full Text Available Background: The urban Lucknow community was studied during a project "A study to evolve material for prevention of drug/alcohol/tobacco (substance abuse through social marketing" funded by Council of Science & Technology, Lucknow. The paper presents pattern and frequency of substance abuse in urban population of Lucknow based upon it. Method: Two mohallas of a ward from Lucknow Municipal Corporation were selected randomly. A total of 842 heads of the households (out of 5420 members were studied using Semi Structured Socio demographic data-sheet and Proforma from WHO-ICMR a collaborative study on narcotics and psychotropic drugs. Data was analyzed using percentage, mean and S.D. Results: Out of 5420 subjects 34.31% (30.22% males & 4.09% females were found to be substance abusers. Majority of subjects used tobacco (68.17% smoking, 65.17% eating. Conclusion : Majority of subjects were regular users constituted 73.65% tobacco smokers and 74.38% eaters/chewers, 62.38% alcoholics were experimenters and amongst those who were psychotropic drug abusers, 64.28% were dependant.
Fry, R A; Fry, L E; Castanelli, D J
A questionnaire on substance abuse was distributed electronically to the heads of 185 Australian and New Zealand College of Anaesthetists accredited anaesthesia departments in Australia and New Zealand. The response rate was 57%. From January 2004 to December 2013, 61 cases of substance abuse were identified, giving an estimated incidence of 1.2 cases per 1000 anaesthetist years. Of 44 detailed reports completed, the majority were aged between 30 and 49 years, were male and of specialist grade. However, when corrected for gender and grade, the estimated overall incidence was higher in females and twice as high for trainees compared with specialists. When compared with prior surveys, the pattern of substance abuse in Australia and New Zealand appears to have changed significantly, with a notable increase in propofol and alcohol abuse and a decrease in reported cases of opioid abuse. Common presenting features of abuse included intoxication and witnessed abuse. Seventy percent of cases had more than one comorbid condition, most frequently either mental health or family problems. Only 32% of abusers had made a long-term recovery within the specialty. Death was the eventual outcome in 18% overall, with a particularly high mortality associated with propofol abuse (45%). Trainee suicide from all causes was reported at three times the rate of specialists. The findings indicate that substance abuse remains a significant problem in Australia and New Zealand and is associated with a significant mortality rate.
Full Text Available Introduction and Aim. Substance abuse imposes hazards on human health in all biopsychosocial aspects. Limited studies exist on epidemiology of substance abuse and its trend in rural areas. The present study aimed to compare substance abuse in one of the rural areas of southeast Iran, in a 12-year period (2000 and 2012. Design and Methods. In a household survey conducted in 2012, in Dashtkhak/Kerman, 1200 individuals above 12 years of age completed a questionnaire to determine their frequency of substance abuse. The questionnaire included the following three areas: demographic characteristics, frequency of substance abuse and ease of access to various drugs. Results. Among 900 completed questionnaires, majority of the participants (61.8% were below 30 years of age and among them 54.4% were male. Cigarette (17.0%, opium (15.7% and opium residue (9.0% were the most frequent substances abused on a daily basis. Based on the participant’s opinion, we conclude that the ease of access to cigarette, waterpipe and opium contributed to their increase in consumption compared with earlier years. Discussion and Conclusion. The steady rise in substance abuse in rural communities demands immediate attention and emergency preventive measures from policy makers.
Sinakhone, Joyce K; Hunter, Bronwyn A; Jason, Leonard A
Women in metropolitan areas have lower employment participation and employment rates than men. Although women face multiple challenges in the labor market, those who have a history of substance use and are abstinent may have a greater disadvantage in obtaining viable employment opportunities due to factors associated with substance use. No research to date has examined employment experiences among women in recovery from substance use. This study examined employment characteristics and experiences of women who had a history of substance use and lived in sober-living environments in urban areas. Data were collected through telephone interviews to sober living homes that were located in 20 urban areas. Themes identified through thematic analysis included employment challenges, the importance of work to substance abuse recovery, job satisfaction, employment aspirations, and employment support in the sober living home. Employment is important to women in substance abuse recovery, not only as a means for financial support, but also as a life priority. The results highlight how employer scheduling practices, low-level positions, and lack of employment supports impact recovery. Findings provide insight into the need for employment support services, including employer education and flexible policies for women in recovery.
Reidy, Lisa J; Junquera, Patricia; Van Dijck, Karolien; Steele, Bernard W; Nemeroff, Charles B
Psychiatric diagnosis mainly relies on behavioral signs and symptoms. Substance abuse can mimic the clinical presentation of primary psychiatric disorders and can also complicate the management of psychiatric patients. The reliability and accuracy of urine toxicology is a vital tool in the optimal treatment of these patients. Current demographics of substance abuse suggest that in addition to the most conventional drugs of abuse (e.g. cocaine, cannabis) that are of concern to treating physicians, prescription medications and new designer drugs also should be when evaluating patients who present with symptoms of psychosis/drug addiction or altered mental status. Urine samples from 220 psychiatric inpatients admitted to either an acute drug and alcohol unit or acute psychiatric unit were analyzed for drugs by the standard hospital assay (KIMS) and by a more sensitive ELISA and GC-MS basic drug screening protocol. The standard hospital toxicology (KIMS) was inferior to the ELISA and GC-MS methods in terms of both assay sensitivity and in detecting a broader number of drugs. The KIMS tests failed to identify opiates and amphetamine/methamphetamine in 50% of the patients. The KIMS screen did not identify zolpidem, buprenorphine and a number of synthetic drugs of abuse including cathinone and tryptamines. In order to reliably identify substance abuse in patients with altered mental status in inpatient settings, analytical methodologies with adequate assay sensitivity and range to detect the vast majority of commonly abused illicit drugs and prescription medications are required for optimal clinical assessment and treatment. Copyright © 2014 Elsevier Ltd. All rights reserved.
Kuhn, Dr. Cynthia
Substance use and abuse begins during adolescence. Male and female adolescent humans initiate use at comparable rates, but males increase use faster. In adulthood, more men than women use and abuse addictive drugs. However, some women progress more rapidly from initiation of use to entry into treatment. In animal models, adolescent males and females consume addictive drugs similarly. However, reproductively mature females acquire self-administration faster, and in some models, escalate use more. Sex/gender differences exist in neurobiologic factors mediating both reinforcement (dopamine, opioids) and aversiveness (CRF, dynorphin), as well as intrinsic factors (personality, psychiatric co-morbidities) and extrinsic factors (history of abuse, environment especially peers and family) which influence the progression from initial use to abuse., Many of these important differences emerge during adolescence, and are moderated by sexual differentiation of the brain. Estradiol effects which enhance both dopaminergic and CRF-mediated processes contribute to the female vulnerability to substance use and abuse. Testosterone enhances impulsivity and sensation seeking in both males and females. Several protective factors in females also influence initiation and progression of substance use including hormonal changes of pregnancy as well as greater capacity for self-regulation and lower peak levels of impulsivity/sensation seeking. Same sex peers represent a risk factor more for males than females during adolescence, while romantic partners increase risk for women during this developmental epoch. In summary, biologic factors, psychiatric co-morbidities as well as personality and environment present sex/gender-specific risks as adolescents begin to initiate substance use. PMID:26049025
Miller, Mark W; Reardon, Annemarie F; Wolf, Erika J; Prince, Lauren B; Hein, Christina L
This study examined the relative influences of posttraumatic stress disorder (PTSD), other psychopathology, and intimate partner alcohol and drug use on substance-related problems in U.S. veterans (242 couples, N = 484). Hierarchical regression analyses revealed that partner alcohol and drug use severity explained more variance in veteran alcohol use and drug use (20% and 13%, respectively) than did veteran PTSD, adult antisocial behavior, or depression symptoms combined (6% for veteran alcohol use; 7% for veteran drug use). Findings shed new light on the influence of relationship factors on veteran alcohol and drug use and underscore the importance of couples-oriented approaches to treating veterans with comorbid PTSD and substance abuse. Published 2013. This article is a US Government work and is in the public domain in the USA.
Kaiser, Roland; Löhrer, Frank; Morgan, Vera; Hambrecht, Martin
The aim of this study was to examine early signs of psychosis in patients suffering from both drug dependence and schizophrenia, compared to a control group of drug-addicted patients without a comorbid psychotic disorder, and to assess whether the presence of these signs was related to changes in the pattern of substance abuse. In a rehabilitation hospital for young addicts, 32 patients with a comorbid diagnosis of schizophrenia and 30 patients without the diagnosis of a psychotic disorder, were assessed using the Interview for the Retrospective Assessment of the Onset of Schizophrenia. Information relating to 64 signs of early psychosis was collected from every patient. From the 64 signs, five groups of symptoms were defined: non-specific and precursor symptoms; non-specific and depressive symptoms; negative symptoms; positive symptoms; and impaired social adjustment. The semiquantitative pattern of substance abuse for each 1-year interval over the previous 10 years was investigated using the categories of chapter F1 of ICD-10 and including an additional category "biological drugs". The relationship between the pattern of substance abuse and the presence of early signs was assessed using anova and non-parametric statistical methods. The results indicate that the defined pathological symptomatology greatly influences the pattern of consumption of psychoactive substances in both the psychosis group and the control group. The group factor exerted the greatest influence within the categories "biological drugs" and "other stimulants", where the "psychosis and addiction group" consumed significantly more than the control group. There is a subgroup of non-psychotic addicted patients whose pattern of psychoactive substance abuse is similar to that found in addicted patients suffering from schizophrenia. It may be helpful to systematically identify this subgroup with regard to possible therapeutic implications, particularly with regard to possible pharmacological treatment
Botvin, G J
The initiation of substance use typically begins during adolescence and appears to be the result of the complex interplay of social, personality, cognitive, attitudinal, behavioral, and developmental factors. Traditional smoking, alcohol, and drug education programs have attempted to increase students' knowledge of the risks associated with using these substances in the hope that this would deter use. Other programs have attempted to enrich the personal and social development of students through what has been referred to as "affective" education. Unfortunately, the inescapable conclusion to be drawn from the substance abuse prevention literature is that few of these programs have demonstrated any degree of success in terms of the actual prevention of substance use/abuse. Traditional educational approaches to substance abuse prevention appear to be inadequate because they are based on faulty assumptions and are too narrow in their focus. The "affective" education approaches, on the other hand, appear to have placed too little emphasis on the acquisition of the kind of skills that are likely to increase general personal competence and enable students to cope with the various interpersonal and intrapersonal pressures to begin using tobacco, alcohol, or drugs. From the perspective of social learning theory (Bandura 1977) and problem behavior theory (Jessor and Jessor 1977), substance use is conceptualized as a socially learned, purposive, and functional behavior which is the result of the interplay of social (environmental) and personal factors. One potentially effective approach to substance abuse prevention might involve enhancing general personal competence and teaching adolescents the kind of problem-specific skills and knowledge which will increase their ability to resist the various forms of pro-substance-use social pressure. Brief reviews of the social skills training literature and the literature related to techniques for coping with anxiety not only provide
Moss, Lori; Vaidya, Nutan
Antidepressant medications remain the principal agents used to treat patients with mood disorders, although 30% to 40% of these patients do not improve. One of the factors associated with poor medication response is alcohol and substance abuse. Persons with mood disorders are at the greatest risk for suicide, and alcoholism is a significant additional risk factor. Electroconvulsive therapy (ECT) is shown to be the most effective treatment for major depression especially when associated with psychosis, catatonia, and suicide intent. However, similar to most antidepressant trials, patients with depression and comorbid alcohol and substance abuse are excluded from ECT efficacy studies. Through a retrospective chart review, we compared response to ECT in patients with mood disorder and comorbid alcohol and drug abuse to those with mood disorder only. From 2004 to 2010, 80 patients with mood disorder received ECT. Fifty of these had comorbid alcohol or drug abuse. Using a 10-item psychopathology scale, we compared pre- and post-ECT symptom severity between the 2 groups. Outcome was determined by measuring a decrease in the pre-ECT and post-ECT score using Wilcoxon rank tests, with statistical significance at P = 0.05. There was no difference between the 2 groups in most demographics, ECT medication, or seizure quality. There was no difference in ECT outcome between those with comorbid alcohol abuse and those without based on percent decrease in pre- and post-ECT symptom scores (abuse: mean [SD], 0.89 [0.2] vs nonabuse: mean [SD], 0.93 [0.16]; Wilcoxon, 1332; P = 0.086). When we compared those who met the criteria for alcohol or drug dependence (19 patients) with those with no abuse, there was a trend for the dependence group to not do as well (dependence: mean [SD], 0.83 [0.25] vs nonabuse: mean [SD], 0.93 [0.16]; Wilcoxon, 405; P = 0.053). Those with combined drug and alcohol abuse (18 patients) did have a significantly worse outcome (combined: mean [SD], 0.82 [0
Kelley, Michelle L; Lawrence, Hannah R; Milletich, Robert J; Hollis, Brittany F; Henson, James M
Children with substance abusing parents are at considerable risk for child maltreatment. The current study applied an actor-partner interdependence model to examine how father only (n=52) and dual couple (n=33) substance use disorder, as well as their depressive symptomology influenced parents' own (actor effects) and the partner's (partner effects) overreactivity in disciplinary interactions with their children, as well as their risk for child maltreatment. Parents completed the Center for Epidemiologic Studies Depression Scale (CES-D; Radloff, 1977), the overreactivity subscale from the Parenting Scale (Arnold, O'Leary, Wolff, & Acker, 1993), and the Brief Child Abuse Potential Inventory (Ondersma, Chaffin, Mullins, & LeBreton, 2005). Results of multigroup structural equation models revealed that a parent's own report of depressive symptoms predicted their risk for child maltreatment in both father SUD and dual SUD couples. Similarly, a parent's report of their own depressive symptoms predicted their overreactivity in disciplinary encounters both in father SUD and dual SUD couples. In all models, partners' depressive symptoms did not predict their partner's risk for child maltreatment or overreactivity. Findings underscore the importance of a parent's own level of depressive symptoms in their risk for child maltreatment and for engaging in overreactivity during disciplinary episodes. Copyright © 2015 Elsevier Ltd. All rights reserved.
Cayir, D.; Demirel, K.; Korkmaz, M.; Koca, G.
Chronic inhalant use is associated with significant toxic effects, including neurological, renal, hepatic, and pulmonary damage. However, there is a paucity of reports regarding respiratory complications in inhalant abusers. The aim of this study was to evaluate pulmonary epithelial permeability in the volatile substance abuse (VSA) using technetium-99m-labeled diethylenetriamine pentaacetic acid (Tc-99m DTPA) aerosol scintigraphy. This study included 18 patients with volatile substance abuse and 18 volunteer controls. All of patients and controls were smokers. Tc-99m DTPA aerosol scintigraphy was performed in all cases. Time-activity curves from each lung were generated and clearance half-time (T 1/2 ) of Tc-99m DTPA were calculated. T 1/2 of whole lung was calculated as a mean of the T 1/2 of left and right lung. The T 1/2 values of Tc-99m DTPA clearance in the substance abusers were significantly decreased as compared to the control group with respective mean values of 28.86±8.44, and 62.14±26.12 min (p=0.001). It was seen Tc-99m DTPA clearance from lung was faster as the duration of substance abuse was increased. Tc-99m DTPA pulmonary clearance is markedly accelerated in the volatile substance abuse. This suggests that inhalant abuse of substance may produce abnormalities in pulmonary alveolo-capillary membrane function. (author)
Cayir, Derya; Demirel, Koray; Korkmaz, Meliha; Koca, Gokhan
Chronic inhalant use is associated with significant toxic effects, including neurological, renal, hepatic, and pulmonary damage. However, there is a paucity of reports regarding respiratory complications in inhalant abusers. The aim of this study was to evaluate pulmonary epithelial permeability in the volatile substance abuse (VSA) using Tc-99m DTPA aerosol scintigraphy. This study included 18 patients with volatile substance abuse and 18 volunteer controls. All of patients and controls were smokers. Tc-99m DTPA aerosol scintigraphy was performed in all cases. Time-activity curves from each lung were generated and clearance half-time (T(1/2)) of Tc-99m DTPA were calculated. T(1/2) of whole lung was calculated as a mean of the T(1/2) of left and right lung. The T(1/2) values of Tc-99m DTPA clearance in the substance abusers were significantly decreased as compared to the control group with respective mean values of 28.86 ± 8.44, and 62.14 ± 26.12 min (p = 0.001). It was seen Tc-99m DTPA clearance from lung was faster as the duration of substance abuse was increased. Tc-99m DTPA pulmonary clearance is markedly accelerated in the volatile substance abuse. This suggests that inhalant abuse of substance may produce abnormalities in pulmonary alveolo-capillary membrane function.
Boulis, Sherif; Khanduja, P Kristina; Downey, Kristi; Friedman, Zeev
The abuse of substances available to anesthesiologists in their workspace is a potentially lethal occupational hazard. Our primary objective was to define the prevalence of substance abuse cases among Canadian anesthesiologists at university-affiliated hospitals. Our secondary aim was to describe the current management of confirmed cases, rehabilitation procedures being offered, and preventative strategies being employed. We conducted a cross-sectional electronic survey of all Canadian anesthesia residency program directors and site chiefs at university-affiliated hospitals. Data analysis was performed using descriptive statistics. The survey response rate was 54% (53/98). Substance abuse was reported as 1.6% for residents and 0.3% for clinical fellows over a ten-year period ending in June 2014. Fentanyl was abused in nine of 24 reported cases. At present, one of 22 respondents (4.5%) reported a formal education program on substance abuse for faculty members, and 72% described mandatory education for residents. The majority of participants did not perceive substance abuse as a growing problem. Seventy-one percent of respondents indicated that methods for controlled-drug handling had changed in the previous ten years; however, 66% did not think that the incidence of controlled substance abuse could be decreased further by more stringent measures. Only 21% of respondents supported the introduction of random urine drug testing. The prevalence of substance abuse among Canadian anesthesiologists and the substances abused appear comparable with data from the United States, with residents being the group most often affected. Early recognition and treatment of chemically dependent anesthesiologists remain imperfect.
Full Text Available Abstract Background The rate of women with substance abuse issues is increasing. Women present with a unique constellation of risk factors and presenting needs, which may include specific needs in their role as mothers. Numerous integrated programs (those with substance use treatment and pregnancy, parenting, or child services have been developed to specifically meet the needs of pregnant and parenting women with substance abuse issues. This synthesis and meta-analysis reviews research in this important and growing area of treatment. Methods We searched PsycINFO, MedLine, PubMed, Web of Science, EMBASE, Proquest Dissertations, Sociological Abstracts, and CINAHL and compiled a database of 21 studies (2 randomized trials, 9 quasi-experimental studies, 10 cohort studies of integrated programs published between 1990 and 2007 with outcome data on maternal substance use. Data were summarized and where possible, meta-analyses were performed, using standardized mean differences (d effect size estimates. Results In the two studies comparing integrated programs to no treatment, effect sizes for urine toxicology and percent using substances significantly favored integrated programs and ranged from 0.18 to 1.41. Studies examining changes in maternal substance use from beginning to end of treatment were statistically significant and medium sized. More specifically, in the five studies measuring severity of drug and alcohol use, the average effect sizes were 0.64 and 0.40, respectively. In the four cohort studies of days of use, the average effect size was 0.52. Of studies comparing integrated to non-integrated programs, four studies assessed urine toxicology and two assessed self-reported abstinence. Overall effect sizes for each measure were not statistically significant (d = -0.09 and 0.22, respectively. Conclusions Findings suggest that integrated programs are effective in reducing maternal substance use. However, integrated programs were not
Nyhlén, Anna; Fridell, Mats; Bäckström, Martin
Background Few longitudinal cohort studies have focused on the impact of substances abused and psychiatric disorders on premature mortality. The aim of the present study was to identify predictors of increased risk of drug related death and non drug related death in substance abusers of opiates...... with a decreased risk. Neurosis, mainly depression and/or anxiety disorders, predicted drug related premature death while chronic psychosis and personality disorders did not. Chronic alcohol addiction was associated with increased risk of non drug related death. Conclusions The cohort of drug abusers had...... and barbiturate abusers over the observed period of 37 years, while stimulant abuse did not have any impact. Alcohol contributed to non drug related death. Keywords: drug related death; risk factor; gender; competing risks Cox regression; cohort study; Predictors...
Morelli, Micaela; Simola, Nicola
This chapter examines the psychostimulant actions of methylxanthines, with a focus on the consequences of their excessive use. Consumption of methylxanthines is pervasive and their use is often associated with that of substances known to produce dependence and to have abuse potential. Therefore, the consequences of this combined use are taken into consideration in order to evaluate whether, and to what extent, methylxanthines could influence dependence on or abuse of other centrally active substances, leading to either amplification or attenuation of their effects. Since the methylxanthine that mostly influences mental processes and readily induces psychostimulation is caffeine, this review mainly focuses on caffeine as a prototype of methylxanthine-produced dependence, examining, at the same time, the risks related to caffeine use.
Piedmont, Ralph L
Does the Spiritual Transcendence Scale (STS; R. L. Piedmont, 1999) predict psychosocial outcomes from an outpatient substance abuse program? Self-report data on symptoms, personality, and coping resources were obtained for 73 consecutive admissions (57 men and 16 women; ages 19-66 years) at intake and again from the 56 (47 men and 9 women) who completed treatment. Controlling for relevant demographic variables, pretreatment STS scores were significantly related to self-ratings at posttreatment. The STS predicted treatment outcomes over and above the contribution of the five-factor model of personality. Significant partial correlations between pretreatment STS scores and therapist ratings of treatment outcome were also obtained. Spiritual Transcendence, especially the facets of Universality and Connectedness, appears to play a significant role in substance abuse recovery. (c) 2004 APA
Haug, Nancy A.; Shopshire, Michael; Tajima, Barbara; Gruber, Valerie; Guydish, Joseph
This research was conducted at a Substance Abuse Forum designed to address local community needs by focusing on Evidence-Based Practices (EBPs) in addiction treatment. The purpose of the study was to assess substance abuse treatment professionals’ readiness to adopt EBPs, experience with EBPs, and attitudes toward EBPs, as well as agency support for EBPs. A total of 119 addiction treatment providers completed pre-test measures, and 82% completed a post-test. Eighty-three percent of participants reported using some EBPs in the past year, and 75% reported currently using EBPs. Participants who were currently licensed or certified in addictions had less negative attitudes toward EBPs than those without credentials. While respondents reported agency support for EBPs, most expressed interest in further training. This study underscores the movement toward EBPs in addiction treatment and the need for effective dissemination and training in this area. PMID:18724657
Schneider, R J; Casey, J; Kohn, R
The aim of this study was to conduct a quasi-experimental comparison of two employee assistance program (EAP) assessment approaches with substance abusers: confrontational interviewing (CI) and motivational interviewing (MI). A total of 176 EAP clients from 14 study sites met the study criteria, and 89 (51%) agreed to participate in the study. At three and nine months postassessment, both the MI and CI groups showed similar changes in readiness for change, completion of initial treatment plans, and subsequent treatment. Most important, both the MI and CI participants showed significant and comparable improvement on all of the substance abuse baseline measures as well as measures of family-social well-being and effects of drinking/drugging on work performance. The results open the door for EAP counselors to use an empirically supported assessment style that is at least as effective as the traditional confrontational approach.
Unsworth, David J; Mathias, Jane L
Alcohol and substance (drugs and/or alcohol) abuse are major risk factors for traumatic brain injury (TBI); however, it remains unclear whether outcomes differ for those with and without a history of preinjury abuse. A meta-analysis was performed to examine this issue. The PubMed, Embase, and PsycINFO databases were searched for research that compared the neuroradiological, cognitive, or psychological outcomes of adults with and without a documented history of alcohol and/or substance abuse who sustained nonpenetrating TBIs. Data from 22 studies were analyzed using a random-effects model: Hedges's g effect sizes measured the mean difference in outcomes of individuals with/without a history of preinjury abuse, and Bayes factors assessed the probability that the outcomes differed. Patients with a history of alcohol and/or substance abuse had poorer neuroradiological outcomes, including reduced hippocampal (g = -0.82) and gray matter volumes (g = -0.46 to -0.82), and enlarged cerebral ventricles (g = -0.73 to -0.80). There were limited differences in cognitive outcomes: Executive functioning (g = -0.51) and memory (g = -0.39 to -0.43) were moderately affected, but attention and reasoning were not. The findings for fine motor ability, construction, perception, general cognition, and language were inconclusive. Postinjury substance and alcohol use (g = -0.97 to -1.07) and emotional functioning (g = -0.29 to -0.44) were worse in those with a history of alcohol and/or substance abuse (psychological outcomes). This study highlighted the type and extent of post-TBI differences between persons with and without a history of alcohol or substance abuse, many of which may hamper recovery. However, variation in the criteria for premorbid abuse, limited information regarding the history of abuse, and an absence of preinjury baseline data prevented an assessment of whether the differences predated the TBI, occurred as a result of ongoing alcohol/substance abuse, or
Sommer, Jessica; Hinsberger, Martina; Elbert, Thomas; Holtzhausen, Leon; Kaminer, Debra; Seedat, Soraya; Madikane, Solomon; Weierstall, Roland
In persistently unsafe environments, the cumulative exposure to violence predicts not only the development of posttraumatic stress disorder (PTSD), but also of increased aggression and violent outbursts. Substance use disorders interact with these developments, as drug consumption may blunt symptoms and also reduce the threshold for violent acts. Investigating the interplay between these variables and the possible cumulative effect of drug abuse on the attraction to cruelty is a crucial step in understanding the cycle of violence and developing intervention programs that address this cycle in violence-troubled communities such as low-income urban areas in South Africa. Young males at risk (N=290) were recruited through a reintegration center for offenders in Cape Town. We assessed types of traumatic events experienced, PTSD symptom severity, appetitive aggression, committed offenses and patterns of drug abuse prior to the perpetration of violence. Path-analyses confirmed a positive relationship between exposure to traumatic events and PTSD symptom severity, appetitive aggression, the number of committed offenses and drug abuse prior to violence. PTSD symptoms were positively associated with the propensity toward aggression. Furthermore, more severe drug abuse was related to higher attraction to violence and more committed offenses. We conclude that like exposure to violence, drug abuse may play a key role in the attraction to aggression and criminal acts. Measures of violence prevention and psychotherapeutic interventions for trauma-related suffering may not be effective without enduring drug abuse rehabilitation. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.
Pieter van der Bijl
Full Text Available Background. Drug abuse is as relevant today as ever. Management of such cases on a primary health care level may be challenging, particularly when laboratory facilities are unavailable. Furthermore, substance abuse and its sequelae place a significant burden on the already overstretched primary health care resources in the country, as well as on other ser- vices and society in general. Objectives. The current study surveyed the trends in demand for laboratory determination of amphetamines, opiates, methaqualone, cannabis, cocaine and ethanol for the period 1991 - 2002, in the Western Cape. The survey was conducted by extracting the relevant data from the records of the Pharmacology/Toxicology Laboratory of the University of Stellenbosch and Tygerberg Academic Hospital. This facility processes the largest number of specimens by a single laboratory in the Western Cape. Results. From the data obtained a seasonal pattern emerged for all substances except ethanol, with a trough appearing in early winter. Demand for ethanol analysis was fairly constant throughout the year, with a peak in the last quarter. Ethanol level was the most frequently requested analysis between 1991 and 1997. This concurs with its status as the main substance of abuse in South Africa and the rest of the world. There was an increased demand for analysis of ampheta- mines, opiates, methaqualone, cannabis and cocaine between 1991 and 2002. Generally dominating, next to ethanol, were requests for cannabis and methaqualone analysis. Interesting to note was the increase in demand for opiate analysis, following the trend observed in certain other regions of the world. Conclusion. The analysis trends observed in this study demon- strate global patterns of drug abuse emerging in the Western Cape. The medical and social effects of drug abuse impose a grave responsibility on policymakers to ensure that adequate funding is available for analytical laboratories. Only in such a way can
Cusack, Karen J; Herring, Amy H; Steadman, Henry J
Many of the individuals with serious mental illness involved in the criminal justice system have experienced interpersonal victimization, such as sexual abuse, and have high rates of alcohol and drug use disorders. Little attention has been paid to the prevalence of posttraumatic stress disorder (PTSD) and its potential role in the substance misuse of offenders with mental illness. The study used a path analytic framework to test the hypothesis that PTSD mediates the relationship between sexual abuse and level of alcohol and drug use among individuals (N=386) with mental illness enrolled in a multisite (N=7) jail diversion project. Sexual abuse was strongly associated with PTSD, which was in turn associated with both heavy drug use and heavy drinking. These findings suggest that PTSD may be an important target for jail diversion programs.
Full Text Available Introduction: Chronic use of opiates is associated with a wide range of neuropsychological deficits. Therefore, this study aimed to evaluate one of the neuropsychological functions, updating function of working memory, in three groups, including substance abusers (heroin and opium, those under treatment with methadone, and normal controls. Methods:The method of this study was causal-comparative. Ninty individuals in three groups, including substance abusers (n = 30, those under treatment with methadone (n = 30, and normal controls (n = 30 were selected from people referred to the addiction treatment Clinics in Shiraz (2015 with the purposeful sampling method. All subjects were evaluated regarding working memory updating and self-reported mental effort scale and the results were analyzed by Multiple Analysis of Variance (MANOVA test and Tukey post hoc test with SPSS software (version 23. Results:The results showed a significant difference between the three groups in the updating function of working memory; so that effectiveness and efficiency of processing in the normal group was better than the other two groups and the performance effectiveness and efficiency of processing in the group under methadone treatment was better than substance abusers group. conclusions:substance abuse has a negative effect on neurological function. Given that the group of methadone treatment had better performance in the updating function of working memory than the group of substance abusers, these results provide hope that the effects of examined drugs on working memory is not permanent and we can look for psychological interventions to treat these patients and prevent problems recurrence.
© 2017 Taylor & Francis. This study leverages critical race and legal epidemiological frameworks to illustrate the race-based historical evolution of U.S. rehabilitation paradigms directed at imprisoned heroin and opioid users. What began as a racist early-20th-century federal antinarcotic trafficking effort has since assumed a state-based treatment agenda whose programmatic operations are largely based in correctional settings disproportionately reserved for poor substance abusers of color...
Nielsen, S M; Toftdahl, N G; Nordentoft, M
.04, 95% confidence interval (CI) 5.84-6.26]. Cannabis (HR 5.20, 95% CI 4.86-5.57) and alcohol (HR 3.38, 95% CI 3.24-3.53) presented the strongest associations. Abuse of hallucinogens (HR 1.86, 95% CI 1.43-2.41), sedatives (HR 1.68, 95% CI 1.49-1.90), and other substances (HR 2.85, 95% CI 2.58-3.15) also...
Ortíz-Gómez, L D; López-Canul, B; Arankowsky-Sandoval, G
Comorbidity of major depression with substance abuse increases the risk of committing suicide. The objective of this work was to determine the psychological and socio-demographic factors associated with depression and suicide attempts in patients rehabilitating for drug consumption. 57 Patients attending a center for drug abuse treatment answered the following instruments: the Mini-international neuropsychiatric interview, a questionnaire of general information and background data on consumption of substances, depression and suicide attempts, and the Spanish adaptation of the Holmes and Rahe scale for the assessment of life events. Chi-square and logistic regression tests were used to establish associations between variables. 68.4% of the Patients had current major depression, of these, 75.4% experienced it before the onset of substance abuse. Patients attempting suicide before drug use corresponded to 26%, whilst 28.1% attempted suicide within the last year. Current depression-related variables were receiving a diagnosis of depression prior to the consumption of drugs and the first used drugs, which were alcohol or marijuana. The adverse life event "Familial drug abuse history", was also significantly related to depression (p=0.02). Variables associated with current suicide attempts were: receiving a diagnosis of depression prior to the consumption of drugs (p=0.02), and suicide attempts previous to drug use (psuicide prior to the use of drugs also experienced these conditions during the rehabilitation process. Substance use in the family was a risk factor for both, underscoring the need of actions aimed at preventing addictions in the household environment. Copyright © 2014. Published by Elsevier B.V.
George N. Ani
Full Text Available Background: Substance abuse refers to the harmful or hazardous use of psychoactive substances, including alcohol and illicit drugs. Use of drugs among adolescents is a global phenomenon eating deep into the fabrics of our society. Students are most vulnerable at this transformative stage in their life. Available report indicates that Nigeria is currently the highest consumer of cannabis and amphetamine in Africa. What is the prevalence of this abuse by students? Methodology: This research was a cross sectional descriptive design to identify the prevalence of substance abuse among students in public senior secondary schools in Mainland Local Government, Lagos. A sample size of two hundred and sixty two was determined and used from randomly selected five out of the nine public schools identified. Multi stage sampling (including simple random and systematic sampling and probability proportional to size methods were usefully employed in scientific selection of 262 samples and subsequent data collection in a total sample frame of 1,938 students. Self-administered questionnaire consisting of open and close-ended questions generated using research objectives was used in data collection. Result: It identified that 19.5% had smoked cigarette once or more in their lifetime. 77.2% had used alcohol once or more in a life time while 7.7% used marijuana, 8.4% tranquilizers and 1.9% cocaine all in a life time respectively. Conclusion: It recommended strict regulation of alcohol and tobacco products import and use in public places as well as aggressive dissemination of information on the dangers of substance use and abuse.
Calsyn, Donald A.; Cousins, Sarah J.; Hatch-Maillette, Mary A.; Forcehimes, Alyssa; Mandler, Raul; Doyle, Suzanne R.; Woody, George
Sex under the influence of drugs or alcohol is associated with high risk sexual behavior. Heterosexual men (n=505) in substance abuse treatment completed a computer administered interview assessing sexual risk behaviors. Most men (73.3%) endorsed sex under the influence in the prior 90 days, and 39.1% endorsed sex under the influence during their most recent sexual event. Sex under the influence at the most recent event was more likely to involve anal intercourse, sex with a casual partner, and less condom use. Patients might benefit from interventions targeting sexual behavior and substance use as mutual triggers. PMID:20163383
Tommasello Anthony C
Full Text Available Abstract Pharmacists, the most accessible of health care professionals, are well positioned to help prevent and treat substance use disorders and should prepare themselves to perform these functions. New research improves our knowledge about the pharmacological and behavioral risks of drug abuse, supports the clinical impression that drug dependence is associated with long-lasting neurochemical changes, and demonstrates effective pharmacological treatments for certain kinds of drug dependencies. The profession is evolving. Pharmacists are engaging in new practice behaviors such as helping patients manage their disease states. Collaborative practice agreements and new federal policies set the stage for pharmacists to assist in the clinical management of opioid and other drug dependencies. Pharmacists need to be well informed about issues related to addiction and prepared not only to screen, assess, and refer individual cases and to collaborate with physicians caring for chemically dependent patients, but also to be agents of change in their communities in the fight against drug abuse. At the end of this article the pharmacist will be better able to: 1. Explain the disease concept of chemical dependence 2. Gather the information necessary to conduct a screen for chemical dependence 3. Inform patients about the treatment options for chemical dependence 4. Locate resources needed to answer questions about the effects of common drugs of abuse (alcohol, marijuana, narcotics, "ecstasy", and cocaine 5. Develop a list of local resources for drug abuse treatment 6. Counsel parents who are concerned about drug use by their children 7. Counsel individuals who are concerned about drug use by a loved one. 8. Counsel individuals who are concerned about their own drug use
Dannon, Pinhas N; Lowengrub, Katherine; Shalgi, Bosmat; Sasson, Marina; Tuson, Lali; Saphir, Yafa; Kotler, Moshe
Pathological Gambling (PG) is a highly prevalent and disabling impulse control disorder. Recent studies have consistently shown that PG patients have responded well to treatment with SSRI's, mood stabilizers, and opioid antagonists. These findings have supported the observation that PG is strongly associated with both mood and anxiety disorders as well as substance abuse. The aim of the study is to evaluate the comorbid psychiatric diagnoses in our sample. Thirty-six female, and forty-two male PG's were enrolled in our study. A comprehensive psychiatric diagnostic evaluation was performed on all patients, and patients were screened for symptoms of depression and anxiety using the Hamilton Depression Rating Scale, the Hamilton Anxiety Rating Scale, the Yale-Brown Obsessive Compulsive Scale, and the Frost Multidimensional Perfectionism Scale. In addition, the patients completed self-report questionnaires about their demographic status and substance abuse. The majority of patients were married with full or part-time employment. The study results demonstrated that PG in males is correlated with substance and alcohol abuse. Diagnoses, which were prevalent among our cohort of female PG's included major depression, affective disorders, anxiety disorders, and eating disorders. In our sample of PGs, the men and women had different patterns of psychiatric comorbidity. The different patterns of psychiatric comorbidity seen in our male versus female PG's raises the question of whether the underlying etiopathology in PG may differ according to gender.
Delmonico, R L; Hanley-Peterson, P; Englander, J
Residual emotional and behavioral difficulties in individuals who have sustained a traumatic brain injury (TBI) have been well documented in the literature. The issues are complex, interdependent, and often include substance abuse, depression, anxiety, chronic suicidal or homicidal ideation, poor impulse control, and significant degrees of frustration and anger. Often, preexisting psychological conditions and poor coping strategies are exacerbated by the trauma. Emotional and behavioral difficulties can interfere with the neurorehabilitation process at all levels. In acute rehabilitation, these issues have traditionally been addressed on an individual basis. However, in postacute settings, an interpersonal group format can be effectively implemented. The majority of individuals with TBI have minimal funding for long-term cognitive and behavioral remediation; often the only avenue available is support groups. This article will describe group psychotherapy models used with individuals with acute or postacute TBI within a comprehensive rehabilitation center. Interdisciplinary treatment of frustration and substance abuse and a continuum of care will be emphasized. Education, social support, skills development, interpersonal process, and cognitive-behavioral approaches will also be discussed. The psychotherapy groups focus on treatment of substance abuse and frustration management through education, social support, and development of interpersonal skills. Practical considerations of running such groups are presented.
Caplan, Brina; Schutt, Russell K; Turner, Winston M; Goldfinger, Stephen M; Seidman, Larry J
To test the effect of living in group housing rather than independent apartments on executive functioning, verbal memory and sustained attention among formerly homeless persons with serious mental illness and to determine whether substance abuse modifies this effect. In metropolitan Boston, 112 persons in Department of Mental Health shelters were randomly assigned to group homes ("Evolving Consumer Households", with project facilitator, group meetings, resident decision-making) or independent apartments. All were case managed. A neuropsychological test battery was administered at baseline, at 18 months (Time 2), with an 81% follow-up rate, and at 48 months (Time 3), with a 59% follow-up rate. Hierarchical Linear Modeling was applied to executive functioning--assessed with the Wisconsin Card Sorting Test (Perseverations)-Logical Memory story recall, and an auditory Continuous Performance Test (CPT) for sustained attention. Subject characteristics were controlled. When moved to group homes, subjects without a lifetime substance abuse history improved on Perseverations, while those who moved to independent apartments deteriorated on Perseverations. Across the two housing conditions, subjects showed no change in Perseverations, but improved on Logical Memory story recall and the CPT. Type of housing placement can influence cognitive functioning; notably, socially isolating housing is associated with weakened executive functioning. Substance abuse significantly diminishes environmental effects. These are important factors to consider in housing placement and subsequent treatment.
Tahereh masoomi mofrad
Full Text Available Executive functions are self-regulated functions and show the ability to inhibition, self-changing, planning, organization, using the working memory, solving problems and targeting for homework and school activities. This study compares the executive functions of inhibition and problem solving in adolescents with and without substance abuse. In this causal-comparative study, 15 adolescents with substance abuse and 15 normal adolescents were selected which matched each other with the same age, sex and education. The research tools were Wisconsin Card, was used for assessing the inhibition executive functions, and Heppner and Petersen Questionnaires for problem solving. The results showed that there were statistically significant differences between groups between average score of inhibition executive functions and solving problem (except trend– avoid component. There were not statistically significant differences in the average score of inhibition executive functions and solving problem according to age, sex and education. It is concluded that the drug addicts are weaker than those without substance abuse based on the inhibition executive function and problem solving. These findings can be used for the prevention program.
Jaichuang, Siriluk; Ratanasiri, Amornrat; Kanato, Manop
Study the impact of substance abuse among migrant workers along the Thai-Laos border region in Nakhon Phanom Province. The target population included migrant workers aged 15 years and over and were selected using the snowball technique. Data were collected from 300 migrant workers and in-depth interviews and focus group discussion were carried out. Data analysis used content analysis, descriptive statistics, and multivariate logistic regression. Fifty-five point seven percent of migrant workers used stimulants namely tobacco, energy drinks, coffee, and methamphetamine. Males were at greater risk for substance abuse than females (AOR 16.03; 95% CI 8.43-30.45) and those who received news and information from community radios and news broadcasting towers were at more risk than other media (AOR 5.38; 95% CI 2.88-10.05). The impact of substance abuse were found to be chronic cough, moodiness, lack of interest in food, headache, wakefulness, sleeplessness, tremor heart palpitation, and accidents. Health promotion strategy must be implemented to minimize the harm. Motivating behavioral modification while keeping in mind the lifestyle, work, and environment of these people could help.
Rasmussen, Hannah F.; Borelli, Jessica L.; Decoste, Cindy; Suchman, Nancy E.
As a group, substance-abusing parents are at risk for maladaptive parenting. The association between substance abuse and parenting may result, in part, from parents’ emotional disengagement from the parent–child relationship, which makes perceiving and responding to children’s cues more challenging. In this study, we examined whether substance-abusing mothers’ levels of disengagement from their relationship with their children (ages 2–44 months), operationalized in two different ways using parenting narratives (representational and linguistic disengagement), prospectively predicted children’s engagement and disengagement cues during a structured mother–child interaction. Within a sample of 29 mothers, we tested the hypotheses that greater maternal disengagement at Time 1 would predict a decrease in children’s engagement and an increase in children’s disengagement at Time 2. Results indicated that representational disengagement predicted a decrease in children’s engagement cues whereas linguistic disengagement predicted an increase in children’s disengagement cues. Results provide partial support for a reciprocal, iterative process in which mothers and children mutually adjust their emotional and behavioral disengagement with one another. PMID:26938485
To help in understanding the manner in which community, individual, and other factors in the United States and Mexico contribute to drug use among transnational migrants, this paper introduces a binational social ecology model of substance abuse in this population. We draw on our 2 NIH-funded ethnographic studies—1 on problem drinking and the other on drug abuse—among transnational Mexican workers in the mushroom industry of southeastern Pennsylvania. Our model demonstrates that major reasons for substance abuse among transnational migrants include nontraditional living arrangements in labor camps and overcrowded apartments, the absence of kin and community deterrents to drug use, social isolation, the presence of drug use and binge drinking subcultures, the availability of drugs, family history of drugs, previous drug use or witnessing of drug use in Mexico, and drug use norms and drug availability in Mexico. It suggests the need for US and Mexican researchers to collaborate in binational teams and address factors on both sides of the border. Our binational social ecology model, together with our research recommendations, will assist alcohol and drug researchers to discover how community and individual factors in both the United States and abroad fit and interact beyond mere association and provide a more comprehensive research approach to substance abuse research among transnational migrants. PMID:18237326
What characterizes substance abusers who commit suicide attempts? Factors related to Axis I disorders and patterns of substance use disorders. A study of treatment-seeking substance abusers in Norway.
Landheim, A S; Bakken, K; Vaglum, P
The frequency of suicide attempts and clinical characteristics of attempters among poly-substance abusers and alcoholics were examined. A consecutive sample (n = 260) of in- and outpatients from two Norwegian counties were assessed by Composite International Diagnostic Interview (Axis I disorders), Millon's Clinical Multiaxial Inventory (Axis II disorders) and the Norwegian National Client Assessment Form. When analysing the association between suicide attempters and the range of predictor variables, logistic regression analysis was conducted. Almost half (47%) of the sample reported lifetime suicide attempts; significantly more frequently in poly-substance abusers (58%) than alcoholics (38%). A substance use disorder with duration of >or=15 years and an early onset (suicide attempter after controlling for Axis I disorders. In addition, eating disorders, agoraphobia and major depression were strongly and independently associated with being a suicide attempter. Attempts at preventing suicidal behaviour should not ignore the suicide risk among poly-substance abusers. In addition, prevention of suicidal behaviour demands a treatment programme focusing concomitantly on both addictive behaviour and comorbid psychiatric disorders. Copyright 2006 S. Karger AG, Basel.
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This study was an attempt to describe the characteristics of U.S. Air Force (USAF) members with stepfamily and divorce conditions who had received services from USAF substance abuse treatment programs...
Full Text Available Objective: The aim of present study was the prediction of tendency to substance abuse on the basis of self esteem and components of emotional intelligence. Method: In this descriptive-correlational Study our sample included 153 students of Azad university of qorveh which selected by simple random sampling. APS, Rosenberg’s self esteem scale and Bradberry’s emotional intelligence questionnaires administered among selected sample. Results: Research findings represented that there are negative significant correlation between tendency to substance abuse and self esteem, also between tendency to substance abuse and self management and relationship management. Conclusion: Results of this study are showing the predictor role of self esteem, self-management and relationship management in tendency to substance abuse.
Schäfer, G; Smoltczyk, H; Dengler, W; Buchkremer, G
The aim of this study was to estimate the frequency and nature of self-reported and drug-related emergencies. 47 patients of a ward for opiate detoxification were interviewed about their experiences with drug-related emergencies. Typical categories had to be found like overdoses, seizures, accidents and suicide attempts respectively. 68% had own experience with drug-related emergency. A majority suffered opiate overdose with different extensions as unconsciousness or breath-depression. Alcohol and polydrug use was associated with overdose. Drug-related accidents were only reported by men. Half the number of drug-related emergencies were treated in hospital. Most emergencies occurred alone either in a home environment or outside. Harm reduction interventions like observed user rooms should be established. Furthermore other strategies to reduce the number of emergencies as sharing naloxon or resuscitation programs in wards for detoxification could also be an effective method to prevent near fatal or fatal overdoses in dependent subjects.
Singh, Darshan; Chawarski, Marek C; Schottenfeld, Richard; Vicknasingam, Balasingam
males to females. There are 37,306 people living with HIV (PLHIV) who are eligible for treatment, and 14,002 PLHIV were receiving antiretroviral treatment (ART) in 2011. The decreasing trend of heroin users who have been detected and arrested could be due to the introduction of medical treatments and harm reduction approaches for drug users, resulting in fewer drug users being arrested. However, we are unable to say with certainty why there has been an increase in heroin seizures in the country. There has been an increasing trend in both ATS users and seizures. A new trend of co-occurring opiate dependence and ATS underscores the need to develop and implement effective treatments for ATS, co-occurring opiate and ATS, and polysubstance abuse disorders. The low numbers of NSEP clients being tested for HIV underscores our caution in interpreting the decline of HIV infections among drug users and the importance of focusing on providing education, prevention, treatment, and outreach to those who are not in treatment.
Aldridge, Arnie; Linford, Robyn; Bray, Jeremy
To estimate changes in the substance use behaviors of patients who received services as part of the US Substance Abuse and Mental Health Services Administration's (SAMHSA) Screening, Brief Intervention and Referral to Treatment (SBIRT) grant program. We use a pre-post design and performance monitoring data collected by SBIRT organizations. For a sample of 17 575 patients, we compare pre-SBIRT substance use with substance use 6 months after receipt of SBIRT services. SBIRT's correlation with changes in substance use was estimated using generalized linear mixed models to account for the clustering of patients within health-care facility and US state. From pre- to post-SBIRT we found large and statistically significant decreases for almost every measure of substance use. Model-adjusted means indicate that the prevalence of alcohol use was lower 6 months later by 35.6%, heavy drinking by 43.4% and illicit drug use by 75.8%. Greater intervention intensity was associated with larger decreases in substance use. The study design does not support causal conclusions and estimated decreases in reported substance use are due, at least in part, to a well-known set of confounders and natural substance use patterns that may be unrelated to any particular SBIRT intervention. Compared with previously published findings on the Screening, Brief Intervention and Referral to Treatment grant program, our estimates of substance use reduction were smaller, but still consistently large in absolute magnitude and within ranges of estimates from past trials of Screening, Brief Intervention and Referral to Treatment. © 2017 Society for the Study of Addiction.
Wong, Conrad J; Dillon, Erin M; Sylvest, Christine E; Silverman, Kenneth
The Therapeutic Workplace is an effective drug abuse treatment that integrates abstinence reinforcement into a work setting by using a salary that drug abusers earn for work. Drug abuse patients are trained and hired to become data entry operators in a Therapeutic Workplace business. Despite the opportunity to earn a high wage, participants frequently arrive at work late and fail to work complete shifts. In the present study, a contingency management intervention to promote consistent and reliable attendance was evaluated in 4 participants. Participants were not allowed to work on days that they arrived late, and their pay was temporarily reduced each time they arrived late at work or failed to complete a work shift. A within-subject reversal design showed that the intervention increased the frequency with which participants arrived at work on time and completed work shifts.