“I can’t live like that”: the experience of caregiver stress of caring for a relative with substance use disorderSubstance Abuse Treatment, Prevention, and Policy - Tập 16 - Trang 1-9 - 2021
Geoffrey Maina, Marcella Ogenchuk, Taryn Phaneuf, Abukari Kwame
The impact of addiction extends beyond the individual using a substance. Caring for an individual with addiction creates persistent stressful circumstances that cause worry, anger, depression, shame, guilt, anxiety, and behavioral problems within the family unit. The paper aims to explore the experiences of caring for a relative with a substance use disorder (SUD) and self-care strategies caregivers employ. The study adopted an exploratory qualitative design. To be included in the study, participants were required to have a relative with a (SUD) disorder and not be actively using the substance themselves. Individual interviews were conducted to gather their experiences, meanings, and how they made sense of caring for a relative with a SUD. Twenty one participants were involved in the study, of which 17 were women, and four were men of which there had a sister, four had a brother, eight had a parent, six had a dependent, and one participant had a grandparent with a SUD. Four themes, whose overarching focus is the pains of living and caring for a family with a SUD, caused the participants and how the participants mitigated these experiences The stress associated with caring for individuals with a SUD impacts the caregiver’s physical and mental health. Specific care modalities targeting caregivers need to be developed to address the health impact and to support self-care.
The social production of substance abuse and HIV/HCV risk: an exploratory study of opioid-using immigrants from the former Soviet Union living in New York CitySubstance Abuse Treatment, Prevention, and Policy - Tập 7 - Trang 1-14 - 2012
Honoria Guarino, Sarah K Moore, Lisa A Marsch, Sal Florio
Several former Soviet countries have witnessed the rapid emergence of major epidemics of injection drug use (IDU) and associated HIV/HCV, suggesting that immigrants from the former Soviet Union (FSU) may be at heightened risk for similar problems. This exploratory study examines substance use patterns among the understudied population of opioid-using FSU immigrants in the U.S., as well as social contextual factors that may increase these immigrants' susceptibility to opioid abuse and HIV/HCV infection. In-depth interviews were conducted with 10 FSU immigrants living in New York City who initiated opioid use in adolescence or young adulthood, and with 6 drug treatment providers working with this population. Informed by a grounded theory approach, interview transcripts were inductively coded and analyzed to identify key themes. The "trauma" of the immigration/acculturation experience was emphasized by participants as playing a critical role in motivating opioid use. Interview data suggest that substance use patterns formed in the high-risk environment of the FSU may persist as behavioral norms within New York City FSU immigrant communities - including a predilection for heroin use among youth, a high prevalence of injection, and a tolerance for syringe sharing within substance-using peer networks. Multiple levels of social context may reproduce FSU immigrants' vulnerability to substance abuse and disease such as: peer-based interactional contexts in which participants typically used opioids; community workplace settings in which some participants were introduced to and obtained opioids; and cultural norms, with roots in Soviet-era social policies, stigmatizing substance abuse which may contribute to immigrants' reluctance to seek disease prevention and drug treatment services. Several behavioral and contextual factors appear to increase FSU immigrants' risk for opioid abuse, IDU and infectious disease. Further research on opioid-using FSU immigrants is warranted and may help prevent increases in HIV/HCV prevalence from occurring within these communities.
Alcohol use disorders and the risk of progression of liver disease in people with hepatitis C virus infection – a systematic reviewSubstance Abuse Treatment, Prevention, and Policy - - 2020
Laura Llamosas‐Falcón, Kevin D. Shield, Maya Gelovany, Jakob Manthey, Jürgen Rehm
AbstractLiver cirrhosis and other chronic liver diseases are usually compartmentalized into separate categories based on etiology (e.g., due to alcohol, virus infection, etc.), but it is important to study the intersection of, and possible interactions between, risk factors. The aim of this study is to summarize evidence on the association between alcohol use disorders (AUDs) and decompensated liver cirrhosis and other complications in patients with chronic Hepatitis C virus (HCV) infection. A systematic search of epidemiological studies was conducted using Ovid Medline databases in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria. Relative Risk estimates were combined using random-effects meta-analyses. The proportion of cases with liver disease progression that could be avoided if no person with a chronic HCV infection had an AUD was estimated using an attributable fraction methodology. A total of 11 studies fulfilled the inclusion criteria, providing data from 286,641 people with chronic HCV infections, of whom 63,931 (22.3%) qualified as having an AUD. Using decompensated liver cirrhosis as the outcome for the main meta-analysis (n = 7 unique studies), an AUD diagnosis was associated with a 3.3-fold risk for progression of liver disease among people with a chronic HCV infection (95% Confidence Interval (CI): 1.8–4.8). In terms of population-attributable fractions, slightly less than 4 out of 10 decompensated liver cirrhosis cases were attributable to an AUD: 35.2% (95% CI: 16.2–47.1%). For a secondary analyses, all outcomes related to liver disease progression were pooled (i.e., liver deaths or cirrhosis in addition to decompensated liver cirrhosis), which yielded a similar overall effect (n = 13 estimates; OR = 3.7; 95% CI: 2.2–5.3) and a similar attributable fraction (39.3%; 95% CI: 21.9–50.4%). In conclusion, AUDs were frequent in people with chronic HCV infections and contributed to worsening the course of liver disease. Alcohol use and AUDs should be assessed in patients who have liver disease of any etiology, and interventions should be implemented to achieve abstinence or to reduce consumption to the greatest possible extent.
Global research mapping of substance use disorder and treatment 1971–2017: implications for priority settingSubstance Abuse Treatment, Prevention, and Policy - - 2019
Bach Xuan Tran, Mackenzie Moir, Carl A. Latkin, Brian J. Hall, Cuong Tat Nguyen, Giang Hai Ha, Nam Ba Nguyen, Cyrus S. H. Ho, Roger C. M. Ho
Globally, substance use disorders are prevalent and remain an intractable public health problem for health care systems. This study aims to provide a global picture of substance use disorders research. The Web of Science platform was used to perform a cross-sectional analysis of scientific articles on substance use disorders and treatment. Characteristics of publication volume, impact, growth, authors, institutions, countries, and journals were examined using descriptive analysis and network visualization graphs. Thirteen thousand six hundred eighty-five papers related to illicit drugs (5403), tobacco (4469), and alcohol (2137) use disorders and treatment were published between 1971 and 2017. The number of publications on Mindfulness and Digital medicine topics had the highest increase with more than 300% since 2003–2007 despite later presence than other methods. The number of papers on other non-pharmaceutical therapies (behavioral therapy, cognitive behavioral therapy, skills training or motivational interviewing) grew gradually, however, the growth rate was lower every 5-year period. The United States is the substance use disorder research hub of the world with the highest volume of publications (8232 or 60.2%) and total citations (252,935 or 65.2%), number of prolific authors (25 of top 30 or 83%) and institutions (24 of top 26 or 92%), formed the most international research partnerships (with 96 distinct countries). The international collaboration followed a pattern based on geographic proximity and cultural similarity. This study offers a comprehensive picture of the global trend of publications of substance use disorder. Findings suggest a need for research policy that supports the examination of interventions that culturally adhere to different local contexts to address substance use disorder in communities.
Khảo sát và so sánh quan điểm của người Pháp về các chính sách kiểm soát hạn chế: một nghiên cứu thử nghiệm Dịch bởi AI Substance Abuse Treatment, Prevention, and Policy - Tập 15 - Trang 1-11 - 2020
Sylvie Castanié, Maria Teresa Munoz Sastre, Lonzozou Kpanake, Etienne Mullet
Các cơ quan công quyền áp dụng nhiều chính sách kiểm soát khác nhau để kiềm chế sự phổ biến của các hành vi không lành mạnh. Vì các chính sách này chỉ có thể thành công đến mức người dân đồng ý với chúng, nghiên cứu này đã xác định các quan điểm của người Pháp về các chính sách kiểm soát hạn chế nói chung. Một mẫu gồm 344 người lớn (trong đó có các chuyên gia y tế và luật sư) đã được trình bày 54 tình huống mô tả một chính sách kiểm soát. Mỗi tình huống bao gồm bốn thông tin: loại hành vi gây nghiện mục tiêu (thuốc lá, rượu bia hoặc cờ bạc), bản chất của các biện pháp dự phòng (ví dụ: các chiến dịch thông tin), mức độ biện pháp quy định (ví dụ: cấm người vị thành niên), và mức độ nghiêm khắc của các hình phạt. Thông qua phân tích cụm, tám quan điểm khác biệt về chất lượng đã được tìm thấy: Không bao giờ chấp nhận (9%), Quy định yếu hoặc vừa phải (5%), Quy định vừa phải kết hợp với phòng ngừa mạnh mẽ (11%), Quy định mạnh mẽ hoặc vừa phải (11%), Quy định mạnh mẽ kết hợp với phòng ngừa mạnh mẽ (23%), Hình phạt vừa phải kết hợp với phòng ngừa mạnh mẽ và quy định vừa phải (9%), Hình phạt nghiêm khắc (9%), và Luôn chấp nhận (9%). Một số người tham gia (14%) không bày tỏ ý kiến gì cả. Các quan điểm của người Pháp về các chính sách kiểm soát rất đa dạng. Tuy nhiên, liên quan đến thuốc lá, một loại chính sách chắc chắn sẽ nhận được sự ủng hộ của đa số người dân: Quy định vừa phải kết hợp với một mức độ phòng ngừa tối thiểu và hình phạt thấp. Đối với rượu bia, một quan điểm chấp nhận được sẽ là: Quy định vừa phải kết hợp với ít nhất một mức độ phòng ngừa vừa phải và hình phạt cao. Đối với cờ bạc, một quan điểm chấp nhận được sẽ là: Quy định mạnh mẽ kết hợp với ít nhất một mức độ phòng ngừa vừa phải và hình phạt thấp.
#chính sách kiểm soát #hành vi gây nghiện #thuốc lá #rượu bia #cờ bạc #hành vi không lành mạnh #phòng ngừa #quy định #hình phạt
The growth of recovery capital in clients of recovery residences in Florida, USA: a quantitative pilot study of changes in REC-CAP profile scoresSubstance Abuse Treatment, Prevention, and Policy -
Sofia Härd, David Best, Arun Sondhi, John W. Lehman, Richard Riccardi
Abstract
Background
There is a growing evidence base around predictors of retention and completion in a range of recovery residence models, particularly Oxford Houses and Sober Living Houses, and recovery housing is recognized as a clearly evidenced area of recovery intervention. The aim of the study was to quantitatively assess recovery capital in a sample of recovery residence clients.
Method
The study used a repeated measures self-completion of a standardized recovery capital instrument (REC-CAP) for clients retained across various houses within one Level 2 recovery residence provider whose program was based on a 12-step approach. While 823 clients participated in the baseline assessment, a sample of 267 clients was achieved for six-month follow-up interview, based on those retained in the residence. A logistic regression model examined factors associated with retention and a repeated measures marginal mixed model evaluated the factors associated with changes in recovery capital between the baseline and the follow-up assessment.
Results
Members of the group that remained in recovery residences were more likely to be older with a record of high participation in recovery groups, with greater drop-out among younger residents, female residents and those with an identified housing need. For those retained to follow-up, greater recovery capital growth was associated with employment, higher levels of social support and more recovery group involvement, as well as age and a higher quality of life. The need for family support was shown to reduce levels of recovery capital. However, those younger people who were retained reported better recovery capital growth during the initial six months of residence.
Conclusion
The key conclusion is that while recovery capital generally increases during a stay in a recovery residence, it does not do so consistently across the sample population. This has implications for how pathways to recovery group engagement are supported for women and young people and how social support (encompassing housing, employment and family issues) is provided to those populations during periods of residence. This suggests the potential need for training and guidance for house managers working with these groups.
Impact of parental history of substance use disorders on the clinical course of anxiety disordersSubstance Abuse Treatment, Prevention, and Policy - Tập 2 - Trang 1-9 - 2007
Maria E Pagano, Richard Rende, Benjamin F Rodriguez, Eric L Hargraves, Amanda T Moskowitz, Martin B Keller
Among the psychological difficulties seen in children of parents with substance use problems, the anxiety disorders are among the most chronic conditions. Although children of alcoholic parents often struggle with the effects of parental substance use problems long into adulthood, empirical investigations of the influence of parental substance use disorders on the course of anxiety disorders in adult offspring are rare. The purpose of this study was to examine prospectively the relationship between parental substance use disorders and the course of anxiety disorders in adulthood over the course of 12 years. Data on 618 subjects were derived from the Harvard/Brown Anxiety Research Project (HARP), a longitudinal naturalistic investigation of the clinical course of multiple anxiety disorders. Kaplan-Meier survival estimates were used to calculate probabilities of time to anxiety disorder remission and relapse. Proportional hazards regressions were conducted to determine whether the likelihood of remission and relapse for specific anxiety disorders was lower for those who had a history of parental substance use disorders than for individuals without this parental history. Adults with a history of parental substance use disorders were significantly more likely to be divorced and to have a high school level of education. History of parental substance use disorder was a significant predictor of relapse of social phobia and panic disorders. These findings provide compelling evidence that adult children of parents with substance use disorders are more likely to have relapses of social phobia and panic disorders. Clinicians who treat adults with anxiety disorders should assess parental substance use disorders and dependence histories. Such information may facilitate treatment planning with regards to their patients' level of vulnerability to perceive scrutiny by others in social situations, and ability to maintain a long-term panic-free state.
Building a bonfire that remains stoked: sustainment of a contingency management intervention developed through collaborative designSubstance Abuse Treatment, Prevention, and Policy - Tập 10 - Trang 1-9 - 2015
Bryan Hartzler
Community dissemination of empirically-supported behavior therapies is fostered by collaborative design, a joint process pooling expertise of purveyors and treatment personnel to contextualize a therapy for sustainable use. The adaptability of contingency management renders it an exemplary therapy to model this collaborative design process. At conclusion of an implementation/effectiveness hybrid trial conducted at an opiate treatment program, a group elicitation interview was conducted with the setting’s five managerial staff to cull qualitative impressions of a collaboratively-designed contingency management intervention after 90 days of provisional implementation in the setting. Two independent raters reviewed the audio-recording and conducted a phenomenological narrative analysis, extracting themes and selecting excerpts to correspond with innovation attributes (i.e., relative advantage, compatibility, complexity, trialability, observability) of a well-known implementation science framework. This qualitative analysis suggested the intervention was regarded as: 1) cost-effective and clinically useful relative to prior practices, 2) a strong fit with existing service structure and staffing resources, 3) procedurally uncomplicated, with staff consistently implementing it as intended, 4) providing site-specific data to sufficiently inform decisions about its sustainment, and 5) offering palpable benefits to staff-patient interactions. The current work complements prior reports of positive implementation outcomes and intervention effectiveness for the parent trial, mapping qualitative managerial accounts of this contingency management intervention to a set of attributes thought to influence the speed and effectiveness with which an innovative practice is disseminated. Findings support the incorporation of collaborative design processes in future efforts to transport contingency management to the addiction treatment community.
Hành vi cờ bạc trong năm qua ở bệnh nhân đang nhận điều trị thay thế opioid Dịch bởi AI Substance Abuse Treatment, Prevention, and Policy - Tập 10 - Trang 1-6 - 2015
Sari Castrén, Anne H Salonen, Hannu Alho, Tuuli Lahti, Kaarlo Simojoki
Lạm dụng chất và các vấn đề liên quan đến cờ bạc có mối liên hệ với nhau, tuy nhiên, các nghiên cứu về vấn đề cờ bạc trong số bệnh nhân điều trị thay thế opioid (OST) còn rất hạn chế. Mục tiêu của nghiên cứu này là khám phá mối liên hệ giữa giới tính, độ tuổi, loại thuốc điều trị và chương trình điều trị với hành vi cờ bạc, bao gồm tham gia cờ bạc và các vấn đề liên quan đến cờ bạc, trong số bệnh nhân OST. Tất cả các bệnh nhân OST (n = 244) tại ba phòng khám ngoại trú tại Phần Lan đã được tuyển chọn trong khoảng thời gian tháng 3 - tháng 4 năm 2014. Tỷ lệ hồi đáp là 64.3%. Các chương trình OST bao gồm hai lựa chọn định hướng (phục hồi/chống tổn thương) và hai lựa chọn về thuốc điều trị (methadone/buprenorphine-naloxone). Trong số 144 người phản hồi, 70.1% đã chơi cờ bạc trong năm qua và 12.5% được xác định là những người có vấn đề cược có khả năng trong năm qua. Việc chơi cờ bạc có tần suất thống kê đáng kể cao hơn ở nam giới (79.8%) so với nữ giới (53.7%). Tương tự, những bệnh nhân trong chương trình phục hồi đã chơi cờ bạc (75.9%) nhiều hơn so với những bệnh nhân trong chương trình chống tổn thương (50.0%). Giới tính, độ tuổi, loại thuốc điều trị hoặc chương trình điều trị không liên quan đến các vấn đề cờ bạc trong năm trước. Sự tham gia cờ bạc của các bệnh nhân OST có vẻ tương tự so với dân số chung Phần Lan, nhưng các vấn đề cờ bạc lại phổ biến hơn trong số các bệnh nhân OST. Giới tính và độ tuổi có thể không phải là những yếu tố chỉ thị mạnh mẽ cho rủi ro khi sàng lọc người có vấn đề cờ bạc trong số các bệnh nhân OST. Khuyến nghị thành lập một chương trình sàng lọc người có vấn đề cờ bạc và can thiệp bổ sung cho các vấn đề cờ bạc nên được thực hiện để đáp ứng nhu cầu này như một phần của OST.
#cờ bạc #bệnh nhân điều trị thay thế opioid #hành vi cờ bạc #vấn đề cờ bạc #tỷ lệ tham gia cờ bạc
Positive drug test trends in fatally-injured drivers in the United States from 2007 to 2017Substance Abuse Treatment, Prevention, and Policy - Tập 14 - Trang 1-10 - 2019
Sunday Azagba, Keely Latham, Lingpeng Shan, Fares Qeadan
The last two decades have seen tremendous changes in the U.S. environment surrounding drugs. Driving under the influence of drugs is a growing public health hazard. The present study examined trends in drug involvement in fatally-injured drivers in the U.S. Data were drawn from the 2007–2017 Fatality Analysis Reporting System. Cochran–Armitage tests were performed to assess the statistical significance of changes in the yearly prevalence of positive drug tests in fatally-injured drivers over time. In addition, analyses were stratified by sex, race, and age. The yearly prevalence of positive drug tests in fatally-injured drivers increased significantly from 20.7% in 2007 to 30.7% in 2017, with results showing a higher prevalence among males, those aged 21–44, and Whites. The gap between Blacks and Whites narrowed in 2017. There was a decline in the yearly prevalence in all age groups between 2016 and 2017, although the decrease in the 21–44 age group was much smaller than other age groups. Among drivers who tested positive for drugs, 34.6% had a blood alcohol concentration (BAC) above the threshold of per se evidence for impaired driving, and 63% had a BAC below the threshold. Our results indicate that the overall yearly prevalence of fatally-injured drivers who tested positive for drugs increased significantly from 2007 to 2017, with similar results found for subgroups. Findings further highlight that drugged driving remains a public health priority, and more action is needed to stem this disturbing trend.
