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Ventura CAA, Moll MF, Zanardo ABR, Ferreira PS, Eugenio SJ, de Ávila Domingos SG. Risk and Protective Factors for the Use of Illicit Drugs: Perspective of the Users. J Addict Nurs 2023; 34:E65-E73. [PMID: 37669346 DOI: 10.1097/jan.0000000000000541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/07/2023]
Abstract
ABSTRACT This article aimed to describe the perspective of people who make harmful use of illicit substances on the contributions of risk and protective factors to the development of problems related to drug use. One hundred eleven participants were recruited from a health service for drug users in a city in the interior of the state of São Paulo through posters with information, distribution of brochures, and snowball sampling technique. The sample consists of 51.9% men and 48.1% women, with 81.3% single and 10.3% married. Among them, 54.2% of participants completed high school, 64.1% were Catholic, and 34% rarely practiced their religion. The results on risk factors were classified into three domains, namely, "personal characteristics and behaviors," "family circumstances," and "other social pressures," and those on protective factors were also classified into three domains, namely, "personal characteristics and behaviors," "family circumstances," and "circumstances in the community." The data make it possible to guide the incorporation of multiple strategies to protect the consumption of illicit drugs in human biopsychosocial development, especially among children and adolescents.
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Russo GM, Smith S, Sperandio KR. A meta‐analysis of neurofeedback for treating substance use disorders. JOURNAL OF COUNSELING AND DEVELOPMENT 2023. [DOI: 10.1002/jcad.12466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Affiliation(s)
- G. Michael Russo
- Department of Educational Psychology University of Oklahoma Norman USA
| | - Samantha Smith
- Department of Counselor Education Boise State University Boise United States
| | - Katharine R. Sperandio
- Department of Educational Leadership and Counseling Saint Joseph's University Philadelphia Pennsylvania USA
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Frone MR, Casey Chosewood L, Osborne JC, Howard JJ. Workplace Supported Recovery from Substance Use Disorders: Defining the Construct, Developing a Model, and Proposing an Agenda for Future Research. OCCUPATIONAL HEALTH SCIENCE 2022; 6:475-511. [PMID: 37206918 PMCID: PMC10193449 DOI: 10.1007/s41542-022-00123-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 07/13/2022] [Accepted: 07/20/2022] [Indexed: 05/21/2023]
Abstract
Substance use disorders (SUDs) represent a critical public and occupational health issue. Therefore, understanding the process of SUD recovery has become an issue of growing importance among substance use and recovery professionals. Nonetheless, despite the acknowledged importance of employment for SUD recovery, little conceptual or empirical work exists on how the workplace might support or undermine SUD recovery. In this article, we address this limitation in several ways. First, to promote a better understanding of SUD recovery for occupational health researchers, we provide a brief overview of the nature of a SUD, prior definitions of SUD recovery, and general themes associated with the recovery process. Second, we develop a working definition of workplace supported recovery. Third, we present a heuristic conceptual model showing how the workplace might impact the SUD recovery process. Fourth, using this model and research from the substance use and occupational health literatures, we develop a series of general research propositions. These propositions highlight broad directions requiring more detailed conceptualization and empirical research to understand better how work conditions may support or undermine the process of employee SUD recovery. Our overarching goal is to motivate innovative conceptualization and research on workplace supported recovery from SUDs. Such research may inform the development and evaluation of workplace interventions and policies supporting SUD recovery and highlight the benefits of workplace supported SUD recovery for employees, employers, and communities. Research on this issue may allow occupational health researchers to impact a significant societal and occupational health issue.
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Affiliation(s)
- Michael R. Frone
- Department of Psychology, University at Buffalo, The State University of New York, Buffalo, NY, United States
| | - L. Casey Chosewood
- Office of the Director, Office for Total Worker Health®, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Atlanta, GA, United States
| | - Jamie C. Osborne
- Office of the Director, Office for Policy, Planning and Evaluation, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Atlanta, GA, United States
| | - John J. Howard
- Office of the Director, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Washington, DC, United States
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Hiernaux C, Varescon I. Spiritual Predictors of Improved Resilience in People Recovering from Alcohol Use Disorder: An Exploratory Study. ALCOHOLISM TREATMENT QUARTERLY 2022. [DOI: 10.1080/07347324.2022.2047130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Manhapra A, Stefanovics EA, Rhee TG, Rosenheck RA. Persistence of significant pain interference following substance use disorder remission: Negative association with psychosocial and physical recovery. Drug Alcohol Depend 2022; 232:109339. [PMID: 35121202 DOI: 10.1016/j.drugalcdep.2022.109339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 01/09/2022] [Accepted: 01/25/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND Although substance use disorder (SUD) is frequently complicated by pain, the prevalence and correlates of persistent pain and dysfunction following SUD remission have not been studied. METHODS Using a cross-sectional sample of United States (US) adults with SUD identified in the National Epidemiologic Survey on Alcohol and Related Conditions Wave III, we evaluated the prevalence of moderate/severe pain interference (PI) in subgroups with current and remitted SUD and the independent association of SUD remission and PI with self-reported psychosocial and physical function (Mental Health Composite Score [MCS] and Physical Function Score [PFS] from the Short Form 12). RESULTS A fifth (20.6%; 7.6 million) of estimated 36.7 million US adults with past year SUD and a slightly higher proportion (25.6%; 9.6 million) of 37.4 million with SUD remission reported PI. MCS and PFS showed independent negative associations with PI among adults with both past year SUD and SUD remission. MCS had a positive independent association with SUD remission, but a stronger negative association with PI. While PFS had no statistically significant association with SUD remission, it had a strong negative association with PI. Analysis of interaction between SUD remission and PI revealed that SUD remission had no effect on the association of PI and MCS but had significant moderating influence on the association between PI and PFS. CONCLUSIONS Moderate to severe pain interference continues to be a significant problem among a sizable population achieving SUD remission potentially impeding recovery, and deserves focused clinical attention both active SUD and its remission.
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Affiliation(s)
- Ajay Manhapra
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; New England Mental Illness Research Education Clinical Center, VA Connecticut Healthcare System, West Haven, CT, USA; Hampton VA Medical center, Hampton, VA, USA; Departments of Physical Medicine & Rehabilitation and Psychiatry, Eastern Virginia Medical School, Norfolk, VA, USA.
| | - Elina A Stefanovics
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; New England Mental Illness Research Education Clinical Center, VA Connecticut Healthcare System, West Haven, CT, USA
| | - Taeho Greg Rhee
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; New England Mental Illness Research Education Clinical Center, VA Connecticut Healthcare System, West Haven, CT, USA; Department of Public Health Sciences, School of Medicine, University of Connecticut, Farmington, CT, USA
| | - Robert A Rosenheck
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; New England Mental Illness Research Education Clinical Center, VA Connecticut Healthcare System, West Haven, CT, USA
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Hystad J, Wangensteen T. Former inpatients’ narratives of substance use four years after substance use disorder treatment: A qualitative follow-up study. NORDIC STUDIES ON ALCOHOL AND DRUGS 2021; 39:190-202. [PMID: 35757091 PMCID: PMC9189560 DOI: 10.1177/14550725211050765] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 09/17/2021] [Indexed: 11/18/2022] Open
Abstract
Aim: The aim of this study was to explore the narratives of former substance use disorder (SUD) inpatients about substance use after their discharge from long-term SUD treatment in 2017. Method: We conducted semi-structured in-depth interviews with 11 former inpatients of SUD treatment. The data were analysed using a qualitative, thematic analysis model. Findings: During the analysis, two main themes emerged pertaining to participant reflections on substance use – their experience of non-problematic substance use (that is, substance use without declining into pre-treatment levels of misuse behaviours) and problematic substance use (that is, substance use associated with destructive patterns). All participants except one had engaged in substance use after their discharge three to four years ago. The commonly used substance was alcohol, which also appeared to be the most common substance for which there was consensus among the informants regarding non-problematic use. Conclusions: Most of the participants continued to use substances in some way, and some reported that such use did not affect them negatively. Healthcare providers and therapists in SUD treatment should avoid defining a relapse or failed treatment outcome in concrete terms. What is perceived as an actual relapse or a failed treatment outcome is highly subjective. Furthermore, complete sobriety might not necessarily be the best or the only way to measure the SUD treatment stay. An improvement in the quality of life and well-being, even when core symptoms are still present, may be considered a successful treatment outcome.
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Worley J. Substance Use Withdrawal and Detox Strategies That Work. J Psychosoc Nurs Ment Health Serv 2021; 59:12-15. [PMID: 34459674 DOI: 10.3928/02793695-20210816-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Substance use disorders are considered chronic but treatable. The first step in recovery is going through withdrawal or detox from the substance used, which typically involves unpleasant physical and psychological symptoms. Some individuals are able and willing to enter inpatient facilities for withdrawal and detox. In some cases, outpatient withdrawal and detox programs are not available. Several barriers to treatment exist, including inability to pay, unavailability of programs, stigma, and co-occurring mental health disorders. During inpatient withdrawal and detox, patients are supported with medications. There is an underutilization of initiating medication that helps reduce substance use, such as naltrexone and suboxone, during inpatient withdrawal and detox. Many individuals opt or have no other choice but to go through withdrawal and detox on their own. Strategies include illicitly obtaining prescription medications for the symptoms and other measures, such as floating in the bathtub and exercise. Recovery from substance use can be facilitated by health care providers through use of harm reduction strategies, referrals to treatment, and prescribing medications when applicable. [Journal of Psychosocial Nursing and Mental Health Services, 59(9), 12-15.].
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Shuster R. Monitoring Programs for Nurses With Substance Use Disorders: One Nurse's Journey and Recommendations. J Psychosoc Nurs Ment Health Serv 2021; 59:13-17. [PMID: 33647158 DOI: 10.3928/02793695-20210212-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Estimates of nurses with substance use disorders (SUDs) are approximately equal to those of the general public. Historically, nurses with SUDs faced public disciplinary action for any violations of the nurse practice act in their respective states, but now many states have alternative-to-discipline (ATD) programs available. Although the consent agreement for disciplinary and non-disciplinary programs are often similar, ATD programs are, in contrast, confidential and assist nurses to safely return to practice. As a RN and person in long-term recovery, I have first-hand experience with an ATD program. I credit the program with saving my career; however, it is not without criticism. Recommendations for improvements include increased education about ATD programs, research to evaluate efficacy of mandated interventions, including nurses in recovery within shared governance of these programs, implementing true peer support with nurses in long-term recovery, defraying the costs of the program to participants, and ensuring all staff within the programs receive standardized onboarding training followed by ongoing education. [Journal of Psychosocial Nursing and Mental Health Services, 59(3), 13-17.].
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Abram MD, White JH. Stumbling toward Vulnerability: Recovery from Substance Use Disorders and Co-Occurring Mental Illness. Issues Ment Health Nurs 2021; 42:628-638. [PMID: 33166230 DOI: 10.1080/01612840.2020.1836540] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
This study investigated the recovery process for individuals engaged in treatment for substance use disorders (SUDs) who had co-occurring anxiety and depression. The participants were eight individuals engaged in treatment. The results of a Grounded Theory design and methods revealed the core category and substantive theory, Stumbling toward Vulnerability. Four phases in which the participants progressed in a linear way emerged. The study results have implications for the role of the advance practice psychiatric-mental health nurse in the early assessment of mental illness for clients with SUDs by providing integrated treatment for these individuals, and focusing on health and wellness as a recovery outcome. Based on the findings, hypotheses for further research are recommended.
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Affiliation(s)
- Marissa D Abram
- College of Nursing and Public Health, Adelphi University, Garden City, New York, USA.,Pulse Center for Patient Safety Education and Advocacy, Wantagh, New York, USA
| | - Jane H White
- College of Nursing and Public Health, Adelphi University, Garden City, New York, USA.,Institute for Nursing, Northwell Health, New Hyde Park, New York, USA
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Seabra PRC, Valentim OMMDS, Fernandes FAV, Severino SSP. Moving Beyond Nursing Standardized Language for Substance Use Problems. Issues Ment Health Nurs 2021; 42:267-273. [PMID: 32790483 DOI: 10.1080/01612840.2020.1793245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Nursing knowledge has been accompanied by the evolution of nursing standardized language systems (SLS) that can help nurses to systematize nursing care. We analyzed referential integrity (diagnosis, results, interventions) of substance related problems in Nursing SLS through documentary analysis: ICNP®, NANDA-I, Nursing Intervention Classification (NIC), Nursing Outcome Classification (NOC), NANDA NIC NOC (NNN). ICNP® has a definition of "substance abuse" but there are no clinical indicators or related factors to help formulate a diagnosis. NANDA-I does not define any related diagnosis, although it appears as related to or as a risk factor in 36 diagnoses. In NIC and NOC there are interventions and outcomes related. The phenomenon is omitted in NANDA-I and treated in a stigmatized manner by ICNP. Clear clinical indicators may be needed to help nursing diagnosis and to lead clinical reasoning.
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Affiliation(s)
- Paulo Rosário Carvalho Seabra
- Nursing School of Lisbon, Researcher at Nursing Development and Research Unit (UI&DE) and at Center for Health Services and Technology Research (NursID - CINTESIS), Lisboa, Portugal
| | | | - Filipa Alexandra Veludo Fernandes
- Universidade Católica Portuguesa, Instituto de Ciências da Saúde-Escola de Enfermagem, Researcher at the Centre for Interdisciplinary Research in Health (CIIS), Lisboa, Portugal
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Liang OS, Chen Y, Bennett DS, Yang CC. Identifying Self-Management Support Needs for Pregnant Women With Opioid Misuse in Online Health Communities: Mixed Methods Analysis of Web Posts. J Med Internet Res 2021; 23:e18296. [PMID: 33538695 PMCID: PMC7892281 DOI: 10.2196/18296] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 12/11/2020] [Accepted: 12/20/2020] [Indexed: 12/18/2022] Open
Abstract
Background The current opioid crisis in the United States impacts broad population groups, including pregnant women. Opioid use during pregnancy can affect the health and wellness of both mothers and their infants. Understanding women’s efforts to self-manage opioid use or misuse in pregnancy is needed to identify intervention points for improving maternal outcomes. Objective This study aims to identify the characteristics of women in an online health community (OHC) with opioid use or misuse during pregnancy and the self-management support needs of these mothers. Methods A total of 200 web posts by pregnant women with opioid use participating in an OHC were double coded. Concepts and their thematic connections were identified through an inductive process until theoretical saturation was reached. Statistical tests were performed to identify patterns. Results The majority of pregnant women (150/200, 75.0%) in the OHC exhibited signs of misuse, and 62.5% (125/200) of the participants were either contemplating or pursuing dosage reduction. Self-managed withdrawal was more common (P<.001) than professional treatment among the population. A total of 5 themes of self-management support needs were identified as women sought information about the potential adverse effects of gestational opioid use, protocols for self-managed withdrawal, pain management safety during pregnancy, hospital policies and legal procedures related to child protection, and strategies for navigating offline support systems. In addition, 58.5% (117/200) of the pregnant women expressed negative emotions, of whom only 10.2% (12/117) sought to address their emotional needs with the help of the OHC. Conclusions OHCs provide vital self-management support for pregnant women with opioid use or misuse. Women pursuing self-managed dosage reduction are prone to misinformation and repeated relapses, which can result in extreme measures to avoid testing positive for drug use at labor. The study findings provide evidence for public policy considerations, including universal screening of substance use for pregnant women, emphasis on treatment rather than legal punishment, and further expansion of the Drug Addiction Treatment Act waiver training program. The improvement of web-based platforms that can organize geo-relevant information, dispense clinically validated withdrawal schedules, and offer structured peer support is envisioned for harm reduction among pregnant women who opt for self-management of opioid misuse.
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Affiliation(s)
- Ou Stella Liang
- College of Computing and Informatics, Drexel University, Philadelphia, PA, United States
| | - Yunan Chen
- Donald Bren School of Information and Computer Sciences, University of California, Irvine, Irvine, CA, United States
| | - David S Bennett
- Department of Psychiatry, College of Medicine, Drexel University, Philadelphia, PA, United States
| | - Christopher C Yang
- College of Computing and Informatics, Drexel University, Philadelphia, PA, United States
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12
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Khazaee-Pool M, Naghibi SA, Pashaei T, Chaleshgar-Kordasiabi M, Daneshnia M, Ponnet K. Drug Abstinence Self-Efficacy Scale (DASES): psychometric properties of the Farsi version. SUBSTANCE ABUSE TREATMENT PREVENTION AND POLICY 2021; 16:1. [PMID: 33388062 PMCID: PMC7778789 DOI: 10.1186/s13011-020-00336-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 12/09/2020] [Indexed: 01/19/2023]
Abstract
Background Research has demonstrated that therapeutic interventions based on the self-efficacy theory produce positive outcomes for people who exhibit addictive behaviors, such as alcohol and drug use. Several questionnaires based on self-efficacy theory have been developed to evaluate the extent to which intervention programs can modify behavior. The present study describes the psychometric properties of the Farsi version of the Drug Abstinence Self-Efficacy Scale (DASES). Design and methods The forward–backward approach was employed to translate the DASES from English into Farsi. A cross-sectional study was conducted, and the psychometric properties of the Farsi version of the DASES were measured. Using a cluster sampling method, 400 male people who use drugs aged 20 years or older were selected from 10 addiction treatment clinics in Mazandaran, Iran. The internal consistency and test–retest methods were used to measure the reliability of the DASES. Face and content validity were measured, and the construct validity of the DASES was assessed through both exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). The data were analyzed using SPSS and AMOS. Results The results of the EFA indicated a four-factor solution for the DASES that accounted for 64.72% of the observed variance. The results obtained from the CFA demonstrated that the data fitted the model: the relative chi square (× 2/df) equaled 1.99 (p < 0.001), and the root mean square error of approximation equaled 0.071 (90% CI = 0.059–0.082). All the comparative indices of the model were equal to or greater than 0.90 (0.91, 0.93, 0.94, 0.93, and 0.90, respectively). The Cronbach’s alpha ranged from 0.90 to 0.93, proving a satisfactory reliability. Additionally, the intraclass correlation coefficient ranged from 0.75 to 0.98, which is an acceptable result. Conclusions This study’s results show that the Iranian version of the DASES has good psychometric properties and is appropriate for assessing substance use behaviors among Iranian addicted persons.
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Affiliation(s)
- Maryam Khazaee-Pool
- Department of Public Health, School of Health, Mazandaran University of Medical Sciences, Sari, Iran. .,Health Sciences Research Center, Addiction Research Institutes, Mazandaran University of Medical Sciences, Sari, Iran.
| | - Seyed Abolhassan Naghibi
- Department of Public Health, School of Health, Mazandaran University of Medical Sciences, Sari, Iran. .,Health Sciences Research Center, Addiction Research Institutes, Mazandaran University of Medical Sciences, Sari, Iran.
| | - Tahereh Pashaei
- Department of Public Health, School of Health, Kurdistan University of Medical Sciences, Sanandaj, Iran.
| | - Mosharafeh Chaleshgar-Kordasiabi
- Department of Public Health, School of Health, Mazandaran University of Medical Sciences, Sari, Iran.,Health Sciences Research Center, Addiction Research Institutes, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mahbobeh Daneshnia
- Department of Nursing and Midwifery Ramsar, School of Medicine, Babol University of Medical Sceinces, Ramsar, Iran
| | - Koen Ponnet
- Department of Communication Studies, imec-mict, Ghent University, Ghent, Belgium
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Mawson K, Goodwin V. Is recovery‐orientated practice destined to reach drug and alcohol services in Australia? Nurs Health Sci 2020; 22:839-842. [DOI: 10.1111/nhs.12731] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 02/24/2020] [Accepted: 04/23/2020] [Indexed: 12/01/2022]
Affiliation(s)
- Kerry Mawson
- Northern Sydney Local Health District, Mental Health Drug and Alcohol Service Royal North Shore Hospital St Leonards New SouthWales Australia
| | - Val Goodwin
- Northern Sydney Local Health District, Mental Health Drug and Alcohol Service Royal North Shore Hospital St Leonards New SouthWales Australia
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Marquez-Arrico JE, Navarro JF, Adan A. Health-Related Quality of Life in Male Patients under Treatment for Substance Use Disorders with and without Major Depressive Disorder: Influence in Clinical Course at One-Year Follow-Up. J Clin Med 2020; 9:E3110. [PMID: 32993107 PMCID: PMC7601390 DOI: 10.3390/jcm9103110] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 09/17/2020] [Accepted: 09/23/2020] [Indexed: 12/26/2022] Open
Abstract
Health-related quality of life (HRQoL) assessment has interest as an indicator of degree of affectation and prognosis in mental disorders. HRQoL is impaired in both Substance Use Disorder (SUD) and Major Depressive Disorder (MDD), two conditions highly prevalent, although less studied when both are coexisting (SUD + MDD). Hence, we decided to explore HRQoL with the SF-36 survey in a sample of 123 SUD and 114 SUD + MDD patients (51 symptomatic and 63 asymptomatic of depressive symptoms) under treatment. We performed analyses to examine HRQoL among groups, and its predictive value at 3-, 6- and 12-month follow-ups through regression models. Patients with SUD + MDD had worse HRQoL than SUD patients and population norms. For Mental Health, Vitality, and General Health dimensions, lower scores were observed for SUD + MDD regardless the presence/absence of depressive symptoms. For Physical Functioning and Health Change, depressive symptomatology and not the comorbidity of SUD + MDD diagnoses explained HRQoL limitations. At 3-, 6- and 12-month follow-ups we observed two predictors of relapses, General Health for asymptomatic SUD + MDD, and Physical Functioning for SUD. Improving HRQoL in SUD + MDD may be targeted during patient's treatment; future studies should explore the influence of HRQoL on patient's prognosis taking into account the presence/absence of depressive symptomatology.
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Affiliation(s)
- Julia E. Marquez-Arrico
- Department of Clinical Psychology and Psychobiology, School of Psychology, University of Barcelona, Passeig de la Vall d’Hebrón 171, 08035 Barcelona, Spain;
| | - José Francisco Navarro
- Department of Psychobiology, School of Psychology, University of Málaga, Campus de Teatinos s/n, 29071 Málaga, Spain;
| | - Ana Adan
- Department of Clinical Psychology and Psychobiology, School of Psychology, University of Barcelona, Passeig de la Vall d’Hebrón 171, 08035 Barcelona, Spain;
- Institute of Neurosciences, University of Barcelona, 08035 Barcelona, Spain
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Abstract
Substance use disorders (SUDs) are chronic health disorders with exacerbation rates of approximately 50%. Spirituality has been identified as a factor that can improve recovery rates. Various definitions of spirituality exist that include concepts of finding meaning and connection in life and contact with the divine or something larger than ourselves. Patients generally want to include spirituality as part of their health care but barriers often exist for health care providers to address it, including lack of confidence, knowledge, and organizational support, and time constraints. Nursing programs lack content related to spirituality and should increase course content on this subject to improve comfort levels and competencies of nurses. Keeping in mind professional boundaries and respecting patients' individual differences, nurses have the potential to help patients in their recovery journey by facilitating discussion and growth in spirituality. Nurses can also advocate for their patients by including spiritual leaders in integrated health care teams. [Journal of Psychosocial Nursing and Mental Health Services, 58(9), 14-17.].
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16
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Thomas SP. New Insights Regarding the Phenomenon of Quitting. Issues Ment Health Nurs 2020; 41:377. [PMID: 32400269 DOI: 10.1080/01612840.2020.1733873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Sandra P Thomas
- University of Tennessee, Knoxville, College of Nursing, Knoxville, Tennessee, USA
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17
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Moon SJE, Lee H. Relapse to substance use: A concept analysis. Nurs Forum 2020; 55:523-530. [PMID: 32350881 DOI: 10.1111/nuf.12458] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2019] [Revised: 04/16/2020] [Accepted: 04/19/2020] [Indexed: 12/25/2022]
Abstract
The concept of relapse is ubiquitous in the health literature related to addiction. Nevertheless, relapse is-and has been-described and measured under various definitions, which precipitates confusion, inconsistency, and stigma. This study aimed to (a) clarify the meaning of relapse and (b) present a comprehensive definition of relapse vis-à-vis substance use. Walker and Avant's method of concept analysis was followed to analyze the relapse using CINAHL, PsychINFO, and PubMed databases. Three key attributes of relapse were identified: (a) interruption of abstinence, (b) vulnerability to uncontrollable substance-related behavior and/or cues, (c) a transition to potential progression or regression. Antecedents and consequences of attributes were identified, followed by the construction of the model and additional cases. Relapse is defined conceptually as either a transition to regression or a progression in the process of recovery, prompted by a return to the previous behavior of substance use, despite the intention to stay abstinent. A standardized definition and understanding of relapse not only minimize confusion, inconsistency, and social and self-stigma associated with the term but also helps provide relapse-sensitive care with accurate methods of assessment and evaluation.
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Affiliation(s)
- Seol Ju Esther Moon
- Health and Community Systems, School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Heeyoung Lee
- Health and Community Systems, School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania
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18
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Thomas SP. A Promising New Approach to Drug Use in an American City. Issues Ment Health Nurs 2020; 41:181. [PMID: 32101507 DOI: 10.1080/01612840.2020.1711661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Sandra P Thomas
- University of Tennessee, Knoxville, College of Nursing, Knoxville, Tennessee, USA
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Worley J, Krishnan D. Fighting the Battle of Recovery Together: A Content Analysis of Anonymous Posts in an Online Substance Use Forum. Issues Ment Health Nurs 2020; 41:102-112. [PMID: 31386598 DOI: 10.1080/01612840.2019.1646364] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Background: The rates of use of substance have increased dramatically worldwide in the past several years. Approximately 10% of people who use illicit substances will develop a substance use disorder (SUD), which is a major health problem internationally. Recovery is a period of time when someone with an SUD is in remission or is not using substances. Little research has been done to examine views of patients with SUDs on recovery, particularly when that information is being shared anonymously.Objective: The purpose of the study is to gain an understanding of the experience of recovery from anonymous online postings in recovery support forums.Design: The study was conducted using a qualitative, descriptive, thematic content analysis approach to analyze 1,230 anonymous posts made to an International online recovery forum.Results: Themes identified from the online postings were that the experience of recovery included (a) the agony of withdrawal and screaming cravings, (b) a psychological roller coaster during withdrawal and recovery, and (c) use of coping skills and other strategies that help in recovery.Conclusions: These findings support current recommendations being given by healthcare providers on the use of coping skills and other recovery strategies. They also suggest that people with SUDs endure physical and psychological suffering and show a level of sophistication in managing their symptoms during recovery. Findings reveal that hope and feelings of self-satisfaction exist as a positive experience of recovery. Finally, we can interpret that there are clear benefits to online recovery communities and that healthcare providers have an important role to play as allies in the recovery experience.
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Affiliation(s)
- Julie Worley
- College of Nursing, Rush University, Chicago, IL, USA
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Liu S, Zou X, Huang X, Liu Y, Lu Q, Ling L. The Association between Living Status Transitions, Behavior Changes and Family Relationship Improvement among Methadone Maintenance Treatment Participants in Guangdong, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 17:E119. [PMID: 31877950 PMCID: PMC6981571 DOI: 10.3390/ijerph17010119] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 12/09/2019] [Accepted: 12/20/2019] [Indexed: 01/16/2023]
Abstract
The quality of family relationships is important for individual and family well-being. Improving family relationships is also an important goal in methadone maintenance treatment (MMT). Little is known about factors associated with the improvement of family relationships among MMT clients. This study aimed to identify factors associated with family relationship improvement in MMT. We retrospectively analyzed existing data from 2006 to 2014 at 15 MMT clinics in Guangdong, China, including 2171 subjects with 4691 follow-ups. Generalized estimating equations were used to investigate the association between living status transitions, behavior changes and family relationship improvement, with covariates controlled for. Family relationship improvement was found in 23.1% of all follow-up intervals. Participants who began living with family, living on a regular wage, and gained employment were more likely to have improved family relationships. The quality of family relationships also improved among participants who ceased contact with drug-addicted fellows, ceased drug use, and those who were sexually active. These results suggest that improvement in living status, positive changes in drug use, and sexual activity are associated with family relationship improvement and corresponding interventions may be developed to facilitate clients' recovery.
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Affiliation(s)
| | | | | | | | | | - Li Ling
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; (S.L.); (X.Z.); (X.H.); (Y.L.); (Q.L.)
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Coping Strategies in Male Patients under Treatment for Substance Use Disorders and/or Severe Mental Illness: Influence in Clinical Course at One-Year Follow-Up. J Clin Med 2019; 8:jcm8111972. [PMID: 31739487 PMCID: PMC6912473 DOI: 10.3390/jcm8111972] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Revised: 10/27/2019] [Accepted: 11/12/2019] [Indexed: 12/14/2022] Open
Abstract
Coping strategies have an impact on substance use disorders (SUD), relapses, and clinical variables, but knowledge on this area is scarce. We explored the coping strategies used during treatment in patients with dual diagnosis (DD), SUD, and severe mental illness (SMI), and the relation with clinical course and relapses at one-year follow-up. A sample of 223 patients was divided into three groups depending on diagnosis: DD (N = 80; SUD with comorbid schizophrenia or major depressive disorder), SUD only (N = 80), and SMI only (N = 63; schizophrenia or major depressive disorder). MANCOVA analyses reflected differences in self-criticism and problem avoidance, with a higher use of these in the DD and SUD groups. The coping strategies used differed depending on the presence/absence of a SUD, but not depending on psychiatric diagnosis. At one-year follow-up, social support was the only strategy that predicted the presence of relapses in DD patients with schizophrenia (positively), and in SMI patients with major depressive disorder (negatively). Thus, social support was associated with relapses, but the relationship was different depending on psychiatric diagnosis. Further studies should analyze the implications of social support as a coping strategy in different mental disorders, as well as its usefulness in individualized interventions.
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Chau K, Mayet A, Legleye S, Beck F, Hassler C, Khlat M, Choquet M, Falissard B, Chau N. Association between cumulating substances use and cumulating several school, violence and mental health difficulties in early adolescents. Psychiatry Res 2019; 280:112480. [PMID: 31377662 DOI: 10.1016/j.psychres.2019.112480] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 07/10/2019] [Accepted: 07/10/2019] [Indexed: 11/29/2022]
Abstract
Multiple substances (alcohol, tobacco, cannabis and other illicit drugs (OID)) have been frequently used in early adolescents maybe due to school, violence and mental-health difficulties. We investigated the associations between substance-use patterns and related difficulties among 1559 middle-school adolescents from north-eastern France (mean age 13.5 ± 1.3). They completed a questionnaire including socioeconomic features, school, violence and mental-health difficulties (school grade repetition, sustained physical/verbal violence, sexual abuse, perpetrated violence, poor social support, depressive symptoms and suicide attempt; cumulated number noted SVMDscore) and the time of their first occurrence during the life course. Data were analyzed using logistic and negative binomial regression models. Alcohol, tobacco, cannabis and OID use affected 35.2, 11.2, 5.6 and 2.8% of the subjects respectively. The risk of using tobacco only, alcohol and tobacco, alcohol plus tobacco and cannabis, or all alcohol, tobacco, cannabis and OID strongly increased with the SVMDscore (socioeconomic features-adjusted odds ratio reaching 85). The risk began in early years in middle schools and then steadily increased, more markedly for elevated SVMDscore. Exposure to several SVMDs may be a transmission vector towards the substance use, starting mostly with alcohol/tobacco, and then shifting to cannabis/OID. These findings help to understand substance-use risk patterns and identify at-risk adolescents.
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Affiliation(s)
- Kénora Chau
- University of Lorraine, Faculty of Medicine, Department of General Medicine, Vandoeuvre-lès-Nancy F-54500, France; INSERM, Centre d'Investigations Cliniques Plurithématique, 1433, UMR 1116, Université de Lorraine, CHU de Nancy, Vandoeuvre-lès-Nancy, France
| | - Aurélie Mayet
- Centre d'épidémiologie et de santé publique des armées, Marseille, France; UMR 912: INSERM-IRD, Université Aix-Marseille, Marseille, France
| | - Stéphane Legleye
- Institut National de la Statistique et des Etudes Economiques (INSEE), Paris, France; CESP, INSERM U1018, Université Paris-Saclay, Univ. Paris-Sud, UVSQ, Univ. Paris-Descartes, Paris, France
| | - François Beck
- Institut National de la Statistique et des Etudes Economiques (INSEE), Paris, France
| | - Christine Hassler
- CESP, INSERM U1018, Université Paris-Saclay, Univ. Paris-Sud, UVSQ, Univ. Paris-Descartes, Paris, France
| | - Myriam Khlat
- Institut National d'Etudes Démographiques, 133 Boulevard Davout, 75980, Paris Cedex 20, France
| | - Marie Choquet
- CESP, INSERM U1018, Université Paris-Saclay, Univ. Paris-Sud, UVSQ, Univ. Paris-Descartes, Paris, France
| | - Bruno Falissard
- CESP, INSERM U1018, Université Paris-Saclay, Univ. Paris-Sud, UVSQ, Univ. Paris-Descartes, Paris, France
| | - Nearkasen Chau
- CESP, INSERM U1018, Université Paris-Saclay, Univ. Paris-Sud, UVSQ, Univ. Paris-Descartes, Paris, France.
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24
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van Hagen LJ, de Waal MM, Christ C, Dekker JJM, Goudriaan AE. Patient Characteristics Predicting Abstinence in Substance Use Disorder Patients With Comorbid Mental Disorders. J Dual Diagn 2019; 15:312-323. [PMID: 31566115 DOI: 10.1080/15504263.2019.1667043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Objective: Patients with both a substance use disorder and comorbid mental disorder, or dual diagnosis, form a heterogeneous group with complex treatment needs. Dual diagnosis patients have worse treatment outcomes compared to patients with substance use disorders alone. There is a lack of research focusing on predictors of treatment outcome in dual diagnosis patients. The aim of this study was to identify patient characteristics associated with abstinence in dual diagnosis patients. Methods: In a cohort design, we examined associations between baseline demographic and clinical patient characteristics and abstinence at 14-month follow-up in 102 dual diagnosis patients undergoing treatment in an addiction-psychiatry service in Amsterdam. Immigration, employment, housing, age, emotion regulation, psychiatric symptoms, and frequency and nature of substance abuse were examined as possible predictors of abstinence. Patients were considered abstinent if they had refrained from any substance use in the 30 days prior to the follow-up assessment, as measured with the Timeline Follow Back method. Results: In a multiple logistic regression analysis corrected for treatment utilization, being a first- or second-generation immigrant was associated with lower odds of abstinence (OR = 5.13; 95% CI [1.63, 18.18]), as well as higher levels of depressive and anxiety symptoms at baseline (OR = 0.90; 95% CI [0.81, 0.99]). Gender, age, housing, employment, emotion regulation, frequency and nature of substance abuse, and the psychiatric symptoms positive symptoms, negative symptoms, and manic excitement and disorganization did not show a significant relationship with abstinence. Conclusions: The results indicate that being a first- or second-generation immigrant and experiencing more symptoms of depression and anxiety are predictive of non-abstinence. Attention for linguistic and cultural congruence of dual diagnosis treatments may enhance abstinence in immigrants. Additionally, addressing symptoms of depression and anxiety in dual diagnosis treatment may be beneficial for the maintenance of abstinence. More research is needed on factors influencing treatment success in dual diagnosis patients.
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Affiliation(s)
- Lisanne J van Hagen
- Department of Research, Arkin Mental Health Care, Amsterdam, The Netherlands
| | - Marleen M de Waal
- Department of Research, Arkin Mental Health Care, Amsterdam, The Netherlands.,Department of Psychiatry, Amsterdam Institute for Addiction Research, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Carolien Christ
- Department of Research, Arkin Mental Health Care, Amsterdam, The Netherlands.,Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Jack J M Dekker
- Department of Research, Arkin Mental Health Care, Amsterdam, The Netherlands.,Department of Clinical Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Anna E Goudriaan
- Department of Research, Arkin Mental Health Care, Amsterdam, The Netherlands.,Department of Psychiatry, Amsterdam Institute for Addiction Research, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
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Surratt HL, Otachi JK, Williams T, Gulley J, Lockard AS, Rains R. Motivation to Change and Treatment Participation Among Syringe Service Program Utilizers in Rural Kentucky. J Rural Health 2019; 36:224-233. [PMID: 31415716 DOI: 10.1111/jrh.12388] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 06/21/2019] [Accepted: 07/16/2019] [Indexed: 12/27/2022]
Abstract
PURPOSE Kentucky experiences a disproportionate burden of substance use disorder (SUD), particularly in rural areas of the state. Multiple factors increase vulnerability to SUD and limit access to services in rural communities. However, the recent implementation and expansion of syringe service programs (SSPs) in rural Kentucky may provide a leverage point to reach at-risk people who inject drugs (PWID). METHODS Data were collected as part of an ongoing NIDA-funded study designed to examine uptake of SSPs among PWID in Appalachian Kentucky. Using Respondent Driven Sampling (RDS), the study enrolled a sample of 186 PWID SSP attenders across 3 rural Appalachian Kentucky counties and conducted face-to-face interviews regarding health behaviors, injecting practices, SSP utilization, and treatment services. Using logistic regression analyses, we examined consistent SSP use, as well as importance and confidence to reduce substance use as predictors of current treatment participation. FINDINGS For the prior 6 months, 44.6% of the sample reported consistent SSP use. Consistent use of SSPs was associated with treatment participation in the unadjusted logistic regression models. Significant predictors of treatment participation in the adjusted model included high confidence to reduce substance use, and not reporting primary methamphetamine injection. CONCLUSIONS Rurally located SSPs may play an important role in supporting confidence and motivation to change substance use behaviors among PWID impacted by SUD. SSPs may be critical venues for integration and expansion of prevention, health promotion, and treatment linkage services for this underserved population.
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Affiliation(s)
- Hilary L Surratt
- Center for Health Services Research, College of Medicine, University of Kentucky, Lexington, Kentucky
| | - Janet K Otachi
- Center for Health Services Research, College of Medicine, University of Kentucky, Lexington, Kentucky
| | - Timothy Williams
- Center for Health Services Research, College of Medicine, University of Kentucky, Lexington, Kentucky
| | | | | | - Rebecca Rains
- Knox County Health Department, Barbourville, Kentucky
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26
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Confirming the factor structure of a generic quality of life instrument among pre-treatment substance use disorder patients. Health Qual Life Outcomes 2019; 17:84. [PMID: 31101049 PMCID: PMC6525421 DOI: 10.1186/s12955-019-1152-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Accepted: 05/01/2019] [Indexed: 11/27/2022] Open
Abstract
Background Quality of life (QoL) is a patient-reported outcome of increasing importance in the substance use disorder (SUD) treatment field, and impaired QoL may be an important impetus for treatment uptake. Instruments and methodologies abound, precluding comparison, as does a dearth of population norms. The QOL10 is a generic, overall QoL tool containing ten items and with simple scoring procedures. It is therefore a potential alternative to the gold standard WHOQOL-BREF. This study aimed to assess the two-factor structure of the QOL10 that has been suggested by a previous exploratory factor analysis. Methods Adults entering 21 participating inpatient or outpatient SUD treatment were recruited to join a national longitudinal cohort study. 531 completed the QOL10 at treatment entry and were included in the analysis. Structural equation modelling (SEM) was used to confirm the model fit of a two-factor structure, and the scaling qualities of the QOL10 were reported. Results According to the SEM analysis, the QOL10 was comprised of one latent variable measuring social QoL, and one measuring global QoL, and all ten items were retained. Goodness of fit tests included: root mean square of approximation = 0.063, 90% CI 0.050–0.076; normed-fit index = 0.919; and comparative fit index = 0.943. Conclusions The QOL10 should be considered when clinicians in the SUD treatment field need a short, valid instrument that measures both global QoL and social QoL, with minimum respondent and administrator burden. The social domain is of particular utility and may be used as a stand-alone instrument. Test-retest reliability should be established in future studies. Electronic supplementary material The online version of this article (10.1186/s12955-019-1152-7) contains supplementary material, which is available to authorized users.
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Abstract
Opioids are commonly prescribed in orthopaedics for acute or chronic pain for a variety of conditions, including injury, trauma, degenerative processes, and postsurgical. Patients who are taking opioids because of a substance use disorder (SUD) are also seen in orthopaedics. Patients who are prescribed opioids are at risk of developing an opioid use disorder (OUD). Ten percent of Americans will develop an SUD, which is considered a chronic medical condition that develops due to an imbalance in brain chemistry. In studies, orthopaedic surgeons have a high rate of prescribing opioids, but this rate is decreasing along with national average due to public and provider awareness of the opioid epidemic and professional recommendations. Despite the evidence of a neurobiological cause for SUDs, stigma toward patients with SUDs and a knowledge deficit are common among healthcare professionals, including orthopaedic nurses. A harm reduction approach when working with orthopaedic patients taking opioids either prescribed or used because of an OUD can be applied to reduce the problematic effects of opioids. Harm reduction strategies are supportive to the patient and include education and prevention, adopting evidence-based treatment and communication strategies, and the use of naloxone to prevent opioid overdose.
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Worley J. Teenagers and Cannabis Use: Why It's a Problem and What Can Be Done About It. J Psychosoc Nurs Ment Health Serv 2019; 57:11-15. [DOI: 10.3928/02793695-20190218-03] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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29
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Thomas SP. A Call to Action from the Heartland of the Opioid Epidemic. Issues Ment Health Nurs 2018; 39:455-456. [PMID: 29877777 DOI: 10.1080/01612840.2018.1483113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Adan A, Marquez-Arrico JE, Gilchrist G. Comparison of health-related quality of life among men with different co-existing severe mental disorders in treatment for substance use. Health Qual Life Outcomes 2017; 15:209. [PMID: 29061151 PMCID: PMC5654090 DOI: 10.1186/s12955-017-0781-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Accepted: 10/06/2017] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Patient-perceived health-related quality of life has become an important outcome in health care as an indicator of treatment effectiveness and recovery for patients with substance use disorder. As no study has assessed health-related quality of life among male patients with substance use disorder and co-existing severe mental illness, we compared health-related quality of life among patients with substance use disorder and the following severe mental illness diagnosis in Barcelona, Spain: schizophrenia, bipolar disorder, major depressive disorder, and examined the associations with clinically related variables. Additionally, we compared results for health-related quality of life in patients with substance use disorder and severe mental illness, with Spanish population norms. METHODS We assessed 107 substance use disorder male patients using the 36-Item Short Form Health Survey comparing results across three groups with: comorbid schizophrenia (n = 37), comorbid bipolar disorder (n = 34), and comorbid major depressive disorder (n = 36). Multiple analyses of variance were performed to explore health-related quality of life by the type of co-existing SMI and linear regression analyses examined clinical correlates for the 36-Item Short Form Health Survey dimensions for each group. RESULTS There were differences in Physical Functioning, Vitality and the Physical Composite Scale among groups. Poorer Physical Functioning was observed for patients with comorbid schizophrenia (80.13±3.27) and major depressive disorder (81.97±3.11) compared with comorbid bipolar disorder patients (94.26±1.93). Patients with substance use disorder and schizophrenia presented lower scores in Vitality (41.6±2.80) than those with co-existing bipolar disorder (55.68±3.66) and major depressive disorder (53.63±2.92). Finally, results in the Physical Composite Scale showed lower scores for patients with comorbid schizophrenia (51.06±1.41) and major depressive disorder (51.99±1.87) than for those with bipolar disorder (60.40±2.17). Moreover, all groups had poorer health-related quality of life, especially Social Functioning, Role-Emotional and Mental Health, compared with population norms. Different clinical variables (e.g. medical disease comorbidity, severity of addiction, psychiatric symptomatology, suicide attempts, drug relapses) were related to different health-related quality of life dimensions depending on the co-existing severe mental illness. CONCLUSIONS Among male patients with substance use disorder, co-existing severe mental illness may influence some health-related quality of life dimensions and clinically related variables. Such differences may require tailored therapeutic interventions.
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Affiliation(s)
- Ana Adan
- Department of Clinical Psychology and Psychobiology, School of Psychology, University of Barcelona, Passeig de la Vall d’Hebron, 171, 08035 Barcelona, Spain
- Institute of Neuroscience, University of Barcelona, Passeig de la Vall d’Hebron, 171, 08035 Barcelona, Spain
| | - Julia E. Marquez-Arrico
- Department of Clinical Psychology and Psychobiology, School of Psychology, University of Barcelona, Passeig de la Vall d’Hebron, 171, 08035 Barcelona, Spain
| | - Gail Gilchrist
- National Addiction Centre, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, 4 Windsor Walk, Denmark Hill, London, SE5 8BB UK
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Aghakhani N, Lopez V, Cleary M. Experiences and Perceived Social Support among Iranian Men on Methadone Maintenance Therapy: A Qualitative Study. Issues Ment Health Nurs 2017; 38:692-697. [PMID: 28745916 DOI: 10.1080/01612840.2017.1341586] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The use of drugs predominantly among Iranian men leads to health and social problems. Iran has established methadone maintenance therapy centres but there is limited research exploring the experiences of men who make use of this therapy. The aim of this qualitative study was to explore the experiences of men on methadone maintenance therapy in Urmia, Iran. Sixteen opioid-dependent males on methadone syrup substitution therapy were interviewed. Transcribed data were subjected to thematic analysis. Three themes emerged from the data: (1) the role of family in drug addiction; (2) the role of environment in drug addiction; and (3) the support needed to overcome drug addiction. While drug rehabilitation programmes in Iran can help the person, their family is seen as the most important support that they need together with sociocultural acceptance to overcome stigmatisation.
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Affiliation(s)
- Nader Aghakhani
- a Patient Safety Research Centre , Urmia University of Medical Sciences , Urmia , Iran
| | - Violeta Lopez
- b Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine , National University of Singapore , Singapore City , Singapore
| | - Michelle Cleary
- c School of Health Sciences , University of Tasmania , Sydney , NSW , Australia
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Abstract
Heroin and fentanyl use have reached epidemic proportions in the United States and are now blamed for the majority of drug-related overdose deaths. Both drugs are produced primarily in South America and Asia and enter the United States illegally. One result of smoking or injecting heroin or fentanyl is the development of a substance use disorder (SUD), which causes changes in brain chemistry and function. These changes result in negative behaviors and an inability to stop use. Yet, treatments are available and recovery is possible. Nurses have the potential to impact the heroin and fentanyl epidemic through developing therapeutic relationships with patients who are at risk or already have a SUD. Strategies for effective communication include maintaining a supportive, nonjudgmental attitude and incorporating motivational interviewing. All patients should be screened for opioid use and referred for treatment if indicated. It is important for nurses to be knowledgeable about heroin and fentanyl and available treatments. [Journal of Psychosocial Nursing and Mental Health Services, 55(6), 16-20.].
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