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Jones R, Jackson D, Woods C, Usher K. Social issues, crisis, and care coordination: First responders experience responding to people affected by methamphetamines. Int J Ment Health Nurs 2023; 32:755-766. [PMID: 36695412 DOI: 10.1111/inm.13119] [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: 03/08/2022] [Revised: 11/21/2022] [Accepted: 12/30/2022] [Indexed: 01/26/2023]
Abstract
Methamphetamines remain a public health problem due to the extensive burden of illicit drug use on society. Callout events in the pre-hospital environment related to methamphetamine use is increasing. In addition, there has been an increase in reported mental health side effects and breakdown in relationships and social networks. Descriptive phenomenology research design was undertaken and data analysed using thematic analysis. Semi-structured interviews were utilized to collect data exploring the experience of first responders attending callouts to people affected by methamphetamines in the pre-hospital environment. Interviews included paramedics (8) and police officers (10) from across Australia. Overall, participants reported responding to people affected by methamphetamines was complex in nature. Complexity was affected by extensive social circumstances, people presenting in states of crisis, lack of coordinated approach, and unsuitable care environments. The social impact of methamphetamine addiction is extensive. Staff working as first responders have an opportunity to help reduce the social impact and crises, referring people to follow-up care and drug and alcohol support services. Further research is needed to determine if a standardized approach, between first responders and EDs, should be developed to help streamlines services and improve how the individual services respond as a group to people affected by substances.
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Affiliation(s)
- Rikki Jones
- School of Health, University of New England, Armidale, New South Wales, Australia
| | - Debra Jackson
- Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia
| | - Cindy Woods
- University of Canberra, Bruce, Australian Capital Territory, Australia
| | - Kim Usher
- School of Health, University of New England, Armidale, New South Wales, Australia
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Wright ME, Temples HS, Shores E, Chafe O, Lannamann R, Lautenschlager C. Pregnant and Parenting Women's Experiences with Substance Use Disorder. MCN Am J Matern Child Nurs 2021; 46:271-276. [PMID: 34398828 DOI: 10.1097/nmc.0000000000000741] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE The purpose of the study was to describe and analyze the experience of women with substance use disorder during pregnancy and parenting to inform health care services that promote recovery. STUDY DESIGN Interviews of pregnant or parenting women with substance use disorder were used in this qualitative descriptive study. METHODS Participants were recruited from two recovery centers serving pregnant or parenting women with substance use disorder. Participants called a study cellphone to speak with the researchers about their substance use and recovery. Four independent reviewers conducted thematic analysis and were facilitated by Atlas.ti qualitative analysis program. RESULTS N = 15 women called the study cellphone; 10 met inclusion criteria and were interviewed. Researchers coded 81 themes with the common occurrence of prior trauma, multiple substances used, stigma and judgment from others, and having children as a motivation to seeking recovery. Co-occurrence of themes of positive social support and the pursuit of recovery was identified. CLINICAL IMPLICATIONS Positive social support co-occurring with recovery supports the need for strengthened social support structures. Health care professionals should intentionally address the culture of caring for pregnant and parenting women with substance use disorder through education, practice, advocacy, and research.
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Ahuja N, Schmidt M, Dillon PJ, Alexander AC, Kedia S. Online Narratives of Methamphetamine Use and Risky Sexual Behavior: Can Shame-Free Guilt Aid in Recovery? ARCHIVES OF SEXUAL BEHAVIOR 2021; 50:323-332. [PMID: 32671499 DOI: 10.1007/s10508-020-01777-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 06/10/2020] [Accepted: 06/13/2020] [Indexed: 06/11/2023]
Abstract
Methamphetamine (meth) use is a recurring public health challenge in the U.S. In 2016, approximately 1.6 million Americans reported using meth. Meth use is associated with a number of adverse outcomes, including those associated with users' sexual health. In particular, meth use is linked to an increased risk for sexually transmitted infections and unplanned pregnancies. While studies have examined associations between substance use of various types-including meth use, and shame and guilt-few studies have examined relationships among substance use, sexual risk behaviors, and shame and guilt. No qualitative studies, to our knowledge, have studied all three of these phenomena in a sample of meth users. The present qualitative study explored the sexual risk behaviors and associated feelings of shame and guilt in relation to meth use. It draws from anonymous letters and stories (N = 202) posted to an online discussion forum by meth users and their family members. A grounded theory analysis of these narratives identified four primary themes pertaining to meth use and sexual behaviors: (1) feeling heightened sexual arousal and stimulation on meth, (2) experiencing sexual dissatisfaction on meth, (3) responding to sexual arousal and dissatisfaction, and (4) feeling ashamed and/or guilty. Ultimately, the present findings indicate that feelings of shame and guilt may arise more from the consequences of sexual risk behaviors stemming from meth use rather than meth use itself. The emotional toll of meth-induced sexual risk behaviors, particularly shame and guilt over the loss of meaningful relationships and self-respect due to multiple sexual partners, may provide an important opportunity for interventionists.
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Affiliation(s)
- Nikhil Ahuja
- Division of Social and Behavioral Sciences, School of Public Health, The University of Memphis, 3825 Desoto Avenue, Memphis, TN, 38152, USA
| | - Michael Schmidt
- Division of Social and Behavioral Sciences, School of Public Health, The University of Memphis, 3825 Desoto Avenue, Memphis, TN, 38152, USA
| | - Patrick J Dillon
- School of Communication Studies, Kent State University at Stark, North Canton, OH, USA
| | - Adam C Alexander
- The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Satish Kedia
- Division of Social and Behavioral Sciences, School of Public Health, The University of Memphis, 3825 Desoto Avenue, Memphis, TN, 38152, USA.
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Dillon PJ, Kedia SK, Isehunwa OO, Sharma M. Motivations for Treatment Engagement in a Residential Substance Use Disorder Treatment Program: A Qualitative Study. Subst Abuse 2020; 14:1178221820940682. [PMID: 32922019 PMCID: PMC7457698 DOI: 10.1177/1178221820940682] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 06/11/2020] [Indexed: 11/16/2022]
Abstract
AIMS The aim of this study was to explore perspectives on motivations for treatment engagement from substance use disorder (SUD) clients in a long-term residential rehabilitation program. DESIGN AND METHODS A convenience sample of 30 clients who were enrolled in a year-long SUD treatment program at a residential rehabilitation facility took part in in-depth interviews. Interview transcripts were analyzed using the directed content analysis approach. RESULTS Participant accounts indicated that their treatment engagement was motivated by factors that aligned with the six primary constructs of the Health Belief Model: (i) perceived susceptibility (eg, believing that their substance use required intervention and that they were prone to relapse), (ii) perceived severity (eg, substance use negatively impacted their health and harmed their close relationships), (iii) perceived benefits (eg, opportunities for a better life, reconnecting with family members and close friends, & avoiding legal consequences), (iv) perceived barriers (eg, the length of the treatment program), (v) cues to actions (eg, decisive moments, elements of the treatment program, & faith and spirituality), and (vi) self-efficacy in remaining abstinent (eg, treatment program provided them with skills and experiences to maintain long-term sobriety). DISCUSSION Our analysis indicates that participants' treatment engagement was linked to their beliefs regarding the severity of their substance use disorder, their treatment program's ability to help them avoid future relapse, and their own capability to act upon the strategies and resources provided by the treatment program. A theoretical understanding of these aspects can contribute to the future planning of precision interventions.
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Affiliation(s)
- Patrick J Dillon
- School of Communication Studies, Kent State University at Stark, North Canton, OH, USA
| | - Satish K Kedia
- School of Public Health, University of Memphis, Memphis, TN, USA
| | - Oluwaseyi O Isehunwa
- Harvard/MGH Center on Genomics, Vulnerable Populations, and Health Disparities, Boston, MA, USA
| | - Manoj Sharma
- School of Public Health, University of Nevada, Las Vegas, NV, USA
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Patterson TL, Semple SJ, Abramovitz D, Harvey-Vera A, Pines HA, Verdugo S, Depp C, Moore DJ, Martinez G, Rangel MG, Strathdee SA. Impact of time perspectives on texting intervention to reduce HIV/STI transmission among female sex workers in Tijuana and Ciudad Juarez, Mexico. J Behav Med 2019; 42:111-127. [PMID: 29987740 PMCID: PMC6326895 DOI: 10.1007/s10865-018-9948-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Accepted: 07/03/2018] [Indexed: 12/13/2022]
Abstract
Text messages may sustain post-counseling gains in behavioral improvements and reduce HIV/STI incidence. However, their effectiveness may depend on the messages' time perspective and characteristics of the individual. We evaluated the impact of time perspective on a text messaging intervention designed to maintain improvements in safer sex practices among drug-using and non-drug-using female sex workers (FSWs) in Tijuana (n = 141) and Cd. Juarez (n = 129), Mexico. FSWs received the efficacious Mujer Segura intervention, and were randomized to receive safer sex maintenance text messages with either a short-term or future-oriented time perspective. The outcome was HIV/STI incidence rate over 6-month follow-up. In Tijuana, combined HIV/STI incidence density was lower among FSWs in the FUTURE group (31.67 per 100 py) compared to women in the SHORT-TERM group (62.40 per 100 py). Conversely, in Cd. Juarez, HIV/STI incidence density was lower (although non-significant) among FSWs in the SHORT-TERM group (19.80 per 100 py) compared to those in the FUTURE group (35.05 per 100 py). These findings suggest that future-oriented text messages may sustain post-counseling improvements in sexual risk behavior among FSWs, but findings may vary by FSWs' characteristics (e.g., drug use), and by region and context.
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Affiliation(s)
- Thomas L Patterson
- Department of Psychiatry, University of California San Diego, 9500 Gilman Drive, Mail Code 0680, La Jolla, CA, 92093, USA.
| | - Shirley J Semple
- Department of Psychiatry, University of California San Diego, 9500 Gilman Drive, Mail Code 0680, La Jolla, CA, 92093, USA
| | - Daniela Abramovitz
- Division of Global Public Health, Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Alicia Harvey-Vera
- Division of Global Public Health, Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Heather A Pines
- Division of Global Public Health, Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Silvia Verdugo
- Department of Psychiatry, University of California San Diego, 9500 Gilman Drive, Mail Code 0680, La Jolla, CA, 92093, USA
| | - Colin Depp
- Department of Psychiatry, University of California San Diego, 9500 Gilman Drive, Mail Code 0680, La Jolla, CA, 92093, USA
| | - David J Moore
- Department of Psychiatry, University of California San Diego, 9500 Gilman Drive, Mail Code 0680, La Jolla, CA, 92093, USA
| | - Gustavo Martinez
- Federación Méxicana de Asociaciones Privadas, A.C. (FEMAP), Ciudad Juarez, Mexico
| | | | - Steffanie A Strathdee
- Division of Global Public Health, Department of Medicine, University of California San Diego, La Jolla, CA, USA
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O'Donnell A, Addison M, Spencer L, Zurhold H, Rosenkranz M, McGovern R, Gilvarry E, Martens M, Verthein U, Kaner E. Which individual, social and environmental influences shape key phases in the amphetamine type stimulant use trajectory? A systematic narrative review and thematic synthesis of the qualitative literature. Addiction 2019; 114:24-47. [PMID: 30176077 PMCID: PMC6519251 DOI: 10.1111/add.14434] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 06/04/2018] [Accepted: 08/24/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND AIMS There is limited evidence on what shapes amphetamine-type stimulant (ATS) use trajectories. This systematic narrative review and qualitative synthesis aimed to identify individual, social and environmental influences shaping key phases in the ATS use trajectory: initiation, continuation, increase/relapse and decrease/abstinence. METHODS MEDLINE, PsycINFO, EMBASE, and PROQUEST (social science premium collection) were searched from 2000 to 2018. Studies of any qualitative design were eligible for inclusion. Extracted data were analysed according to four key phases within drug pathways, and then cross-analysed for individual, social and environmental influences. RESULTS Forty-four papers based on 39 unique studies were included, reporting the views of 1879 ATS users. Participants were aged 14-58 years, from varied socio-economic and demographic groups, and located in North America, Europe, Australasia and South East Asia. Reasons for initiation included: to boost performance at work and in sexual relationships, promote a sense of social 'belonging' and help manage stress. Similar reasons motivated continued use, combined with the challenge of managing withdrawal effects in long-term users. Increased tolerance and/or experiencing a critical life event contributed to an increase in use. Reasons for decrease focused on: increased awareness of the negative health impacts of long-term use, disconnecting from social networks or relationships and financial instability. CONCLUSIONS Amphetamine-type stimulant users are a highly diverse population, and their drug use careers are shaped by a complex dynamic of individual, social and environmental factors. Tailored, joined-up interventions are needed to address users' overlapping economic, health and social care needs in order to support long-term abstinence.
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Affiliation(s)
- Amy O'Donnell
- Institute of Health and SocietyNewcastle UniversityNewcastle upon TyneUK
| | - Michelle Addison
- Institute of Health and SocietyNewcastle UniversityNewcastle upon TyneUK
| | - Liam Spencer
- Institute of Health and SocietyNewcastle UniversityNewcastle upon TyneUK
| | - Heike Zurhold
- Centre of Interdisciplinary Addiction Research of Hamburg University, Department of PsychiatryUniversity Medical Centre Hamburg‐EppendorfHamburgGermany
| | - Moritz Rosenkranz
- Centre of Interdisciplinary Addiction Research of Hamburg University, Department of PsychiatryUniversity Medical Centre Hamburg‐EppendorfHamburgGermany
| | - Ruth McGovern
- Institute of Health and SocietyNewcastle UniversityNewcastle upon TyneUK
| | - Eilish Gilvarry
- Institute of Health and SocietyNewcastle UniversityNewcastle upon TyneUK
| | - Marcus‐Sebastian Martens
- Centre of Interdisciplinary Addiction Research of Hamburg University, Department of PsychiatryUniversity Medical Centre Hamburg‐EppendorfHamburgGermany
| | - Uwe Verthein
- Centre of Interdisciplinary Addiction Research of Hamburg University, Department of PsychiatryUniversity Medical Centre Hamburg‐EppendorfHamburgGermany
| | - Eileen Kaner
- Institute of Health and SocietyNewcastle UniversityNewcastle upon TyneUK
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Schmidt M, Dillon PJ, Jackson BM, Pirkey P, Kedia SK. "Gave me a line of ice and I got hooked": Exploring narratives of initiating methamphetamine use. Public Health Nurs 2018; 36:18-27. [PMID: 30565331 DOI: 10.1111/phn.12568] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2018] [Revised: 10/22/2018] [Accepted: 11/13/2018] [Indexed: 11/30/2022]
Abstract
OBJECTIVE This study explores factors associated with methamphetamine initiation based on the narratives from an online support group for methamphetamine users. METHODS We conducted a qualitative study of 202 first-person narratives submitted to an anonymous, online support group for methamphetamine users. The narratives were analyzed in the Dedoose qualitative software using Charmaz's adaptations to Glaserian grounded theory methodology. RESULTS Ten factors for initiating methamphetamine use emerged from our analysis and corresponded to three constructs from the Theory of Planned Behavior: attitude (needing energy to work, wishing to escape pain, wanting to have fun, and desiring a thinner body), subjective norms (ubiquity of methamphetamine use, yearning for closer relationships, and wanting to fit in), and perceived behavioral control (believing addiction is inevitable, feeling forced to fit in, and having no real control). Many participants described initiating methamphetamine use because they believed it would help them meet personal goals or needs. Other participants began using it out of curiosity, to develop relationships, and/or because of the drug's ubiquity in their social environments. Some users described how their perceived lack of control left them with limited ability to resist trying the drug. CONCLUSIONS Results from this study may aid public health researchers and interventionists seeking theoretically informed methamphetamine prevention programs.
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Affiliation(s)
- Michael Schmidt
- Department of Art, Social and Behavioral Sciences, School of Public Health, University of Memphis, Memphis, Tennessee
| | - Patrick J Dillon
- School of Communication Studies, Kent State University at Stark, North Canton, OH
| | - Bianca M Jackson
- Multidisciplinary Thoracic Oncology Program, Baptist Cancer Center, Memphis, Tennessee
| | - Paige Pirkey
- Department of Counseling, Educational Psychology, & Research, University of Memphis, Memphis, Tennessee
| | - Satish K Kedia
- Social and Behavioral Sciences, School of Public Health, University of Memphis, Memphis, Tennessee
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Fogarty S, Ramjan LM. The tipping point of change in Anorexia Nervosa (AN): Qualitative findings from an online study. Women Health 2017; 58:1050-1061. [PMID: 28922078 DOI: 10.1080/03630242.2017.1372846] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
The aim of this study was to understand factors related to treatment and/or recovery from self-reported Anorexia Nervosa (AN), including 'the tipping point of change'. An online questionnaire was developed and administered from December 2014 to December 2015 to individuals ≥18 years of age with AN in the past or currently who were recruited through eating disorder organizations in Australia and the United Kingdom. Responses to a specific qualitative question on 'the tipping point of change' were analyzed using conventional content analysis (CCA). One hundred sixty-one participants completed some or all of the questionnaire; only 67 women (41.61%) answered Question six on 'the tipping point of change', and analyses were restricted to data from these women. The themes identified were: 1) realizing the loss of something valuable, 2) the risk of losing something valuable, and 3) something to live for/stay well for. These results are important for health-care providers as they work with patients to identify life experiences, including 'loss/potential loss' and 'the need for preservation', that have personal significance. Some patients may realize that 'enough is enough'; something needs to change. These intrinsic motivating factors may also be the impetus for eventual recovery for some individuals.
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Affiliation(s)
- Sarah Fogarty
- a School of Medicine , Western Sydney University, Campbelltown, New South Wales, Australia.,b National Institute of Complementary Medicine , Western Sydney University , Campbelltown , New South Wales , Australia
| | - Lucie M Ramjan
- c School of Nursing and Midwifery , Western Sydney University , Parramatta , New South Wales , Australia.,d Centre for Applied Nursing Research , Ingham Institute of Applied Medical Research , Penrith , New South Wales , Australia
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