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Neufeld M, Bunova A, Fadeeva E, Nadezhdin A, Tetenova E, Vyshinsky K, Ferreira-Borges C, Yurasova E, Allenov A, Gornyi B, Ivanova E, Kalinina A, Kontsevaya A, Bryun E, Drapkina O, Gil A, Khalfin R, Koshkina E, Khaltourina D, Madyanova V, Rehm J. Translating and adapting the Alcohol Use Disorders Identification Test (AUDIT) for use in the Russian Federation: A multicentre pilot study to inform validation procedures. NORDIC STUDIES ON ALCOHOL AND DRUGS 2023; 40:536-553. [PMID: 37969901 PMCID: PMC10634389 DOI: 10.1177/14550725231183236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 06/05/2023] [Indexed: 11/17/2023] Open
Abstract
Aims: The Alcohol Use Disorders Identification Test (AUDIT) is one of the most widely used screening instruments worldwide. Although it was translated into many languages, not many country-specific adaptations exist, and a formal validation procedure of the Russian version has been carried out only recently. The present contribution documents the different steps taken to formally translate and adapt a Russian-specific version of the AUDIT (RUS-AUDIT). Methods: The AUDIT was translated into Russian following an established protocol, revised and adapted to the country context using an expert panel, and field-tested in an iterative approach, in line with WHO rules on instrument translation and adaptation A total of three pilot phases were carried out on 134 patients from primary healthcare (PHC) and 33 patients from specialised alcohol treatment facilities (narcology), guided by a specially established advisory board. Changes in each version were informed by the findings of the previous pilot phase and a thorough panel discussion. Results: Based on the findings of three different pilot phases, the RUS-AUDIT was developed as a paper-and-pencil interview for PHC professionals. Since various issues with representation and counting of standard drinks for the second test item arose, a special show card was developed to support the assessment. Preliminary AUDIT-C scores indicated that more than one-third of the screened women (34.2%) and about half of the screened men (50.9%) from PHC facilities have exceeded risk thresholds. Conclusions: The RUS-AUDIT was constructed as a feasible assessment tool for interviewers and patients. The large number of PHC patients who exceed the risk threshold has corroborated the need for formal validation and Russia-specific cut-off scores, considering the specific drinking patterns.
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Affiliation(s)
- Maria Neufeld
- WHO European Office for Prevention and Control of Noncommunicable Diseases, Moscow, Moscow, Russian Federation
| | - Anna Bunova
- National Research Center for Therapy and Preventive Medicine of the Ministry of Health of the Russian Federation, Moscow, Russian Federation
| | - Eugenia Fadeeva
- National Research Centre on Addictions – branch, V. Serbsky National Medical Research Centre for Psychiatry and Narcology of the Ministry of Health of the Russian Federation, Moscow, Russian Federation
| | - Alexey Nadezhdin
- Moscow Research and Practical Centre for Narcology of the Department of Public Health, Moscow, Russian Federation
| | - Elena Tetenova
- Moscow Research and Practical Centre for Narcology of the Department of Public Health, Moscow, Russian Federation
| | - Konstantin Vyshinsky
- National Research Centre on Addictions – branch, V. Serbsky National Medical Research Centre for Psychiatry and Narcology of the Ministry of Health of the Russian Federation, Moscow, Russian Federation
| | - Carina Ferreira-Borges
- WHO European Office for Prevention and Control of Noncommunicable Diseases, Moscow, Moscow, Russian Federation
| | - Elena Yurasova
- WHO Country Office in the Russian Federation, Moscow, Russian Federation
| | - Andrey Allenov
- I.M. Sechenov First Moscow State Medical
University (Sechenov University), Moscow,
Russian Federation
| | - Boris Gornyi
- National Research Center for Therapy and Preventive Medicine of the Ministry of Health of the Russian Federation, Moscow, Russian Federation
| | - Ekaterina Ivanova
- National Research Center for Therapy and
Preventive Medicine of the Ministry of Health
of the Russian Federation, Moscow, Russian Federation
| | - Anna Kalinina
- National Research Center for Therapy and Preventive Medicine of the Ministry of Health of the Russian Federation, Moscow, Russian Federation
| | - Anna Kontsevaya
- National Research Center for Therapy and Preventive Medicine of the Ministry of Health of the Russian Federation, Moscow, Russian Federation
| | - Evgeny Bryun
- Moscow Research and Practical Centre for Narcology of the Department of Public Health, Moscow, Russian Federation
| | - Oxana Drapkina
- National Research Center for Therapy and Preventive Medicine of the Ministry of Health of the Russian Federation, Moscow, Russian Federation
| | - Artyom Gil
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
| | - Ruslan Khalfin
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
| | - Evgenia Koshkina
- Moscow Research and Practical Centre for Narcology of the Department of Public Health, Moscow, Russian Federation
| | - Daria Khaltourina
- Federal Research Institute for Health Organization and Informatics of Ministry of Health of the Russian Federation, Moscow, Russian Federation
| | - Viktoria Madyanova
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
| | - Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada; Campbell Family Mental Health Research Institute, CAMH, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Institute for Clinical Psychology and Psychotherapy, TU Dresden, Dresden, Germany
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Neufeld M, Rehm J, Bunova A, Gil A, Gornyi B, Rovira, P, Manthey J, Yurasova E, Dolgova S, Idrisov B, Moskvicheva M, Nabiullina G, Shegaym O, Zhidkova I, Ziganshina Z, Ferreira-Borges C. Validation of a screening test for alcohol use, the Russian Federation. Bull World Health Organ 2021; 99:496-505. [PMID: 34248222 PMCID: PMC8243036 DOI: 10.2471/blt.20.273227] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 02/02/2021] [Accepted: 02/02/2021] [Indexed: 01/30/2023] Open
Abstract
OBJECTIVE To validate a Russian-language version of the World Health Organization's Alcohol Use Disorders Identification Test (AUDIT). METHODS We invited 2173 patients from 21 rural and urban primary health-care centres in nine Russian regions to participate in the study (143 declined and eight were excluded). In a standardized interview, patients who had consumed alcohol in the past 12 months provided information on their sociodemographic characteristics and completed the Russian AUDIT, the Kessler Psychological Distress Scale and the Composite International Diagnostic Interview to identify problem drinking and alcohol use disorders. We assessed the feasibility of administering the test, its internal consistency and its ability to predict hazardous drinking and alcohol use disorders in primary health care in the Russian Federation. FINDINGS Of the 2022 patients included in the study, 1497 were current drinkers with Russian AUDIT scores. The test was internally consistent with good psychometric properties (Cronbach's α : 0.842) and accurately predicted alcohol use disorders and other outcomes (area under the curve > 75%). A three-item short form of the test correlated well with the full instrument and had similar predictive power (area under the curve > 80%). We determined sex-specific thresholds for all outcomes, as non-specific thresholds resulted in few women being identified. CONCLUSION With the validated Russian AUDIT, there is no longer a barrier to introducing screening and brief interventions into primary health care in the Russian Federation to supplement successful alcohol control policies.
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Affiliation(s)
- Maria Neufeld
- World Health Organization European Office for Prevention and Control of Noncommunicable Diseases, Leontyevsky Pereulok 9, 125009 Moscow, Russian Federation
| | - Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada
| | - Anna Bunova
- National Medical Research Center for Therapy and Preventive Medicine of the Ministry of Health of the Russian Federation, Moscow, Russian Federation
| | - Artyom Gil
- Institute for Leadership and Health Management, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | - Boris Gornyi
- National Medical Research Center for Therapy and Preventive Medicine of the Ministry of Health of the Russian Federation, Moscow, Russian Federation
| | - Pol Rovira,
- Program on Substance Abuse, Public Health Agency of Catalonia, Barcelona, Spain
| | - Jakob Manthey
- Institute for Clinical Psychology and Psychotherapy, Technische Universität, Dresden, Germany
| | - Elena Yurasova
- World Health Organization Office in the Russian Federation, Moscow, Russian Federation
| | | | - Bulat Idrisov
- Moscow Institute of Physics and Technology, Moscow, Russian Federation
| | - Marina Moskvicheva
- Department of Public Health and Healthcare, South Ural State Medical University, Chelyabinsk, Russian Federation
| | | | - Olga Shegaym
- Center for Medical Prevention, Tomsk, Russian Federation
| | - Irina Zhidkova
- Amur Regional Center for Preventive Medicine, Blagoveshchensk, Russian Federation
| | - Zukhra Ziganshina
- Institute of Management, Economics and Finance, Kazan Federal University, Kazan, Russian Federation
| | - Carina Ferreira-Borges
- World Health Organization European Office for Prevention and Control of Noncommunicable Diseases, Leontyevsky Pereulok 9, 125009 Moscow, Russian Federation
| | - & the 2019/2020 RUS-AUDIT Collaborators & the RUS-AUDIT Project Advisory Board
- World Health Organization European Office for Prevention and Control of Noncommunicable Diseases, Leontyevsky Pereulok 9, 125009 Moscow, Russian Federation
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada
- National Medical Research Center for Therapy and Preventive Medicine of the Ministry of Health of the Russian Federation, Moscow, Russian Federation
- Institute for Leadership and Health Management, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
- Program on Substance Abuse, Public Health Agency of Catalonia, Barcelona, Spain
- Institute for Clinical Psychology and Psychotherapy, Technische Universität, Dresden, Germany
- World Health Organization Office in the Russian Federation, Moscow, Russian Federation
- Vologda City Policlinic, Vologda, Russian Federation
- Moscow Institute of Physics and Technology, Moscow, Russian Federation
- Department of Public Health and Healthcare, South Ural State Medical University, Chelyabinsk, Russian Federation
- Center for Medical Prevention, Astrakhan, Russian Federation
- Center for Medical Prevention, Tomsk, Russian Federation
- Amur Regional Center for Preventive Medicine, Blagoveshchensk, Russian Federation
- Institute of Management, Economics and Finance, Kazan Federal University, Kazan, Russian Federation
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Neufeld M, Bunova A, Gornyi B, Ferreira-Borges C, Gerber A, Khaltourina D, Yurasova E, Rehm J. Russia's National Concept to Reduce Alcohol Abuse and Alcohol-Dependence in the Population 2010-2020: Which Policy Targets Have Been Achieved? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E8270. [PMID: 33182377 PMCID: PMC7664947 DOI: 10.3390/ijerph17218270] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 10/23/2020] [Accepted: 10/24/2020] [Indexed: 12/15/2022]
Abstract
In the 2000s, Russia was globally one of the top 5 countries with the highest levels of alcohol per capita consumption and prevailing risky patterns of drinking, i.e., high intake per occasion, high proportion of people drinking to intoxication, and high frequency of situations where alcohol is consumed and tolerated. In 2009, in response to these challenges, the Russian government formed the Federal Service for Alcohol Market Regulation and published a national strategy concept to reduce alcohol abuse and alcohol-dependence at the population level for the period 2010-2020. The objectives of the present contribution are to analyze the evidence base of the core components of the concept and to provide a comprehensive evaluation framework of measures implemented (process evaluation) and the achievement of the formulated targets (effect evaluation). Most of the concept's measures were found to be evidence-based and aligned with eight out of 10 areas of the World Health Organization (WHO) policy portfolio. Out of the 14 tasks, 7 were rated as achieved, and 7 as partly achieved. Ten years after the concept's adoption, alcohol consumption seems to have declined by about a third and alcohol is conceptualized as a broad risk factor for the population's health in Russia.
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Affiliation(s)
- Maria Neufeld
- Institute for Clinical Psychology and Psychotherapy, TU Dresden, Chemnitzer Str. 46, 01187 Dresden, Germany;
- WHO European Office for Prevention and Control of Noncommunicable Diseases, Moscow, Leontyevsky Pereulok 9, 125009 Moscow, Russia;
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), 33Ursula Franklin, Toronto, ON M5S 2S1, Canada
| | - Anna Bunova
- National Medical Research Center for Therapy and Preventive Medicine of the Ministry of Health of the Russian Federation, Petroverigskiy Pereulok 10, 101990 Moscow, Russia; (A.B.); (B.G.)
| | - Boris Gornyi
- National Medical Research Center for Therapy and Preventive Medicine of the Ministry of Health of the Russian Federation, Petroverigskiy Pereulok 10, 101990 Moscow, Russia; (A.B.); (B.G.)
| | - Carina Ferreira-Borges
- WHO European Office for Prevention and Control of Noncommunicable Diseases, Moscow, Leontyevsky Pereulok 9, 125009 Moscow, Russia;
| | - Anna Gerber
- Sechenov First Moscow State Medical University (Sechenov University), 109004 Moscow, Russia;
| | - Daria Khaltourina
- Federal Research Institute for Health Organization and Informatics of Ministry of Health of the Russian Federation, Dobrolyubov Street 11, 127254 Moscow, Russia;
| | - Elena Yurasova
- WHO Office in the Russian Federation, Leontyevsky Pereulok 9, 125009 Moscow, Russia;
| | - Jürgen Rehm
- Institute for Clinical Psychology and Psychotherapy, TU Dresden, Chemnitzer Str. 46, 01187 Dresden, Germany;
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), 33Ursula Franklin, Toronto, ON M5S 2S1, Canada
- Sechenov First Moscow State Medical University (Sechenov University), 109004 Moscow, Russia;
- Campbell Family Mental Health Research Institute, CAMH, 250 College Street, Toronto, ON M5T 1R8, Canada
- Institute of Medical Science (IMS), University of Toronto, Medical Sciences Building, 1 King’s College Circle, Room 2374, Toronto, ON M5S 1A8, Canada
- Department of Psychiatry, University of Toronto, 250 College Street, 8th Floor, Toronto, ON M5T 1R8, Canada
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, 6th Floor, Toronto, ON M5T 3M7, Canada
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Dahl HM, Rezvyy G, Bogdanov A, Øiesvold T. Outpatient clinics treating substance use disorders in Northwest Russia and Northern Norway: a descriptive comparative study. Int J Circumpolar Health 2018; 76:1411733. [PMID: 29241406 PMCID: PMC5738642 DOI: 10.1080/22423982.2017.1411733] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Both in Norway and Russia a considerable portion of the population have substance use disorders. However, the knowledge about outpatient services treating substance use disorders in Norway and Russia is limited. This study will describe and compare outpatient clinics treating substance use disorders in Arkhangelsk in Northwest Russia and in Bodø and Tromsø in Northern Norway on availability, accessibility and treated prevalence (patients treated in one year). The managers (N=3) of the outpatient clinics (N=3) were interviewed with the European Service Mapping Schedule (ESMS) and the International Classification of Mental Health Care (ICMHC). The interviews were supplemented by e-mail and phone calls. The treatment in Arkhangelsk was mainly biologically oriented (medical), while a greater variety of methods was available in Bodø and Tromsø. The clinic in Russia was a drop-in clinic, while in Norway patients needed a referral to get an appointment in the clinic. Patients treated in Arkhangelsk (treated prevalence) was 1662, while in Bodø it was 233 and in Tromsø 220. The present study revealed great differences between the clinics involved in accessibility, availability and treated prevalence. Cultural traditions and budgeting of the mental health care system could explain some of the findings.
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Affiliation(s)
- Helene Marie Dahl
- a Institute of Clinical Medicine, Faculty of Health Sciences , University of Tromsø, the Arctic University of Norway , Tromsø , Norway.,b Division of general psychiatry , Nordland Hospital , Bodø , Norway
| | - Grigory Rezvyy
- a Institute of Clinical Medicine, Faculty of Health Sciences , University of Tromsø, the Arctic University of Norway , Tromsø , Norway.,c Outpatient clinic of psychiatry , Kirkenes Hospital , Kirkenes , Norway
| | - Anatoly Bogdanov
- d Department of Psychiatry and Addictive Disorder , Arkhangelsk Clinical Psychiatric Hospital , Arkhangelsk region , Russia
| | - Terje Øiesvold
- a Institute of Clinical Medicine, Faculty of Health Sciences , University of Tromsø, the Arctic University of Norway , Tromsø , Norway.,b Division of general psychiatry , Nordland Hospital , Bodø , Norway
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Lunze K, Idrisov B, Golichenko M, Kamarulzaman A. Mandatory addiction treatment for people who use drugs: global health and human rights analysis. BMJ 2016; 353:i2943. [PMID: 27284009 PMCID: PMC6884099 DOI: 10.1136/bmj.i2943] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/20/2016] [Indexed: 11/04/2022]
Affiliation(s)
- Karsten Lunze
- Boston University School of Medicine, Boston, MA, USA
| | - Bulat Idrisov
- Boston University School of Medicine, Boston, MA, USA
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Dickson-Gomez J, Bodnar G, Petroll A, Johnson K, Glasman L. HIV Treatment for Alcohol and Non-Injection Drug Users in El Salvador. QUALITATIVE HEALTH RESEARCH 2015; 25:1719-1732. [PMID: 25595149 PMCID: PMC5027900 DOI: 10.1177/1049732314568322] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Since the mid-1990 s, many developing countries have introduced and expanded the availability of combination antiretroviral therapy (cART) to persons living with HIV (PLH). However, AIDS-related mortality continues to be high particularly among drug users. In this article, we present results from in-depth interviews with 13 HIV medical providers and 29 crack cocaine and alcohol using PLH in El Salvador. Providers endorsed negative attitudes toward substance using PLH and warned PLH that combining cART with drugs and alcohol would damage their livers and kidneys resulting in death. Upon diagnosis, PLH received little information about HIV treatment and many suffered depression and escalated their drug use. PLH reported suspending cART when they drank or used drugs because of providers' warnings. Substance using PLH were given few strategies and resources to quit using drugs. Messages from medical providers discourage drug users from initiating or adhering to antiretroviral therapy (ART) and may contribute to treatment abandonment.
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Affiliation(s)
| | - Gloria Bodnar
- Fundación Antidrogas de El Salvador, Santa Tecla, El Salvador
| | - Andy Petroll
- Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Kali Johnson
- Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Laura Glasman
- Medical College of Wisconsin, Milwaukee, Wisconsin, USA
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7
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Bach P, Milloy MJ, Nguyen P, Koehn J, Guillemi S, Kerr T, Wood E. Gender differences in access to methadone maintenance therapy in a Canadian setting. Drug Alcohol Rev 2015; 34:503-507. [PMID: 25735544 DOI: 10.1111/dar.12251] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Accepted: 01/04/2015] [Indexed: 11/27/2022]
Abstract
INTRODUCTION AND AIMS Methadone maintenance therapy (MMT) is an evidence-based treatment for opioid addiction. While gender differences in MMT pharmacokinetics, drug use patterns and clinical profiles have been previously described, few studies have compared rates of MMT use among community-recruited samples of persons who inject drugs (PWID). DESIGN AND METHODS The present study used prospective cohorts of PWID followed between May 1996 and May 2013 in Vancouver, British Columbia, Canada. We investigated potential factors associated with time to methadone initiation using Cox proportional hazards modelling. Stratified analyses were used to examine for gender differences in rates of MMT enrolment. RESULTS Overall, 1848 baseline methadone-naïve PWID were included in the study, among whom 595 (32%) were female. In an adjusted model, male gender was independently associated with increased time to MMT initiation and an overall lower rate of enrolment [adjusted relative hazard = 0.74 (95% confidence interval: 0.65-0.85)]. Among both female and male PWID, Caucasian ethnicity and daily injection heroin use were associated with decreased time to methadone initiation, while in females, pregnancy was also associated with more rapid initiation. DISCUSSION AND CONCLUSIONS These data highlight gender differences in methadone use among a population of community-recruited PWID. While factors associated with methadone use were similar between genders, rates of use were lower among male PWID, highlighting the need to consider gender when designing strategies to improve recruitment into MMT. [Bach P, Milloy M-J, Nguyen P, Koehn J, Guillemi S, Kerr T, Wood E. Gender differences in access to methadone maintenance therapy in a Canadian setting. Drug Alcohol Rev 2015;34:503-7].
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Affiliation(s)
- Paxton Bach
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, Canada.,Department of Medicine, University of British Columbia, Vancouver, Canada
| | - M-J Milloy
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, Canada.,Department of Medicine, University of British Columbia, Vancouver, Canada
| | - Paul Nguyen
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, Canada
| | - John Koehn
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, Canada.,Department of Medicine, University of British Columbia, Vancouver, Canada
| | - Silvia Guillemi
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, Canada
| | - Thomas Kerr
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, Canada.,Department of Medicine, University of British Columbia, Vancouver, Canada
| | - Evan Wood
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, Canada.,Department of Medicine, University of British Columbia, Vancouver, Canada
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8
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Salwan J, Katz CL. A Review of Substance Use Disorder Treatment in Developing World
Communities. Ann Glob Health 2014; 80:115-21. [DOI: 10.1016/j.aogh.2014.04.010] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2013] [Accepted: 08/01/2013] [Indexed: 11/26/2022] Open
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Stoltzfus KM, Cecil D. "A different atmosphere of love": a qualitative study of the experiences of participants in Evangelical substance user rehabilitation programs in the Russian Federation. Subst Use Misuse 2013; 48:421-8. [PMID: 23461666 DOI: 10.3109/10826084.2013.770026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
This article explores the lived experiences of individuals who have participated in faith-based substance user rehabilitation programs in the Russian Federation. The Russian Federation has high rates of alcohol and opioid dependence and a dearth of professional treatment options. In the post-Soviet period, Evangelical Christian groups have developed substance user rehabilitation programs to attempt to address substance use and its related problems. Data were collected during 2010 via focus group interviews with participants in three Evangelical rehabilitation programs in the Volga region of the Russian Federation. Themes emerging from the qualitative data analysis process were classified into three broad categories: Typical Day, Personal Background/Decision to Enter Rehabilitation, and Helpful Aspects of Rehabilitation Process.
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Affiliation(s)
- Kenneth M Stoltzfus
- Social Sciences Department, LCC International University, Klaipeda, Lithuania.
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10
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Abstract
Illicit drug use and substance abuse disorders have increased dramatically in developing countries during recent decades. Sadly, treatment for people diagnosed as manifesting and/or attributed with substance abuse disorders in developing countries is usually inadequate to meet demand, not evidence based, and of poor quality. In response, international health organizations have developed best-practice guidelines for substance user treatment in developing countries, although little research has evaluated their implementation. This opinion piece will examine one such effort to improve substance user treatment in El Salvador. It will be argued that the program failed (2007-2008) because of a lack of political will by the Salvadoran government through their Ministry of Health to effectively supervise, monitor, and subsidize substance user treatment.
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Affiliation(s)
- Julia Dickson-Gómez
- Center for AIDS Intervention Research, Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin 53202, USA.
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11
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Currie CL, Kuzmina MV, Nadyuk RI. The Counseling Profession in Russia: Historical Roots, Current Trends, and Future Perspectives. JOURNAL OF COUNSELING AND DEVELOPMENT 2012. [DOI: 10.1002/j.1556-6676.2012.00060.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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12
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Abstract
The HIV epidemic in higher-income nations is driven by receptive anal intercourse, injection drug use through needle/syringe sharing, and, less efficiently, vaginal intercourse. Alcohol and noninjecting drug use increase sexual HIV vulnerability. Appropriate diagnostic screening has nearly eliminated blood/blood product-related transmissions and, with antiretroviral therapy, has reduced mother-to-child transmission radically. Affected subgroups have changed over time (e.g., increasing numbers of Black and minority ethnic men who have sex with men). Molecular phylogenetic approaches have established historical links between HIV strains from central Africa to those in the United States and thence to Europe. However, Europe did not just receive virus from the United States, as it was also imported from Africa directly. Initial introductions led to epidemics in different risk groups in Western Europe distinguished by viral clades/sequences, and likewise, more recent explosive epidemics linked to injection drug use in Eastern Europe are associated with specific strains. Recent developments in phylodynamic approaches have made it possible to obtain estimates of sequence evolution rates and network parameters for epidemics.
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Affiliation(s)
- Sten H Vermund
- Institute for Global Health and Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, Tennessee, USA.
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Abdala N, Kershaw T, Krasnoselskikh TV, Kozlov AP. Contraception use and unplanned pregnancies among injection drug-using women in St Petersburg, Russia. ACTA ACUST UNITED AC 2011; 37:158-64. [PMID: 21493618 DOI: 10.1136/jfprhc-2011-0079] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND This cross-sectional study estimated the prevalence of contraceptive methods and investigated whether abortion rates influence contraceptive behaviour among injection drug-using (IDU) women in St Petersburg, Russia. METHODOLOGY A self-administered questionnaire of behaviour in the last 3 months was applied to a convenient sample of IDU women. RESULTS Of 80 sexually active participants, 67% had had an abortion. No participant reported using hormonal contraceptives or intrauterine devices (IUDs). The only valid method of contraception used was condoms, which was reported by half of the participants. Consistent condom use was reported by 22% of participants and was no more likely among those who had an abortion. Condom use was significantly associated with having multiple or casual sex partners [prevalence ratio (PR) 1.75, 95% (confidence interval) CI 1.11-2.78, p = 0.01], having an IDU sex partner (PR 0.55, 95% CI 0.36-0.85, p = 0.029) and with a negative attitude toward condoms (PR 0.53, 95% CI 0.33-0.84, p = 0.01). Abortions were less likely among those who had multiple or casual sex partners (PR 0.69, 95% CI 0.49-0.97, p = 0.03). CONCLUSIONS Despite the high prevalence of abortions among IDU women, none reported the use of hormonal contraception or IUDs. Having had an abortion was not associated with greater likelihood of using condoms. Participants mostly used condoms with casual or multiple sex partners, suggesting that condoms were used mainly to prevent HIV/sexually transmitted infection transmission and not to prevent pregnancy. Programmes to prevent unwanted pregnancies and reduce abortion-related health risks among this understudied vulnerable group are needed.
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Affiliation(s)
- Nadia Abdala
- Yale School of Public Health, New Haven, CT 06520-8034, USA.
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Dickson-Gomez J, Bodnar G, Guevara CE, Rodriguez K, De Mendoza LR, Corbett AM. With God's help i can do it: crack users? Formal and informal recovery experiences in El Salvador. Subst Use Misuse 2011; 46:426-39. [PMID: 20735191 PMCID: PMC3704222 DOI: 10.3109/10826084.2010.495762] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Crack use has increased dramatically in El Salvador in the last few decades. As with other developing countries with sudden onsets of drug problems, El Salvador has few medical staff trained in addictions treatment. Little research has examined drug users? attempts to reduce or abstain from drug use in countries where government-regulated formal medical treatment for drug addiction is scarce. This paper uses qualitative and quantitative data gathered from active crack users to explore their formal and informal strategies to reduce or abstain from drugs, and compares these with components of informal and formal treatment in developed countries.
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Affiliation(s)
- Julia Dickson-Gomez
- Medical College of Wisconsin, Psychiatry and Behavioral Medicine, Milwaukee, Wisconsin 53202, USA.
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Israelsson M. Welfare, temperance and compulsory commitment to care for persons with substance misuse problems: a comparative study of 38 European countries. Eur Addict Res 2011; 17:329-41. [PMID: 22067475 DOI: 10.1159/000331003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2011] [Accepted: 07/15/2011] [Indexed: 11/19/2022]
Abstract
AIMS The study explores the existence and types of law on compulsory commitment to care (CCC) of adult substance misusers in Europe and how such laws are related to variations in demographics, alcohol consumption and epidemiology in misuse of opiates, cocaine, amphetamines, temperance culture heritage, health and welfare expenditure, and involvement and role of the state in welfare distribution. MATERIAL AND METHODS Legal information on laws on CCC of misusers was obtained primarily through a survey of 38 European countries. Predictors of laws on CCC, and types of such, were analyzed from country descriptors in multivariate models. RESULTS A majority (74%) of the explored countries have a law concerning CCC. The most common type of CCC law is within criminal justice legislation (45%), but civil CCC is almost as frequent (37%). These two models of CCC legislation are related to differences in cultural heritage and welfare distribution models. CONCLUSIONS Temperance cultures, i.e. countries with a history of a strong temperance movement, and countries with a Beveridgean distribution of welfare, i.e. through the state, tend to favor civil CCC, while countries with a Bismarckian distribution of welfare, i.e. through insurance with less state interference, tend to favor CCC within criminal justice legislation.
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Affiliation(s)
- Magnus Israelsson
- Department of Social Work, Mid Sweden University, Östersund, Sweden.
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Gavaza P, Shepherd M, Shcherbakova N, Khoza S. The state of health economics and pharmaceoconomics research in Russia: a systematic review. JOURNAL OF PHARMACEUTICAL HEALTH SERVICES RESEARCH 2010. [DOI: 10.1111/j.1759-8893.2010.00023.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Challenges in providing services in methadone maintenance therapy clinics in China: service providers' perceptions. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2009; 21:173-8. [PMID: 19818591 DOI: 10.1016/j.drugpo.2009.09.002] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2009] [Revised: 08/23/2009] [Accepted: 09/09/2009] [Indexed: 11/24/2022]
Abstract
BACKGROUND The Methadone Maintenance Therapy (MMT) program has been initiated in China since 2004. As of the end of November, 2008, 558 MMT clinics had been established countrywide. The objective of this study was to elucidate the difficulties and challenges as perceived by service providers working in MMT clinics. METHODS One service provider from each of the 28 MMT study clinics in Zhejiang and Jiangxi Provinces of China participated in a face-to-face in-depth interview for about 1-2h to describe their perceptions of working in MMT clinics. Qualitative data were analysed using ATLAS.ti. The grounded theory was used to guide the data analysis. RESULTS Participants identified major problems in providing services in MMT clinics including lack of resources, professional training, and institutional support. Difficulties in pursuit of career, concern for personal safety, low income, heavy working load, and poor opinion of MMT by Chinese society often contributed to greater stress and burnout among the service providers. CONCLUSION The MMT programs in China desperately need additional resource allocation and institutional support for the current and perhaps future expansion of the programs. The service providers are in urgent need of professional training to improve the quality of care they can offer MMT clients.
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