Desistance and Treatment Seeking Among Women With Substance Use Disorders

Multiple psychological senses of community and community influences on personal recovery processes from substance use problems in later life: a collaborative and deductive reflexive thematic analysis

PURPOSE

There is a pressing need for substance use services to know more about how to promote recovery from substance use problems, particularly in later life. Psychological sense of community (PSOC) is an important recovery dimension. This study aims to clarify in what ways PSOC and communities influence later life recovery processes.

METHOD

A collaborative and deductive reflexive thematic approach was used to analyse 23 interviews with older adults in recovery from different substance use problems.

RESULTS

The findings suggest that PSOC and recovery in later life include multiple communities (relational, geographical, substance use-related, ideal and service-related) and affective states (PSOC and NPSOC). Older adults' recovery, moreover, can be described as personal and heterogenic (with respect to community relationships, individual needs, type of substance use problem, age of onset and meaningful activities).

CONCLUSIONS

The findings confirm age of onset, type of substance use problem and community memberships as essential to later life recovery. They also supplement prior evidence on community resources and challenges to later life recovery. Importantly, the new findings extend and nuance current understandings of later life recovery. Taken together, the article illustrates MPSOC as a useful concept, with central practical and theoretical implications for later life recovery.

Qualitative description of outreach and engagement in perinatal substance treatment in Finland

BACKGROUND

Women with perinatal substance problems experience a multitude of barriers to care. They have specific early intervention needs, they endure societal stigma, and both substances and mental health issues influence the way they navigate within support and treatment systems. Early interventions for women with perinatal substance problems are underresearched contexts. The aim of the study is to describe building relationships and engagement within an outreach and low threshold service encounter tailored for pregnant women with SUD (substance use disorder).

METHODS

The data consist of online written narratives from 11 workers involved in the program and feedback from 504 families in the recovery process comprising 228 open-ended answers. The data were analyzed with a thematic analysis.

RESULTS

The programs are characterized by flexibility and the implementation of inclusive ways to approach families. The themes for enhancing relationships and engagement within outreach and low threshold programs are Acceptance and attitude: a sensitive approach of approval; flexibility within strictness to allow for diversity and individuality; availability and space to ensure a trustful atmosphere; negotiating via doing to build connections; and everyday life changes: imagining recovery. The themes represent the need of being available, focusing on the worker's attitudes and building connections by doing together, and visioning recovery together.

CONCLUSIONS

The study results can add to the understanding of SUD outreach and low threshold work during pregnancy. The elements described in this study need further theoretical development, research and critical assessment. Building relationships during pregnancy were characterized by connecting within everyday life situations and supporting the development of an attachment relationship between the baby and the parents. To promote recovery, a comprehensive approach in which substance-related issues and mental health conditions are interconnected can be favored. Engaging early on during pregnancy might enhance success during future rehabilitation.

Experimental (Re)structuring: The Clinical Trial as Turning Point Among Medical Research Participants

Amid the growth of addiction medicine randomized controlled trials (RCTs), scholars have begun examining participants' study experiences, highlighting facilitators and barriers to enrollment. However, this work can overlook the interplay between trial participation and social-structural dimensions among people with substance use disorders linked to the social nature of use, socioeconomic marginalization, and time demands of substance procurement and use. To effectively conduct RCTs with this unique population, it is necessary to examine the broader social context of study participation. We conducted nested qualitative interviews with 22 participants involved in an RCT testing a treatment for alcohol and opioid use disorders in HIV clinics. Thematic analyses revealed social-structural circumstances shaping RCT participation as well as how participation constitutes a turning point, prompting individuals to reconfigure social networks, reorient to spatial environments, and reorganize day-to-day life-with implications for how substance use disorder RCTs should be approached by researchers.

Benefits of Digital Health Resources for Substance Use Concerns in Women: Scoping Review

BACKGROUND

Digital health resources are being increasingly used to support women with substance use concerns. Although empirical research has demonstrated that these resources have promise, the available evidence for their benefit in women requires further investigation. Evidence supports the capacity of interventions that are sex-, gender-, and trauma-informed to improve treatment access and outcomes and to reduce health system challenges and disparities. Indeed, both sex- and gender-specific approaches are critical to improve health and gender equity. Violence and trauma are frequent among those with substance use concerns, but they disproportionately affect those who identify as female or women, further underscoring the need for trauma-informed care as well.

OBJECTIVE

The objective of this investigation was to evaluate the evidence supporting the efficacy or effectiveness of online or mobile interventions for risky or harmful substance use in adults who identify as female or women, or who report a history of trauma.

METHODS

This scoping review is based on an academic search in MEDLINE, APA PsycINFO, Embase, Cochrane Central, and CINAHL, as well as a grey literature search in US and Canadian government and funding agency websites. Of the 7807 records identified, 465 remained following title and abstract screening. Of these, 159 met all eligibility criteria and were reviewed and synthesized.

RESULTS

The 159 records reflected 141 distinct studies and 125 distinct interventions. Investigations and the interventions evaluated predominantly focused on alcohol use or general substance use. Evaluated digital health resources included multisession and brief-session interventions, with a wide range of therapeutic elements. Multisession online and mobile interventions exhibited beneficial effects in 86.1% (105/122) of studies. Single-session interventions similarly demonstrated beneficial effects in 64.2% (43/67) of study conditions. Most investigations did not assess gender identity or conduct sex- or gender-based analyses. Only 13 investigations that included trauma were identified.

CONCLUSIONS

Despite the overall promise of digital health interventions for substance use concerns, direct or quantitative evidence on the efficacy or effectiveness of interventions in females or women specifically is weak.