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Saunders EC, Satcher MF, Monico LB, McDonald RD, Springer SA, Farabee D, Gryczynski J, Nyaku A, Reeves D, Kunkel LE, Schultheis AM, Schwartz RP, Lee JD, Marsch LA, Waddell EN. The impact of COVID-19 on the treatment of opioid use disorder in carceral facilities: a cross-sectional study. HEALTH & JUSTICE 2022; 10:35. [PMID: 36529829 PMCID: PMC9760540 DOI: 10.1186/s40352-022-00199-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 12/06/2022] [Indexed: 06/17/2023]
Abstract
While the COVID-19 pandemic disrupted healthcare delivery everywhere, persons with carceral system involvement and opioid use disorder (OUD) were disproportionately impacted and vulnerable to severe COVID-associated illness. Carceral settings and community treatment programs (CTPs) rapidly developed protocols to sustain healthcare delivery while reducing risk of COVID-19 transmission. This survey study assessed changes to OUD treatment, telemedicine use, and re-entry support services among carceral and CTPs participating in the National Institute on Drug Abuse (NIDA)-funded study, Long-Acting Buprenorphine vs. Naltrexone Opioid Treatments in Criminal Justice System-Involved Adults (EXIT-CJS) study. In December 2020, carceral sites (n = 6; median pre-COVID 2020 monthly census = 3468 people) and CTPs (n = 7; median pre-COVID 2020 monthly census = 550 patients) participating in EXIT-CJS completed a cross-sectional web-based survey. The survey assessed changes pre- (January-March 2020) and post- (April-September 2020) COVID-19 in OUD treatment, telemedicine use, re-entry supports and referral practices. Compared to January-March 2020, half of carceral sites (n = 3) increased the total number of persons initiating medication for opioid use disorder (MOUD) from April-September 2020, while a third (n = 2) decreased the number of persons initiated. Most CTPs (n = 4) reported a decrease in the number of new admissions from April-September 2020, with two programs stopping or pausing MOUD programs due to COVID-19. All carceral sites with pre-COVID telemedicine use (n = 5) increased or maintained telemedicine use, and all CTPs providing MOUD (n = 6) increased telemedicine use. While expansion of telemedicine services supported MOUD service delivery, the majority of sites experienced challenges providing community support post-release, including referrals to housing, employment, and transportation services. During the COVID-19 pandemic, this small sample of carceral and CTP sites innovated to continue delivery of treatment for OUD. Expansion of telemedicine services was critical to support MOUD service delivery. Despite these innovations, sites experienced challenges providing reintegration supports for persons in the community. Pre-COVID strategies for identifying and engaging individuals while incarcerated may be less effective since the pandemic. In addition to expanding research on the most effective telemedicine practices for carceral settings, research exploring strategies to expand housing and employment support during reintegration are critical.
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Affiliation(s)
- Elizabeth C Saunders
- Center for Technology and Behavioral Health, Geisel School of Medicine at Dartmouth College, 46 Centerra Parkway, Suite 315, Lebanon, NH, 03766, USA.
| | - Milan F Satcher
- Department of Community and Family Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
| | | | - Ryan D McDonald
- New York University Grossman School of Medicine, New York, NY, USA
| | - Sandra A Springer
- Department of Internal Medicine, Section of Infectious Diseases, Yale School of Medicine, New Haven, CT, USA
| | - David Farabee
- New York University Grossman School of Medicine, New York, NY, USA
| | | | - Amesika Nyaku
- Division of Infectious Diseases, Rutgers New Jersey Medical School, New Brunswick, NJ, USA
| | - Donald Reeves
- Rutgers University Correctional Health Care, Rutgers-Robert Wood Johnson Medical School, Trenton, NJ, USA
| | - Lynn E Kunkel
- Oregon Health and Science University -Portland State University School of Public Health and Addiction Medicine Section, Division of General Internal Medicine & Geriatrics, Oregon Health and Science University, Portland, OR, USA
| | - Alysse M Schultheis
- Department of Internal Medicine, Section of Infectious Diseases, Yale School of Medicine, New Haven, CT, USA
| | | | - Joshua D Lee
- New York University Grossman School of Medicine, New York, NY, USA
| | - Lisa A Marsch
- Center for Technology and Behavioral Health, Geisel School of Medicine at Dartmouth College, 46 Centerra Parkway, Suite 315, Lebanon, NH, 03766, USA
| | - Elizabeth Needham Waddell
- Oregon Health and Science University -Portland State University School of Public Health and Addiction Medicine Section, Division of General Internal Medicine & Geriatrics, Oregon Health and Science University, Portland, OR, USA
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Motyka MA, Al-Imam A, Haligowska A, Michalak M. Helping Women Suffering from Drug Addiction: Needs, Barriers, and Challenges. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14039. [PMID: 36360917 PMCID: PMC9656705 DOI: 10.3390/ijerph192114039] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 10/19/2022] [Accepted: 10/25/2022] [Indexed: 06/16/2023]
Abstract
Statistical data on the use of various psychoactive substances indicate a narrowing of previous differences in substance use between men and women. Data from studies conducted among women suffering from drug addiction are increasingly published, with the authors highlighting the specific needs of this group and the difficulties that women with addiction problems encounter. The current study aimed to identify the barriers and needs of this audience, both when seeking help and during treatment. The method used in the study was secondary content analysis. To identify publications describing the barriers and needs of women suffering from drug addiction, we searched the PubMed database to find publications that met the adopted research objective. We set the data search period to the last ten years to examine the timeliness of the issue under study. The search yielded 199 research reports. Twenty-three articles describing 21 studies were included in the final analysis. The selected publications dealt with the difficulties and challenges faced by women with addiction problems. Barriers to accessing treatment for this group, the needs, and the challenges of helping women suffering from addiction were identified. Results showed that the barriers are mainly stigma but also deficits in the therapeutic offerings for this group. The primary need was identified as the introduction of appropriate drug policies, and the challenges, unfortunately, are the still-reported gender inequalities. To improve the situation of women, regular attention to these issues and the need to include them in national health strategies is essential.
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Affiliation(s)
- Marek A. Motyka
- Institute of Sociological Sciences, University of Rzeszow, 35-959 Rzeszów, Poland
| | - Ahmed Al-Imam
- Department of Computer Science and Statistics, Doctoral School, Poznan University of Medical Sciences, 61-806 Poznan, Poland
- Department of Anatomy and Cellular Biology, College of Medicine, University of Baghdad, Baghdad 10001, Iraq
- Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London E1 2AD, UK
| | | | - Michał Michalak
- Department of Computer Science and Statistics, Poznan University of Medical Sciences, Rokietnicka 7 St. (1st Floor), 61-806 Poznan, Poland
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Boeri M, Lamonica AK, Turner JM, Parker A, Murphy G, Boccone C. Barriers and Motivators to Opioid Treatment Among Suburban Women Who Are Pregnant and Mothers in Caregiver Roles. Front Psychol 2021; 12:688429. [PMID: 34276513 PMCID: PMC8280285 DOI: 10.3389/fpsyg.2021.688429] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 06/02/2021] [Indexed: 12/29/2022] Open
Abstract
Women of childbearing age who misuse opioids are a particularly vulnerable population, and their barriers to treatment are unique because of their caregiver roles. Research on treatment for opioid use generally draws from urban and rural areas. This study fills a gap in research that focuses on barriers and motivators to opioid treatment in suburban areas. The aim of this study was to give voice to suburban pregnant women and mothers caring for children while using opioids. Ethnographic methods were used for recruitment, and 58 in-depth interviews were analyzed using a modified grounded theory approach. Barriers to medication-assisted treatment (MAT) included stigma, staff attitudes, and perceptions the women had about MAT treatment. Barriers associated with all types of treatment included structural factors and access difficulties. Relationships with partners, friends, family, and providers could be barriers as well as motivators, depending on the social context of the women’s situation. Our findings suggest increasing treatment-seeking motivators for mothers and pregnant women by identifying lack of resources, more empathetic consideration of social environments, and implementing structural changes to overcome barriers. Findings provide a contemporary understanding of how suburban landscapes affect mothers’ treatment-seeking for opioid dependence and suggest the need for more focus on emotional and structural resources rather than strict surveillance of women with opioid dependence who are pregnant or caring for children.
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Affiliation(s)
- Miriam Boeri
- Department of Sociology, Bentley University, Waltham, MA, United States
| | - Aukje K Lamonica
- Department of Public Health, Southern Connecticut State University, New Haven, CT, United States
| | - Jeffrey M Turner
- Department of Public Health, Southern Connecticut State University, New Haven, CT, United States
| | - Amanda Parker
- Department of Sociology, Bentley University, Waltham, MA, United States
| | - Grace Murphy
- Department of Sociology, Bentley University, Waltham, MA, United States
| | - Carly Boccone
- Department of Sociology, Bentley University, Waltham, MA, United States
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Ivers JH, Harris A, McKeown P, Barry J. Mothers experiences of the Parenting Under Pressure Program (PuP) in a Residential Therapeutic Community: A qualitative study. J Psychoactive Drugs 2020; 53:230-237. [PMID: 33320076 DOI: 10.1080/02791072.2020.1856455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Several studies suggest parental substance use, while not always the case, exposes children to a higher risk of physical, psychological, behavioral and emotional problems. Identifying interventions that best support the parent and child needs is imperative. The PuP programme aims to improve family functioning and child outcomes by supporting parents who are or have been drug or alcohol dependent. PuP combines psychological principles relating to parenting, child behavior and parental emotion regulation within a case-management model. The current study was the first evaluation of the PuP program in a residential setting globally. Twenty-three women took part in pre and post-program qualitative interviews. Guilt was a dominant theme across interviews. The principal expectation of participants was to improve their relationships and access to their children. The benefits of the PuP program to the women and their children, as reported by participants, were immediate and direct. As the women progressed through the program, they were visibly building belief in their abilities to parent.
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Affiliation(s)
- Jo-Hanna Ivers
- Department of Public Health & Primary Care, Institute of Population Health, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | | | | | - Joe Barry
- Department of Public Health & Primary Care, Institute of Population Health, School of Medicine, Trinity College Dublin, Dublin, Ireland
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Expectations and Experiences of Women Imprisoned for Drug Offending and Returning to Communities in Thailand: Understanding Women’s Pathways Into, Through, and Post-Imprisonment. LAWS 2020. [DOI: 10.3390/laws9020015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Thailand places a high priority on the gender-specific contexts out of which offending arises and the differential needs of women in the criminal justice system. Despite this, Thailand has the highest female incarceration rate in South East Asia and there has been substantial growth since the 1990s. This increase has been driven by punitive changes in drug law, criminal justice policy/practice which have disproportionately impacted women. As female representation in Thailand’s prisons grows, so does the number of women who return to communities. Thus, one of the challenges facing Thai society is the efficacious re-integration of growing numbers of formally incarcerated women. However, what is known about re-entry comes almost exclusively from studies of prisoners (usually men) returning home in western societies. Re-integration does not occur in a vacuum. Supporting women post-release necessitates knowledge of their pathways to, experiences of, and journeys out of prison. Utilising in-depth interviews with (n = 80) imprisoned/formally incarcerated women and focus groups with (n = 16) correctional staff, this paper reports findings from the first comprehensive study of women’s re-integration expectations and experiences in Thailand. Findings showed that women had multifaceted and intersectional needs which directed their pathways into, during, and out of prison.
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Ates N, Unubol B, Bestepe EE, Bilici R. The effect of perceived social support on quality of life in Turkish men with alcohol, opiate and cannabis use disorder. J Ethn Subst Abuse 2019; 22:316-336. [PMID: 31686619 DOI: 10.1080/15332640.2019.1685051] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE The purpose of this study was to investigate the effect of perceived social support on the quality of life of male patients with alcohol, opiate and synthetic cannabinoid use disorders by considering sociodemographic factors and mood, and to compare these three groups in terms of social support and quality of life. METHOD One hundred and thirtyone (131) patients who were hospitalized at Addiction Clinic of Istanbul Erenkoy Psychiatric and Neurological Diseases Training and Research Hospital in Turkey and diagnosed as alcohol, opiate and synthetic cannabinoid use disorder were included in the study. Sociodemographic Data Form, Turkish version of the World Health Organization Quality of Life Questionnaire Scale (WHOQOL-BREF-TR), Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), Multidimensional Scale of Perceived Social Support (MSPSS), API (Addiction Profile Index) were applied to the participants. RESULTS A total of 131 male patients were 32 synthetic cannabinoids, 51 opiates and 48 alcohol use disorders diagnosed. The mean age of alcohol users was higher than the other groups. Separation/divorce rate was higher in alcohol users and single rate in opiate users. Alcohol use was higher in living alone and opiate users lived with first degree relatives. The crime history was higher in the cannabis group. Prison experience, probation and self-injury were higher among opiate users. Family history of substance use was higher in opiate users. Crime was found to be less in alcohol users. In the comparison of alcohol and substance (opiate, cannabis) groups, the rate of self-injury (93.8%) was found to be significantly higher in the substance user' group. There was no statistically significant difference between the groups in terms of depression and anxiety scores. When the alcohol and substance (opiate, cannabis) comparisons were made between the groups, the mean depression (21.02 ± 11.6) and anxiety (20.09 ± 17.49) of the alcohol group was significantly higher. The "effect on life" (31.8 ± 6.13) and "motivation" subscales (10.38 ± 2.39) of API was found to be significantly higher in patients with substance use. In the opioid group, physical, environmental and psychological subscales of the WHOQOL-BREF-TR did not show significant correlation with MSPSS, and the family, friend' subscales and total perceived social support were significantly correlated with the social subscale of WHOQOL-BREF-TR. In the alcohol group, the environmental and social subscales of WHOQOL-BREF-TR showed a significant correlation with perceived social support from the family and private person and total perceived support. CONCLUSION Addiction is a recurrent and chronic disease and inevitably reduces quality of life. Social support has an important role on the quality of life. Improving the quality of life seems to be one of the main goals during the addiction treatment. For this purpose, it is very important to provide psychosocial support with pharmacological treatment by evaluating the medical, mental and social needs of the dependent patient as a whole.
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Affiliation(s)
- Nazli Ates
- Darica Farabi Training and Research Hospital, Kocaeli, Turkey
| | - Basak Unubol
- Erenkoy Mental Health and Neurological Diseases Training and Research Hospital, Istanbul, Turkey
| | - Engin Emrem Bestepe
- Erenkoy Mental Health and Neurological Diseases Training and Research Hospital, Istanbul, Turkey
| | - Rabia Bilici
- Erenkoy Mental Health and Neurological Diseases Training and Research Hospital, Istanbul, Turkey
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Larance B, Gisev N, Cama E, Nelson EC, Darke S, Larney S, Degenhardt L. Predictors of transitions across stages of heroin use and dependence prior to treatment-seeking among people in treatment for opioid dependence. Drug Alcohol Depend 2018; 191:145-151. [PMID: 30107320 PMCID: PMC6698181 DOI: 10.1016/j.drugalcdep.2018.03.056] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 03/30/2018] [Accepted: 03/31/2018] [Indexed: 01/16/2023]
Abstract
BACKGROUND AND AIMS Little is known about transition pathways among heroin users prior to treatment. This study examined the demographic and clinical predictors of transition speed from heroin use, to dependence, to first treatment episode. METHODS 1149 heroin-dependent participants recruited from opioid agonist treatment clinics in Sydney, Australia, underwent a structured interview. Age of onset (AOO) was collected for heroin use, dependence and treatment-seeking, childhood maltreatment, psychiatric history and other substance dependence. Discrete-time survival analyses modelled years from onset of use to dependence, and from dependence to treatment-seeking, including demographic and clinical covariates. FINDINGS Median AOO for first heroin use, dependence and treatment-seeking was 18 years (inter-quartile range, or IQR = 6), 21 years (IQR = 7), and 24 years (IQR = 10) respectively. In adjusted models, younger birth cohorts (vs. born <1960), greater childhood maltreatment and later AAO of first heroin use were associated with more rapid transitions from heroin use to dependence. Living independently, parental violence, and alcohol dependence were associated with slower transitions. Earlier treatment-seeking was associated with younger birth cohorts, having dependent children and later AOO of dependence. Delayed treatment-seeking was associated with <10 years school education, living independently, depression and alcohol dependence. CONCLUSIONS In this treatment sample, onset of heroin use occurred during late adolescence, suggesting the need for targeted interventions in mid-adolescence. Transitions to heroin dependence, then treatment-seeking, occurred during early adulthood. Rapid transitions from use to dependence were associated with younger birth cohorts, greater exposure to childhood maltreatment, and later onset of use.
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Affiliation(s)
- Briony Larance
- National Drug and Alcohol Research Centre, University of New South Wales, 22-32 King Street Randwick, Sydney, NSW, 2052, Australia.
| | - Natasa Gisev
- National Drug and Alcohol Research Centre, University of New South Wales, 22-32 King Street Randwick, Sydney, NSW, 2052, Australia
| | - Elena Cama
- National Drug and Alcohol Research Centre, University of New South Wales, 22-32 King Street Randwick, Sydney, NSW, 2052, Australia
| | - Elliot C Nelson
- Washington University, School of Medicine, Department of Psychiatry, 660 South Euclid Avenue, Campus Box 8134, St. Louis, MO, 63110, USA
| | - Shane Darke
- National Drug and Alcohol Research Centre, University of New South Wales, 22-32 King Street Randwick, Sydney, NSW, 2052, Australia
| | - Sarah Larney
- National Drug and Alcohol Research Centre, University of New South Wales, 22-32 King Street Randwick, Sydney, NSW, 2052, Australia
| | - Louisa Degenhardt
- National Drug and Alcohol Research Centre, University of New South Wales, 22-32 King Street Randwick, Sydney, NSW, 2052, Australia
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He AS, Traube DE, Young NK. Perceptions of parental substance use disorders in cross-system collaboration among child welfare, alcohol and other drugs, and dependency court organizations. CHILD ABUSE & NEGLECT 2014; 38:939-51. [PMID: 24268380 DOI: 10.1016/j.chiabu.2013.10.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2013] [Revised: 10/23/2013] [Accepted: 10/27/2013] [Indexed: 05/21/2023]
Abstract
Cross-system collaboration among child welfare (CW), alcohol and other drugs (AOD), and court organizations shows promise in addressing the many needs of CW-involved families experiencing parental substance use disorders (SUDs). Research has suggested that differing perceptions of parents with SUDs among staff in these organizations may hinder the collaborative process. Using a sequential explanatory mixed-method approach, this study explored staff perceptions of parental SUDs among CW, AOD, and court organizations. Logistic regression analyses indicated that, compared to CW respondents, AOD respondents were: (a) less likely to believe that parents could provide effective parenting; (b) more likely to believe that abstinence should be a criterion for reunification; (c) more likely to agree that parents should receive jail time as a consequence for noncompliance with court orders; and (d) more likely to believe that parents could succeed in treatment. Thematic analyses of these focal areas identified two core themes (focus on the primary client and mandated time frames for permanency), as well as multiple subthemes, that provided a nuanced understanding of differing perceptions on these matters. Suggestions for the development of anticipatory cross-system training and practices and implications for policy evaluation are discussed.
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Affiliation(s)
- Amy S He
- School of Social Work, University of Southern California, Los Angeles, CA 90089, USA
| | - Dorian E Traube
- School of Social Work, University of Southern California, Los Angeles, CA 90089, USA
| | - Nancy K Young
- Children and Family Futures, Lake Forest, CA 92630, USA
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Beitel M, Savant JD, Cutter CJ, Peters S, Belisle N, Barry DT. Psychopathology and pain correlates of dispositional optimism in methadone-maintained patients. Am J Addict 2013; 21 Suppl 1:S56-62. [PMID: 23786512 DOI: 10.1111/j.1521-0391.2012.00293.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Although higher levels of dispositional optimism are associated with decreased levels of psychopathology and pain, and higher levels of mental health functioning-important outcomes in opioid treatment programs-a paucity of studies has examined dispositional optimism among individuals with opioid use disorders. The aim of this study was to examine the clinical correlates (i.e., psychopathology, pain status) of dispositional optimism in opioid dependent patients enrolled in methadone maintenance treatment (MMT). METHODS A survey targeting demographics, pain, psychopathology, and dispositional optimism was administered to 150 MMT patients. RESULTS In multivariable analyses, higher levels of dispositional optimism were significantly associated with lower levels of: depression, screened personality disorder criteria, screened symptoms of posttraumatic stress disorder, and pain-related emotional strain. In comparison to those without a history of chronic pain (ie, noncancer related physical pain lasting at least 3 months), MMT patients who reported either lifetime or current chronic pain exhibited significantly lower levels of dispositional optimism. CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE The associations among higher levels of dispositional optimism, lower levels of psychopathology, and lower pain-related emotional strain suggest that research focusing on the efficacy of specific interventions to promote dispositional optimism in MMT patients is warranted.
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Affiliation(s)
- Mark Beitel
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06519, USA
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Duffy P, Baldwin H. Recovery post treatment: plans, barriers and motivators. SUBSTANCE ABUSE TREATMENT PREVENTION AND POLICY 2013; 8:6. [PMID: 23363550 PMCID: PMC3573929 DOI: 10.1186/1747-597x-8-6] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/09/2012] [Accepted: 01/16/2013] [Indexed: 11/17/2022]
Abstract
Background The increasing focus on achieving a sustained recovery from substance use brings with it a need to better understand the factors (recovery capital) that contribute to recovery following treatment. This work examined the factors those in recovery perceive to be barriers to (lack of capital) or facilitators of (presence of capital) sustained recovery post treatment. Methods A purposive sample of 45 participants was recruited from 11 drug treatment services in northern England. Semi-structured qualitative interviews lasting between 30 and 90 minutes were conducted one to three months after participants completed treatment. Interviews examined key themes identified through previous literature but focused on allowing participants to explore their unique recovery journey. Interviews were transcribed and analysed thematically using a combination of deductive and inductive approaches. Results Participants generally reported high levels of confidence in maintaining their recovery with most planning to remain abstinent. There were indications of high levels of recovery capital. Aftercare engagement was high, often through self referral, with non substance use related activity felt to be particularly positive. Supported housing was critical and concerns were raised about the ability to afford to live independently with financial stability and welfare availability a key concern in general. Employment, often in the substance use treatment field, was a desire. However, it was a long term goal, with substantial risks associated with pursuing this too early. Positive social support was almost exclusively from within the recovery community although the re-building of relationships with family (children in particular) was a key motivator post treatment. Conclusions Addressing internal factors and underlying issues i.e. ‘human capital’, provided confidence for continued recovery whilst motivators focused on external factors such as family and maintaining aspects of a ‘normal’ life i.e. ‘social and physical capital’. Competing recovery goals and activities can leave people feeling under pressure and at risk of taking on or being pushed to do too much too soon. The breadth of re-integration and future plans at this stage is limited primarily to the recovery community and treatment sector. Services and commissioners should ensure that this does not become a limiting factor in individuals’ long term recovery journeys.
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Affiliation(s)
- Paul Duffy
- Criminal Justice Manager, Centre for Public Health, Liverpool John Moores University, 2nd Floor, Henry Cotton Campus, 15-21 Webster Street, Liverpool, L3 2ET, UK.
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Nyamathi AM, Nandy K, Greengold B, Marfisee M, Khalilifard F, Cohen A, Leake B. Effectiveness of intervention on improvement of drug use among methadone maintained adults. J Addict Dis 2011; 30:6-16. [PMID: 21218306 DOI: 10.1080/10550887.2010.531669] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The purpose of this study is to evaluate the effectiveness of three interventions (individual motivational interviewing, group motivational interviewing, or nurse-led hepatitis health promotion) in reducing drug use. A randomized, controlled trial was conducted with 256 methadone maintained moderate-to-heavy alcohol-using adults attending one of five MM outpatient clinics. Drug use in the overall sample was significantly reduced from baseline to 6-month follow-up, as assessed by a 30-day recall (p < 0.0001), with a trend apparent for 6-month recall (p = 0.09). The group and individual programs revealed significant decreases in drug use at the 30-day recall.
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Affiliation(s)
- Adeline M Nyamathi
- University of California, Los Angeles, School of Nursing, Room 2-250, Factor Building, Box 951720, Los Angeles, CA 90095-1702, USA.
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Friendship networks of inner-city adults: a latent class analysis and multi-level regression of supporter types and the association of supporter latent class membership with supporter and recipient drug use. Drug Alcohol Depend 2010; 107:134-40. [PMID: 19939586 PMCID: PMC2822006 DOI: 10.1016/j.drugalcdep.2009.09.012] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2009] [Revised: 09/03/2009] [Accepted: 09/27/2009] [Indexed: 11/24/2022]
Abstract
BACKGROUND Social support is a multi-dimensional construct that is important to drug use cessation. The present study identified types of supportive friends among the social network members in a community-based sample and examined the relationship of supporter-type classes with supporter, recipient, and supporter-recipient relationship characteristics. We hypothesized that the most supportive network members and their support recipients would be less likely to be current heroin/cocaine users. METHODS Participants (n=1453) were recruited from low-income neighborhoods with a high prevalence of drug use. Participants identified their friends via a network inventory, and all nominated friends were included in a latent class analysis and grouped based on their probability of providing seven types of support. These latent classes were included as the dependent variable in a multi-level regression of supporter drug use, recipient drug use, and other characteristics. RESULTS The best-fitting latent class model identified five support patterns: friends who provided Little/No Support, Low/Moderate Support, High Support, Socialization Support, and Financial Support. In bivariate models, friends in the High, Low/Moderate, and Financial Support were less likely to use heroin or cocaine and had less conflict with and were more trusted by the support recipient than friends in the Low/No Support class. Individuals with supporters in those same support classes compared to the Low/No Support class were less likely to use heroin or cocaine, or to be homeless or female. Multivariable models suggested similar trends. CONCLUSIONS Those with current heroin/cocaine use were less likely to provide or receive comprehensive support from friends.
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Abstract
Drug addiction is a serious issue in today's society. Women are giving birth to infants who are born addicted to illicit drugs, and these mothers are not able to care for their infants safely and competently without training and support. This article examines the prevalence of the problem. It also discusses the possible impact of parenting skills classes, as part of recovery efforts, for women seeking recovery who have recently given birth. Several programs already in place in the U.S have shown positive results for these mothers and their infants. Infants exposed in utero to illicit drugs need to be given all of the resources society can provide in an effort to stop the intergenerational cycle of drug addiction.
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Affiliation(s)
- Brenda Blunt
- Neonatal Intensive Care Unit, 4940 Eastern Avenue, Baltimore, MD 21224, USA.
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