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Patel EU, Grieb SM, Winiker AK, Ching J, Schluth CG, Mehta SH, Kirk GD, Genberg BL. Structural and social changes due to the COVID-19 pandemic and their impact on engagement in substance use disorder treatment services: a qualitative study among people with a recent history of injection drug use in Baltimore, Maryland. Harm Reduct J 2024; 21:91. [PMID: 38720307 PMCID: PMC11077846 DOI: 10.1186/s12954-024-01008-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 04/22/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Substance use disorder treatment and recovery support services are critical for achieving and maintaining recovery. There are limited data on how structural and social changes due to the COVID-19 pandemic impacted individual-level experiences with substance use disorder treatment-related services among community-based samples of people who inject drugs. METHODS People with a recent history of injection drug use who were enrolled in the community-based AIDS Linked to the IntraVenous Experience study in Baltimore, Maryland participated in a one-time, semi-structured interview between July 2021 and February 2022 about their experiences living through the COVID-19 pandemic (n = 28). An iterative inductive coding process was used to identify themes describing how structural and social changes due to the COVID-19 pandemic affected participants' experiences with substance use disorder treatment-related services. RESULTS The median age of participants was 54 years (range = 24-73); 10 (36%) participants were female, 16 (57%) were non-Hispanic Black, and 8 (29%) were living with HIV. We identified several structural and social changes due the pandemic that acted as barriers and facilitators to individual-level engagement in treatment with medications for opioid use disorder (MOUD) and recovery support services (e.g., support group meetings). New take-home methadone flexibility policies temporarily facilitated engagement in MOUD treatment, but other pre-existing rigid policies and practices (e.g., zero-tolerance) were counteracting barriers. Changes in the illicit drug market were both a facilitator and barrier to MOUD treatment. Decreased availability and pandemic-related adaptations to in-person services were a barrier to recovery support services. While telehealth expansion facilitated engagement in recovery support group meetings for some participants, other participants faced digital and technological barriers. These changes in service provision also led to diminished perceived quality of both virtual and in-person recovery support group meetings. However, a facilitator of recovery support was increased accessibility of individual service providers (e.g., counselors and Sponsors). CONCLUSIONS Structural and social changes across several socioecological levels created new barriers and facilitators of individual-level engagement in substance use disorder treatment-related services. Multilevel interventions are needed to improve access to and engagement in high-quality substance use disorder treatment and recovery support services among people who inject drugs.
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Affiliation(s)
- Eshan U Patel
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA.
| | - Suzanne M Grieb
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Abigail K Winiker
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jennifer Ching
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA
| | - Catherine G Schluth
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA
| | - Shruti H Mehta
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA
| | - Gregory D Kirk
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Becky L Genberg
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA
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Setiawan A, Sahar J, Santoso B, Mansyur M, Syamsir SB. Coping Mechanisms Utilized by Individuals With Drug Addiction in Overcoming Challenges During the Recovery Process: A Qualitative Meta-synthesis. J Prev Med Public Health 2024; 57:197-211. [PMID: 38726579 PMCID: PMC11164602 DOI: 10.3961/jpmph.24.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 03/17/2024] [Accepted: 03/23/2024] [Indexed: 06/12/2024] Open
Abstract
OBJECTIVES Recovery from drug addiction often poses challenges for the recovering person. The coping mechanisms employed by these individuals to resist temptations and manage stress play a key role in the healing process. This study was conducted to explore the coping strategies or techniques that individuals with addiction use to handle stress and temptation while undergoing treatment. METHODS A qualitative meta-synthesis approach was utilized to critically evaluate relevant qualitative research. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines were used for article selection, with these standards applied to 4 academic databases: Scopus, PubMed, ProQuest, and CINAHL. The present review included studies published between 2014 and 2023, selected based on pre-established inclusion criteria. The quality of the studies was assessed using the Critical Appraisal Skills Programme Qualitative Studies Checklist. This review was registered with the International Prospective Register of Systematic Reviews (PROSPERO) under the registration number CRD42024497789. RESULTS The analysis of 13 qualifying qualitative articles revealed 5 major themes illustrating the coping mechanisms employed in the pursuit of recovery by individuals who use drugs. These themes include seeking social support, as well as psychological coping strategies, spiritual experiences, professional interventions, and the enhancement of awareness. CONCLUSIONS Among individuals with drug addiction, coping mechanisms are crucial for resisting stress and temptations throughout the recovery process. Healthcare professionals, as medical specialists, can establish more thorough and effective plans to support these patients on their path to recovery.
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Affiliation(s)
- Agus Setiawan
- Faculty of Nursing, Universitas Indonesia, Depok, Indonesia
| | - Junaiti Sahar
- Faculty of Nursing, Universitas Indonesia, Depok, Indonesia
| | - Budi Santoso
- Faculty of Nursing, Universitas Indonesia, Depok, Indonesia
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Wah TH, Ong AJX, Naidu KNC, Hanafi S, Tan K, Tan A, Ong TJJ, Ong E, Ho DWS, Subramaniam M, See MY, Tan RKJ. Navigating drug use, cessation, and recovery: a retrospective case notes review among sexual minority men at a community-based service in Singapore. Subst Abuse Treat Prev Policy 2024; 19:23. [PMID: 38627809 PMCID: PMC11020317 DOI: 10.1186/s13011-024-00605-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 03/29/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND In Singapore, where drug use is a highly stigmatized and criminalized issue, there is limited understanding of the challenges faced by individuals, particularly sexual minority men, in their journey towards recovery from substance dependence or addiction. This qualitative study aimed to investigate the driving forces behind drug use, the factors contributing to drug cessation, and the elements influencing the recovery process. METHODS Data were extracted from clinical records provided by The Greenhouse Community Services Limited between January 2020 to May 2022. These records encompassed information from four distinct forms: the intake assessment, progress notes, case closing summary, and the care plan review. Thematic analysis was employed to identify and categorize recurring themes within the data. RESULTS Data from beneficiaries (n = 125) were analyzed and yielded a series of themes related to facilitators of drug use, motivations to cease drug use, and managing one's ongoing recovery. Within the facilitators of drug use, two sub-themes were identified: (a) addressing trauma and triggers and (b) managing emotions. Additionally, managing one's recovery was marked by four significant sub-themes: (a) uncovering personal identities, (b) losing motivation and drive, (c) overcoming obstacles, and (d) preparing for aftercare. CONCLUSIONS The study contributes valuable insights into the dynamics of ongoing recovery management, offering potential avenues for interventions that could enhance support for individuals in their journey to overcome substance dependence. Enhancing psychoeducation and fostering peer support have the potential to facilitate the recovery process. Clearly, a holistic approach is needed to address these complex issues that cuts across our societies.
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Affiliation(s)
- Tzy Hyi Wah
- The Greenhouse Community Services Limited, Singapore, Singapore
| | | | - Kuhanesan N C Naidu
- The Greenhouse Community Services Limited, Singapore, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, 12 Science Drive 2, MD1 Tahir Foundation Building #10-01, Singapore, Singapore
- Department of Psychological Medicine, National University Health System, Singapore, Singapore
| | - Syaza Hanafi
- The Greenhouse Community Services Limited, Singapore, Singapore
| | - Kelvin Tan
- The Greenhouse Community Services Limited, Singapore, Singapore
| | - Alaric Tan
- The Greenhouse Community Services Limited, Singapore, Singapore
| | | | - Eleanor Ong
- The Greenhouse Community Services Limited, Singapore, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, 12 Science Drive 2, MD1 Tahir Foundation Building #10-01, Singapore, Singapore
| | | | - Mythily Subramaniam
- The Greenhouse Community Services Limited, Singapore, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, 12 Science Drive 2, MD1 Tahir Foundation Building #10-01, Singapore, Singapore
- Research Division, Institute of Mental Health, Singapore, Singapore
| | | | - Rayner Kay Jin Tan
- The Greenhouse Community Services Limited, Singapore, Singapore.
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, 12 Science Drive 2, MD1 Tahir Foundation Building #10-01, Singapore, Singapore.
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Wood E, Bright J, Hsu K, Goel N, Ross JWG, Hanson A, Teed R, Poulin G, Denning B, Corace K, Chase C, Halpape K, Lim R, Kealey T, Rehm J. Ligne directrice canadienne pour la prise en charge clinique de la consommation d’alcool à risque élevé et du trouble d’utilisation de l’alcool. CMAJ 2024; 196:E303-E321. [PMID: 38467412 PMCID: PMC10927286 DOI: 10.1503/cmaj.230715-f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/13/2024] Open
Abstract
Contexte: Au Canada, on note que les équipes soignantes et les personnes qui bénéficieraient de soins ciblés connaissent peu les interventions fondées sur des données probantes pour la prise en charge clinique du trouble d’utilisation de l’alcool. Pour combler cette lacune, l’Initiative canadienne de recherche sur l’abus de substances a créé un comité national dans le but d’élaborer une ligne directrice pour la prise en charge clinique de la consommation d’alcool à risque élevé et du trouble lié à la consommation d’alcool. Méthodes: L’élaboration de cette ligne directrice s’est faite selon le processus ADAPTE, et est inspirée par une ligne directrice britanno-colombienne de 2019 pour le trouble lié à la consommation d’alcool. Un comité national de rédaction de la ligne directrice (composé de 36 membres de divers horizons, notamment des universitaires, des médecins, des personnes ayant ou ayant eu des expériences de consommation d’alcool et des personnes s’identifiant comme Autochtones ou Métis) a choisi les thèmes prioritaires, a passé en revue les données probantes et atteint un consensus relatif aux recommandations. Nous avons utilisé l’outil AGREE II (Appraisal of Guidelines for Research and Evaluation Instrument II) et les principes de divulgation des intérêts et de gestion des conflits lors du processus de rédaction des lignes directrices (Principles for Disclosure of Interests and Management of Conflicts in Guidelines) publiés en anglais par le Réseau international des lignes directrices (Guidelines International Network) pour nous assurer que la ligne directrice répondait aux normes internationales de transparence, de qualité élevée et de rigueur méthodologique. Nous avons évalué les recommandations finales à l’aide de l’approche GRADE (Grading of Recommendations Assessment, Development, and Evaluation). Les recommandations ont fait l’objet d’une revue externe par 13 spécialistes et parties prenantes d’ici et de l’étranger. Recommandations: La ligne directrice comprend 15 recommandations qui concernent le dépistage, le diagnostic, la prise en charge du sevrage et le traitement continu, y compris les interventions psychosociales, les pharmacothérapies et les programmes communautaires. Le comité de rédaction de la ligne directrice a reconnu la nécessité d’insister sur la sous-utilisation des interventions qui pourraient être bénéfiques et sur les modes de prescription et autres pratiques d’usage courant qui ne reposent pas sur des données probantes et pourraient aggraver les effets de la consommation d’alcool. Interprétation: La ligne directrice se veut une ressource à l’intention des médecins, des responsables des orientations politiques et des membres des équipes cliniques et autres, de même que des personnes, des familles et des communautés affectées par la consommation d’alcool. Ces recommandations proposent un cadre fondé sur des données probantes pour alléger le lourd fardeau du trouble d’utilisation de l’alcool au Canada et combler les besoins en matière de traitements et de soins.
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Affiliation(s)
- Evan Wood
- Département de médecine (Wood), Université de la Colombie-Britannique; Centre sur la toxicomanie de la Colombie-Britannique (Wood, Bright, Hsu, Goel, Ross, Hanson, Chase), Vancouver, C.-B.; Programme sur les classes de médicaments (Teed), Craven, Sask.; Département de psychiatrie (Poulin), Université du Manitoba; Centre Waypoint de santé mentale (Poulin), Winnipeg, Man.; Programme de lutte contre la consommation problématique de substances toxiques, ministère de la Santé et des Services sociaux, Gouvernement des Territoires du Nord-Ouest (Denning), Yellowknife, T.N.-O.; Centre de santé mentale Royal Ottawa (Corace); Département de psychiatrie (Corace), Université d'Ottawa, Ottawa, Ont.; Régie de la santé des Premières Nations (Chase), Vancouver, C.-B.; École de pharmacie et de nutrition (Halpape), Université de la Saskatchewan, Saskatoon, Sask.; Université de Calgary (Lim), Calgary, Alb.; Société d'assurance Knight Archer (Kealey), Regina, Sask.; Institut de recherche sur les politiques en santé mentale (Rehm), Centre de toxicomanies et de santé mentale; École Dalla Lana de santé publique (Rehm), Université de Toronto, Toronto, Ont.
| | - Jessica Bright
- Département de médecine (Wood), Université de la Colombie-Britannique; Centre sur la toxicomanie de la Colombie-Britannique (Wood, Bright, Hsu, Goel, Ross, Hanson, Chase), Vancouver, C.-B.; Programme sur les classes de médicaments (Teed), Craven, Sask.; Département de psychiatrie (Poulin), Université du Manitoba; Centre Waypoint de santé mentale (Poulin), Winnipeg, Man.; Programme de lutte contre la consommation problématique de substances toxiques, ministère de la Santé et des Services sociaux, Gouvernement des Territoires du Nord-Ouest (Denning), Yellowknife, T.N.-O.; Centre de santé mentale Royal Ottawa (Corace); Département de psychiatrie (Corace), Université d'Ottawa, Ottawa, Ont.; Régie de la santé des Premières Nations (Chase), Vancouver, C.-B.; École de pharmacie et de nutrition (Halpape), Université de la Saskatchewan, Saskatoon, Sask.; Université de Calgary (Lim), Calgary, Alb.; Société d'assurance Knight Archer (Kealey), Regina, Sask.; Institut de recherche sur les politiques en santé mentale (Rehm), Centre de toxicomanies et de santé mentale; École Dalla Lana de santé publique (Rehm), Université de Toronto, Toronto, Ont
| | - Katrina Hsu
- Département de médecine (Wood), Université de la Colombie-Britannique; Centre sur la toxicomanie de la Colombie-Britannique (Wood, Bright, Hsu, Goel, Ross, Hanson, Chase), Vancouver, C.-B.; Programme sur les classes de médicaments (Teed), Craven, Sask.; Département de psychiatrie (Poulin), Université du Manitoba; Centre Waypoint de santé mentale (Poulin), Winnipeg, Man.; Programme de lutte contre la consommation problématique de substances toxiques, ministère de la Santé et des Services sociaux, Gouvernement des Territoires du Nord-Ouest (Denning), Yellowknife, T.N.-O.; Centre de santé mentale Royal Ottawa (Corace); Département de psychiatrie (Corace), Université d'Ottawa, Ottawa, Ont.; Régie de la santé des Premières Nations (Chase), Vancouver, C.-B.; École de pharmacie et de nutrition (Halpape), Université de la Saskatchewan, Saskatoon, Sask.; Université de Calgary (Lim), Calgary, Alb.; Société d'assurance Knight Archer (Kealey), Regina, Sask.; Institut de recherche sur les politiques en santé mentale (Rehm), Centre de toxicomanies et de santé mentale; École Dalla Lana de santé publique (Rehm), Université de Toronto, Toronto, Ont
| | - Nirupa Goel
- Département de médecine (Wood), Université de la Colombie-Britannique; Centre sur la toxicomanie de la Colombie-Britannique (Wood, Bright, Hsu, Goel, Ross, Hanson, Chase), Vancouver, C.-B.; Programme sur les classes de médicaments (Teed), Craven, Sask.; Département de psychiatrie (Poulin), Université du Manitoba; Centre Waypoint de santé mentale (Poulin), Winnipeg, Man.; Programme de lutte contre la consommation problématique de substances toxiques, ministère de la Santé et des Services sociaux, Gouvernement des Territoires du Nord-Ouest (Denning), Yellowknife, T.N.-O.; Centre de santé mentale Royal Ottawa (Corace); Département de psychiatrie (Corace), Université d'Ottawa, Ottawa, Ont.; Régie de la santé des Premières Nations (Chase), Vancouver, C.-B.; École de pharmacie et de nutrition (Halpape), Université de la Saskatchewan, Saskatoon, Sask.; Université de Calgary (Lim), Calgary, Alb.; Société d'assurance Knight Archer (Kealey), Regina, Sask.; Institut de recherche sur les politiques en santé mentale (Rehm), Centre de toxicomanies et de santé mentale; École Dalla Lana de santé publique (Rehm), Université de Toronto, Toronto, Ont
| | - Josey W G Ross
- Département de médecine (Wood), Université de la Colombie-Britannique; Centre sur la toxicomanie de la Colombie-Britannique (Wood, Bright, Hsu, Goel, Ross, Hanson, Chase), Vancouver, C.-B.; Programme sur les classes de médicaments (Teed), Craven, Sask.; Département de psychiatrie (Poulin), Université du Manitoba; Centre Waypoint de santé mentale (Poulin), Winnipeg, Man.; Programme de lutte contre la consommation problématique de substances toxiques, ministère de la Santé et des Services sociaux, Gouvernement des Territoires du Nord-Ouest (Denning), Yellowknife, T.N.-O.; Centre de santé mentale Royal Ottawa (Corace); Département de psychiatrie (Corace), Université d'Ottawa, Ottawa, Ont.; Régie de la santé des Premières Nations (Chase), Vancouver, C.-B.; École de pharmacie et de nutrition (Halpape), Université de la Saskatchewan, Saskatoon, Sask.; Université de Calgary (Lim), Calgary, Alb.; Société d'assurance Knight Archer (Kealey), Regina, Sask.; Institut de recherche sur les politiques en santé mentale (Rehm), Centre de toxicomanies et de santé mentale; École Dalla Lana de santé publique (Rehm), Université de Toronto, Toronto, Ont
| | - Averill Hanson
- Département de médecine (Wood), Université de la Colombie-Britannique; Centre sur la toxicomanie de la Colombie-Britannique (Wood, Bright, Hsu, Goel, Ross, Hanson, Chase), Vancouver, C.-B.; Programme sur les classes de médicaments (Teed), Craven, Sask.; Département de psychiatrie (Poulin), Université du Manitoba; Centre Waypoint de santé mentale (Poulin), Winnipeg, Man.; Programme de lutte contre la consommation problématique de substances toxiques, ministère de la Santé et des Services sociaux, Gouvernement des Territoires du Nord-Ouest (Denning), Yellowknife, T.N.-O.; Centre de santé mentale Royal Ottawa (Corace); Département de psychiatrie (Corace), Université d'Ottawa, Ottawa, Ont.; Régie de la santé des Premières Nations (Chase), Vancouver, C.-B.; École de pharmacie et de nutrition (Halpape), Université de la Saskatchewan, Saskatoon, Sask.; Université de Calgary (Lim), Calgary, Alb.; Société d'assurance Knight Archer (Kealey), Regina, Sask.; Institut de recherche sur les politiques en santé mentale (Rehm), Centre de toxicomanies et de santé mentale; École Dalla Lana de santé publique (Rehm), Université de Toronto, Toronto, Ont
| | - Rand Teed
- Département de médecine (Wood), Université de la Colombie-Britannique; Centre sur la toxicomanie de la Colombie-Britannique (Wood, Bright, Hsu, Goel, Ross, Hanson, Chase), Vancouver, C.-B.; Programme sur les classes de médicaments (Teed), Craven, Sask.; Département de psychiatrie (Poulin), Université du Manitoba; Centre Waypoint de santé mentale (Poulin), Winnipeg, Man.; Programme de lutte contre la consommation problématique de substances toxiques, ministère de la Santé et des Services sociaux, Gouvernement des Territoires du Nord-Ouest (Denning), Yellowknife, T.N.-O.; Centre de santé mentale Royal Ottawa (Corace); Département de psychiatrie (Corace), Université d'Ottawa, Ottawa, Ont.; Régie de la santé des Premières Nations (Chase), Vancouver, C.-B.; École de pharmacie et de nutrition (Halpape), Université de la Saskatchewan, Saskatoon, Sask.; Université de Calgary (Lim), Calgary, Alb.; Société d'assurance Knight Archer (Kealey), Regina, Sask.; Institut de recherche sur les politiques en santé mentale (Rehm), Centre de toxicomanies et de santé mentale; École Dalla Lana de santé publique (Rehm), Université de Toronto, Toronto, Ont
| | - Ginette Poulin
- Département de médecine (Wood), Université de la Colombie-Britannique; Centre sur la toxicomanie de la Colombie-Britannique (Wood, Bright, Hsu, Goel, Ross, Hanson, Chase), Vancouver, C.-B.; Programme sur les classes de médicaments (Teed), Craven, Sask.; Département de psychiatrie (Poulin), Université du Manitoba; Centre Waypoint de santé mentale (Poulin), Winnipeg, Man.; Programme de lutte contre la consommation problématique de substances toxiques, ministère de la Santé et des Services sociaux, Gouvernement des Territoires du Nord-Ouest (Denning), Yellowknife, T.N.-O.; Centre de santé mentale Royal Ottawa (Corace); Département de psychiatrie (Corace), Université d'Ottawa, Ottawa, Ont.; Régie de la santé des Premières Nations (Chase), Vancouver, C.-B.; École de pharmacie et de nutrition (Halpape), Université de la Saskatchewan, Saskatoon, Sask.; Université de Calgary (Lim), Calgary, Alb.; Société d'assurance Knight Archer (Kealey), Regina, Sask.; Institut de recherche sur les politiques en santé mentale (Rehm), Centre de toxicomanies et de santé mentale; École Dalla Lana de santé publique (Rehm), Université de Toronto, Toronto, Ont
| | - Bryany Denning
- Département de médecine (Wood), Université de la Colombie-Britannique; Centre sur la toxicomanie de la Colombie-Britannique (Wood, Bright, Hsu, Goel, Ross, Hanson, Chase), Vancouver, C.-B.; Programme sur les classes de médicaments (Teed), Craven, Sask.; Département de psychiatrie (Poulin), Université du Manitoba; Centre Waypoint de santé mentale (Poulin), Winnipeg, Man.; Programme de lutte contre la consommation problématique de substances toxiques, ministère de la Santé et des Services sociaux, Gouvernement des Territoires du Nord-Ouest (Denning), Yellowknife, T.N.-O.; Centre de santé mentale Royal Ottawa (Corace); Département de psychiatrie (Corace), Université d'Ottawa, Ottawa, Ont.; Régie de la santé des Premières Nations (Chase), Vancouver, C.-B.; École de pharmacie et de nutrition (Halpape), Université de la Saskatchewan, Saskatoon, Sask.; Université de Calgary (Lim), Calgary, Alb.; Société d'assurance Knight Archer (Kealey), Regina, Sask.; Institut de recherche sur les politiques en santé mentale (Rehm), Centre de toxicomanies et de santé mentale; École Dalla Lana de santé publique (Rehm), Université de Toronto, Toronto, Ont
| | - Kim Corace
- Département de médecine (Wood), Université de la Colombie-Britannique; Centre sur la toxicomanie de la Colombie-Britannique (Wood, Bright, Hsu, Goel, Ross, Hanson, Chase), Vancouver, C.-B.; Programme sur les classes de médicaments (Teed), Craven, Sask.; Département de psychiatrie (Poulin), Université du Manitoba; Centre Waypoint de santé mentale (Poulin), Winnipeg, Man.; Programme de lutte contre la consommation problématique de substances toxiques, ministère de la Santé et des Services sociaux, Gouvernement des Territoires du Nord-Ouest (Denning), Yellowknife, T.N.-O.; Centre de santé mentale Royal Ottawa (Corace); Département de psychiatrie (Corace), Université d'Ottawa, Ottawa, Ont.; Régie de la santé des Premières Nations (Chase), Vancouver, C.-B.; École de pharmacie et de nutrition (Halpape), Université de la Saskatchewan, Saskatoon, Sask.; Université de Calgary (Lim), Calgary, Alb.; Société d'assurance Knight Archer (Kealey), Regina, Sask.; Institut de recherche sur les politiques en santé mentale (Rehm), Centre de toxicomanies et de santé mentale; École Dalla Lana de santé publique (Rehm), Université de Toronto, Toronto, Ont
| | - Corrina Chase
- Département de médecine (Wood), Université de la Colombie-Britannique; Centre sur la toxicomanie de la Colombie-Britannique (Wood, Bright, Hsu, Goel, Ross, Hanson, Chase), Vancouver, C.-B.; Programme sur les classes de médicaments (Teed), Craven, Sask.; Département de psychiatrie (Poulin), Université du Manitoba; Centre Waypoint de santé mentale (Poulin), Winnipeg, Man.; Programme de lutte contre la consommation problématique de substances toxiques, ministère de la Santé et des Services sociaux, Gouvernement des Territoires du Nord-Ouest (Denning), Yellowknife, T.N.-O.; Centre de santé mentale Royal Ottawa (Corace); Département de psychiatrie (Corace), Université d'Ottawa, Ottawa, Ont.; Régie de la santé des Premières Nations (Chase), Vancouver, C.-B.; École de pharmacie et de nutrition (Halpape), Université de la Saskatchewan, Saskatoon, Sask.; Université de Calgary (Lim), Calgary, Alb.; Société d'assurance Knight Archer (Kealey), Regina, Sask.; Institut de recherche sur les politiques en santé mentale (Rehm), Centre de toxicomanies et de santé mentale; École Dalla Lana de santé publique (Rehm), Université de Toronto, Toronto, Ont
| | - Katelyn Halpape
- Département de médecine (Wood), Université de la Colombie-Britannique; Centre sur la toxicomanie de la Colombie-Britannique (Wood, Bright, Hsu, Goel, Ross, Hanson, Chase), Vancouver, C.-B.; Programme sur les classes de médicaments (Teed), Craven, Sask.; Département de psychiatrie (Poulin), Université du Manitoba; Centre Waypoint de santé mentale (Poulin), Winnipeg, Man.; Programme de lutte contre la consommation problématique de substances toxiques, ministère de la Santé et des Services sociaux, Gouvernement des Territoires du Nord-Ouest (Denning), Yellowknife, T.N.-O.; Centre de santé mentale Royal Ottawa (Corace); Département de psychiatrie (Corace), Université d'Ottawa, Ottawa, Ont.; Régie de la santé des Premières Nations (Chase), Vancouver, C.-B.; École de pharmacie et de nutrition (Halpape), Université de la Saskatchewan, Saskatoon, Sask.; Université de Calgary (Lim), Calgary, Alb.; Société d'assurance Knight Archer (Kealey), Regina, Sask.; Institut de recherche sur les politiques en santé mentale (Rehm), Centre de toxicomanies et de santé mentale; École Dalla Lana de santé publique (Rehm), Université de Toronto, Toronto, Ont
| | - Ronald Lim
- Département de médecine (Wood), Université de la Colombie-Britannique; Centre sur la toxicomanie de la Colombie-Britannique (Wood, Bright, Hsu, Goel, Ross, Hanson, Chase), Vancouver, C.-B.; Programme sur les classes de médicaments (Teed), Craven, Sask.; Département de psychiatrie (Poulin), Université du Manitoba; Centre Waypoint de santé mentale (Poulin), Winnipeg, Man.; Programme de lutte contre la consommation problématique de substances toxiques, ministère de la Santé et des Services sociaux, Gouvernement des Territoires du Nord-Ouest (Denning), Yellowknife, T.N.-O.; Centre de santé mentale Royal Ottawa (Corace); Département de psychiatrie (Corace), Université d'Ottawa, Ottawa, Ont.; Régie de la santé des Premières Nations (Chase), Vancouver, C.-B.; École de pharmacie et de nutrition (Halpape), Université de la Saskatchewan, Saskatoon, Sask.; Université de Calgary (Lim), Calgary, Alb.; Société d'assurance Knight Archer (Kealey), Regina, Sask.; Institut de recherche sur les politiques en santé mentale (Rehm), Centre de toxicomanies et de santé mentale; École Dalla Lana de santé publique (Rehm), Université de Toronto, Toronto, Ont
| | - Tim Kealey
- Département de médecine (Wood), Université de la Colombie-Britannique; Centre sur la toxicomanie de la Colombie-Britannique (Wood, Bright, Hsu, Goel, Ross, Hanson, Chase), Vancouver, C.-B.; Programme sur les classes de médicaments (Teed), Craven, Sask.; Département de psychiatrie (Poulin), Université du Manitoba; Centre Waypoint de santé mentale (Poulin), Winnipeg, Man.; Programme de lutte contre la consommation problématique de substances toxiques, ministère de la Santé et des Services sociaux, Gouvernement des Territoires du Nord-Ouest (Denning), Yellowknife, T.N.-O.; Centre de santé mentale Royal Ottawa (Corace); Département de psychiatrie (Corace), Université d'Ottawa, Ottawa, Ont.; Régie de la santé des Premières Nations (Chase), Vancouver, C.-B.; École de pharmacie et de nutrition (Halpape), Université de la Saskatchewan, Saskatoon, Sask.; Université de Calgary (Lim), Calgary, Alb.; Société d'assurance Knight Archer (Kealey), Regina, Sask.; Institut de recherche sur les politiques en santé mentale (Rehm), Centre de toxicomanies et de santé mentale; École Dalla Lana de santé publique (Rehm), Université de Toronto, Toronto, Ont
| | - Jürgen Rehm
- Département de médecine (Wood), Université de la Colombie-Britannique; Centre sur la toxicomanie de la Colombie-Britannique (Wood, Bright, Hsu, Goel, Ross, Hanson, Chase), Vancouver, C.-B.; Programme sur les classes de médicaments (Teed), Craven, Sask.; Département de psychiatrie (Poulin), Université du Manitoba; Centre Waypoint de santé mentale (Poulin), Winnipeg, Man.; Programme de lutte contre la consommation problématique de substances toxiques, ministère de la Santé et des Services sociaux, Gouvernement des Territoires du Nord-Ouest (Denning), Yellowknife, T.N.-O.; Centre de santé mentale Royal Ottawa (Corace); Département de psychiatrie (Corace), Université d'Ottawa, Ottawa, Ont.; Régie de la santé des Premières Nations (Chase), Vancouver, C.-B.; École de pharmacie et de nutrition (Halpape), Université de la Saskatchewan, Saskatoon, Sask.; Université de Calgary (Lim), Calgary, Alb.; Société d'assurance Knight Archer (Kealey), Regina, Sask.; Institut de recherche sur les politiques en santé mentale (Rehm), Centre de toxicomanies et de santé mentale; École Dalla Lana de santé publique (Rehm), Université de Toronto, Toronto, Ont
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Snodgrass S, Corcoran L, Jerry P. Spirituality in Addiction Recovery: A Narrative Review. JOURNAL OF RELIGION AND HEALTH 2024; 63:515-530. [PMID: 37486580 DOI: 10.1007/s10943-023-01854-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/12/2023] [Indexed: 07/25/2023]
Abstract
In the area of addiction, Canada has been in a public health crisis since 2016. Addiction takes a toll on an individual's self-worth and identity. In this narrative literature review, the distinct nature of spirituality was addressed. Next, individualized conceptualizations of spirituality were outlined. Subsequently, the importance of fellowship in addiction recovery was detailed. Next, the significance of being of service was presented. Meaningful and authentic spirituality were discussed in the context of recovery identity. Lastly, spirituality as a personal journey is described. A narrative literature review of 70 manuscripts published between 1999 and 2021 was undertaken to determine multiple approaches to treating addiction recovery in the context of spiritual development. An understanding of spirituality can inform counsellors regarding spiritual development in addiction recovery. Implications for counselling include a roadmap to support clients developing an individualized spiritual connection and operating as a functional system.
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Affiliation(s)
- Shelbi Snodgrass
- Faculty of Health Disciplines, Athabasca University, Athabasca, AB, Canada.
| | - Lynn Corcoran
- Faculty of Health Disciplines, Athabasca University, Athabasca, AB, Canada
| | - Paul Jerry
- Faculty of Health Disciplines, Athabasca University, Athabasca, AB, Canada
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6
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Wood E, Bright J, Hsu K, Goel N, Ross JWG, Hanson A, Teed R, Poulin G, Denning B, Corace K, Chase C, Halpape K, Lim R, Kealey T, Rehm J. Canadian guideline for the clinical management of high-risk drinking and alcohol use disorder. CMAJ 2023; 195:E1364-E1379. [PMID: 37844924 PMCID: PMC10581718 DOI: 10.1503/cmaj.230715] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2023] Open
Abstract
BACKGROUND In Canada, low awareness of evidence-based interventions for the clinical management of alcohol use disorder exists among health care providers and people who could benefit from care. To address this gap, the Canadian Research Initiative in Substance Misuse convened a national committee to develop a guideline for the clinical management of high-risk drinking and alcohol use disorder. METHODS Development of this guideline followed the ADAPTE process, building upon the 2019 British Columbia provincial guideline for alcohol use disorder. A national guideline committee (consisting of 36 members with diverse expertise, including academics, clinicians, people with lived and living experiences of alcohol use, and people who self-identified as Indigenous or Métis) selected priority topics, reviewed evidence and reached consensus on the recommendations. We used the Appraisal of Guidelines for Research and Evaluation Instrument (AGREE II) and the Guidelines International Network's Principles for Disclosure of Interests and Management of Conflicts to ensure the guideline met international standards for transparency, high quality and methodological rigour. We rated the final recommendations using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) tool; the recommendations underwent external review by 13 national and international experts and stakeholders. RECOMMENDATIONS The guideline includes 15 recommendations that cover screening, diagnosis, withdrawal management and ongoing treatment, including psychosocial treatment interventions, pharmacotherapies and community-based programs. The guideline committee identified a need to emphasize both underused interventions that may be beneficial and common prescribing and other practice patterns that are not evidence based and that may potentially worsen alcohol use outcomes. INTERPRETATION The guideline is intended to be a resource for physicians, policymakers and other clinical and nonclinical personnel, as well as individuals, families and communities affected by alcohol use. The recommendations seek to provide a framework for addressing a large burden of unmet treatment and care needs for alcohol use disorder within Canada in an evidence-based manner.
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Affiliation(s)
- Evan Wood
- Department of Medicine (Wood), University of British Columbia; British Columbia Centre on Substance Use (Wood, Bright, Hsu, Goel, Ross, Hanson, Chase), Vancouver, BC; Drug Class Program (Teed), Craven, Saskatchewan; Department of Psychiatry (Poulin), University of Manitoba; Waypoint Centre for Mental Health Care (Poulin), Winnipeg, Man.; Problematic Substance Use, Department of Health and Social Services, Government of the Northwest Territories (Denning), Yellowknife, NWT; The Royal Ottawa Mental Health Centre (Corace); Department of Psychiatry (Corace), University of Ottawa, Ottawa, Ont.; First Nations Health Authority (Chase), Vancouver, BC; College of Pharmacy and Nutrition (Halpape), University of Saskatchewan, Saskatoon, Sask.; University of Calgary (Lim), Calgary, Alta.; Knight Archer Insurance (Kealey), Regina, Sask.; Institute for Mental Health Policy Research (Rehm), Centre for Addiction and Mental Health; Dalla Lana School of Public Health (Rehm), University of Toronto, Toronto, Ont.
| | - Jessica Bright
- Department of Medicine (Wood), University of British Columbia; British Columbia Centre on Substance Use (Wood, Bright, Hsu, Goel, Ross, Hanson, Chase), Vancouver, BC; Drug Class Program (Teed), Craven, Saskatchewan; Department of Psychiatry (Poulin), University of Manitoba; Waypoint Centre for Mental Health Care (Poulin), Winnipeg, Man.; Problematic Substance Use, Department of Health and Social Services, Government of the Northwest Territories (Denning), Yellowknife, NWT; The Royal Ottawa Mental Health Centre (Corace); Department of Psychiatry (Corace), University of Ottawa, Ottawa, Ont.; First Nations Health Authority (Chase), Vancouver, BC; College of Pharmacy and Nutrition (Halpape), University of Saskatchewan, Saskatoon, Sask.; University of Calgary (Lim), Calgary, Alta.; Knight Archer Insurance (Kealey), Regina, Sask.; Institute for Mental Health Policy Research (Rehm), Centre for Addiction and Mental Health; Dalla Lana School of Public Health (Rehm), University of Toronto, Toronto, Ont
| | - Katrina Hsu
- Department of Medicine (Wood), University of British Columbia; British Columbia Centre on Substance Use (Wood, Bright, Hsu, Goel, Ross, Hanson, Chase), Vancouver, BC; Drug Class Program (Teed), Craven, Saskatchewan; Department of Psychiatry (Poulin), University of Manitoba; Waypoint Centre for Mental Health Care (Poulin), Winnipeg, Man.; Problematic Substance Use, Department of Health and Social Services, Government of the Northwest Territories (Denning), Yellowknife, NWT; The Royal Ottawa Mental Health Centre (Corace); Department of Psychiatry (Corace), University of Ottawa, Ottawa, Ont.; First Nations Health Authority (Chase), Vancouver, BC; College of Pharmacy and Nutrition (Halpape), University of Saskatchewan, Saskatoon, Sask.; University of Calgary (Lim), Calgary, Alta.; Knight Archer Insurance (Kealey), Regina, Sask.; Institute for Mental Health Policy Research (Rehm), Centre for Addiction and Mental Health; Dalla Lana School of Public Health (Rehm), University of Toronto, Toronto, Ont
| | - Nirupa Goel
- Department of Medicine (Wood), University of British Columbia; British Columbia Centre on Substance Use (Wood, Bright, Hsu, Goel, Ross, Hanson, Chase), Vancouver, BC; Drug Class Program (Teed), Craven, Saskatchewan; Department of Psychiatry (Poulin), University of Manitoba; Waypoint Centre for Mental Health Care (Poulin), Winnipeg, Man.; Problematic Substance Use, Department of Health and Social Services, Government of the Northwest Territories (Denning), Yellowknife, NWT; The Royal Ottawa Mental Health Centre (Corace); Department of Psychiatry (Corace), University of Ottawa, Ottawa, Ont.; First Nations Health Authority (Chase), Vancouver, BC; College of Pharmacy and Nutrition (Halpape), University of Saskatchewan, Saskatoon, Sask.; University of Calgary (Lim), Calgary, Alta.; Knight Archer Insurance (Kealey), Regina, Sask.; Institute for Mental Health Policy Research (Rehm), Centre for Addiction and Mental Health; Dalla Lana School of Public Health (Rehm), University of Toronto, Toronto, Ont
| | - Josey W G Ross
- Department of Medicine (Wood), University of British Columbia; British Columbia Centre on Substance Use (Wood, Bright, Hsu, Goel, Ross, Hanson, Chase), Vancouver, BC; Drug Class Program (Teed), Craven, Saskatchewan; Department of Psychiatry (Poulin), University of Manitoba; Waypoint Centre for Mental Health Care (Poulin), Winnipeg, Man.; Problematic Substance Use, Department of Health and Social Services, Government of the Northwest Territories (Denning), Yellowknife, NWT; The Royal Ottawa Mental Health Centre (Corace); Department of Psychiatry (Corace), University of Ottawa, Ottawa, Ont.; First Nations Health Authority (Chase), Vancouver, BC; College of Pharmacy and Nutrition (Halpape), University of Saskatchewan, Saskatoon, Sask.; University of Calgary (Lim), Calgary, Alta.; Knight Archer Insurance (Kealey), Regina, Sask.; Institute for Mental Health Policy Research (Rehm), Centre for Addiction and Mental Health; Dalla Lana School of Public Health (Rehm), University of Toronto, Toronto, Ont
| | - Averill Hanson
- Department of Medicine (Wood), University of British Columbia; British Columbia Centre on Substance Use (Wood, Bright, Hsu, Goel, Ross, Hanson, Chase), Vancouver, BC; Drug Class Program (Teed), Craven, Saskatchewan; Department of Psychiatry (Poulin), University of Manitoba; Waypoint Centre for Mental Health Care (Poulin), Winnipeg, Man.; Problematic Substance Use, Department of Health and Social Services, Government of the Northwest Territories (Denning), Yellowknife, NWT; The Royal Ottawa Mental Health Centre (Corace); Department of Psychiatry (Corace), University of Ottawa, Ottawa, Ont.; First Nations Health Authority (Chase), Vancouver, BC; College of Pharmacy and Nutrition (Halpape), University of Saskatchewan, Saskatoon, Sask.; University of Calgary (Lim), Calgary, Alta.; Knight Archer Insurance (Kealey), Regina, Sask.; Institute for Mental Health Policy Research (Rehm), Centre for Addiction and Mental Health; Dalla Lana School of Public Health (Rehm), University of Toronto, Toronto, Ont
| | - Rand Teed
- Department of Medicine (Wood), University of British Columbia; British Columbia Centre on Substance Use (Wood, Bright, Hsu, Goel, Ross, Hanson, Chase), Vancouver, BC; Drug Class Program (Teed), Craven, Saskatchewan; Department of Psychiatry (Poulin), University of Manitoba; Waypoint Centre for Mental Health Care (Poulin), Winnipeg, Man.; Problematic Substance Use, Department of Health and Social Services, Government of the Northwest Territories (Denning), Yellowknife, NWT; The Royal Ottawa Mental Health Centre (Corace); Department of Psychiatry (Corace), University of Ottawa, Ottawa, Ont.; First Nations Health Authority (Chase), Vancouver, BC; College of Pharmacy and Nutrition (Halpape), University of Saskatchewan, Saskatoon, Sask.; University of Calgary (Lim), Calgary, Alta.; Knight Archer Insurance (Kealey), Regina, Sask.; Institute for Mental Health Policy Research (Rehm), Centre for Addiction and Mental Health; Dalla Lana School of Public Health (Rehm), University of Toronto, Toronto, Ont
| | - Ginette Poulin
- Department of Medicine (Wood), University of British Columbia; British Columbia Centre on Substance Use (Wood, Bright, Hsu, Goel, Ross, Hanson, Chase), Vancouver, BC; Drug Class Program (Teed), Craven, Saskatchewan; Department of Psychiatry (Poulin), University of Manitoba; Waypoint Centre for Mental Health Care (Poulin), Winnipeg, Man.; Problematic Substance Use, Department of Health and Social Services, Government of the Northwest Territories (Denning), Yellowknife, NWT; The Royal Ottawa Mental Health Centre (Corace); Department of Psychiatry (Corace), University of Ottawa, Ottawa, Ont.; First Nations Health Authority (Chase), Vancouver, BC; College of Pharmacy and Nutrition (Halpape), University of Saskatchewan, Saskatoon, Sask.; University of Calgary (Lim), Calgary, Alta.; Knight Archer Insurance (Kealey), Regina, Sask.; Institute for Mental Health Policy Research (Rehm), Centre for Addiction and Mental Health; Dalla Lana School of Public Health (Rehm), University of Toronto, Toronto, Ont
| | - Bryany Denning
- Department of Medicine (Wood), University of British Columbia; British Columbia Centre on Substance Use (Wood, Bright, Hsu, Goel, Ross, Hanson, Chase), Vancouver, BC; Drug Class Program (Teed), Craven, Saskatchewan; Department of Psychiatry (Poulin), University of Manitoba; Waypoint Centre for Mental Health Care (Poulin), Winnipeg, Man.; Problematic Substance Use, Department of Health and Social Services, Government of the Northwest Territories (Denning), Yellowknife, NWT; The Royal Ottawa Mental Health Centre (Corace); Department of Psychiatry (Corace), University of Ottawa, Ottawa, Ont.; First Nations Health Authority (Chase), Vancouver, BC; College of Pharmacy and Nutrition (Halpape), University of Saskatchewan, Saskatoon, Sask.; University of Calgary (Lim), Calgary, Alta.; Knight Archer Insurance (Kealey), Regina, Sask.; Institute for Mental Health Policy Research (Rehm), Centre for Addiction and Mental Health; Dalla Lana School of Public Health (Rehm), University of Toronto, Toronto, Ont
| | - Kim Corace
- Department of Medicine (Wood), University of British Columbia; British Columbia Centre on Substance Use (Wood, Bright, Hsu, Goel, Ross, Hanson, Chase), Vancouver, BC; Drug Class Program (Teed), Craven, Saskatchewan; Department of Psychiatry (Poulin), University of Manitoba; Waypoint Centre for Mental Health Care (Poulin), Winnipeg, Man.; Problematic Substance Use, Department of Health and Social Services, Government of the Northwest Territories (Denning), Yellowknife, NWT; The Royal Ottawa Mental Health Centre (Corace); Department of Psychiatry (Corace), University of Ottawa, Ottawa, Ont.; First Nations Health Authority (Chase), Vancouver, BC; College of Pharmacy and Nutrition (Halpape), University of Saskatchewan, Saskatoon, Sask.; University of Calgary (Lim), Calgary, Alta.; Knight Archer Insurance (Kealey), Regina, Sask.; Institute for Mental Health Policy Research (Rehm), Centre for Addiction and Mental Health; Dalla Lana School of Public Health (Rehm), University of Toronto, Toronto, Ont
| | - Corrina Chase
- Department of Medicine (Wood), University of British Columbia; British Columbia Centre on Substance Use (Wood, Bright, Hsu, Goel, Ross, Hanson, Chase), Vancouver, BC; Drug Class Program (Teed), Craven, Saskatchewan; Department of Psychiatry (Poulin), University of Manitoba; Waypoint Centre for Mental Health Care (Poulin), Winnipeg, Man.; Problematic Substance Use, Department of Health and Social Services, Government of the Northwest Territories (Denning), Yellowknife, NWT; The Royal Ottawa Mental Health Centre (Corace); Department of Psychiatry (Corace), University of Ottawa, Ottawa, Ont.; First Nations Health Authority (Chase), Vancouver, BC; College of Pharmacy and Nutrition (Halpape), University of Saskatchewan, Saskatoon, Sask.; University of Calgary (Lim), Calgary, Alta.; Knight Archer Insurance (Kealey), Regina, Sask.; Institute for Mental Health Policy Research (Rehm), Centre for Addiction and Mental Health; Dalla Lana School of Public Health (Rehm), University of Toronto, Toronto, Ont
| | - Katelyn Halpape
- Department of Medicine (Wood), University of British Columbia; British Columbia Centre on Substance Use (Wood, Bright, Hsu, Goel, Ross, Hanson, Chase), Vancouver, BC; Drug Class Program (Teed), Craven, Saskatchewan; Department of Psychiatry (Poulin), University of Manitoba; Waypoint Centre for Mental Health Care (Poulin), Winnipeg, Man.; Problematic Substance Use, Department of Health and Social Services, Government of the Northwest Territories (Denning), Yellowknife, NWT; The Royal Ottawa Mental Health Centre (Corace); Department of Psychiatry (Corace), University of Ottawa, Ottawa, Ont.; First Nations Health Authority (Chase), Vancouver, BC; College of Pharmacy and Nutrition (Halpape), University of Saskatchewan, Saskatoon, Sask.; University of Calgary (Lim), Calgary, Alta.; Knight Archer Insurance (Kealey), Regina, Sask.; Institute for Mental Health Policy Research (Rehm), Centre for Addiction and Mental Health; Dalla Lana School of Public Health (Rehm), University of Toronto, Toronto, Ont
| | - Ronald Lim
- Department of Medicine (Wood), University of British Columbia; British Columbia Centre on Substance Use (Wood, Bright, Hsu, Goel, Ross, Hanson, Chase), Vancouver, BC; Drug Class Program (Teed), Craven, Saskatchewan; Department of Psychiatry (Poulin), University of Manitoba; Waypoint Centre for Mental Health Care (Poulin), Winnipeg, Man.; Problematic Substance Use, Department of Health and Social Services, Government of the Northwest Territories (Denning), Yellowknife, NWT; The Royal Ottawa Mental Health Centre (Corace); Department of Psychiatry (Corace), University of Ottawa, Ottawa, Ont.; First Nations Health Authority (Chase), Vancouver, BC; College of Pharmacy and Nutrition (Halpape), University of Saskatchewan, Saskatoon, Sask.; University of Calgary (Lim), Calgary, Alta.; Knight Archer Insurance (Kealey), Regina, Sask.; Institute for Mental Health Policy Research (Rehm), Centre for Addiction and Mental Health; Dalla Lana School of Public Health (Rehm), University of Toronto, Toronto, Ont
| | - Tim Kealey
- Department of Medicine (Wood), University of British Columbia; British Columbia Centre on Substance Use (Wood, Bright, Hsu, Goel, Ross, Hanson, Chase), Vancouver, BC; Drug Class Program (Teed), Craven, Saskatchewan; Department of Psychiatry (Poulin), University of Manitoba; Waypoint Centre for Mental Health Care (Poulin), Winnipeg, Man.; Problematic Substance Use, Department of Health and Social Services, Government of the Northwest Territories (Denning), Yellowknife, NWT; The Royal Ottawa Mental Health Centre (Corace); Department of Psychiatry (Corace), University of Ottawa, Ottawa, Ont.; First Nations Health Authority (Chase), Vancouver, BC; College of Pharmacy and Nutrition (Halpape), University of Saskatchewan, Saskatoon, Sask.; University of Calgary (Lim), Calgary, Alta.; Knight Archer Insurance (Kealey), Regina, Sask.; Institute for Mental Health Policy Research (Rehm), Centre for Addiction and Mental Health; Dalla Lana School of Public Health (Rehm), University of Toronto, Toronto, Ont
| | - Jürgen Rehm
- Department of Medicine (Wood), University of British Columbia; British Columbia Centre on Substance Use (Wood, Bright, Hsu, Goel, Ross, Hanson, Chase), Vancouver, BC; Drug Class Program (Teed), Craven, Saskatchewan; Department of Psychiatry (Poulin), University of Manitoba; Waypoint Centre for Mental Health Care (Poulin), Winnipeg, Man.; Problematic Substance Use, Department of Health and Social Services, Government of the Northwest Territories (Denning), Yellowknife, NWT; The Royal Ottawa Mental Health Centre (Corace); Department of Psychiatry (Corace), University of Ottawa, Ottawa, Ont.; First Nations Health Authority (Chase), Vancouver, BC; College of Pharmacy and Nutrition (Halpape), University of Saskatchewan, Saskatoon, Sask.; University of Calgary (Lim), Calgary, Alta.; Knight Archer Insurance (Kealey), Regina, Sask.; Institute for Mental Health Policy Research (Rehm), Centre for Addiction and Mental Health; Dalla Lana School of Public Health (Rehm), University of Toronto, Toronto, Ont
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Torres VN, Fulton BR, Wong EC, Derose KP. Prevalence and Predictors of Substance Use Support Programming Among U.S. Religious Congregations. JOURNAL OF DRUG ISSUES 2023; 53:581-601. [PMID: 37799348 PMCID: PMC10552553 DOI: 10.1177/00220426221138479] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/07/2023]
Abstract
We conducted a cross-sectional secondary analysis of data from the 2012 National Congregation Study, a nationally representative survey of religious congregations in the United States ( N = 1,331). Multivariate logistic regression was used to identify congregational characteristics associated with providing substance use support programing. Nearly one-third (38%) of U.S. congregations indicated that they provided substance use support programming; approximately half (52%) of all congregational attendees were in a congregation that provided some type of substance use support. The internal factors associated with a congregation providing substance use programming include having members who are unemployed and younger, being conservative Protestant, engaging in the practice of speaking in tongues, and having the resources to support social services. The analysis also identifies external factors (i.e., assessing community needs and hosting social service speakers) as being associated with a congregation’s likelihood of providing substance use programming. Findings identify factors associated with congregations providing substance use support.
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Affiliation(s)
- Vanessa N Torres
- RAND Corporation, Santa Monica, CA, USA
- Department of Policy and Management, Fielding School of Public Health, University of California, Los Angeles, CA, USA
| | - Brad R Fulton
- O'Neill School of Public and Environmental Affairs, Indiana University, Bloomington, IN, USA
| | | | - Kathryn P Derose
- RAND Corporation, Santa Monica, CA, USA
- Department of Health Promotion and Policy, School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA, USA
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Sinclair DL, Sussman S, Savahl S, Florence M, Vanderplasschen W. Narcotics Anonymous attendees' perceptions and experiences of substitute behaviors in the Western Cape, South Africa. Subst Abuse Treat Prev Policy 2023; 18:40. [PMID: 37408038 DOI: 10.1186/s13011-023-00552-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 06/26/2023] [Indexed: 07/07/2023] Open
Abstract
BACKGROUND Much remains unknown about the dynamics of substitute behaviors during addiction recovery among persons attending recovery support groups. Insight into the nature, motives for, and course of substitute behaviors could help to shape recovery support and harm reduction services. METHODS Twenty-three semi-structured in-depth interviews (n = 14 males and n = 9 females) were conducted with a convenience sample of Narcotics Anonymous attendees from a number of groups in the Western Cape, South Africa. Participants ranged in age from 22-55 years (M = 39.3, SD = 9.35). RESULTS Thematic analysis yielded four themes: (i) substance-to-substance substitution; (ii) substance-to-behavior substitution; (iii) substitute behaviors and harm (reduction) and (iv) support needs to manage and resolve substitute behaviors. According to the study, participants' substitute behaviors developed across recovery stages; were temporary or long-term replacements for substance use disorders and were engaged for distraction, isolation from others, calming, assuaging boredom, keeping occupied, filling a perceived experiential void, modifying mood and to self-medicate. While substitutes were utilized for harm reduction or relapse prevention, the potential for ostensibly healthy behaviors to threaten recovery and lead to relapse was also recognized. CONCLUSIONS Self-monitoring, ongoing vigilance, and awareness of when substitutes become genuine addictions are critical for timely, suitable interventions.
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Affiliation(s)
- Deborah Louise Sinclair
- Department of Psychology, University of the Western Cape, Cape Town, 7535, South Africa.
- Department of Special Needs Education, Ghent University, 9000, Ghent, Belgium.
| | - Steve Sussman
- Departments of Population and Public Health Sciences, and Psychology, and School of Social Work, University of Southern California, Los Angeles, CA, 90032-3628, USA
| | - Shazly Savahl
- Centre for Interdisciplinary Studies of Children, Families and Society, University of the Western Cape, South Africa, Cape Town, 7535, South Africa
| | - Maria Florence
- Department of Psychology, University of the Western Cape, Cape Town, 7535, South Africa
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Alenezi A. Expectations of Patients and Their Families After the Treatment of Substance Use Disorder. J Addict Nurs 2023; 34:E108-E118. [PMID: 37669350 DOI: 10.1097/jan.0000000000000472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
BACKGROUND Substance use disorders are economically and socially devastating to families and societies. Expectations of the patients and their families during the posttreatment phase of substance use disorder need to be emphasized to maintain a patient's sobriety and prevent relapse. AIM The aim of this study was to examine the prediction power of personal and sociodemographic factors of patients and their families to treatment outcomes. METHODS A descriptive, correlational, cross-sectional design was used. Data were collected from 80 patients treated for substance use disorders from a major psychiatric hospital and their family members regarding social, health, and psychological expectations. A three-step multiple hierarchical regression analysis was used to predict the power of personal and sociodemographic characteristics of patients' and their families' expectations to treatment outcomes. RESULTS Heroin use, codeine use, family education, and family support were significant predictors of rehabilitation expectation ( p < .05). Level of education and heroin use were predictors for lower levels of rehabilitation expectation, whereas family support and codeine use were indicators for higher scores of rehabilitation expectation. CONCLUSION Emphasis should be given to expectations of the patient and their family through appropriate psychoeducation and enhanced understanding and partnership.
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Affiliation(s)
- Atallah Alenezi
- Atallah Alenezi, College of Applied Medical Sciences, Shaqra University, Saudi Arabia
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Muswerakuenda FF, Mundagowa PT, Madziwa C, Mukora-Mutseyekwa F. Access to psychosocial support for church-going young people recovering from drug and substance abuse in Zimbabwe: a qualitative study. BMC Public Health 2023; 23:723. [PMID: 37081488 PMCID: PMC10117257 DOI: 10.1186/s12889-023-15633-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 04/08/2023] [Indexed: 04/22/2023] Open
Abstract
BACKGROUND The church and other religious-affiliated organizations have promising yet underexplored potential to provide social support services for young people recovering from substance abuse in communities where drug and substance rehabilitation services are limited. This study aimed to establish the barriers and facilitators of accessing psychosocial support, the role of the church, and strategies to promote access to psychosocial support for youths recovering from drug and substance abuse. METHODS This was a qualitative cross-sectional study, and semi-structured interviews of 18 church-going youths and three youth pastors were conducted in eastern Zimbabwe. Data were collected using recorded telephone interviews. Data were transcribed and analyzed using the thematic network analysis technique of producing basic themes, which build into organizing themes. Organizing themes produces one overarching global theme. The Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines for reporting on qualitative research were used in reporting the study findings. RESULTS The interviews produced the following basic themes under organizing theme barriers: stigma and discrimination, parental/guardian denial, radical religious beliefs, and negative role models. Under the organizing theme facilitators, the basic themes were acceptance, confidentiality, peer and parental support, and an organized support program. The church acted as the bridge between the barriers to access to services and support seeking through innovative, inclusive projects and activities, as well as a pillar of social support. CONCLUSIONS Acceptance of one's addiction problem is critical to initiate seeking psychosocial support. Confidentiality, support from trustworthy relationships, and the availability of a well-coordinated recovery program enable young people to seek support. We recommend formal training church-based counselors in the ethical aspects of psychotherapy to reduce the preconceived social stigma associated with drug and substance abuse.
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Affiliation(s)
| | - Paddington T Mundagowa
- Clinical Research Center, Africa University, Mutare, Zimbabwe.
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, USA.
| | - Clara Madziwa
- College of Social Sciences, Theology and Education, Africa University, Mutare, Zimbabwe
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11
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Alsubaie S. Psychosocial Life Aspects among Substance Misuse Clients who are at Rehabilitation Phase: A Narrative Review. Health Psychol Res 2023; 11:66174. [PMID: 36777809 PMCID: PMC9907330 DOI: 10.52965/001c.66174] [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: 01/29/2023] Open
Abstract
Objective The present study aimed at exploring the psychosocial life aspects among substance misuse clients through conducting a review of the literature related to the research topic. A scoping search in the literature revealed the significant lack of both local, regional and international studies exploring the psychosocial life aspects among substance misuse clients who are at the rehabilitation stage. Method A comprehensive literature search was performed using the keywords: "psychosocial, "psychological", "social", "life", "rehabilitation" and "substance misuse". The search process was performed in the following electronic databases "MEDLINE, PubMed, CINAHL, PsycINFO". Full text articles, published in English during the period between 2016 and 2021 were included in the literature. Results A total of 7 studies were found to be in relation with the topic addressed in this study, which is the psychosocial life aspects of substance misuse clients at rehabilitation phase. The results showed that there is a significant weakness of psychosocial life aspects among substance misuse clients, in addition to a significant lack of both educational and training program that aim at enhancing and improving the psychosocial life aspects among substance misuse clients who are at the rehabilitation phase. Conclusion The study concluded that there should be concise and clear measurement tools to be used in assessing the psychosocial life aspects of substance misuse clients who are the rehabilitation phase.
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12
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Kimball TG, Shumway ST, Hune ND, Bradshaw SD. Capacity for Meaningful Relationship in Severe Substance Use Recovery: A Qualitative Study. ALCOHOLISM TREATMENT QUARTERLY 2022. [DOI: 10.1080/07347324.2022.2149372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Thomas G. Kimball
- Community, Family, and Addiction Sciences, Texas Tech University, Lubbock, Texas, USA
| | - Sterling T. Shumway
- Community, Family, and Addiction Sciences, Texas Tech University, Lubbock, Texas, USA
| | - Nicole D. Hune
- Community, Family, and Addiction Sciences, Texas Tech University, Lubbock, Texas, USA
| | - Spencer D. Bradshaw
- Human Development and Family Studies, Utah State University, Logan, Utah, USA
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13
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Madill A, Duara R, Goswami S, Graber R, Hugh‐Jones S. Pathways to recovery model of youth substance misuse in Assam, India. Health Expect 2022; 26:318-328. [PMID: 36349556 PMCID: PMC9854309 DOI: 10.1111/hex.13658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 10/26/2022] [Accepted: 10/27/2022] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION There are global calls for better understanding of substance use disorder (SUD) to inform prevention, risk reduction and treatment of this relapse-prone disorder. Our aim in this article is to understand the pathways to recovery of youth in Assam, India who have suffered SUD. METHODS We recruited 15 participants (11 men and 4 women) via two rehabilitation facilities. All are addicts-in-recovery aged 19-24 years. Material was generated through photo-led interviews, analysed using an inductive variant of thematic analysis and the resulting model refined through expert and participant checks. RESULTS We present a multiroute, multidirectional pathway to recovery model. It has three phases, Recreational Use, Addiction (Relaxed, Chaotic, Strategic) and Supported Recovery, each phase consisting of cycling between, or transitioning through, a series of stages. CONCLUSIONS The model enhances psycho-socio-cultural insights into the experience of risk and recovery, and informs prevention and treatment for youth substance misuse in Assam. This is the first model of its kind and an important public health resource. We discuss the possible transferability of the model to a wider range of contexts. PATIENT OR PUBLIC CONTRIBUTION The model presented was generated through analysis of interviews with addicts-in-recovery. Four of these addicts-in-recovery, and two mental health and rehabilitation service providers, conducted participant and expert checks of the model leading to its improvement.
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Affiliation(s)
- Anna Madill
- School of PsychologyUniversity of LeedsLeedsUK
| | | | - Sangeeta Goswami
- Institute of Positive Mental Health & ResearchGuwahatiAssamIndia
| | - Rebecca Graber
- School of Humanities and Social ScienceUniversity of BrightonBrightonEast SussexUK
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14
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Exploring how greenspace programmes might be effective in supporting people with problem substance use: a realist interview study. BMC Public Health 2022; 22:1661. [PMID: 36050664 PMCID: PMC9436451 DOI: 10.1186/s12889-022-14063-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 08/23/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Greenspace programmes are health projects run outside in nature, typically with the aim of improving mental health. Research suggests that programmes may also be effective in supporting people with problem substance use (PSU), but there is limited understanding of the key components that make them successful for this client group. Previous work has claimed that a realist-informed intervention framework for greenspace programmes for mental health could be transferable to programmes that support people with PSU, and that this could provide insight into the causal processes within programmes. However, this claim is yet to be explored in depth. The aim of this study was to further test, refine, and consolidate the proposed framework to show how greenspace programmes could support people with PSU. METHODS Using a realist approach, 17 participants (8 programme staff; 9 wider stakeholders) were interviewed about contexts, mechanisms, and outcomes (CMOs) relative to greenspace programmes for mental health and PSU. Semi-structured interviews were used since they facilitated exploration of the proposed framework but were flexible enough to allow identification of new CMOs for framework refinement. Interviews were audio-recorded, fully transcribed, and analysed inductively and deductively against the proposed framework. RESULTS Findings supported the proposed framework and indicated that greenspace programmes support people with poor mental health and PSU due to: feelings of escape; space to reflect; physical activity; self-efficacy; feelings of purpose; relationships; and shared experiences. However, data showed that programmes must also consider: explicit intervention focus to ensure adequate support for clients; existing challenges with funding and stakeholder buy-in; and the impact of COVID-19. Findings allowed development of a refined framework that shows how greenspace programmes can support people with PSU. CONCLUSION The findings of this project are theoretically novel and have practical relevance for those designing greenspace programmes by providing recommendations on how to optimise, tailor, and implement future interventions. Findings could be particularly relevant for academic researchers, multidisciplinary health professionals, and for those working in the third sector, developing and delivering greenspace programmes for people to improve their mental health and to support them with PSU.
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15
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Wilburn VG, Stoll HB, Rohr AC, Moring K. The Ambiguity of Parenting Adult Children With Substance Use Disorder. Can J Occup Ther 2022; 89:127-134. [PMID: 35037785 DOI: 10.1177/00084174211073260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background. Substance Use Disorder can impede parent-child relationships. The Theory of Ambiguous Loss provides a structure for occupational therapy practitioners in developing interventions to support the parent-child relationship. Purpose. This study explores the roles of parents of adult children diagnosed with Substance Use Disorder in the context of the Theory of Ambiguous Loss. Method. Volunteer participants were recruited from three urban parental support groups. Inclusion criteria were involved in a support group and having an adult child diagnosed with Substance Use Disorder. Eight mothers and one father participated in semi-structured interviews using a phenomenological approach. Themes and structural descriptions were developed. Findings. Five themes were identified: hopeful coping, occupational interference, changes in social constructs and participation, burdenful caregiving and receiving, and blending of occupations. Themes offer intervention considerations for occupational therapy. Implications. Research provides additional conceptual consideration to build occupation-centered interventions for parents and their adult children in Substance Use Disorder recovery.
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16
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Shadowen C, Jallo N, Parlier-Ahmad AB, Brown L, Kinser P, Svikis D, Martin CE. What Recovery Means to Postpartum Women in Treatment for Opioid Use Disorder. WOMEN'S HEALTH REPORTS (NEW ROCHELLE, N.Y.) 2022; 3:93-103. [PMID: 35136881 PMCID: PMC8812494 DOI: 10.1089/whr.2021.0064] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 12/17/2021] [Indexed: 11/12/2022]
Abstract
Introduction: Opioid overdose has become a leading cause of pregnancy-associated deaths, particularly in the 1st year postpartum, highlighting the need to better understand how to promote recovery for postpartum women. This mixed-methods study aims to investigate how postpartum women receiving medication for opioid use disorder (MOUD) define recovery and factors associated with recovery progression or inhibition. Methods: Women receiving MOUD 2-6 months postpartum were recruited from an outpatient perinatal addiction clinic. Participants completed electronic measures including the Brief Assessment of Recovery Capital (BARC-10, total score range: 6-60) and semistructured individual interviews. Substance Abuse and Mental Health Services Administration (SAMHSA)'s recovery framework served as the conceptual model for interview guide development. Descriptive statistics were generated for survey responses. A qualitative descriptive approach was used to analyze and report the interview data. Results: On average, participants (n = 8) were 28.6 years old and taking 19.5 mg/day buprenorphine (range 8-24). Fifty percent identified as white and 37.5% as black. All participants identified as currently in recovery, with mean BARC-10 score 52.5 (standard deviation 4.8). Recovery goals included no use of drugs or alcohol (62.5%), being a better partner/spouse (87.5%), and improving finances (87.5%). Interviews generated themes including recovery as transformative, building resilience, and transforming one's health, relationships, and environment through recovery. Conclusions: Participants defined recovery as a dynamic transformative process, including nonabstinence-based goals consistent with SAMHSA domains coupled with reduced substance use. Central to recovery for our postpartum participants was the sense of self reinforced throughout their recovery journey. Women highlighted the key role of MOUD in their recovery process. Findings underscore the need for individualized treatment for postpartum women with opioid use disorder based on their personal goals and will inform development of a validated, gender-informed measure of patient-reported recovery outcomes tailored for this population.
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Affiliation(s)
- Caroline Shadowen
- Virginia Commonwealth University Health System, Richmond, Virginia, USA.,Department of Obstetrics and Gynecology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Nancy Jallo
- Department of Family and Community Health Nursing, School of Nursing, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Anna Beth Parlier-Ahmad
- Virginia Commonwealth University Health System, Richmond, Virginia, USA.,Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA.,Department of Family and Community Health Nursing, Institute for Women's Health, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Lisa Brown
- Department of Family and Community Health Nursing, School of Nursing, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Patricia Kinser
- Department of Family and Community Health Nursing, School of Nursing, Virginia Commonwealth University, Richmond, Virginia, USA.,Department of Family and Community Health Nursing, Institute for Women's Health, Virginia Commonwealth University, Richmond, Virginia, USA.,Department of Family and Community Health Nursing, School of Medicine, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Dace Svikis
- Virginia Commonwealth University Health System, Richmond, Virginia, USA.,Department of Family and Community Health Nursing, Institute for Women's Health, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Caitlin E Martin
- Virginia Commonwealth University Health System, Richmond, Virginia, USA.,Department of Obstetrics and Gynecology, Virginia Commonwealth University, Richmond, Virginia, USA.,Department of Family and Community Health Nursing, School of Medicine, Virginia Commonwealth University, Richmond, Virginia, USA.,Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, Virginia, USA
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17
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Vigdal MI, Moltu C, Bjornestad J, Selseng LB. Social recovery in substance use disorder: A metasynthesis of qualitative studies. Drug Alcohol Rev 2022; 41:974-987. [PMID: 35104369 PMCID: PMC9306622 DOI: 10.1111/dar.13434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 11/15/2021] [Accepted: 12/20/2021] [Indexed: 11/28/2022]
Abstract
Issues In substance use disorder, connection to social communities plays a significant role in the recovery process. The aim here has been to identify and synthesise the qualitative research examining the process of social recovery from a first‐person perspective and how social communities assist in this process. Approach Metasynthesis using the following databases: CINAHL, Embase, MEDLINE, PsycINFO, Scopus, SocIndex and Web of Science. The search returned 6913 original articles, of which 18 met the following criteria: examining the experience of social recovery from a first‐person perspective and how social communities support this process, age of 18+, recovery of at least 12 months, in an English‐language peer‐reviewed journal. Review protocol registration: PROSPERO (CRD42020190159). Key Findings The persons in recovery emphasised communities that they perceived as being safe and non‐stigmatising. These are qualities that contributed to positive self‐change, and these communities were perceived as suitable arenas in which to confront responsibility and trust. Additionally, participants found that their relationship skills were improving due to the new social bonds forged in these communities. A sense of citizenship was gained along with a regaining of social dignity through voluntary work and giving back to society. Implications The pivotal role of the social community identified in this review underscores the importance of recognising and supporting persons in recovery's needs when connecting with such communities Conclusion We propose a four‐stage model to guide research into social recovery from a first‐person perspective and how social communities support this process.
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Affiliation(s)
- Mariann Iren Vigdal
- Department of Welfare and Participation, Western Norway University of Applied Sciences, Sogndal, Norway
| | - Christian Moltu
- District General Hospital of Førde, Førde, Norway.,Department of Health and Caring Sciences, Western Norway University of Applied Science, Førde, Norway
| | - Jone Bjornestad
- District General Hospital of Førde, Førde, Norway.,Department of Social Studies, University of Stavanger, Stavanger, Norway
| | - Lillian Bruland Selseng
- Department of Welfare and Participation, Western Norway University of Applied Sciences, Sogndal, Norway
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18
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Collinson B, Hall L. The role of social mechanisms of change in women’s addiction recovery trajectories. DRUGS: EDUCATION, PREVENTION AND POLICY 2021. [DOI: 10.1080/09687637.2021.1929077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Beth Collinson
- Department of Law and Criminology, Sheffield Hallam University, Sheffield, England
| | - Lauren Hall
- Department of Law and Criminology, Sheffield Hallam University, Sheffield, England
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19
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Abram MD, White JH. Stumbling toward Vulnerability: Recovery from Substance Use Disorders and Co-Occurring Mental Illness. Issues Ment Health Nurs 2021; 42:628-638. [PMID: 33166230 DOI: 10.1080/01612840.2020.1836540] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
This study investigated the recovery process for individuals engaged in treatment for substance use disorders (SUDs) who had co-occurring anxiety and depression. The participants were eight individuals engaged in treatment. The results of a Grounded Theory design and methods revealed the core category and substantive theory, Stumbling toward Vulnerability. Four phases in which the participants progressed in a linear way emerged. The study results have implications for the role of the advance practice psychiatric-mental health nurse in the early assessment of mental illness for clients with SUDs by providing integrated treatment for these individuals, and focusing on health and wellness as a recovery outcome. Based on the findings, hypotheses for further research are recommended.
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Affiliation(s)
- Marissa D Abram
- College of Nursing and Public Health, Adelphi University, Garden City, New York, USA.,Pulse Center for Patient Safety Education and Advocacy, Wantagh, New York, USA
| | - Jane H White
- College of Nursing and Public Health, Adelphi University, Garden City, New York, USA.,Institute for Nursing, Northwell Health, New Hyde Park, New York, USA
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20
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Howell A, Lambert A, Pinkston MM, Blevins CE, Hayaki J, Herman DS, Moitra E, Stein MD, Kim HN. Sustained Sobriety: A Qualitative Study of Persons with HIV and Chronic Hepatitis C Coinfection and a History of Problematic Drinking. AIDS Behav 2021; 25:1083-1093. [PMID: 33064248 PMCID: PMC7979443 DOI: 10.1007/s10461-020-03067-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/13/2020] [Indexed: 12/16/2022]
Abstract
For persons diagnosed with HIV and who are coinfected with hepatitis C virus (HCV), chronic liver disease is a leading cause of death and excessive consumption of alcohol can be a contributing factor. Little is known about the factors these individuals identify as key to achieving sustained sobriety. In this qualitative study, fourteen HIV/HCV coinfected persons who endorsed past problematic drinking were interviewed about their path to sustained sobriety. In open-ended interviews, participants often described their drinking in the context of polysubstance use and their decision to become sober as a singular response to a transcendent moment or a traumatic event. All articulated specific, concrete strategies for maintaining sobriety. The perceived effect of the HIV or HCV diagnosis on sobriety was inconsistent, and medical care as an influence on sobriety was rarely mentioned. Qualitative interviews may offer new insights on interventions and support strategies for heavy-drinking persons with HIV/HCV coinfection.
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Affiliation(s)
- Abigail Howell
- Department of Medicine, University of Washington, 325 Ninth Avenue Box 359930, Seattle, WA, 98104, USA
| | - Audrey Lambert
- Section of General Internal Medicine, CARE Unit, Boston Medical Center, Boston, MA, USA
- Department of Health Law, Policy and Management, Boston University School of Public Health, Boston, MA, USA
| | - Megan M Pinkston
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
| | - Claire E Blevins
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
| | - Jumi Hayaki
- Department of Psychology, College of the Holy Cross, Worcester, MA, USA
| | - Debra S Herman
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
| | - Ethan Moitra
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
| | - Michael D Stein
- Department of Health Law, Policy and Management, Boston University School of Public Health, Boston, MA, USA
| | - H Nina Kim
- Department of Medicine, University of Washington, 325 Ninth Avenue Box 359930, Seattle, WA, 98104, USA.
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21
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Gueta K, Chen G, Ronel N. Maintenance of long-term recovery from substance use: a mixed methods study of self- and treatment-changers. DRUGS: EDUCATION, PREVENTION AND POLICY 2020. [DOI: 10.1080/09687637.2020.1800592] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Keren Gueta
- Department of Criminology, Bar-Ilan University, Ramat-Gan, Israel
| | - Gila Chen
- Department of Criminology, Ashkelon Academic College, Ashkelon, Israel
| | - Natti Ronel
- Department of Criminology, Bar-Ilan University, Ramat-Gan, Israel
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22
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Reynolds L, Rogers O, Benford A, Ingwaldson A, Vu B, Holstege T, Alvarado K. Virtual Nature as an Intervention for Reducing Stress and Improving Mood in People with Substance Use Disorder. JOURNAL OF ADDICTION 2020; 2020:1892390. [PMID: 32518704 PMCID: PMC7256771 DOI: 10.1155/2020/1892390] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 04/23/2020] [Accepted: 04/29/2020] [Indexed: 11/17/2022]
Abstract
Substance use disorder (SUD) afflicts a large percentage of the United States population, with negative implications that cost more than $420 billion annually. This population often experiences negative emotions throughout the recovery process, including anxiety, depression, stress, and negative affect. Currently, evidence-based treatment strategies for SUD include cognitive behavioral therapy, motivational interviewing, 12-step programs, and mindfulness-based treatment. One intervention that has not been studied at length among individuals with SUD is use of the natural environment as treatment. Among other patient populations, nature has been shown to reduce stress and anxiety by regulating autonomic nervous system function, reducing symptoms of depression, and improving mood. The purpose of this study was to investigate whether viewing nature videos could similarly reduce stress and improve mood in individuals with SUD. A crossover design was used to compare viewing a nature scene and practicing mindfulness-based activities for women with SUD at a residential treatment facility. Over four weeks, participants engaged in the two activities for the first 10 minutes of their daily program. Immediately before and after each 10 minute session, measures were taken for heart rate, in beats per minute (BPM); affect, using the Positive and Negative Affect Scale (PANAS); and overall mood, using a 10-point rating scale from "very unpleasant" to "pleasant." Thirty-six women completed the study. For viewing a nature scene and practicing the mindfulness-based activities, there were statistically significant reductions in mean negative affect scores (p=0.001) and heart rate (p ≤ 0.001). In addition, for participants in both conditions, overall mood improved significantly (p=0.030). The results from this study provide initial evidence that viewing nature has similar benefits to MBT in the treatment of stress and negative mood associated with the SUD recovery process and may be an additional, cost-effective treatment strategy for individuals with SUD.
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Affiliation(s)
- Lori Reynolds
- Department of Occupational Therapy, Northern Arizona University, 435 N 5th Street, Phoenix, AZ 85004, USA
| | - Oaklee Rogers
- Faculty Lead for the Community Health Mentor Program (CHMP), 435 N 5th Street, Phoenix, AZ 85004, USA
| | - Andrew Benford
- Department of Occupational Therapy, Northern Arizona University, 435 N 5th Street, Phoenix, AZ 85004, USA
| | - Ammie Ingwaldson
- Department of Occupational Therapy, Northern Arizona University, 435 N 5th Street, Phoenix, AZ 85004, USA
| | - Bethany Vu
- Department of Occupational Therapy, Northern Arizona University, 435 N 5th Street, Phoenix, AZ 85004, USA
| | - Tiffany Holstege
- Department of Occupational Therapy, Northern Arizona University, 435 N 5th Street, Phoenix, AZ 85004, USA
| | - Korinna Alvarado
- Department of Occupational Therapy, Northern Arizona University, 435 N 5th Street, Phoenix, AZ 85004, USA
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23
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McDaniel JM, Brown AM, Thompson Heller A, Johnston TW, Bergman B, Bohler R, Brown T, Eisenhart E, Finch A, Harper K, Hart C, Kimball T, Rabolt T, Speciale C, Whitney J, Ashford RD. Interdisciplinary Expansions: Applying Recovery-Informed Theory to Interdisciplinary Areas of Recovery Science Research. ALCOHOLISM TREATMENT QUARTERLY 2019. [DOI: 10.1080/07347324.2019.1701598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Jessica M. McDaniel
- Center for Young Adult Addiction & Recovery, Kennesaw State University, Kennesaw, USA
| | - Austin M. Brown
- Center for Young Adult Addiction & Recovery, Kennesaw State University, Kennesaw, USA
| | | | - Teresa W. Johnston
- Center for Young Adult Addiction & Recovery, Kennesaw State University, Kennesaw, USA
| | - Brandon Bergman
- Recovery Research Institute, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | | | - Tiffany Brown
- College of Education, University of Oregon, Eugene, USA
| | - Emily Eisenhart
- Center for Addiction Recovery, Georgia Southern University, Statesboro, USA
| | - Andrew Finch
- Department of Human and Organizational Development, Vanderbilt University, Nashville, USA
| | | | | | - Thomas Kimball
- Center for Collegiate Recovery Communities, Texas Tech University, Lubbock, USA
| | - Tim Rabolt
- Association of Recovery in Higher Education, Atlanta, GA
| | | | - Jason Whitney
- College of Education, Pennsylvania State University, State College, USA
| | - Robert D. Ashford
- Substance Use Disorders Institute, University of the Sciences, Philadelphia, USA
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24
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Frazer Z, McConnell K, Jansson LM. Treatment for substance use disorders in pregnant women: Motivators and barriers. Drug Alcohol Depend 2019; 205:107652. [PMID: 31704383 DOI: 10.1016/j.drugalcdep.2019.107652] [Citation(s) in RCA: 98] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 09/11/2019] [Accepted: 09/12/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Pregnancy is a unique opportunity to provide broad and necessary medical care for women- including treatment for Substance Use Disorders (SUD). The standard of care for SUD in pregnant women is treatment at a comprehensive care facility. There is little existing qualitative research exploring what brings pregnant women with SUD to treatment and what barriers to treatment exist for this population. This study explored women's self-reported reasons for pursuing treatment or hesitating to do so. METHODS This qualitative study used interviews to explore common factors that motivate pregnant women with SUD to seek comprehensive care during pregnancy and common hesitations/ barriers to treatment. The study population included 20 women in treatment at a comprehensive care facility for pregnant and parenting women at Johns Hopkins. Participants volunteered to do interviews which were recorded and transcribed for analysis. RESULTS Interviews revealed several major themes in motivators to seek treatment: readiness to stop using, concern for the baby's health, concern about custody of the baby or other children, wanting to escape violent environments or homelessness, and seeking structure. Barriers to treatment included fear of loss of custody, not wanting to be away from children/partner, concern about stigma or privacy, and lack of childcare and transportation. CONCLUSIONS This study revealed common motivators to seek treatment and barriers to treatment for pregnant women with SUD. These themes may help direct future studies and guide efforts to increase access to crucial care in this vulnerable population.
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Affiliation(s)
- Zane Frazer
- Johns Hopkins University School of Medicine, 733 North Broadway, Baltimore, MD 21205, United States.
| | - Krystle McConnell
- Johns Hopkins University School of Medicine, 733 North Broadway, Baltimore, MD 21205, United States.
| | - Lauren M Jansson
- Johns Hopkins University School of Medicine, 733 North Broadway, Baltimore, MD 21205, United States.
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Dekkers A, De Ruysscher C, Vanderplasschen W. Perspectives of cocaine users on addiction recovery: a qualitative study following a CRA + vouchers programme. DRUGS: EDUCATION, PREVENTION AND POLICY 2019. [DOI: 10.1080/09687637.2019.1687647] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Anne Dekkers
- Department of Special Needs Education, Ghent University, Ghent, Belgium
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