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Rahman L, Raymond H, Labuguen B, Gladysz H, Holshausen K, Brasch J, Amlung M, MacKillop J. Perceptions of prevalence, consequences, and strategies for managing contraband substance use in an inpatient concurrent disorders program: A qualitative study of patient perspectives and survey of clinician perspectives. Front Psychiatry 2022; 13:911552. [PMID: 36147979 PMCID: PMC9485475 DOI: 10.3389/fpsyt.2022.911552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 08/15/2022] [Indexed: 11/13/2022] Open
Abstract
Objective Inpatient treatment programs for substance use disorders (SUDs) typically have an abstinence policy for patients, but unsanctioned substance use nonetheless takes place and can have significant negative clinical impacts. The current study sought to understand this problem from a patient perspective and to develop strategies for improved contraband substance management in an inpatient concurrent disorders sample. Methods First, a qualitative study (n = 10; 60% female) was undertaken to ascertain perceived prevalence, impact, and patient-generated strategies. Second, an anonymous follow-up survey was conducted with unit staff clinicians to evaluate the suggested strategies. Results Patients reported that contraband substance use was present and had significant negative consequences clinically. Recommendations from patients included more extensive urine drug screening, the use of drug-sniffing dogs, and direct contingencies for contraband use. Nineteen staff competed an anonymous follow-up questionnaire to evaluate the viability of these strategies, revealing variable perceptions of feasibility and effectiveness. Conclusion These findings emphasize the adverse consequences of contraband substance use in addiction treatment programs and identify patient-preferred strategies for managing this challenge.
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Affiliation(s)
- Liah Rahman
- Peter Boris Centre for Addictions Research, McMaster University and St. Joseph’s Healthcare Hamilton, Hamilton, ON, Canada
- Concurrent Disorders Program, St. Joseph’s Healthcare Hamilton, Hamilton, ON, Canada
| | - Holly Raymond
- Concurrent Disorders Program, St. Joseph’s Healthcare Hamilton, Hamilton, ON, Canada
| | - Bradley Labuguen
- Concurrent Disorders Program, St. Joseph’s Healthcare Hamilton, Hamilton, ON, Canada
| | - Hollie Gladysz
- Concurrent Disorders Program, St. Joseph’s Healthcare Hamilton, Hamilton, ON, Canada
| | - Katherine Holshausen
- Peter Boris Centre for Addictions Research, McMaster University and St. Joseph’s Healthcare Hamilton, Hamilton, ON, Canada
- Concurrent Disorders Program, St. Joseph’s Healthcare Hamilton, Hamilton, ON, Canada
| | - Jennifer Brasch
- Peter Boris Centre for Addictions Research, McMaster University and St. Joseph’s Healthcare Hamilton, Hamilton, ON, Canada
- Concurrent Disorders Program, St. Joseph’s Healthcare Hamilton, Hamilton, ON, Canada
| | - Michael Amlung
- Peter Boris Centre for Addictions Research, McMaster University and St. Joseph’s Healthcare Hamilton, Hamilton, ON, Canada
- Concurrent Disorders Program, St. Joseph’s Healthcare Hamilton, Hamilton, ON, Canada
| | - James MacKillop
- Peter Boris Centre for Addictions Research, McMaster University and St. Joseph’s Healthcare Hamilton, Hamilton, ON, Canada
- Homewood Research Institute, Hamilton, ON, Canada
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McEvedy SM, Furness T, McKenna B. Introduction of a drug-detection dog programme in mental health inpatient units: A mixed-methods study of consumer, staff, and carers' perceptions. Int J Ment Health Nurs 2018; 27:408-421. [PMID: 28589658 DOI: 10.1111/inm.12335] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/19/2017] [Indexed: 11/30/2022]
Abstract
Many consumers admitted to mental health inpatient units also use illicit drugs, and some continue to do so while receiving treatment. In an attempt to curb the impact of illicit drug use, one of Australia's largest mental health services introduced a programme of drug-detection dog (DDD) searches. Our aim was to evaluate perceptions of the DDD programme among mental health consumers, staff, and carers. A mixed-methods research design using a concurrent triangulation approach was adopted, involving three focus group discussions with consumer, staff, and carer groups, and a structured survey among 94 consumers who were receiving treatment and 102 staff working in the units at the time of a DDD visit. Data were analysed using thematic analysis, and descriptive and inferential statistics. Major themes were that: (i) drug use in these units is perceived as 'prevalent' and 'destructive'; (ii) the DDD programme is 'beneficial' but 'incongruous' in a health-care setting; (iii) consumers are 'uninformed'; and (iv) consequences should be 'customized' to circumstances. Survey results corroborated qualitative themes, with the exception that although concerns about incongruity do exist, they were not prevalent and were outweighed by positive perceptions of the programme. Most perceptions were consistent between consumers and staff. However, consumers tended to think that, if found, drugs should be confiscated, whereas staff were more strongly in favour of the consumer being discharged. In conclusion, the DDD programme was seen as a positive step towards addressing drug use in mental health units. However, improved dissemination of information to consumers through verbal and written communication is required.
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Affiliation(s)
- Samantha M McEvedy
- School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
| | - Trentham Furness
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Melbourne, Victoria, Australia.,NorthWestern Mental Health, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Brian McKenna
- School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand.,Auckland Regional Forensic Psychiatry Services, Waitemata District Health Board, Auckland, New Zealand
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