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Beeler S, Gerrish O, Aldred BG, Asher BlackDeer A. Histories of violence among clients seeking substance use disorder treatment: a systematic mapping review. Front Psychiatry 2024; 15:1307641. [PMID: 38505794 PMCID: PMC10948608 DOI: 10.3389/fpsyt.2024.1307641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 02/08/2024] [Indexed: 03/21/2024] Open
Abstract
Introduction There is a limited literature base regarding the intersection of drug and alcohol treatment, violence, and trauma. While research substantiates that exposure to violence and trauma impacts the propensity to misuse substances, the conceptualization in clinical trials and practice has largely been narrow and gendered, referring only to intimate partner or domestic violence. Our systematic mapping review explored a more inclusive and expansive review of survivors of and perpetrators of violence and trauma (e.g., intimate partner violence, sexual assault, stalking, child abuse, political and community violence, criminal violence, micro violence, structural violence, and oppression) to establish: 1) the types of treatment settings included in intervention studies, 2) the common indicators of success or common outcomes recorded, and 3) understanding who is seeking treatment for drug and alcohol use with histories of violence. Methods A systematic mapping review was conducted to identify any peer-reviewed articles published from 2011 to 2022. The Web of Science database was searched using a broad set of Boolean search terms related to violence, substance use disorders, and treatment. Over 8,800 records were identified from the systematic review with a total of 48 articles meeting inclusion criteria. Results Most studies in this review included populations reporting perpetration of violence (n=23, 48%) versus participants reporting survival of trauma/violence (n=17, 35%). Results also indicated female identifying populations (n=19; 40%) were predominantly served, were treated in the US (n=33; 69%) and seen in an outpatient setting (n=24; 50%). Authors also were attentive to studies that included sexual and gender minorities and discovered only three studies (6%) explicitly acknowledging inclusion of transgender participants or participants in relationship with partners of the same sex; three more studies (6%) were focused on participants with histories of or engaging in sex work. Discussion This review outlines treatment and research implications directly situated in the gap of service delivery found in this review. Specifically, the results elucidate the impact on minoritized and excluded identities based on gender, sexual preference, criminal legal status and directions for research and treatment to increase inclusion, representation, and equity across research and treatment settings.
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Affiliation(s)
- Sara Beeler
- Jane Addams College of Social Work, University of Illinois Chicago, Chicago, IL, United States
| | - Olivia Gerrish
- Jane Addams College of Social Work, University of Illinois Chicago, Chicago, IL, United States
| | - B. Grantham Aldred
- University Library, University of Illinois Chicago, Chicago, IL, United States
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Uthurralt N, Miao Cao F, Reid SE, Nithyanandam L, Burns L, Day CA. Characteristics of clients entering women-only substance use treatment services in New South Wales. Womens Health (Lond) 2023; 19:17455057231200133. [PMID: 37921428 PMCID: PMC10625314 DOI: 10.1177/17455057231200133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 07/23/2023] [Accepted: 08/22/2023] [Indexed: 11/04/2023]
Abstract
BACKGROUND Women experiencing substance use disorders face barriers to treatment, including childcare, stigma and lack of gender/trauma-informed programming. Several non-government organizations in New South Wales run women-only treatment services to address these needs. OBJECTIVES We aim to assess characteristics of women entering treatment in these services. DESIGN Data on client characteristics from six women-only non-government organization substance use disorder treatment services in New South Wales between 2014 and 2018 were extracted from a database containing demographics, drug use and treatment characteristics and psychological distress (Kessler-10 scale) of women entering the services. Logistic regression models were used to estimate unadjusted odds ratio and adjusted odds ratio for treatment completion and different drugs on entry. RESULTS Data were available for 1357 women. Most (91%) episodes were for residential treatment. Women's mean age was 35.4 years (standard deviation = 9.8; range = 17-67). Residential clients tended to be younger than non-residential clients (35.1 vs 38.5 years, p < 0.001). Methamphetamine (43%) and alcohol (32%) were the most reported principal drug of concern. Women (89%) reported high levels of psychological distress (median Kessler-10 scale score = 27.5, range = 10-50), highest for women reporting alcohol as their principal drug. Overall, 43% of episodes resulted in treatment completion, most commonly for women entering residential treatment (45% vs 22%, p < 0.001) and for alcohol treatment (adjusted odds ratio = 1.42; confidence interval = 1.07-1.90; p < 0.001). Women with Kessler-10 scale scores indicating anxiety or depression at treatment entry were less likely to complete treatment than those with lower scores (adjusted odds ratio = 0.56; confidence interval = 0.38-0.80; p < 0.001). CONCLUSION Women entering women-only residential treatment tend to be younger and report methamphetamine as principal drug of concern. Women enter treatment with high degrees of psychological distress. Women's services need to ensure their programmes can respond to diverse needs of younger women presenting with methamphetamine use disorder and older women with alcohol use disorder experiencing high levels of psychological distress.
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Affiliation(s)
- Natalia Uthurralt
- Specialty of Addiction Medicine, Central Clinical School, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
- The Edith Collins Centre (Translational Research in Alcohol, Drugs and Toxicology), Sydney Local Health District, Sydney, NSW, Australia
| | - Felicia Miao Cao
- Specialty of Addiction Medicine, Central Clinical School, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
| | - Sharon E Reid
- Specialty of Addiction Medicine, Central Clinical School, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
- The Edith Collins Centre (Translational Research in Alcohol, Drugs and Toxicology), Sydney Local Health District, Sydney, NSW, Australia
| | | | - Lucy Burns
- National Drug and Alcohol Research Centre, UNSW, Sydney, NSW, Australia
| | - Carolyn A Day
- Specialty of Addiction Medicine, Central Clinical School, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
- The Edith Collins Centre (Translational Research in Alcohol, Drugs and Toxicology), Sydney Local Health District, Sydney, NSW, Australia
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Merrick TT, Louie E, Cleary M, Molloy L, Baillie A, Haber P, Morley KC. A systematic review of the perceptions and attitudes of mental health nurses towards alcohol and other drug use in mental health clients. Int J Ment Health Nurs 2022; 31:1373-1389. [PMID: 35909095 PMCID: PMC9796325 DOI: 10.1111/inm.13043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/30/2022] [Indexed: 01/01/2023]
Abstract
Mental and substance use disorders are leading contributing factors for the Australian non-fatal burden of disease. These disorders frequently co-occur in the mental health population, and mental health nurses are the largest group of professionals treating dual diagnosis. A comprehensive understanding of mental health nurses' attitudes and perceptions is required to inform future implementation of dual diagnosis training programs. A systematic literature review of sources derived from electronic databases including Medline, CINAHL, SCOPUS review, and PsychINFO, along with Connected Papers. Selection criteria included a focus on mental health nurses' attitudes towards dual diagnosis of mental illness and substance use. Extracted data was qualitatively synthesized. Of the 5232 articles retrieved initially, 12 were included in the review. Four themes emerged from the synthesis: drug and alcohol use among mental health consumers (seven studies), caring for dual diagnosis consumers (eight studies), role perception (six studies), and treatment optimism (five studies). Salient beliefs included substance use as a self-inflicted choice (71%) or a form of 'self-medication' (29%); a lack of willingness to provide care (75%), or a strong commitment to care (25%); greater comfort with screening and acute medical management rather than ongoing management (83%); and pessimism about treatment effectiveness (100%). Mental health nurses' beliefs and attitudes towards dual diagnosis were often negative, which is likely to result in poor quality care and treatment outcomes. However, the lack of recent studies in this research area indicates the need for up-to-date knowledge that can inform the development of training programs.
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Affiliation(s)
- Tammy Tran Merrick
- Sydney Medical School, Faculty of Medicine and Health Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Eva Louie
- Sydney Medical School, Faculty of Medicine and Health Sciences, The University of Sydney, Sydney, New South Wales, Australia.,Edith Collins Centre for Translational Research, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
| | - Michelle Cleary
- School of Nursing, Midwifery & Social Science, Central Queensland University, Queensland, Rockhampton, Australia
| | - Luke Molloy
- School of Nursing, University of Wollongong, Wollongong, New South Wales, Australia
| | - Andrew Baillie
- School of Health Sciences, Faculty of Medicine and Health Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Paul Haber
- Sydney Medical School, Faculty of Medicine and Health Sciences, The University of Sydney, Sydney, New South Wales, Australia.,Edith Collins Centre for Translational Research, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
| | - Kirsten C Morley
- Sydney Medical School, Faculty of Medicine and Health Sciences, The University of Sydney, Sydney, New South Wales, Australia.,Edith Collins Centre for Translational Research, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
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Hill B, Williams M, Woolfenden S, Martin B, Palmer K, Nathan S. Healing journeys: experiences of young Aboriginal people in an urban Australian therapeutic community drug and alcohol program. Health Sociol Rev 2022; 31:193-212. [PMID: 35786397 DOI: 10.1080/14461242.2022.2091948] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 06/16/2022] [Indexed: 06/15/2023]
Abstract
Disproportionately high numbers of Aboriginal young people access residential alcohol and other drug programs in Australia. While demand is high, these programs often have low numbers of Aboriginal staff. Residential programs, however, generally offer supports that reflect features of Aboriginal health care - holistic, group-based, connected to local communities, and addressing determinants of health. The qualitative research outlined in this paper was a collaboration between a mainstream residential therapeutic community program and two Aboriginal community-controlled organisations, and Aboriginal young people and researchers, with Aboriginal research leadership. It used an Aboriginal healing framework to understand the experiences of 12 young Aboriginal people in the program, triangulated with 19 key informant interviews. This provided an opportunity to understand how Indigenous knowledge about healing related to mainstream programs and the experiences of Aboriginal young people. This moves beyond individualist and deficit-focused conceptions of youth alcohol and drug use and centres Aboriginal cultures as healing. Findings point to the need for critically self-reflective mainstream organisations, a larger Aboriginal workforce with leadership roles, partnerships with Aboriginal Elders and organisations, and an investment in Aboriginal community-controlled alcohol and other drug services.
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Affiliation(s)
- Brittany Hill
- School of Population Health, UNSW Sydney, Sydney, Australia
| | - Megan Williams
- Girra Maa Indigenous Health Discipline, School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Susan Woolfenden
- Population Child Health Research Group, School of Women and Children's Health, UNSW Sydney, Sydney, Australia
- Sydney Children's Hospital Network, Sydney, Australia
| | | | | | - Sally Nathan
- School of Population Health, UNSW Sydney, Sydney, Australia
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Kealy-Bateman W, Christian N, Wetton R, Bruce BJ, Rowe D, McIntyre S. Use of a quality improvement strategy to increase drug and alcohol consultation and care opportunities for mental health inpatients in rural and remote New South Wales. Aust J Rural Health 2021; 29:586-590. [PMID: 34148275 PMCID: PMC8453571 DOI: 10.1111/ajr.12736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 02/08/2021] [Accepted: 02/17/2021] [Indexed: 11/30/2022] Open
Abstract
PROBLEM Mental health inpatients have high rates of co-morbid substance use disorders which may exceed 50% in addition to the presenting complaint(s). Treating teams may prioritise, and substance use disorders are often not addressed. SETTING Dubbo inpatient mental health units. KEY MEASURES FOR IMPROVEMENT Rates of drug and alcohol consult of inpatients. DESIGN Retrospective audit of all inpatient records for mental health units at Dubbo Hospital (May-October period 2018 and 2019) following the intervention. Qualitative reflections of clinical staff were also included. STRATEGIES FOR CHANGE From early 2019, the problem was communicated with staff via education and open discussion. Modelling of the expected numbers of referral was understood as manageable within existing resources. The agenda of the morning meeting then always included an item that asked all team members to identify and refer a person if they needed drug and alcohol care. EFFECT OF CHANGE Consultation by the drug and alcohol clinical nurse consultant increased from 48 of 228 (21%) patients in the 2018 period to 83 of 232 (35.8%) patients in the 2019 period. LESSONS LEARNT The community and inpatient multidisciplinary team can correctly inform and increase drug and alcohol referral for mental health inpatients.
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Affiliation(s)
- Warren Kealy-Bateman
- Western NSW Local Health District, Dubbo, NSW, Australia.,School of Medicine, University of Wollongong, Wollongong, NSW, Australia
| | | | - Rebecca Wetton
- Western NSW Local Health District, Dubbo, NSW, Australia
| | - Billy-Jo Bruce
- Western NSW Local Health District, Dubbo, NSW, Australia
| | - Deborah Rowe
- Western NSW Local Health District, Dubbo, NSW, Australia
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Berry S, Crowe T, Deane FP, Quinlan E. An exploratory study of culture in treatment for Aboriginal Australian men in residential drug and alcohol rehabilitation services. J Ethn Subst Abuse 2020; 21:149-173. [PMID: 32031501 DOI: 10.1080/15332640.2020.1725706] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The objectives of the research are to describe the cultural activities offered in residential drug and alcohol rehabilitation for Aboriginal Australian men, along with client perceptions of the benefits associated with these cultural activities. Participants were 101 Australian Aboriginal male clients attending five residential drug and alcohol rehabilitation services in New South Wales. Participants completed a semi-structured interview and questionnaires that included the Growth and Empowerment Measure, the Aboriginal Cultural Engagement Survey, Clinical Global Impressions, and two questionnaires regarding cultural engagement while in treatment. Service users indicated that the most beneficial cultural activities offered within services were traditional art/craft, culturally-focused talks/meetings, and being on the land. Hierarchical multiple regression analysis indicated that cultural engagement in everyday life significantly predicted empowerment but not other measures of mental ill-health. The opinions of service users are presented, and recommendations are made regarding ways to enhance the effectiveness of cultural activities within drug and alcohol rehabilitation programs.
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Affiliation(s)
- Stacey Berry
- Illawarra Institute for Mental Health, University of Wollongong, Wollongong, Australia
| | - Trevor Crowe
- Illawarra Institute for Mental Health, University of Wollongong, Wollongong, Australia
| | - Frank P Deane
- Illawarra Institute for Mental Health, University of Wollongong, Wollongong, Australia
| | - Elly Quinlan
- Illawarra Institute for Mental Health, University of Wollongong, Wollongong, Australia
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Staiger PK, Liknaitzky P, Lake AJ, Gruenert S. Longitudinal Substance Use and Biopsychosocial Outcomes Following Therapeutic Community Treatment for Substance Dependence. J Clin Med 2020; 9:jcm9010118. [PMID: 31906337 PMCID: PMC7020066 DOI: 10.3390/jcm9010118] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 12/20/2019] [Accepted: 12/23/2019] [Indexed: 11/16/2022] Open
Abstract
The Therapeutic Community (TC) model is considered an effective treatment for substance dependence, particularly for individuals with complex presentations. While a popular approach for this cohort across a number of countries, few studies have focussed on biopsychosocial and longer-term outcomes for this treatment modality. This study reports on substance use, dependence, and biopsychosocial outcomes up to 9 months post-exit from two TC sites. METHODS A longitudinal cohort study (n = 166) with two follow-up time points. Measures included substance use, dependence, subjective well-being, social functioning, and mental and physical health. Generalized Linear Models were employed to assess change over time. RESULTS At 9 months, 68% of participants reported complete 90-day drug abstinence. Alcohol frequency and quantity were reduced by over 50% at 9 months, with 32% of the sample recording 90-day abstinence at 9 months. Both alcohol and drug dependence scores were reduced by over 60%, and small to medium effect sizes were found for a range of psychosocial outcomes at 9 months follow-up, including a doubling of wellbeing scores, and a halving of psychiatric severity scores. Residents who remained in the TC for at least 9 months reported substantially better outcomes. CONCLUSIONS With notably high study follow-up rates (over 90% at 9 months post-exit), these data demonstrate the value of the TC model in achieving substantial and sustained improvements in substance use and psychosocial outcomes for a cohort with severe substance dependence and complex presentations. Implications for optimal length of stay are discussed.
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Affiliation(s)
- Petra K. Staiger
- School of Psychology, Deakin University, Geelong 3220, Australia; (P.L.); (A.J.L.)
- Deakin University Centre for Drug Use, Addictive and Antisocial Behaviour Research (CEDAAR), Burwood 3125, Australia
- Correspondence: ; Tel.: +61-3-924-46876
| | - Paul Liknaitzky
- School of Psychology, Deakin University, Geelong 3220, Australia; (P.L.); (A.J.L.)
- Odyssey House Victoria, Melbourne 3121, Australia;
| | - Amelia J. Lake
- School of Psychology, Deakin University, Geelong 3220, Australia; (P.L.); (A.J.L.)
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, Victoria 3051, Australia
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Bui TA, Wijesekera N. Unemployment and the rate of psychoactive-substance-related psychiatric hospital admission in regional Queensland: An observational, longitudinal study. Australas Psychiatry 2019; 27:388-391. [PMID: 31246111 DOI: 10.1177/1039856219859265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To examine the relationship between a regional economic downturn (indicated by the rise of population unemployment rate) and the rate of psychoactive-substance-induced psychiatric hospital admissions in the population in a rural/regional setting. METHODS Hospital admission records from January 2013 to December 2016 were reviewed retrospectively. All patients with admissions to the Mackay inpatient psychiatric unit with diagnosis of mental and behavioural disorders due to psychoactive substance use were recorded using (ICD-10) F10-F19 codes. The relationship between the regional unemployment rate and the hospital admission rate was analysed using linear regression analysis. RESULTS A statistically significant regression was found (F(1,46) = 39.46, p < 0.0001), R2 = 0.46). The predicted number of admissions per 100,000 population in a month was observed to increase on average by 3.13 per month (95% CI = 2.12-4.13, p < 0.0001) for each percentage increase in the regional unemployment rate. CONCLUSIONS There was a statistically significant association between the population unemployment rate and the rate of substance induced psychiatric hospital admissions. Implications for regional Australian service provision and unmet needs were discussed. Further research is required to confirm this observation.
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Affiliation(s)
- Tuan Anh Bui
- Psychiatry Registrar, Gold Coast University, Southport, QLD, Australia
| | - Ninel Wijesekera
- Psychiatry Registrar, Queensland Health, Mackay Base Hospital, Mackay, QLD, Australia
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Oliver M, Adonopulos AA, Haber PS, Dinh MM, Green T, Wand T, Vitte A, Chalkley D. Impact of acutely behavioural disturbed patients in the emergency department: A prospective observational study. Emerg Med Australas 2018; 31:387-392. [PMID: 30230230 DOI: 10.1111/1742-6723.13173] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 07/30/2018] [Accepted: 07/31/2018] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The present study describes patients with acute behavioural disturbance presenting to the ED, the impact they have on the department and any complications that occur. METHODS We performed a prospective observational study of adult patients (>17 years old) requiring parenteral sedation for acute behavioural disturbance over a 13 month period. Demographic data, mode of arrival, indication, drug type and dosing used for sedation were collected. Departmental data were recorded including the staff type and numbers involved and the condition of the department. The main outcomes were complications from sedative medication and injury sustained to patients or staff. RESULTS Over the study period 173 patients met inclusion criteria, the majority (n = 104, 60%) were men with a mean age of 38.5 years (standard deviation 14.4); 51% of patients had more than one indication for sedation (n = 89), the commonest being mental health related plus drug intoxication (n = 30, 33.7%). Intoxication was frequently from either alcohol (n = 62, 47%) or methamphetamine (n = 41, 31%). The median number of staff involved was 10 (interquartile range 8-12). Staff members received an injury in 12% (n = 20) of sedations, with only 1% (n = 2) of patients receiving any physical injury; 12% (n = 20) had a minor complication from the sedation medication. No patient had any major complication (apnoea, intubation, arrhythmias or cardiac arrest). CONCLUSION Patients with acute behavioural disturbance often have a history of mental illnesses and are commonly intoxicated. These patients have impacts on healthcare resources and pose risks to staff safety, but significant complications to patients do not occur frequently.
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Affiliation(s)
- Matthew Oliver
- Department of Emergency Medicine, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.,Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
| | - Aaron A Adonopulos
- Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
| | - Paul S Haber
- Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.,Department of Drug Health, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Michael M Dinh
- Department of Emergency Medicine, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.,Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
| | - Tim Green
- Department of Emergency Medicine, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Tim Wand
- Department of Emergency Medicine, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.,Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
| | - Alexandre Vitte
- Department of Emergency Medicine, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Dane Chalkley
- Department of Emergency Medicine, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
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Munro A, Allan J, Shakeshaft A, Snijder M. Riding the rural radio wave: The impact of a community-led drug and alcohol radio advertising campaign in a remote Australian Aboriginal community. Aust J Rural Health 2017; 25:290-297. [PMID: 28234420 DOI: 10.1111/ajr.12345] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/17/2016] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE Aboriginal people experience a higher burden of disease as a consequence of drug and alcohol (D&A) abuse. Although media campaigns can be a popular tool for disseminating health promotion messages, evidence of the extent to which they reduce the impact of substance abuse is limited, especially for rural Aboriginal communities. This paper is the first to examine the impact a locally designed D&A radio advertising campaign for Aboriginal people in a remote community in Western NSW. DESIGN A post-intervention evaluation. SETTING The radio campaign was implemented in Bourke, (population 2465, 30% Aboriginal). PARTICIPANTS Fifty-three community surveys were completed. MAIN OUTCOME MEASURE(S) The self-reported level of awareness of the campaign and the number of self-referrals to local D&A workers in the intervention period. RESULTS Most respondents (79%) reported they listen to radio on a daily basis, with 75% reporting that they had heard one or more of the advertisements. The advertisement that was remembered best contained the voice of a respected, local person. There was one self-referral to local health services during the intervention timeframe. CONCLUSION The community-led radio advertising campaign increased community awareness of substance abuse harms, but had limited impact on formal help-seeking. This paper highlights the value of radio as a commonly used, trusted and culturally relevant health promotion medium for rural communities, especially when engaging local respected Aboriginal presenters.
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Affiliation(s)
- Alice Munro
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Julaine Allan
- The Lyndon Community, Orange, New South Wales, Australia
| | - Anthony Shakeshaft
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Mieke Snijder
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
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Abstract
In 2001, there were 35 million Latinos living in the United States. It is estimated that by 2050 Latinos will comprise 97 million people in the United States, or one-fourth of the U.S. population, establishing this ethnic group as the fastest growing and soon to be largest in the country (U.S. Census Bureau, 2001 ). These numbers highlight the need for a multicultural paradigm shift, or the inclusion of culture-specific skills and culturally responsive interventions in psychological practice. Latinos face challenges as a racial/ethnic group that the traditional Euro-American model of treatment neither addresses nor validates. Unfortunately, substance abuse serves a purposeful function for many Latinos as a means of escape from the problems related to the social, environmental, and political structures. The current article adapts the model set forth by Parham ( 2002 ) as a strength-based therapeutic framework for intervention. The following stages are outlined to serve as the basis for most therapeutic encounters with clients from all racial and ethnic groups presenting with substance abuse problems: therapeutic alliance building, culturally appropriate assessment, sociopolitical awareness and liberation, creating collaborative change, and addressing sustainability of change.
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Abstract
BACKGROUND AND OBJECTIVE The Cochrane Drugs and Alcohol Group aims to produce, update, and disseminate systematic reviews on the prevention, treatment, and rehabilitation of problematic drug and alcohol use. This paper describes what the Group has done since the 1990s to produce evidence to guide policy, practice, and research. METHOD We analyze the coverage of topics by our reviews, the body of studies they have included, and the evidence produced. RESULTS By July 2013, the Group had published 67 reviews, with 376 authors from 25 different countries. These reviews included 906 studies, of 3061 studies considered for inclusion. Most (90%) included studies were randomized trials. Considering the 'Implications for practice' section of each review, 41% interventions were classified as 'do it', 15% as 'do not do', and 44% as 'do only in research'. These proportions varied according to the type of substance of abuse studied. The proportion of 'do it' interventions were 46% for alcohol, 40% for opioids, 20% for psychostimulants, 40% for polydrugs, and 62% for prevention. CONCLUSION Cochrane Reviews produced by the Drugs and Alcohol Group provide evidence on the effectiveness of several interventions, and identify areas of uncertainty where new research is needed.
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Affiliation(s)
- Laura Amato
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
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