Cathinones are psychostimulant compounds heavily implicated as drugs of abuse. They exert their physiological actions at the monoamine transporters, which are responsible for maintaining synaptic neurotransmitter homeostasis. Monoamine transporters produce currents during transport and have been shown to depolarize cell membranes and activate voltage-gated calcium channels in mammalian expression systems. This phenomenon is harnessed in an assay which measures these induced calcium transients, allowing for quantification of pharmacodynamic effects of compounds at monoamine transporters. It is unknown if this electrical coupling occurs in neurons, but the implications if it does are significant. In the current work, fluorescent resonance energy transfer studies of HEK cells expressing hDAT suggest that a subpopulation of monoamine transporters and calcium channels may be interacting directly. Additionally, this work presents calcium assay data comparing several novel methcathinone analogs. Of the compounds tested, a single α-methyl substituent at the α-carbon yields the greatest potency at hDAT. The implications of these results shed light on future psychostimulant studies and further define the physiological relationship of the components of a system used to study these compounds.

Efforts to increase employment rates through vocational skills training and job interview skills development have yielded mixed results. While initial studies of Job Seekers Workshop (JSW) found greater employment success for participants randomized to JSW as compared to a control condition (Hall, Loeb & Norton, 1977), a more recent Clinical Trials Network (CTN) study found no differences in employment outcomes between the JSW and control groups and the rate of employment overall was substantively lower than those reported in the early studies (Svikis et al., 2012). To better understand these discrepant findings, the present study conducted secondary analyses using the 2012 RCT dataset. It examined whether JSW participants engaged in more types and higher frequencies of various job-seeking behaviors than SC controls. The study also examined the relationship between JSW intervention dose and employment outcomes. Finally, the study sought to identify individual and treatment variables associated with getting a job. The results showed comparable rates of job-seeking behavior in JSW and SC controls. However, JSW intervention dose (number of sessions attended) was related to the likelihood of employment at 6-month follow-up. Univariate analysis found a variety of demographic, treatment, and psychosocial variables associated with becoming employed during study follow-up. Multivariate analyses found the most parsimonious model for predicting employment during the 6- month follow up period including being male, attending psychosocial outpatient treatment, attending more JSW sessions, submitting a job application, and living with a sexual partner or children. Future research should look more closely at barriers to employment and how to better measure client motivation to get a job.

Crack cocaine users need efficacious treatment options to address triggers and cravings for the drug. The purpose of this qualitative, multiple case study was to explore the recovery narratives of 3 purposefully selected substance abuse counselors who were once addicted to crack cocaine and whether or not these narratives fit within the 5 stages of the transtheoretical model of change (TTM). The TTM was used in this study to explore the stages of change in those with prior addiction regarding the motivational strategies needed to promote change. Data collected in face to face interviews were organized using thematic content analysis and QDA Minor Lite analysis software. Study results showed that the action stage seems the be the most promising focus for change. Each participant once in the action stage moved between action and relapse until action and maintenance became solidified in their mindset. The action stage, therefore led to social change for the individual, their family, and the community in which they lived. Therefore, the process of recover does fit within the stages of the TTM, however, relapse and risk of relapse plays a vital part of not making the stages qualitatively distinct. The results of the study show that various factors create the addiction process and help to recover from it. However, self-actualization and self-determination prove to be the motivating factors of change and recovery. The findings contribute to social change by understanding how the recovery stories fit within the stages of the TTM and how further understanding of the relapse process is necessary to possibly get to a definitive termination stage.

Heroin addiction is a growing epidemic in the United States. The need for proper treatment programs accessible by heroin users who wish to or are mandated to participate in recovery programs is a growing need, and pathways to sobriety for ex-offenders have presented in literature as understudied. The purpose of this study was to examine heroin-addicted offenders' experiences prior to and after release on their paths to sobriety. This study followed a qualitative phenomenological approach based on the theory of personal causation, which posits that individuals see events in life as either driven by themselves or caused by others, both of which affect internal motivation. An empirical phenomenological approach was used to explore how this group of individuals perceived or experienced heroin addiction and their subsequent attempts at sobriety A purposeful sample of 15 heroin-addicted offenders were interviewed in a jail in a rural county of Wisconsin. Upon re-entry, 4 participants completed follow- up interviews. The results showed that external motivators such as social and treatment factors were separate from internal factors, although external motivators could influence the way a person makes internal choices. Results were obtained by performing coding on the semi-structured interviews both by hand and within the Atlas-ti analysis program. The theory of personal causation supports and is supported by the findings of this study. Implications for positive social change include a better understanding of the needs of heroin-addicted offenders moving from incarceration to release in treatment program development, thereby reducing harm to the heroin user, family members, and communities by decreasing relapse, recidivism, and chances of overdose and death.

Research in the late 1990s and early 2000s projected that the number of people aged 50 and older who needed treatment for illicit drug use and abuse of prescribed medications to increase from approximately 1.7 million in 2001 to approximately 4.4 million in 2020. The purpose of this study was to examine how gender, marital status, employment status, and primary referral source predicted treatment outcomes with this older population. Of interest was how these predictions could better prepare treatment providers to treat individuals born between 1946 and 1964 who are addicted to substances. This quantitative study used an archival database, the Treatment Episode Dataset-Discharges (TEDS-D) from the Substance Abuse and Mental Health Services Administration. A discriminant function analysis revealed significance in the predictor variables with treatment outcomes. The second research question asked whether the criminal justice system/legal system alone, as the primary referral source, could predict treatment outcomes. A chi-square test revealed the primary referral source had a significant impact on treatment outcomes. These findings have implications for positive social change by empowering practitioners working with the older adult generation in substance abuse treatment to recognize the changing roles of retirement. These findings may, in turn, help those adults cope with physical health problems and loss of mobility, foster social supports within the community, and address the mental health problems among this population.

There is limited data about the positive application of self-efficacy and the practice of transparency for individuals in recovery to achieve long-term recovery from substance addiction and criminal recidivism. The purpose of this qualitative phenomenological study was to gain more insight and knowledge about how the application of self-efficacy and the practice of transparency help individuals in recovery achieve long-term recovery from substance addiction and criminal recidivism for two or more years. The conceptual framework used to guide this study was Albert Bandura's self-efficacy theory. This study is significant because it explains that long-term recovery is not an easy task to achieve, and many individuals who have a history of addiction and criminal behavior find it extremely difficult to achieve long-term recovery. A qualitative phenomenological approach was used for this study. This study employed a chain sample, using a semi-structured interview guide composed of open-ended questions. Five individuals agreed to the study and reported applying and practicing self-efficacy and transparency to achieve long-term recovery. The study analyzed and coded data to identify categories and themes. The findings reveled the importance of the use of self-efficacy and transparency in achieving long-term recovery from substances and decreasing recidivism. Themes identified was the ability to live day-to-day, breaking the cycle of addiction and recidivism, believing they are worth recovery (a better life), and sharing their story (transparency). This study may stimulate positive social change with the application of self-efficacy, as people struggling with addiction and recidivism may learn the importance of being transparent during the recovery process.

The introduction of a Thomistic framework to contemporary models of addiction provides new insight that may prove useful in efforts toward therapy and understanding. Aquinas's conception of the human soul and its proper functioning contrasts with the suggested disordered functioning of the addict's soul in such a way that this may prove useful for addicts attempting to interpret their physical, psychological, and moral feelings or intuitions. This framework can then be related to the common contemporary addiction therapy found in Alcoholics Anonymous and other Twelve Step programs in order to provide a greater understanding of what psychological and moral processes may be at work within the addict with the hope that greater understanding will lead to more effective therapy.

The mesolimbic dopamine (DA) system has been implicated in providing the basis of pleasure, guiding the general mechanism of reinforcement as well as motivation. Support for these roles have grown from neurochemical research in the field of addiction. It is now well known that DA activity increases in the nucleus accumbens septi (NAcc) with exposure to addictive substances. Moreover, pharmacological manipulation of this system produces predictable changes in the administration of drugs of abuse, as well as natural reinforcers. This system is responsive to natural reinforcers and addiction may be the transference of routine mesolimbic function to environmental stimuli predictive of drug administration. The role of the NAcc in addiction specifically appears to be the facilitation of attention to drug-paired stimuli and addiction may be the behavioral manifestation of conditioned NAcc DA reactivity to the presence of drug-related stimuli. Although these findings have been reported in adults, few studies have focused on adolescence, the time when drug use/abuse begins. Adolescents may be particularly susceptible to addiction when considered in the light of this hypothesis. Recent research has revealed that the mesolimbic system of periadolescent animals is undergoing dramatic transition in functional tone. DA receptor and transporter levels are up regulated, synthesis rates are altered, and innervation from prefrontal cortex (PFC), involved in regulating tonic and phasic DA activity, is increasing. Consequently, during adolescence there is a dramatic change in tonic DA levels, variations in phasic responses to acute drug administration and alterations in how the system adapts to repeated drug exposure. The present study utilizes the procedures of conditioned place preference, Novelty preference and in vivo microdialysis to determine how this conditioning process changes during the period of adolescence. The results indicate that adolescents are different from adults not only on behavioral measures associated with drug abuse, but in their neurochemical responsiveness to alcohol, and that these differences are related to a general developmental aspect of adolescence that renders them susceptible to addiction.

In this dissertation, I seek to examine the effects of purposeful journaling and guided storytelling on past traumas, perception of current lives, and the development of new coping skills among men at The Salvation Army’s residential adult rehabilitation center (ARC). All residents of the ARC must attend Christian-based devotional services, go to Alcoholics Anonymous (A.A.) meetings, follow the A.A. 12-step program, and sign up for several weekly counseling and educational groups, one of which is the “Guided Journaling and Storytelling” group I lead. The men who attended this group are (1) addicted to drugs and/or alcohol, (2) face homelessness, (3) cope with some form of mental or physical health issue, (4) may have criminal records, and (5) have alienated most of their social support. Through a twelve-week curriculum I developed, I introduced coping skills—building resilience, expressive writing, and deep breathing—while incorporating art, music, and poetry in the groups. I elicited participants’ stories through prompts, using my own experiences to model vulnerability and demonstrate concepts, such as: narrative reframing; how memories can be uncertain, partial, and elusive; how storytelling can prompt forgotten stories; and the efficacy of including emotion and rich details in the stories we tell. Knowing the value of writing and storytelling, I set out to see if the communicative practices I had learned in the past that had improved my life situation might assist others to write themselves out of destructive patterns, desperation, and trauma, and into sober and more fulfilling lives.

Since the introduction of tobacco into New Zealand, smoking and smoking related illnesses have become more prevalent in the Maori population than New Zealand's general population. The aim of the present research was to investigate smoking from a Maori perspective. It was hoped this information would provide a better understanding of how Maori can become smokefree. The present research also investigated a number of possible benefits that could be obtained by Maori through becoming smokefree. These benefits were analysed through Mason Durie's Whare Tapa Wha model, a Maori holistic health model. Semi-structured in-depth interviews were conducted with four Maori people, two of whom were current smokers and two who were ex-smokers. Common themes emerged from these interviews including the social aspect of smoking for Maori and the influence of the enviroment on smoking behaviour. Suggestions were given to illustrate how the social aspect of smoking and the cycle that subsequently develops can be broken. Using the Whare Tapa Wha model and the personal accounts given, the benefits of breaking such a cycle were discussed. Lastly, the importance of nurturing smokefree environments, especially Maori environments, was outlined. The notion of being positive about becoming smokefree and the need to celebrate giving up smoking were highlighted throughout this research.