First offering insight into the disease of sexual addiction overall and what, in fact, does delineate it from sexual promiscuity, this paper will go on to seek ways to mitigate such behavior by exploring not only symptoms, but the existing underlying issues as well through a yogic whole-body perspective. Furthermore, diving deeper into such an application, specifically under the context of the yamas and niyamas and investigating how both might, not only serve as therapeutic tools for sex addicts, but perhaps allow for a healthier approach overall to sex in the modern world. First offering insight into the disease of sexual addiction overall and what, in fact, does delineate it from sexual promiscuity, this paper will go on to seek ways to mitigate such behavior by exploring not only symptoms, but the existing underlying issues as well through a yogic whole-body perspective. Furthermore, diving deeper into such an application, specifically under the context of the yamas and niyamas and investigating how both might, not only serve as therapeutic tools for sex addicts, but perhaps allow for a healthier approach overall to sex in the modern world.

Ett begrepp som på senare tid fått större utrymme inom behandling av beroendesjukdom är skadereduktion (Harm reduction). Skadereduktion är metoder och ambitioner syftar till att minska skadeverkningarna av ett beteende utan att nödvändigtvis minska beteendet. Skadereduktion är ett begrepp som under senare år har fått en ökad användning inom sjukvård och socialtjänst men också inom rättsväsende och policyarbete. Trots att det använts i olika kontexter sedan 90-talet så finns det ingen tydlig definition av vad det innebär och olika tolkningar av begreppet kan leda till svårigheter att implementera dessa vårdåtgärder. Syftet är att beskriva skadereduktion som begrepp inom beroendevård med hjälp av begreppsanalys. En begreppsanalys utifrån Segesten modell (2017) har genomförts. Resultatet utgörs av en lexikal del och en litterär del som leder till att definiera meningsbärande attribut som sedan sorterats in i framträdande attribut för skadereduktion. I den litterära analysen presenteras de framträdande attributen som är: Autonomi, delaktighet av personer som tar droger, fokus på skador, folkhälsa, mänskligt värde och praktiskt och pragmatiskt. Tre fallbeskrivningar utformades för att beskriva och förtydliga resultatet. Avslutningsvis diskuteras hur skadereduktion och dess attribut förhåller sig inom kontexten beroendevård. Skadereduktion är mer än bara specifika insatser utan också ett förhållningssätt och ett annat sätt att se på de som brukar droger. Skadereducerande insatser och förhållningssätt flyttar fokus från att bota till att fokusera på att minska skador för dem som brukar droger.

Counselor educators prepare master's-level counselors-in-training on addiction topics. This content analysis examined the frequency and types of addiction topics for counselor educator continuing education. The results revealed limited attention to addiction topics within professional literature and conference presentations.

The contributions of impulsive and risk-taking behaviour in depressive and bipolar disorders, motivational and motor behaviours in anhedonic and substance addictive states, and the factors, particularly distress and trauma, underlying the development of neuropathology in affective status are described from clinical, epidemiological and laboratory perspectives. In order to distinguish one case factor for biopsychological substrates of health, an array of self-reported characteristics, e.g., positive or negative affect, stress or energy, optimism, etc., that may be predictive or counterpredictive for the propensity for physical exercise and activity were analysed using a linear regression in twelve different studies. Several individual characteristics were found to be markedly and significantly predictive of the exercise propensity, i.e., positive affect, energy, health-seeking behaviour and character, while optimism was of lesser, though significant, importance. Several individual characteristics were found to be significantly counterpredictive: expression of BDI- and HAD-depression, major sleep problems and lack/negligence of healthseeking behaviour. The consequences of physical activity and exercise for both affective well-being, cognitive mobility and neurogenesis is noted, particularly with regard to developmental assets for younger individuals. Affective disorder states may be studied through analyses of personal characteristics that unfold predispositions for symptom-profiles and biomarkers derived from properties of dysfunction, such as impulsiveness, temperament dimensions, anhedonia and 'over-sensitivity', whether interpersonal or to reward.

Forgiveness is argued to be highly relevant to problematic substance use, yet supportive empirical evidence is lacking. Findings are presented from a longitudinal study exploring the relationship between religiousness and spirituality (RS) variables and alcohol use disorders. We examined forgiveness of self (ForSelf), of others (ForOthers), and by God (ByGod), hypothesizing positive relationships with RS and negative relationships with alcohol use and consequences, at both baseline (N = 157) and six-month follow-up (N = 126). ForSelf scores were significantly lower than ForOthers and ByGod scores, and ForOthers scores increased modestly over time. ByGod was most consistently associated with other RS variables. ForSelf and ForOthers were associated with alcohol-related variables at both time points, and baseline ForSelf and ForOthers were associated with fewer drinking consequences at follow-up, but not after controlling for other pertinent variables. ForSelf may be most difficult to achieve and thus most important to recovery, thereby preventing full recovery and fostering relapses.

Naloxone (NAL) is administered parenterally or intranasally for treating opioid overdose. The short duration of action of NAL calls for frequent re-dosing which may be eliminated by the development of a transdermal system. This study aimed to assess the effect of microneedles on improving the skin permeation of NAL hydrochloride. In vitro permeation of NAL across intact and microneedle-treated (Dr. Pen™ Ultima A6) porcine skin was evaluated. The effect of microneedle length and application duration, and donor concentration on NAL permeation were investigated. In-vitro in-vivo correlation of the permeation results was done to predict the plasma concentration kinetics of NAL in patients. In vitro passive permeation of NAL after 6 h was observed to be 8.25±1.06 µg/cm2. A 56- and 37-fold enhancement was observed with 500 and 250 µm needles applied for 1 min, respectively. Application of 500 µm MNs for 2 min significantly reduced the lag time to ~ 8 min and increasing the donor concentration for the same treatment group doubled the permeation (p < 0.05). Modeling simulations demonstrated the attainment of pharmacokinetic profile of NAL comparable to those obtained with the FDA-approved intramuscular and intranasal devices. Microneedle-mediated transdermal delivery holds potential for rapid and sustained NAL delivery for opioid overdose treatment.

This study examined which particular facets of mindfulness (nonreactivity, observing thoughts and feelings, acting with awareness, describing experience, and nonjudging of experience) accounted for improvements in mood and warning signs of relapse in an adult population. This exploratory study examined the impact of the five facets of mindfulness on both warning signs of relapse and mood in a primarily minority adult population in a residential substance abuse treatment facility. Results showed that all five facets were significantly correlated with mood and warning signs at the bivariate level. When considering the facets together, observing and nonjudging were related to mood, and acting with awareness and nonjudging were related to warning signs. Implications for future research and practice are offered.

This exploratory study was based upon Bowen Family Systems theory and investigated emotional cutoff in women (n = 168) who entered a substance abuse treatment program. Three questions were explored: First, the degree of emotional cutoff in this sample was compared to a non-clinical sample of women. Secondly, the relationship was explored between the variable of emotional cutoff and the following variables: substance abuse variables, individual psychological functioning variables, and marital and family relationship variables. Finally, the relationship was explored between dropout from substance abuse treatment and emotional cutoff.Results indicate that the degree of emotional cutoff was significantly higher in this clinical sample of women who abused substances than in two comparison samples - one was a non-clinical sample of women balancing multiple roles and responsibilities and one mixed sample of divorced men and women. Emotional cutoff was found to have a significant positive relationship with the following variables: behaviors characteristic of substance abusers, behaviors of a highly defensive person, symptoms of depression, anxiety, hostility, psychoticism, somatization, obsessive compulsive disorder, interpersonal sensitivity, and a global assessment of psychological dysfunction. Emotional cutoff was found to have a significant negative relationship with denial of substance abuse. No significant relationship was found between emotional cutoff and marital satisfaction, health or distress in family functioning, dropout from treatment, severity of substance abuse, and symptoms of paranoia or phobia. These results have implications for further research based on Bowen theory and the understanding of the emotional process of addicted family systems. / Master of Science

Hypocretin/Orexin (HCRT) neurotransmission facilitates drug-seeking behavior. HCRT neurotransmission at HCRT-receptors 1 and 2 (HCRT-R1 and -R2, respectively) is implicated in addiction. During the shift to alcohol-dependency, adaptations in neurotransmitter systems occur in reward- and stress-related brain regions. Specifically, neurotransmission systems in the central amygdala (CeA) are modulated by alcohol drinking/exposure. Therefore, this study investigated Hcrtr1 and Hcrtr2 mRNA expression in the CeA of alcohol-dependent rats and in non-dependent controls during acute alcohol withdrawal. Fos mRNA expression in the CeA of alcohol-dependent and non-dependent rats was also determined to assess adaptations in neuronal activation. To our knowledge, this is the first study to utilize RNAscope to quantify Hcrtr1 and Hcrtr2 mRNA in a rodent model of alcohol dependence. However, Hcrtr1, Hcrtr2, and Fos mRNA levels were not found to be significantly different in alcohol-dependent rats compared to non-dependent controls, possibly due to the temporal dynamics of these neuroadaptations.

Bakgrund: Opiattillgängligheten är ett växande problem världen över. Således kan personer som är beroende eller missbrukare av opiater komma att söka sig till hälso- och sjukvården på grund av smärta. Personer som sjuksköterskan inom ramen för sitt omvårdnadsansvar kan behöva skatta avseende smärtintensitet och administrera smärtstillande läkemedel till. Syfte: Syftet med studien är att kartlägga sjuksköterskors upplevelser av att smärtlindra personer beroende av opiater.Metod: Studien genomfördes som en litteraturstudie med kvalitativ ansats. Resultat: Kartläggning resulterade fyra huvudteman: Likvärdigt bemötande, där en del sjuksköterskor visade empati medan andra inte gjorde det, handlingsberedskap via erfarenhet som hjälpte sjuksköterskors bemötande av personer med beroendeproblematik. Det tredje temat var misstänksamhet begränsar, där sjuksköterskor hade en misstänksamhet och deras syn på personer var att personerna bara ville ha smärtstillande läkemedel. Sjuksköterskor uttryckte även smärtbedömningens komplexitet vid bedömning av personens smärta.Konklusion: Sjuksköterskor ställs inför många komplexa situationer relaterat till smärta och beroende där varje person och situation är unik. Utifrån studiens fynd behöver sjuksköterskor implementera hela sin skicklighet, i mötet med personer beroende av opiater, vilket görs genom att de arbetar personcentrerat och holistiskt. Då antalet studier med kvalitativ ansats är få inom detta område behövs vidare forskning från såväl sjuksköterskans perspektiv som från personen beroende av opiater. / Background: Opiate availability is a growing problem worldwide. These people who are addicted or addicted to opiates may seek medical care because of pain. Persons to whom the nurses within the scope of their nursing responsibilities may need to assess pain intensity and administer additional painkillers. Aim: The purpose of the study is to survey nurses experiences of relief pain from persons with opiate addiction. Method: The study was conducted as a literature review with a qualitative approach. Results: Four main themes during the data-analysis. The four main themes were first; equal treatment, towards the person they care for, second; action readiness through experience, which helped nurses in dealing with people with addiction problems. Third; suspicion limiting, where nurses had a suspicion and their view was that individuals only wanted painkillers. Last; nurses expressed the complexity of pain assessment. Conclusion: Nurses are faced with many complex situations related to pain and dependence where each person and situation is unique. Based on the findings of this study, nurses need to implement all their skills in the meeting with the opioid-dependent person. This was done by working through person-centered care and with a holistic approach. As the number of studies with a qualitative approach is few in this area, further research is needed from both the nurse's perspective and from the person dependent on opiate.Keywords: Addiction, experiences, nurse, opiate, pain.