The topic Needs of people addicted to drugs and alcohol to maintain succesful abstinence in aftercare was chosen. Aftercare is an important part of addiction treatment, but often overlooked and unused. The aim is to clarify the needs of abstinent persons addicted to alcohol and other non-alcohol drugs and their subsequent comparison. The thesis is divided into two parts, theoretical and practical. The theoretical part deals with the development of addiction, its diagnosis, description of drugs and treatments options. Chapters dealing with treatment are thoroughly discussed because of the individual usage during the treatment of addiction. Aftecare of addicted people and problems with relapse take place in this part of work. The second part deals with research focused on identifying the needs of addicted people to drugs and alcohol to maintain successful abstinence and their subsequent comparison. Clarifying of these needs can serve as a recommendation to other abstaining people or as a support to services in the system of aftercare to successful abstinence nowadays. KEYWORDS Addiction, addictive substances, drug addiction treatment, abstinence, relapse, aftercare for drug and alcohol rehab

Utifrån de teoretiska begreppen handlingsutrymme och paternalism undersöker studien handläggares hantering av gravida kvinnor med missbruksproblematik med fokus på samverkan och hänsyn till graviditet. Urvalet består av sex handläggare med erfarenhet av gravida klienter med missbruk. Hälften av intervjupersonerna arbetar i stadsdelsförvaltningar och kommuner i Stockholm medan den andra hälften arbetar i andra kommuner. Det empiriska materialet insamlades genom semi-strukturerade intervjuer med utgångspunkt i en vinjett. Därefter analyserades materialet utifrån en tematisk analys. Resultatet visar att handläggarnas hantering av klientgruppen varierar i stor utsträckning. Vissa handläggare anpassar insatserna på grund av klientens graviditet medan andra inte låter sig påverkas av det. Dessutom skiljer sig handläggarnas uppfattning kring vad som krävs för att tillämpa LVM när det gäller en gravid klient. Tidigare forskning visar att det är framgångsrikt att samla insatser för att tillgodose klientgruppens behov. Samtidigt visar studiens resultat att detta inte går att uppnå om det inte finns en god samverkan mellan kommun och region. Handläggarnas fokus på samverkan varierar vilket också påverkar klientgruppens möjlighet att få heltäckande behandling. / Based on the theoretical concepts of room for action and paternalism, the study examines caseworkers' handling of pregnant women with substance abuse problems with a focus on collaboration and consideration of pregnancy. The selection consists of six caseworkers with experience of pregnant clients with addiction. Half of the interviewees work in district administrations and municipalities in Stockholm, while the other half work in other municipalities. The empirical material was collected through semi-structured interviews based on a vignette. The material was then analyzed based on a thematic analysis. The results show that the case managers' handling of the client group varies to a large extent. Some caseworkers adapt the interventions due to the client's pregnancy, while others are not affected by it. In addition, case managers differ in their views on what is required to apply compulsory care when it comes to a pregnant client. Previous research shows that it is successful to gather efforts to meet the needs of the client group, the results of the study show that this cannot be achieved if there is no good cooperation between municipality and county council. The case managers' focus on collaboration varies, which also affects the client group's ability to receive comprehensive treatment.

Drug addiction is at crisis level in the United States. Nurses caring for persons affected by substance use disorder (SUD) have a resource in Mr. Ming Ho Liu's testimony on Good TV (Taiwan)—translated and summarized in this article—of his addiction experiences and successful treatment at Operation Dawn, a Christian drug rehabilitation center. Recovery from SUD is possible by God's power. In Mr. Liu's case, his recovery was accomplished without medication.

Indiana University-Purdue University Indianapolis (IUPUI) / Nicotine use among individuals with schizophrenia occurs at extremely high rates. The prevailing theory is that individuals with schizophrenia smoke as a form of self-medication to ameliorate sensory and cognitive deficits. However, these individuals also have enhanced rates of addiction to several drugs of abuse and may therefore smoke as a result of enhanced addiction liability. The experiments described herein explored these two hypotheses by assessing the effect that nicotine has on working memory, addiction vulnerability (locomotor sensitization and self-administration), and nicotinic acetylcholine receptor (nAChR) expression as well as the developmental expression of these characteristics in the neonatal ventral hippocampal (NVHL) neurodevelopmental animal model of schizophrenia. The results from these studies indicate that NVHLs had working memory impairments in both adolescence and adulthood, with nicotine having a negligible effect. Additionally, NVHLs displayed enhanced locomotor sensitization to nicotine which emerged in adulthood as well as an enhanced acquisition of nicotine self-administration, administering more nicotine overall. These behavioral differences cannot be attributed to nAChR expression as nicotine upregulated nAChR to a similar extent between NVHL and SHAM control animals. These data indicate that the enhanced rates of nicotine use among individuals with schizophrenia may occur as a result of an enhanced vulnerability to nicotine addiction.

Beginning with the diagnosis of nymphomania in the 19th Century, there has been widespread and continued interest across the mental health and bio-medical realm of what constitutes normality of female sexual behavior, and of the boundary at which sexual desire is deemed to be excessive, and thus abnormal. However, research questions that specifically investigate the subjective female voice and perspective in considerations of so-called hypersexuality or sex addiction remain understudied. This research project proposes to examine the cultural pathways and systemic foundations which have historically in the West problematized female sexuality by investigating women's own perceptions of sexual addiction and their experiences in seeking (or not) addiction treatment. In addition, this research project proposes to investigate the perceptions of therapists (psychologists and psychiatrists) who treat hypersexual female patients, in order to examine their beliefs about the cultural and biological genesis of the disorder, and its appearance in female patients. Theoretically, this project aims to move away from the concept of individualized bodies suffering singularly from (dis)ease and abnormality, and investigate the ways in which Western cultural notions of normal female sexuality shape women's self-perceptions and notions about sexual deviance.

No description available.

<p>Substance abuse is a major public health concern. Scholars predict a growing proportion of people aged 50 years and older suffering from addiction to alcohol, prescription or over-the-counter medications and/or illegal substances (Wu & Blazer, 2011; Han et al., 2009). Available Canadian statistics reveal that 6-10% of older adults experience alcohol problems, 1% use illegal substances and approximately 6% seek addiction treatment for prescription opioids (Public Health Agency of Canada, 2010; Tjepkema, 2004; CAMH, 2008). Older adults face personal, social, and structural barriers to treatment, which result in a significant number of people living with addiction and remaining undiagnosed and untreated in the community (Crome & Bloor, 2005b). Nevertheless, this issue is significantly understudied and under-recognized, particularly within Canadian literature.</p> <p>This qualitative research study examined the perspectives of addiction service providers regarding the issue of addiction among older adults. A descriptive, qualitative research design was used to explore the perspectives of addiction service providers using in-depth, semi-structured personal interviews. Purposive sampling techniques were used to recruit 24 service providers employed by Hamilton addiction services. Semi-structured interviews included questions on (a) the current provision of addiction services for older adults, (b) characteristics of older adults (c) perceived barriers to treatment, and (d) recommendations for addressing the needs of older adults living with addiction. The interview also collected demographic information to describe the demographic profile of agencies and research participants involved in the study.</p> <p>By using Braun and Clarke’s (2006) phases of thematic analysis, this study observed several key themes that confirmed and extended existing literature. New contributions highlight the following: (1) according to service providers, older adults demonstrate a greater readiness for change and stronger commitment to their treatment plan regardless of whether they are enrolled in a mixed-age or age-specific program. (2) Some older adults use substances to cope with cumulative shame that stems from unresolved, traumatic early-life experiences. This new finding supports principles of the life course perspective by highlighting the impact of early life events on late life experiences. (3) Service providers can address some of the age-specific needs of older adults by assigning them to an older counselor in treatment. (4) In order to enhance treatment outcomes, older adults should <em>direct</em> their care and be viewed as experts in their treatment needs. (5) From the perspective of service providers, older and younger adults benefit from interactions with each other when the older adult is in recovery and the younger adult is recovering. Older adults recovering also benefit from interactions with older peers in recovery, particularly when they are in mixed-age programs. Opportunities for peer interaction during and after treatment can produce favourable recovery outcomes.</p> / Master of Arts (MA)

The aim of this dissertation is to examine the implementation of the Addiction Severity Index (ASI) in social services and how it affects the encounter between the clients and their social workers. As structured interviews are unusual in social service based addiction care there is concern that they will have negative consequences on the relation between the social workers and their clients. The first study therefore investigates the clients’ acceptance of the ASI. The results show that 95 % of the clients accepted the ASI and that 85% viewed it in positive terms. Approximately 8% reported feeling violated by one question without this having any negative effect on the relation to the social workers or confidence in the social services. The results did not give empirical support for negative effects of the ASI. In the second study a comparison was made between a group that had participated in an assessment session using the ASI and a group with which the ASI had not been used. The results show that there is no difference in perception of “the alliance” or “negative experiences” with or without the ASI, but that the clients’ feeling of “own competence” is lower when the ASI is employed. The question of whether the reduced feeling of own competence among the clients is an expression of greater realism and reduced denial or only the negative effect of increased helplessness on the clients’ self-esteem can not be resolved in this study. In the third study, based on the same groups participating in the second study, the social workers were also asked to judge how the clients experienced such assessment sessions. The results show that the social workers’ assessment of the clients’ experiences differed from the clients’ own experiences regarding the “alliance” and “clients’ own feelings of competence”. However, the social workers made a correct assessment of the clients’ “negative experiences” of the sessions. The two different forms of session, with or without the ASI, did not influence the social workers’ assessment of the clients’ perceptions. The fourth study presents the results of a national questionnaire completed by 555 members of staff in social services, the prison service, and addiction services. The results show that supervisors and bosses take an increasingly greater responsibility for ASI training and that opportunities for using the ASI varied according to the place of work. Differences can probably be explained by different services being in different phases of implementation at the time of the study. The ASI has primarily been used in direct client work and only to a minor extent for follow-ups and evaluation. The number of ASI interviews carried out is small especially for those trained prior to 1999.

Heroinberoende har en hög dödlighet och innebär stora kostnader för samhället, och den mest förekommande och effektiva behandlingen är läkemedelsassisterad behandling (LAB). Studiens syfte var att studera LAB vid heroinberoende ur ett omvårdnadsperspektiv. Omvårdnadsteorin som applicerades var ”Tidvattenmodellen” vars filosofi grundar sig på att det finns psykiska behov, att omvårdnad kan vara ett sätt att möta dessa behov, att människan redan har lösningen på sina livsproblem och att omvårdnad handlar om att ta fram dessa lösningar. En systematisk litteraturstudie gjordes. Resultatet baseras på tio kvantitativa artiklar och presenteras med tre teman: Bakgrundsfaktorernas roll, Personcentrerad omvårdnad och Accepterande omvårdnad. Olika bakgrundsfaktorer påverkar deltagande och fullföljande av behandlingen, så som att ha ett arbete samt civilstatus. För ett positivt resultat av LAB är det viktigt med en personcentrerad omvårdnad som erbjuder ett socialt stöd. För att öka deltagandet, och därmed tillgången till omvårdnad, måste behandlingens krav sänkas och omfattas av en högre acceptansnivå. I framtiden behövs det en bredare forskning gällande omvårdande insatser vid LAB samt diskussioner för att utforma en så säker vård som möjligt. / Heroin addiction has a high mortality and implies high costs to society, and the most common and effective treatment is maintenance treatment (MT). The study's aim was to study MT during a heroin addiction from a nursing perspective. The nursing theory applied was “The Tidal Model” whose philosophy is based on the existence of psychological needs, that nursing can be a way to meet those needs, that humans already have the solution to their problems of life and that nursing is about to develop these solutions. A literature review was made. The result is based on ten quantitative articles and presents three themes: The Meaning of Background Factors, Person-centered Care and Nursing Acceptance. Different background factors affect participation and retention in treatment, for example to have a job or the marital status. To get a positive outcome of the MT it is important with a person-centered care that provides a social support. To increase participation, and therefore the access to care, treatment policy must be lowered and have a higher level of acceptance. In the future we need comprehensive research on nursing during MT and discussions to design the safest care possible.

While addiction narratives have been a feature of American culture at least since the early 19th century’s temperance tales, the creation of the Johnson Intervention in the late 1960s and the corresponding advent of the War on Drugs waged by U.S. Presidents have wrought significant changes in the stories told about addiction and recovery. These changes reflect broader changes in conceptions of agency and the relationship of subject to culture in the postmodern era. In the way that it iterates the imperatives of the War on Drugs initiated by Richard Nixon, the rhetoric of successive U.S. Presidents provides a compelling heuristic for analyzing popular and literary texts as reflective of the changing shape of addiction and recovery narratives over the last half century. Johnson, by defining addiction, not intoxication, as a break with reality, argued that confronting addicts with narratives of the potential crises could convince them to seek treatment before they hit bottom. Johnson’s version of “reality therapy” thus presented threatened or simulated crises, rather than real ones. Examining presidential rhetoric and popular culture representations of addiction—in horror movies, “very special episodes,” and reality television—this dissertation identifies features of the postmodern Intervention and recovery narrative in fiction by William Peter Blatty, Stephen King, Jay McInerney, Tama Janowitz, David Foster Wallace, and Jess Walter. I demonstrate how the Intervention is key to understanding the cultural products of the War on Drugs and its continued salience in American culture.