My thesis is about supervision in therapeutic communities for drug abusers in the Czech Republic. In the first, theoretical part, there are described concepts the supervision and the therapeutic community. It shows a developement of TC's in the world and also in the Czech Republic and describes the history of TC's for drug abusers after 1989. Part of thesis is about clients of TC's and also about what is therapeutic community therapeutic. It's giving point also to quality standards, that are for these organisations and their supervision. The second part, empirical, maps and describes supervision praxis in TC's in the Czech Republic. Answers the questions: who is providing supervision in TC's(external, internal), with whom is supervision provided (team, individual, group), what is it about (case, program, focused on employees for example team, management), how is it provided (regular, occasional, crisis). After all it is about the developement of supervision in TC's after 1989 and reasons, that in TC's leads to change of supervisor. And at least to conflicts of roles, that accompanied (accompanies?) supervision in TC's.

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

Adolescence is a sensitive developmental period encompassing neural maturation that is critical for an individual’s behavioral transition into adulthood. Due to widespread physiological changes attributed to this period, adolescents are also vulnerable to the initiation of risky behaviors, such as drug experimentation and use, as well as the emergence of various neuropsychiatric disorders. The mesocorticolimbic dopamine (DA) system in the brain undergoes a transient peak in activity and continues to mature during adolescence, potentially mediating adolescent hypersensitivity to social, appetitive, and drug-associated rewards. Simultaneously, the serotonin (5-HT) system exerts its influence on the dopamine system throughout adolescence, a process vital for proper impulse control and emotional regulation in adulthood. Substance use disorders (SUDs) are multifaceted and are comprised of diverse maladaptive behaviors that promote compulsive drug seeking, including loss of control and the propensity to engage in drug use irrespective of personal risks and/or consequences. Drug addiction and substance use have a large negative impact globally both economically and with regards to public health outcomes, representing approximately 1.3% of the global burden of disease. Furthermore, dopamine reward pathways are heavily impacted by drug use, particularly with respect to stimulants, and the level of drug-induced dopamine release in the ventral striatum can be correlated with a drug’s perceived “high.” Certain experiences and adverse behaviors linked to refinement of monoamine connectivity in the brain during adolescence, such as heightened stress and sensation seeking, may predispose individuals for developing SUDs in adulthood. However, how drug reward sensitivity and associated activity of the dopamine system is altered in adulthood as a consequence of interfering with monoamine neurodevelopment during adolescence has not been clarified. To this end, I aim to understand how imbalanced monoamine development during adolescence contributes to stimulant-mediated behaviors in adulthood, specifically contextual reward associations, in relation to in vivo activity of the dopamine reward system. I introduce a sensitive peri-adolescent (PA) period in mice, during which blockade of the serotonin transporter (SERT) via fluoxetine administration during postnatal (P) days 22-41 leads to inhibited adult aggression and locomotor response to stimulants. Conversely, I describe a more refined PA (P32-41) period during which systemic dopamine transporter (DAT) blockade via GBR12909 administration leads to enhanced aggression and stimulant-induced locomotor activity in adulthood. Utilizing these behaviorally opposing models characterized in our lab, I describe the diverging effects of systemic DAT and SERT blockade from P32-41 on cocaine-induced locomotor response as well as cocaine-mediated contextual preference. I administered cocaine intraperitoneally (i.p.) at doses of 5 and 10 mg/kg, applying the open field test and cocaine conditioned place preference (CPP) paradigm to assess stimulant-induced locomotor response and environmental reward associations, respectively. Potentiation of serotonergic tone during P32-41 via fluoxetine administration leads to decreased cocaine-induced locomotor response and a lack of preference for a cocaine-associated context in adulthood at a dose of 10 mg/kg, compared to controls and PA GBR treated subjects. Conversely, potentiation of dopaminergic tone by administering GBR12909 during P32-41 is associated with enhanced cocaine-induced locomotor reactivity at 10 mg/kg and greater contextual preference at lower doses of cocaine (5 mg/kg), in comparison to PA fluoxetine treated mice and controls. To understand how in vivo VTA dopamine population activity is altered in both PA models during cocaine-associated behaviors in adulthood, I performed cocaine CPP while recording calcium signals in VTA dopamine neurons using fiber photometry in freely behaving subjects. Importantly, I utilize these recordings as a proxy for measuring changes in VTA dopamine activity as the subjects engage with a cocaine-paired environment. I found that PA DAT blockade was associated with greater baseline VTA dopamine activity in adulthood compared to controls, as well as heightened VTA dopamine activity while the subjects were in a cocaine-paired context during selected portions of the behavioral task compared to control subjects. Additionally, we found a significant positive correlation between the magnitude of preference for a cocaine-associated context and the frequency of VTA dopamine calcium signals recorded while the subject is engaged with a cocaine-paired environment. Adult mice following PA DAT blockade displayed a greater frequency of recorded VTA dopamine calcium signals while in a cocaine-paired environment compared to PA fluoxetine treated mice. Supporting our correlational analysis, I detected a decreased preference for a cocaine-paired context in PA fluoxetine treated subjects compared to both controls and PA GBR12909 mice, when using a dose of cocaine in between the previous concentrations tested (7.5 mg/kg). Interestingly, PA fluoxetine treated subjects showed transition-dependent differences in VTA dopamine calcium activity during the final five-minute portion of our behavioral task, displaying less activity shortly post-entry into the cocaine-paired environment compared to pre-entry. In congruence, PA fluoxetine subjects showed enhanced VTA dopamine calcium activity on the saline-paired side shortly post-entry compared to pre-entry. In collaboration with the Sulzer Lab, we also probed the effects of both PA manipulations on electrically evoked dopamine release in the ventral striatum of adult anesthetized mice using fast-scan cyclic voltammetry. Electrical stimulation was targeted to the midbrain and evoked dopamine release was recorded in the ventral striatum both at baseline and in response to cocaine injection, using the same 7.5 mg/kg dose applied in the calcium imaging study. Overall, we found a significant increase in dopamine release at baseline in the ventral striatum of adult PA GBR12909 treated subjects compared to both PA fluoxetine subjects and controls. Moreover, we found significantly greater cocaine-induced dopamine release in our PA GBR12909 mice compared to controls in adulthood. These findings are consistent with the imaging and behavioral data, highlighting the persistence of an elevated dopaminergic phenotype due to systemic PA DAT blockade. Conversely, systemic PA SERT blockade leads to behaviorally opposing effects and generally lower VTA DA activity dynamics in comparison to PA GBR12909 treated subjects in adulthood. The unique, combinatorial approach applied in this dissertation work further our knowledge of how sensitive developmental periods influence the emergence of complex behaviors in adulthood, which is vital to improving treatment approaches for neuropsychiatric disorders.

I denna studie kommer det att undersökas hur SIS LVM-hem och behandlingshemarbetar med kvinnliga klienter inför en § 27 placering. Att förbereda enmissbrukare inför behandling kan utspela sig på flera olika sätt i Sverige. Därmissbrukare som befinner sig i ett missbruk kan bli tvångsomhänderta ochplacerade på låst behandling ifall deras missbruk har gått till den gränsen attindividen utsätter sin hälsa för så pass allvarlig fara så att det kan leda till att denavlider. När en individ placeras på låst behandling är avsikten att den skaförberedas succesivt för behandling i öppnare former enligt §27. I denna studiehar jag valt att studera ett perspektiv som involverar hur Statensinstitutionsstyrelse LVM-hem för kvinnor och ett behandlingshem arbetar med attanpassa övergången från låst behandling till öppet behandlingshem. Dåmissbruksvården är bred och de finns olika former av låsta behandlingar ochöppna behandlingar så föll valet på SIS LVM-hem för kvinnor ochbehandlingshem. Valet av avgränsning till kvinnor är på grund att som (Statensinstitutionsstyrelse (2020) redovisar är kvinnor mera utsatta än männen när dethamnar i ett drogmissbruk.I studien utformades 11 semistrukturerade intervjuer där sex var från SIS LVMhem och fem från behandlingshem. Valet av teoretiskt perspektiv föll påsamverkansteori, coping och socialt nätverk. I resultatet framkommer det att medkontinuerlig och strategisk samverkan kan missbruksvården förbättra övergångenfrån låst behandling till öppet behandlingshem. De berörda enheterna som arbetarmed missbrukaren bör gemensamt studera klientensbehov med avsikten för attförstärka deras coping strategier så att klienten bygger upp en resiliens motmissbruk. Genom att studera klienters sociala nätverk kan man kartlägga vilkenpåverkan de olika individerna har i klientens nätverk för att vägleda de tillpositiva förebilder så det upprätthåller nykterhet efter att behandlingen är klar. / In this study I will research Sis LVM-home and treatment home works withfemale drug addicts for a placement according to § 27. To prepare a drug addictfor treatment have different approaches in Sweden. Where if the drug addict is ina serious drug addiction they can be forcibly acquired and placed in a locked drugtreatment institution before they can start their treatment in more open treatmentoptions according to § 27.Based on that I have chosen to study how staff work from the lockedrehabilitation facilities, Statens institutionsstyrelse LVM-hem for women and onetreatment home. Works with the transition from locked rehab facilities to openfacility paragraph § 27 for women from 18 years and above. Due to the broaddrug treatment in Sweden where there are many kinds of forms of locked facilitiesand open facilities, I have chosen SIS LVM-homes and treatment home wherethey live. The reason why I chose to study women drug addicts is based on(Statens institutionsstyrelse (2020) that they are in general more exposed thanmen during drug addiction.In this study, I have conducted 11 semi structured interviews where six are fromSIS LVM-homes and five from treatment home. The choice of theoreticalperspective is cooperation, coping and social network. As stated in the results,with a continuous strategic cooperation you can improve the transaction fromlocked to open facility. Where it is important that the concerned units commonlystudy the client's needs with the intention to improve the clients' coping strategiesso they can build up a resilience against drug addiction. By studying the socialnetwork, one can chart what kind of impact different kind of individuals have onthe client’s social network. This is used to guide the drug addicted person towhich people have a good impact on them so they can maintain a life sober whenthe rehab is done.

Society's view of addiction problems and their treatment is constantly evolving. This study highlights the experience of counselors, nurses and others with social worker education of the structure of the activities, the practical work and the social work in a medical context. Based on previous research and theoretical concepts, this qualitative study is conducted to gain a more in-depth insight into the practical work of the professions and to create an understanding of the structure of the organization. The reason for conducting this study is also to see similarities and differences in how the employees of the syringe exchange activities experience what social work looks like in a medically permeated workplace. To obtain the empirical data, semi-structured interviews were conducted with seven different active professions at different needle exchange facilities in Sweden. The results of the study highlight, among other things, the professions' flexibility and broad scope of action, the importance of collegial collaboration for knowledge exchange and support, and the laws and regulations that the activities need to relate to. Conclusions that could be drawn were that the social work at the syringe exchange facilities is also a pervasive part of the work of the professionals and the interventions offered. Similarly, laws and regulations are perceived to be somewhat flexible according to the interviewees and many times solutions are found to ensure the best interests of the patient. Another conclusion is that large parts of the professionals' experiences of the activities support the goal and purpose of the syringe exchange activities in Sweden, i.e. to motivate people to receive care and treatment.

The aim of this thesis is to explore how men in recovery from substance use conceptualize challenges and use their inherent strengths to navigate them. Estimates of substance use prevalence rates in Canada suggest that approximately one-in-five Canadians will meet the diagnostic criteria for substance use disorder throughout their lifetime (Pearson, Janz & Ali, 2013). These prevalence estimates represent a significant cause for concern as addiction is a significant phenomenon in contemporary Canadian society. A scoping literature review was conducted on nineteen research studies to investigate the state of current research. Although there is a wealth of studies on addiction, research frequently utilizes pathologizing approaches. These approaches are commonly focused on addiction in the context of a social or individual issue ripe with problematizing discourses. Six qualitative semi-structured interviews were conducted on men living in recovery-based supportive housing for this research to explore their experiences from the onset of substance use into substance use and recovery efforts. A strength-based perspective was adopted for analysis purposes in order to more accurately reflect on the inherent strengths of the participants. The men provided in-depth accounts of their experiences, conceptualized challenges to their recovery and contrary to many contemporary research discourses, demonstrated an affluence of strengths while articulating challenge navigation. The men were also proactive in their ability to anticipate future challenges and conceive methods of effective challenge navigation. Findings of this study are analyzed and discussed in the context of recognizing the magnitude of the challenges facing the men in recovery and the incredible strengths that they demonstrate in challenge navigation. The implications for current social work practice are outlined and several suggestions are tabled with the goal of improving current practice methods. Finally, suggestions for future strength-based addiction research are offered with the intention of seeking overall improvements to the research field and addressing existing gaps within the literature. / Thesis / Master of Social Work (MSW)

Thesis (Ph.D. (Nursing Sciences)) -- University of Limpopo, 2022 / It is in the parents’ interest to protect their youth and keep them away from substance abuse. It can be particularly disturbing for them to learn that their child abuses substances, or is an addict. When the youth abuses the substance, it is normal for parents to experience feelings of guilt and sadness. They also become angry; they may feel angry towards each other, the world at large or towards their youth. Stress levels can increase when caring for an addicted child. Parents who have youth abusing substances need support. The desire to get the correct and clear information about their child is one of the important needs of parents. They desire information and support about their child’s improvement during hospitalisation and post hospitalisation. The purpose of this study is to develop and implement a support programme for parents of youth abusing substances in selected public hospitals in Limpopo Province. The objectives were to explore and describe the experiences of parents of youth abusing substances; to describe the knowledge and practices of parents of youth abusing substances in caring for youth abusing substance; to identify the support needs of parents of youth abusing substances; to describe a conceptual framework for the development and implementation of a support programme for parents of youth abusing substances; to develop a support programme for parents of youth abusing substances and lastly to implement a support programme for parents of youth abusing substances in selected public hospitals in Limpopo Province. A mixed-method, exploratory sequential research design was used in this study to achieve the study aim. Fourteen participants consented to participate in the qualitative strand of the study while 169 participants consented to take part in the quantitative strand of the study. Tesch’s eight steps of data analysis were used to analyse qualitative data, data was analysed in a form of themes and sub-themes. SPSS version 26 was used to analyse quantitative data. Logistic regression and ANOVA test were used to calculate associations, odds ratios and means for knowledge The findings of this study indicate that the parents need support from the nurses which include the following: Knowledge and information sharing regarding substance abuse; Attention with regard to their own wellbeing as parents of youth abusing substances; Capacitation with better strategies and interventions to manage themselves while helping their youth with substance abuse disorders; Support by the nurses to the parents as the relatives of the patients which include debriefing on the patient’s condition, counselling, and referral to the relevant healthcare professionals. To support the parents of youth abusing substances the nurses need to continue with the implementation of the support programme. The Limpopo’s Department of Health may assist in allowing the in-service education for the nurses to support the parents of youth abusing substances. There should also be awareness programmes that are about substance abuse for the parents and the youth / Tirisano faculty in UCLA

Незаконный оборот наркотических веществ, его употребление и сбыт влекут за собой множество действий, противоправного характера, возрастает рост употребления наркотиков среди молодого поколения, наркомания стала почти субкультурной тенденцией, поддерживаемой современной музыкой, которая значительно влияет, формирует и меняет мировоззрение, происходит переворот ценностей, которые были сформированы на протяжении многих лет и веков. Такое развитие ситуации требует нового подхода к решению проблемы наркотической зависимости в молодежной среде. В диссертационном исследовании представлены теоретические основы исследования наркотической зависимости в молодежной среде, рассмотрена медико-социальная реабилитация молодежи, эмпирической базой исследования наркозависимой молодежи выступила клиника лечения зависимостей «Свободные люди» г. Алматы, в которой было проведено исследование. В данной исследовательской работе был сделан акцент на вторичную и третичную профилактику, предложены профилактические меры, которые эффективны при комплексном использовании, целенаправленном подходе, при точной ориентации на целевую аудиторию. Определено, что профилактическая работа должна быть систематической, постоянной, мониторинговой, охватывающая молодежь и систему в целом, с созданием жизненных условий, которые моделируют оптимальные, жизненные условия и предотвращают повторное употребление и вступление в зависимость. Реабилитационная работа должна доставлять импульсы для более активного вступления в контакт с другими и с самим собой. / Illicit drug trafficking, its use and sale entail many illegal actions, the growth of drug use among the younger generation is increasing, drug addiction has become almost a subcultural trend supported by modern music, which significantly influences, shapes and changes the worldview, there is a revolution of values that have been formed over many years and centuries. This development of the situation requires a new approach to solving the problem of drug addiction among young people. The dissertation research presents the theoretical foundations of the study of drug addiction in the youth environment, the medical and social rehabilitation of youth is considered, the empirical basis for the study of drug-dependent youth was the addiction treatment clinic "Free People" in Almaty, in which the study was conducted. In this research work, emphasis was placed on secondary and tertiary prevention, preventive measures were proposed that are effective with a comprehensive use, a targeted approach, with an accurate orientation to the target audience. It is determined that preventive work should be systematic, constant, monitoring, covering young people and the system as a whole, with the creation of living conditions that simulate optimal living conditions and prevent repeated use and addiction. Rehabilitation work should provide impulses for more active contact with others and with oneself.

Bestaande navorsing aangaande die terapeutiese intervensie met die dwelmafhanklike adolessent is beperk, veral navorsing wat fokus op die bewuswordingsproses tydens die terapeutiese intervensie. In hierdie studie is gepoog om die benuttingswaarde van Gestalthulpmiddels ten opsigte van die verhoging van bewuswording by die dwelmafhanklike adolessent, tydens die terapeutiese proses vas te stel. Die navorsingsproses is deur kwalitatiewe navorsing gering om in hierdie doel te slaag. Die navorsingsinligting is met behulp van 'n uitgebreide literatuurstudie, asook deur middel van die waarneming en bestudering van twaalf gevallestudies bekom. Die benuttingswaarde en die toepassingsmoontlikhede van die Gestalthulpmiddels binne die Gestaltterapeutiese proses met die dwelmafhanklike adolessent, is verken en beskryf. Deur middel van die prossesering en integrering van die bevindinge wat tydens die empiries ondersoek verkry is, kon die data vir praktiese doeleindes toegepas word. 'n Riglyn wat vir die verhoging van bewuswording by die dwelmafhanklike adolessent gebruik kan word is aanbeveel. SUMMARY Existing research on the therapeutic intervention with the drug-addicted adolescent is limited, especially research that focused on the awareness process during therapeutic involvement. This study attempt to determine the face value of Gestalt helping aids throughout the improved awareness of the drug-addicted adolescent during the therapeutic process. A qualitative research approach was followed to achieve this goal. The research data is gained by a detailed literature study, as well as by the observation and study of twelve case studies. The value and the possibilities of application of the Gestalt helping aids in the Gestalt therapeutic process with the drug-addicted adolescent, is examined and described. By processing and integrating the assumptions obtained during the empirical study, the data could have been practically applied. As suggested out of this study a guideline can be developed for the improvement of awareness of the drug addicted adolescent. / Social work / M.Diac (Play Therapy)

Substance abuse amongst children is a major problem in South Africa and world-wide. The trend of new drugs entering the drug market has increased in South Africa. Currently in South Africa, there is a new drug on the market known as “nyaope” being abused mostly by adolescents in the Townships. The negative consequences of substance abuse affect not only individuals who abuse substances but also their parents and significant others. The researcher observed that most literature in the field of substance abuse focuses on the children addressing issues such as causes, effects, psychological impact and others. Very little is documented on parents‟ experiences and coping capabilities as well as the support they need or receive. This further contributed to the researcher‟s purpose of conduct this study to explore parents‟ experience and support needs with regard to their children‟s addiction to nyaope. / MA (Social Work)