published_or_final_version / Sociology / Master / Master of Social Sciences

This study consisted of a qualitative analysis of articles from two Canadian newspapers related to North America’s only safe injection facility for drug users, Vancouver’s Insite, and examined the texts for latent themes derived from a review of harm reduction and governmentality literature. The investigation asked “In what ways are Insite and its clients represented in the media and what implications do those portrayals have in terms of Insite’s operation as a harm reduction practice as well as a governmental strategy designed to direct the conduct of drug users who visit the site?” The analysis revealed conflicting representations, some which have positive potential in terms of Insite’s adherence to the fundamental principles of harm reduction and others that undermined those principles and suggested that the site may have traditional governmental functions, perhaps indicating less distance between the harm reduction and governmentality philosophies in the discourse surrounding the SIS than expected.

The main goal of the theoretical part of submitted theses is to describe the field of specialized treatment of imprisoned drug users. The author's emphasis is to put the specialized treatment to a broader frame of the Risk-needs theory as well as to the frame of physical diseases and mental disorders that are often associated with addiction or drug abuse. Different kinds of specialized interventions that are usually used for treatment of imprisoned drug users in different countries are described. There is although demonstrated in which way these interventions are implemented in Czech prison system. By these interventions are especially meant treatment on the entry at the prison, detoxification, counselling and other programs and interventions with low intensity. Especial emphasis is put on residential prison programmes such as prison therapeutic communities for drug users and on opioid substitution treatment. A great number of pages are dedicated to the research of effectivity of treatment programmes. In the practical part of submitted theses results of cross-sectional study that was implemented in all Czech prisons in three waves in 2010, 2012 and 2014 are presented. Representative samples of Czech prisoners were chosen for the purpose of this cross-sectional study. These prisoners were asked to...

This study consisted of a qualitative analysis of articles from two Canadian newspapers related to North America’s only safe injection facility for drug users, Vancouver’s Insite, and examined the texts for latent themes derived from a review of harm reduction and governmentality literature. The investigation asked “In what ways are Insite and its clients represented in the media and what implications do those portrayals have in terms of Insite’s operation as a harm reduction practice as well as a governmental strategy designed to direct the conduct of drug users who visit the site?” The analysis revealed conflicting representations, some which have positive potential in terms of Insite’s adherence to the fundamental principles of harm reduction and others that undermined those principles and suggested that the site may have traditional governmental functions, perhaps indicating less distance between the harm reduction and governmentality philosophies in the discourse surrounding the SIS than expected.

In America, it is estimated that between 500,000 and two million children run away each year. A majority of these runaways become involved with illegal substance abuse. This study questions whether children experience substance abuse prior to their running away or if their substance abuse is an attempt to cope with the new stressors created by street life. Data collection will include having 50 volunteers complete a questionnaire, with consideration of race and gender. The findings suggested that no relationship exist between runaways engaging in drug use and the amount of stress experienced at home or during the runaway.

MA (Psychology) / Department of Psychology / The aim of the study was to explore the impact of nyaope among the youth in the rural communities of Thulamela Municipality. The study adopted qualitative approach and exploratory research design. Population of the study were from Itsani, Maniini and Muledane villages in Thulamela municipality, both males and females, 18-31 and who were involved in the use of nyaope. Non-probability purposive and snowball sampling methods were adopted because participants who use nyaope are hard to locate. The total number of participants (8) who formed part of the study was determined by data saturation. Semi-structured interviews were used as a method of data collection. To ensure trustworthiness, pre-testing of the instrument was conducted to identify any potential problems. Credibility, transferability and conformability was well considered. Thematic data analysis was employed since the researcher was more involved in interpretation of collected data, thematic analysis enabled the researcher to capture complex meaning.

L’infection par le virus de l’hépatite C (VHC) est l’un des principaux problèmes de santé publique chez les utilisateurs de drogues injectables (UDI). Actuellement, plusieurs outils sont disponibles pour réduire le fardeau du VHC dans cette population. Ceux-ci incluent des programmes de réduction des méfaits, tels que le traitement par un opioïde agoniste (TAO), pouvant réduire le risque d'infection par le VHC, ainsi que des traitements antiviraux extrêmement efficaces pour éradiquer le virus parmi les infectés. Plus récemment, il y a eu un intérêt national et international à éliminer le VHC en tant que menace pour la santé publique d'ici 2030, tout en priorisant les UDI dans les efforts de prévention et traitement. Parallèlement à ce mouvement, plus globalement, le fardeau des méfaits liés aux pratiques d’injection chez les UDI, tels que la surdose, soulignent la nécessité d’adopter une vision plus large sur leur santé. Dans l’ensemble, cette thèse vise à combler certaines lacunes dans les connaissances vis-à-vis de l’élimination du VHC chez les UDI. Premièrement, puisque le lien entre l’adéquation du dosage des TAO et le risque d’infection au VHC est peu connu, j’examine cette relation dans un échantillon d’UDI suivis dans la cohorte HEPCO à Montréal. Les résultats indiquent que le risque d'infection par le VHC ne serait pas systématiquement réduit chez toutes les personnes recevant des TAO, mais plutôt que ce risque varie en fonction de la dose prescrite et de l’adéquation du dosage telle que perçue par le patient. Ces résultats soulignent qu’un élargissement de l'accès aux TAO ne serait pas suffisant pour atteindre les objectifs de prévention et d'élimination du VHC, et que l’adéquation du dosage devrait être prise en compte dans le cadre de nos efforts de prévention. Deuxièmement, l’accès aux traitements antiviraux est faible chez les UDI, en partie à cause des préoccupations des prestataires et des décideurs politiques qui craignent une augmentation de la consommation de drogues et des comportements à risque après le traitement. En capitalisant sur deux études différentes - la cohorte IMPACT à Montréal et les essais SIMPLIFY / D3FEAT menés dans plusieurs pays - je montre que les comportements liés à la drogue diminuent ou restent stables après le traitement du VHC. Ensemble, ces deux études suggèrent que les préoccupations liées à une consommation élevée de drogue ou à une hausse des comportements à risque après le traitement ne seraient pas fondées. Ainsi, ces résultats appuient davantage une augmentation de l’accès au traitement chez les UDI. Troisièmement, allant au-delà du VHC en tant que problématique principale, en capitalisant une fois de plus sur les données collectées dans HEPCO, j’examine les associations entre trois facteurs - le TAO, le logement et le revenu - et la fréquence d’injection chez les UDI. Puisque la consommation de drogues est dynamique dans le temps, j'examine dans quelle mesure ces trois facteurs sont liés à la fréquence d’injection chez des UDI ayant des trajectoires d’injection variées. Nos résultats indiquent que la stabilité socioéconomique et le TAO seraient systématiquement liés à une fréquence d'injection inférieure chez les UDI, quelles que soit leurs trajectoires d’injection sous-jacentes. Globalement, ces résultats suggèrent qu’il y aurait des moyens de soutenir tous les UDI à atteindre de petits changements comportementaux qui pourraient réduire les risques liés aux pratiques d’injection, qu’ils soient ou non en mesure d’arrêter l’injection de drogues. En conclusion, alors que presque tous les pays ont lancé un effort mondial pour éliminer le VHC, des efforts sont nécessaires pour optimiser les programmes de réduction des méfaits bien établis afin de réduire la transmission du VHC, et d’accroître l’accès au traitement chez ceux qui sont infectés, tout en considérant les besoins et les préoccupations des communautés touchées. Cette thèse a fourni des données permettant d’éclairer (i) l’optimisation des TAO dans la prévention de la transmission du VHC, (ii) l’élargissement de l’accès au traitement du VHC et (iii) l’accès à des logements et revenus stables afin de réduire plus globalement les risques liés aux pratiques d’injection chez les UDI. Ainsi, ces résultats pourraient aider à réduire le fardeau du VHC chez les UDI et à soutenir le progrès vers l'élimination du VHC. / Infection with hepatitis C virus (HCV) is one of the main public health concerns affecting people who inject drugs (PWID). Although no effective prophylactic vaccine currently exists to prevent acquisition of HCV, a number of other tools are available to curb the HCV burden among PWID. These include harm-reduction programs, such as opioid agonist treatment (OAT), which can reduce the risk of HCV infection among those susceptible, and highly effective antiviral therapies to eradicate the virus among those who are infected. In recent years, there has been national and international interest in eliminating HCV as a public health threat by 2030, prioritising PWID in prevention and treatment efforts given that they are the population most affected. In parallel to this global effort, the high prevalence of injection-related harms among PWID that are unrelated to HCV, such as overdose, highlight a need to adopt a broader view on drug user health. Overall, this thesis is concerned with addressing some of the knowledge gaps and barriers that remain to achieving HCV elimination in PWID. First, because little is known about the importance of OAT dosage in influencing the risk of HCV acquisition, I examine this relationship in a sample of PWID followed in the Hepatitis Cohort (HEPCO) in Montreal. Findings indicate that the risk of HCV infection may not be systematically reduced for everyone receiving OAT and rather, that the risk of infection varies considerably according to the level of the prescribed OAT dosage and patient-perceived dosage adequacy. These findings suggest that simply scaling-up OAT access may not be sufficient to achieving the HCV elimination goals, and that the dosage of treatment should be considered as part of prevention efforts. Second, uptake of HCV treatment is low among PWID, partly due to concerns among providers and policymakers that drug use and injection risk behaviours may increase following treatment, thereby negating the benefits of therapy. Capitalising on two different studies - the IMPACT Cohort in Montreal and the SIMPLIFY/D3FEAT trials conducted in several countries - I illustrate that drug-related behaviours decrease or remain stable following HCV treatment. Together, these two studies suggest that concerns of escalating drug use or risk behaviours following HCV treatment are unfounded, further supporting the importance of expanding access to therapy among PWID. Third, moving beyond HCV as the primary focus of research, and capitalising once more on data collected in HEPCO, I examine the associations between three factors- OAT, housing and income, and patterns of injection frequency among PWID. Recognizing that injection patterns are dynamic over time, I examine the extent to which these three factors relate to injection frequencies among PWID with diverse trajectories of injection drug use, followed over a period of 7.5 years. Our findings indicate that socioeconomic stability and OAT are consistently associated with a lower injection frequency among all PWID, irrespective of their underlying injection trajectory and whether or not they are on a path to cessation. These findings suggest that there may be ways to support PWID in making small behavioral changes that could reduce their risks of injection-related harms, irrespective of whether or not they are in a position to stop injecting. In conclusion, at a time when many countries have embarked onto a global effort to eliminate HCV, efforts are needed to ensure that well-evidenced harm-reduction programs are optimised to reduce transmission of HCV, treatment for HCV infection is scaled-up among those who are infected ,and efforts do not overlook the basic needs and concerns of affected communities. This thesis provided data to help inform (i) optimisation of OAT provision for the prevention of HCV transmission, (ii) expanded access to HCV treatment, and (iii) access to stable housing and income to reduce the risk of injection-related harms among PWID. Ultimately, findings could contribute to reducing the HCV burden among PWID, helping move towards HCV elimination and, more broadly, improving the overall health of this marginalised group.

Drug policy and the treatment of drug offenders' is an area that receives much attention worldwide. Because of the authorities' apparent inability to deal with this form of crime, it has universally been deemed necessary to look generally at the punishment of this category of offender and specifically at alternative methods to deal with these perpetrators. An extensive study of drug treatment approaches and models used by various countries merely highlights and emphasises the need for the creation and implementation of a suitable treatment modality for drug offenders. Other countries do not and cannot offer solutions to South Africa's dilemma in the handling of its large offender population. It is for this reason that the researcher has selected workable aspects from various systems in a multidimensional and multidisciplinary management approach to the handling of drug offenders in the South African context. The researcher utilises certain components of the systems theory to describe the manner in which the criminal justice system processes drug offenders. For this purpose, the researcher uses the systems theory as a framework for the application of the drug model that takes place on all levels within the criminal justice system. The researcher aims to use existing drug policy to form the basis of the drug model, and sets structural and procedural guidelines for dealing with this category of offender. The researcher furthermore calls for the implementation of such a model. / Corrections Management / D.Litt. et Phil. (Penology)

Thesis (MPhil (Sociology and Social Anthropology))--Stellenbosch University, 2008. / Rising crime rates among the youth in South Africa is a major problem. In the Western Cape this concern is particularly urgent and is compounded by issues relating to gangsterism and drugs. This study analyses why youth offenders, based at Lindelani become involved in crime and how they subsequently see their future. The first part of the study reviews theories of crime and deviance, such as the classical school of criminology, psychological, biological and sociological explanations of crime. The usefulness of the criminological developmentalist approach toward identifying risk factors statistically correlated to the perpetration of crime is discussed. Common factors associated with crime in the South African context are identified including family, peers, gang, drug, school, media and neighbourhood related factors as well as the absence of spirituality. Thereafter the literature associated with the development of aspirations, life goals and the concept of possible selves is explained. The relationship between possible selves, aspirations and life goals are discussed and details regarding how possible selves influence delinquency are presented. Following the theoretical analysis, the problem of crime in South Africa with reference to the youths interviewed is outlined. The strategies pursued by government to combat crime are discussed and the effective potential of these approaches are evaluated. An overview of government’s policy toward youth in South Africa is given followed by specific reference to the issues surrounding youth and crime in the Western Cape, with explicit reference to the Cape Flats and gangs. This provides the background to the Lindelani case study. An overview of the operations and challenges facing Lindelani Place of Safety and the profile of offences typically committed by youth are given. Hereafter the findings are presented. The findings are divided into two sections; the first explores the life world of youth at Lindelani by discussing why youth in the Western Cape perpetrate crime and identifies factors that are associated with their involvement. The findings report on the influence of family and household structure, peers, neighbourhood environment, gangs, drugs, school, media, perceived aptitude of youth offenders, role models and spirituality. Section two presents the findings regarding the possible selves, life goals and aspirations of the youth. The general aspirations, possible selves, family aspirations, friendship, neighbourhood, spiritual, educational and occupational aspirations are explored. The study thereby presents the voices of these young offenders.

published_or_final_version / abstract / Criminology / Master / Master of Social Sciences