published_or_final_version / Social Work / Master / Master of Social Work

published_or_final_version / Social Work / Master / Master of Social Work

While research investigating the effectiveness of rehabilitation programs for adolescent substance use has increased in recent years, few studies have explored predictors of differential response to these rehabilitation programs. Delay of gratification (DG), which refers to the tendency to forego strong immediate satisfaction in the pursuit of larger long-term rewards, is one factor potentially relevant to all rehabilitation programs, as substance use can be characterized as a choice between short-lasting satisfaction from drug consumption and long-term benefits from abstinence. This study aims at investigating the changes of delay of gratification and the relationship between delay of gratification, future orientation and drug avoidance throughout a drug rehabilitation programme. A sample of one hundred and eleven students in Christian Zheng Sheng College was recruited to participate in this longitudinal study with four waves of data collection. The findings of the present study contribute to the literature of risky behavior by demonstrating the relationship between delay of gratification and drug avoidance, as well as the finding that delay of gratification is a changeable trait which can be strengthened through interventions. Further study will be required to examine the mechanism of change in delay of gratification and drug avoidance, as well as the influences of future orientation on delay of gratification and drug avoidance. / published_or_final_version / Clinical Psychology / Master / Master of Social Sciences

Trata-se de um estudo qualitativo sobre a representação da família, em um grupo de adolescentes dependentes de drogas e residentes na cidade de São Paulo. O objetivo do trabalho é fornecer subsídios a uma proposta de programa para o atendimento à família, na área de educação em saúde pública. Foram entrevistados 12 adolescentes do sexo masculino, com idade de 14 a 21 anos, internados em clínica de tratamento para dependentes de droga. Os dados obtidos são mostrados num esquema de representação da família, que emprega o conceito \"união-fratura\" do grupo familiar como eixo semântico para uma compreensão do problema. É sugerido um programa de educação para prevenção das toxicomanias, com enfoque no ambiente familiar, nas dificuldades relacionais e no apoio aos pais em suas adaptações aos papéis e funções familiares / It is about a qualitative study of family representation, in a teenager drug addicted group, residents in São Paulo city. The purpose of the study is to provide subsidies to a proposal of a program which attends families, in public education health. Twelve male teenagers, aged between 14 to 21 and living in a clinic for drug addicts, have been interviewed. The data obtained are shown on a scheme of representation of the family, wich uses the concept of \"union-fracture\" of the family group as a semmantic axle, for the comprehension of the problem. An educational program to prevent toxicomania with focus on the family environment, on difficult relashionships and on the aid to parents on their adjustment to familiar roles and functions, is suggested.

by Tse Kam Fai. / Thesis (M.Phil.)--Chinese University of Hong Kong, 1995. / Includes bibliographical references (leaves 216-228). / Abstract / Acknowledgements / Chapter Chapter 1: --- Introduction / Chapter 1.1 --- Contexts and Objectives of the Study --- p.1 / Chapter 1.2 --- Related Studies in Hong Kong --- p.9 / Chapter 1.3 --- "Identity, Role, and Social Behavior" --- p.13 / Chapter 1.4 --- Data and Methodology --- p.16 / Chapter 1.5 --- Outline of Chapters --- p.20 / Chapter Chapter 2: --- Literature Review / Chapter 2.1 --- Medical-Disease Model: Exposition and Critique --- p.22 / Chapter 2.2 --- Social Deviance Model --- p.24 / Chapter 2.2.1 --- On Etiology and Process of Drug Use / Chapter 2.2.2 --- On Cessation of Drug Use / Chapter 2.2.3 --- "Social Learning, Resocialization and Therapeutic Community" / Chapter 2.2.4 --- Resocialization as Social Learning: The Oversocialization Critique / Chapter 2.3 --- Identity Model --- p.32 / Chapter 2.3.1 --- Resocialization as Identity Transformation / Chapter 2.3.2 --- Types of Identity Transformation / Chapter 2.3.3 --- Resocialization as Conversion / Chapter Chapter 3: --- A Comparison Between SARD A and Operation Dawn / Chapter 3.1 --- "History, Services, and Social Position" --- p.43 / Chapter 3.2 --- Treatment Philosophy and Practice --- p.47 / Chapter 3.3 --- Treatment and Rehabilitation Programme --- p.48 / Chapter 3.3.1 --- Pre-admission Procedure / Chapter 3.3.2 --- In-patient Service / Chapter 3.3.3 --- Halfway House and Aftercare / Chapter 3.4 --- A Statistical Profile of Admission Cases: SKC vs Dawn Island Centre --- p.60 / Chapter Chapter 4: --- Pre-admission Stage / Chapter 4.1 --- "Addict Role-taking, Role-engulfment and Deviant Identity Formation" --- p.63 / Chapter 4.1.1 --- First Use and the Honeymoon; Taking the addict role / Chapter 4.1.2 --- "Addiction and Life as ""Junkie"": Developing the deviant self-identity" / Chapter 4.2 --- Addict Role-strain and Identity Crisis --- p.83 / Chapter 4.2.1 --- """Hitting the Bottom"" and Motivation to Change" / Chapter 4.2.2 --- Preliminary Attempts: Using Self-administered Methods / Chapter Chapter 5: --- Treatment and Rehabilitation Stage / Chapter 5.1 --- Role-conflict and Identity Negotiation --- p.92 / Chapter 5.1.1 --- "Accepting the ""patient"" or ""sinner"" role" / Chapter 5.1.2 --- The Intensity and Nature of Role Conflict / Chapter 5.1.3 --- Altercasting of Normal Identity / Chapter 5.1.4 --- "Strategies of Identity Negotiation: ""how actors react""" / Chapter 5.2 --- "Identity Transformation: ""how actors are transformed""" --- p.115 / Chapter 5.2.1 --- "Strategies, Materials, and Agents" / Chapter 5.2.2 --- Cognitive Base of Transformation / Chapter 5.2.3 --- Affective Base of Transformation / Chapter 5.2.4 --- Normative Base of Transformation / Chapter Chapter 6: --- Continued Rehabilitation and Social-Reintegration Stage / Chapter 6.1 --- Types of Identity Transformation --- p.140 / Chapter 6.1.1 --- Dawn Island Centre: Religious Conversion / Chapter 6.1.2 --- SKC: Alternation / Chapter 6.2 --- Identity Validation and Types of Role-Support --- p.144 / Chapter 6.2.1 --- Identity Validation and Legitimation / Chapter 6.2.2 --- Types of Role-Support / Chapter Chapter 7: --- Conclusion and Discussion / Chapter 7.1 --- "Identity Transformation, Role-Support and Abstinence" --- p.156 / Chapter 7.2 --- Drug Addicts' Recovery: An Interactive and Joint Accomplishment --- p.159 / Chapter 7.3 --- The Contingent Nature of Recovery Career --- p.161 / Chapter 7.4 --- SARD A and Operation Dawn: Two Different Pathways of Recovery --- p.163 / Chapter 7.4.1 --- Religious Conversion: Pathway to Christianity / Chapter 7.4.2 --- Alternation: Pathway to Normality / Chapter 7.5 --- Significance and Limitations of Study --- p.166 / Appendix I: A Socio-Demographic Profile of Informants --- p.169 / Appendix II: Tables --- p.173 / Appendix III: A Glossary of Hongkong Addicts' Argots --- p.190 / Appendix IV: Document and Questionnaire Samples --- p.192 / Appendix V: Photos of the Dawn Island Gospel Treatment Centre --- p.203 / Appendix VI: Interview Schedules --- p.209 / Bibliography --- p.216

by Cheung Wai-ting. / Thesis (M.Phil.)--Chinese University of Hong Kong, 1999. / Includes bibliographical references (leaves 131-142). / Abstracts in English and Chinese. / Chapter Chapter 1 --- The Research Problem --- p.1 / Chapter Chapter 2 --- Literature Review / Chapter 2.1 --- Prohibitionist Approach --- p.7 / Chapter 2.2 --- Medical-Treatment Approach --- p.8 / Chapter 2.3 --- How Should We Understand Post-Treatment Drug Use Behavior ？ --- p.14 / Chapter Chapter 3 --- Analytical Framework / Chapter 3.1 --- Social Capital Theory --- p.24 / Chapter 3.2 --- Differential Association Theory and Social Capital --- p.26 / Chapter 3.3 --- Control Theory and Social Capital --- p.31 / Chapter 3.4 --- Labeling Theory --- p.39 / Chapter 3.5 --- Self-Efficacy Theory --- p.44 / Chapter 3.6 --- The Hypotheses --- p.48 / Chapter Chapter 4 --- Methodology / Chapter 4.1 --- Data and Sample --- p.52 / Chapter 4.2 --- General Profile of Respondents --- p.54 / Chapter 4.3 --- Conceptualization and Operationalization of Variables --- p.57 / Chapter 4.4 --- Method of Data Analysis --- p.66 / Chapter Chapter 5 --- Results / Chapter 5.1 --- Quantitative Analysis --- p.68 / Chapter 5.1.1 --- Bivariate Analysis / Chapter 5.1.2 --- Path Analysis / Chapter 5.1.3 --- Verification of Hypotheses / Chapter 5.2 --- Qualitative Analysis --- p.86 / Chapter Chapter 6 --- Summary and Discussion / Chapter 6.1 --- The Study --- p.112 / Chapter 6.2 --- Summary of Findings --- p.113 / Chapter 6.3 --- Theoretical Implications --- p.117 / Chapter 6.4 --- Practical Implications --- p.120 / Chapter 6.5 --- Limitations and Suggestions for Future Research --- p.122 / Appendix I Interview Schedule --- p.125 / Appendix II Socio-demographic Profile of the Ten Informants --- p.127 / Bibliography --- p.130

Tsen Wai Sing. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2005. / Includes bibliographical references (leaves 307-317). / Abstracts in English and Chinese. / Abstract --- p.i / Acknowledgements --- p.v / Content --- p.vii / Chapter Chapter 1: --- Introduction --- p.1 / Chapter Section I: --- Theoretical models and Research Issues of Drug Addiction / Chapter Chapter 2: --- Theoretical models of Drug Addiction --- p.10 / Chapter 2.1 --- The concepts of ´بDrug Addiction' --- p.11 / Chapter 2.2 --- Drug Addiction Models --- p.13 / Chapter 2.2.1 --- Moral Model --- p.13 / Chapter 2.2.2 --- Disease Model --- p.14 / Chapter 2.2.3 --- Psychoanalytic Approach --- p.15 / Chapter 2.2.4 --- Social Learning Model --- p.16 / Chapter 2.2.5 --- Socio-cultural Model --- p.17 / Chapter 2.2.6 --- Cognitive Model --- p.18 / Chapter 2.2.7 --- Identity Model --- p.19 / Chapter 2.3 --- "Symbolic Interactionism on ´بDeviant Identity´ة: Self, Identity and Transformation" --- p.20 / Chapter 2.3.1 --- Five Central roles of Symbolic Interactionism --- p.21 / Chapter 2.3.2 --- The Nature of Self --- p.24 / Chapter 2.3.3 --- "Self-Communication, Self-perception, Self-Control and Identity" --- p.25 / Chapter 2.3.4 --- Symbolic Interactionism in the study of 'Drug Addiction' --- p.28 / Chapter Chapter 3: --- The Research Issues on 'Drug Addiction' --- p.32 / Chapter 3.1 --- The ´بMyth´ة of Addiction --- p.32 / Chapter 3.2 --- ´بAddiction´ة as a Social and Contextual ´بLabel，？ --- p.35 / Chapter 3.3 --- The Paradox of ´بScientific，evidence on drug addiction --- p.36 / Chapter 3.3.1 --- ´بAddictive Substance' vs. 'Non-Addictive Substance' --- p.37 / Chapter 3.3.2 --- Craving and Withdrawal: 'Have to' vs. ´بWant to' --- p.38 / Chapter 3.4 --- The Very Nature of Drug Problem --- p.40 / Chapter 3.5 --- A Theoretical basis for the Research Concern on Religious Discourses in formulating Addicts ´ة Identity --- p.41 / Chapter Section II: --- General Figure of Local Youth Drug Abuse and Drug Rehabilitation / Chapter Chapter 4: --- Present Situation of Youth Drug Addiction in Hong Kong --- p.46 / Chapter 4.1 --- General Historical Background of Drug Addiction in Hong Kong --- p.47 / Chapter 4.2 --- Recent Trend of Drug Addiction in Hong Kong --- p.49 / Chapter 4.3 --- Recent Youth Drug Addiction Profile - the Rise of Psychotropic Substances --- p.51 / Chapter 4.4 --- Youth Attitudes on Drug Addiction --- p.53 / Chapter 4.5 --- Rave Culture' and Psychotropic Drugs Addiction --- p.55 / Chapter 4.6 --- Cross Border Drug Addiction in Youth Community --- p.57 / Chapter Chapter 5: --- Drug Treatment and Rehabilitation - Principles and Practices --- p.61 / Chapter 5.1 --- Treatment Goals in Rehabilitation --- p.61 / Chapter 5.2 --- The Ultimate Goal of Treatment: Recovery --- p.62 / Chapter 5.3 --- Major Treatment Modes --- p.64 / Chapter 5.3.1 --- Detoxification --- p.64 / Chapter 5.3.2 --- Outpatient Drug-free Treatment --- p.64 / Chapter 5.3.3 --- Self-help Groups --- p.65 / Chapter 5.3.4 --- Methadone Maintenance --- p.65 / Chapter 5.3.5 --- Residential Treatment --- p.66 / Chapter 5.4 --- Treatments and Rehabilitation in Hong Kong --- p.68 / Chapter 5.4.1 --- Methadone Treatment Program in Hong Kong --- p.68 / Chapter 5.4.2 --- Compulsory Drug Treatment Scheme --- p.69 / Chapter 5.4.3 --- Voluntary Residential Treatment and Rehabilitation Programs --- p.70 / Chapter 5.4.4 --- Substance Abuse Clinics --- p.73 / Chapter 5.5 --- Religion-based Drug Treatment and Rehabilitation --- p.73 / Chapter Section III: --- Lifestyle Changes in the Research Field / Chapter Chapter 6: --- Research Field and Methodology --- p.76 / Chapter 6.1 --- Why study Christianity drug rehabilitation? --- p.76 / Chapter 6.2 --- Why choosing the Christian New Being Fellowship (CNBF)? --- p.78 / Chapter 6.3 --- Getting into the field --- p.79 / Chapter 6.4 --- Basic Information about Christian New Being Fellowship --- p.81 / Chapter 6.4.1 --- Historical Background of the CNBF --- p.82 / Chapter 6.4.2 --- Treatment Stages in the CNBF --- p.83 / Chapter 6.4.3 --- Training Programs in the CNBF --- p.86 / Chapter 6.4.4 --- Recently development of anti-drug campaign in the CNBF --- p.87 / Chapter 6.5 --- Methodology --- p.88 / Chapter 6.5.1 --- Participant Observation --- p.91 / Chapter 6.5.2 --- In-depth Interviews: the CNBF trainees --- p.95 / Chapter 6.5.3 --- "In-depth Interviews: Ex-addicts helper, preacher and social workers" --- p.96 / Chapter Chapter 7 --- Getting Started --- p.99 / Chapter 7.1 --- ´بBartering，-the Start --- p.99 / Chapter 7.2 --- Detoxification period - Involuntary Stay in Rehabilitation Camp --- p.102 / Chapter 7.3 --- ´بScheduled life´ة in the CNBF --- p.104 / Chapter 7.4 --- Life with Limited Resources --- p.108 / Chapter Chapter 8: --- A Dull Life --- p.112 / Chapter 8.1 --- ´بStandardization´ة of living --- p.113 / Chapter 8.2 --- Detachment from Outside World --- p.114 / Chapter 8.3 --- Jail is better than here！´ة --- p.116 / Chapter 8.4 --- ´بNo more pretty girls!' --- p.118 / Chapter 8.5 --- ´بBeware of what you speak！´ة --- p.121 / Chapter 8.6 --- Religious Practices - the core hardness? --- p.122 / Chapter 8.7 --- Responsibilities in Everyday life --- p.125 / Chapter 8.8 --- ´بWe can tackle...´ة --- p.127 / Chapter Section IV: --- Discursive Strategy in the Rehabilitation Camp / Chapter Chapter 9 --- Ways to Tackle --- p.129 / Chapter 9.1 --- ´بYou are not in-group！， --- p.129 / Chapter 9.2 --- To be a member of the ´بin-group， --- p.135 / Chapter 9.3 --- Ways to Tackle --- p.138 / Chapter 9.3.1 --- The main principle: Identify ´بWho can help?， --- p.139 / Chapter 9.3.2 --- A Preliminary Try: How to get the body care products I want? --- p.140 / Chapter 9.3.3 --- "´بYou can get cigarettes, soft drinks and cup noodles here!'" --- p.141 / Chapter 9.3.4 --- The technique of smoking in the CNBF --- p.142 / Chapter 9.3.5 --- Singing pop songs - A ´بsoft´ة way of tackle and opposition --- p.143 / Chapter 9.3.6 --- To get contact with outside world --- p.144 / Chapter 9.3.7 --- Tackle with the boring assembly and biblical studies --- p.144 / Chapter 9.3.8 --- Last way to tackle: Run Away! --- p.145 / Chapter 9.4 --- Ways to Tackle: An 'Underground Community' threatens the Fellowship Health --- p.146 / Chapter Chapter 10 --- In Response to Jesus --- p.149 / Chapter 10.1 --- The 'Underground Community' --- p.150 / Chapter 10.2 --- Study of Discourses in rehabilitation camp --- p.152 / Chapter 10.3 --- Theoretical Perspective in Discourse Analysis in Drug Rehabilitation Camp --- p.154 / Chapter 10.4 --- John Booth Davies (1997): Drugspeak --- p.156 / Chapter 10.5 --- Typology of Discourses in rehabilitation camp --- p.159 / Chapter 10.5.1 --- Let it go' discourse --- p.161 / Chapter 10.5.2 --- Destiny' discourse --- p.162 / Chapter 10.5.3 --- ´بFlexibility´ة discourse --- p.163 / Chapter 10.5.4 --- ´بGet through' discourse --- p.164 / Chapter 10.6 --- A Shrinking Private Space --- p.166 / Chapter 10.7 --- Possible explanation of the 'Ways to Tackle' --- p.167 / Chapter Section V: --- The Multiple Meanings of Drug Addiction / Chapter Chapter 11 --- Heroin，vs. “Non-heroin，Drug Experience --- p.173 / Chapter 11.1 --- Brief Review about the ten trainee informants --- p.176 / Chapter 11.2 --- Descriptions of 'Heroin' and 'Non-heroin' drug experience --- p.178 / Chapter 11.3 --- Descriptions on 'pleasant' effect of drugs --- p.180 / Chapter 11.4 --- The presence / absence of 'Withdrawal' symptoms --- p.181 / Chapter 11.5 --- The descriptions of 'Addiction' --- p.185 / Chapter 11.6 --- Non-volitional vs. Volitional nature of drug use --- p.187 / Chapter 11.7 --- ´بPhysiological Addiction'(身癮）vs. ´بPsychological Addiction' (心癮） --- p.190 / Chapter 11.8 --- Functional use vs. Non-functional use of drugs --- p.193 / Chapter 11.9 --- Positive vs. Negative attitude towards past drug experience --- p.196 / Chapter 11.10 --- Challenges to the Christianity Discourse --- p.199 / Chapter Chapter 12 --- The Meanings of 'Drug Addiction' --- p.202 / Chapter 12.1 --- The meanings of ´بDrug， --- p.203 / Chapter 12.1.1 --- ´بDrug´ة as the means of 'normal habitual use' --- p.204 / Chapter 12.1.2 --- Drug' is not necessarily 'harmful' --- p.206 / Chapter 12.1.3 --- ´بDrug，is only 'Devil' when it refers to ´بHeroin´ة --- p.208 / Chapter 12.2 --- The meanings of ´بAddiction´ة --- p.211 / Chapter 12.2.1 --- The definitions of 'Psychological Addiction' --- p.212 / Chapter 12.2.2 --- ´بAddiction，means 'Physical Dependence' and 'Withdrawal' --- p.216 / Chapter 12.2.3 --- ´بHeroin addiction´ة is the real ´بAddiction´ة --- p.217 / Chapter 12.2.4 --- "´بHeroin Addiction´ة is 'Sinful', but 'Psychological Addiction' is not" --- p.219 / Chapter 12.3 --- The preferred meaning of ´بDrug Addiction' --- p.221 / Chapter Chapter 13 --- The Practices of 'Love' and “Heal， --- p.223 / Chapter 13.1 --- Presenting the 'Love，and ´بHeal´ة --- p.225 / Chapter 13.1.1 --- Christianity as ´بa whole lifestyle change' --- p.226 / Chapter 13.1.2 --- Building up a ´بRole Model' --- p.228 / Chapter 13.1.3 --- Health and Legal Appeal --- p.230 / Chapter 13.1.4 --- ´بPrayer´ة as the most explicit demonstration --- p.232 / Chapter 13.1.5 --- ´بHuman Sin' and ´بHeal´ة as the core concept of Christianity --- p.233 / Chapter 13.2 --- Oppositional attitudes towards the Christianity --- p.237 / Chapter 13.2.1 --- Christianity as the set of ´بRules and Regulations' --- p.237 / Chapter 13.2.2 --- Christianity as ´بtoo mystic' --- p.239 / Chapter 13.2.3 --- Christianity as a ´بFunctional tool' for 'survival' --- p.240 / Chapter 13.2.4 --- Opposition to Health Appeal --- p.241 / Chapter 13.2.5 --- Oppositions to the Discourse of ´بSin' --- p.242 / Chapter 13.3 --- Christianity Discourse and ´بOut-dated Heroin Discourse' --- p.244 / Chapter 13.4 --- Christianity still functions --- p.249 / Chapter Chapter 14 --- Summary and Conclusion -Volitional Nature of Drug Use in New Generation --- p.253 / Chapter 14.1 --- Summary --- p.253 / Chapter 14.2 --- Symbolic Interactionsim and the Social Self --- p.263 / Chapter 14.3 --- Major Findings on 'Drug Addiction' --- p.266 / Chapter 14.4 --- Answers to Research Questions --- p.268 / Chapter 14.5 --- Limitations --- p.271 / Chapter 14.6 --- Implications --- p.273 / Appendix I - Socio-demographic profile of trainee informants and interview report --- p.278 / Appendix II 一 Socio-demographic profiles of the CNBF guides informants and interview report --- p.291 / Appendix III - A Selected Glossary of the CNBF trainees --- p.299 / Appendix VI - Interview schedule for the trainees informants --- p.301 / Appendix V - Interview schedule for the CNBF guides --- p.303 / Bibliography --- p.307

Trata-se de um estudo qualitativo sobre a representação da família, em um grupo de adolescentes dependentes de drogas e residentes na cidade de São Paulo. O objetivo do trabalho é fornecer subsídios a uma proposta de programa para o atendimento à família, na área de educação em saúde pública. Foram entrevistados 12 adolescentes do sexo masculino, com idade de 14 a 21 anos, internados em clínica de tratamento para dependentes de droga. Os dados obtidos são mostrados num esquema de representação da família, que emprega o conceito \"união-fratura\" do grupo familiar como eixo semântico para uma compreensão do problema. É sugerido um programa de educação para prevenção das toxicomanias, com enfoque no ambiente familiar, nas dificuldades relacionais e no apoio aos pais em suas adaptações aos papéis e funções familiares / It is about a qualitative study of family representation, in a teenager drug addicted group, residents in São Paulo city. The purpose of the study is to provide subsidies to a proposal of a program which attends families, in public education health. Twelve male teenagers, aged between 14 to 21 and living in a clinic for drug addicts, have been interviewed. The data obtained are shown on a scheme of representation of the family, wich uses the concept of \"union-fracture\" of the family group as a semmantic axle, for the comprehension of the problem. An educational program to prevent toxicomania with focus on the family environment, on difficult relashionships and on the aid to parents on their adjustment to familiar roles and functions, is suggested.

The consequences of drug use and benefits of methadone maintenance therapy (MMT) were investigated in a random sample of Maori and non- Maori injecting drug users in Christchurch, Aotearoa New Zealand. Eighty- five injecting drug users (IDUs) who had been on MMT for a mean time of 57 months were interviewed and followed up over an average 18 month period. Markov models were used to model cohorts of IDUs, changes in their health states and the effects of MMT and anti-viral therapy on morbidity and mortality. The savings in life from reductions in drug overdoses were used as the main outcome measure in cost-effectiveness analysis. Cost-utility and cost-benefit analysis were also used to provide additional information on the costs and outcomes of treatment. Comparisons were made between: (a) MMT alone; (b) MMT provided with conventional combination therapy for hepatitis C virus (HCV); and (c) MMT provided with anti-viral therapy with pegylated interferon. The monetary costs of drug use and benefits of MMT were similar for Maori and non-Maori. However, Markov modelling indicated that MMT is associated with greater savings in life for Maori than for non-Maori. Further, Maori IDUs identified the main personal costs of drug use as being loss of their children and loss of marriage or partners. Large reductions in use of opioids and benzodiazipines were reported at interview, compared with before starting MMT. The participants also reported large reductions in crime and stabilisation of their lifestyles. Improvements in the general health of IDUs om MMT were reported. However, 89% were positive for HCV infection, which was identified as the major physical health problem affecting IDUs in New Zealand. Few IDUs had received anti-viral therapy for HCV infections, despite having stabilised on MMT. This study investigated the benefits of providing anti-viral therapy for HCV to all patients meeting treatment criteria. The cost-effectiveness of MMT alone was estimated at $25,397 per life year saved (LYS) for non- Maori men and $25,035 for non-Maori women IDUs (costs and benefits discounted at 3%). The incremental effects of providing anti-viral therapy for HCV to all eligible patients were to save extra years of life, as well as to involve additional costs. The net effect was that anti-viral therapy could be provided, at a similar level of cost-effectiveness, to all patients who meet HCV treatment criteria. Cost-effectiveness could be improved if IDUs could be stabilised on MMT five years earlier at an average age of 26 instead of the current age of 31 years. The cost-effectiveness of treatment with pegylated interferon was similar to that for conventional combination therapy because there were incremental savings in life as well as increased treatment costs. Costs per LYS were estimated to be lower for Maori than for non-Maori, reflecting ethnic differences in mortality. Sensitivity analysis revealed that provision of MMT with anti-viral treatment remained cost-effective under varying assumptions of mortality, disease progression and compliance with treatment. the main problems that were not improved during MMT were continuing use of tobacco and cannabis, low participation in paid employment, only three participants had received specific treatment for their HCV infections. Cost-benefit analysis using a conservative approach showed a ratio of the benefits to the costs of MMT of 8:1. Benefits were demonstrated in terms of large reductions in crime. Benefit to cost ratios were similar for the different policy examined, as well as for both Maori and non-Maori IDUs.

Thesis (Ph. D.)--University of California, San Diego, and San Diego State University, 2004. / Vita. Includes bibliographical references (leaves 86-93).