Fetal alcohol spectrum disorder (FASD) is the leading non-genetic cause of brain damage. In an effort to reduce alcohol-exposed pregnancies, steps are needed to identify at risk women as early as possible so that appropriate intervention can occur. The objective of this dissertation was to examine screening methods validated in identifying pregnant women at risk for consuming alcohol and illicit drugs during pregnancy. A systematic review identified three main approaches including maternal self-report, use of standardized questionnaires and detection via biological markers. Since most screening tools were developed in alcoholic women, it was important to examine performance in problem drinkers. Alcohol screening tools (ASQ), currently the best method of predicting prenatal problem drinking, were not effective in a cohort representative of problem drinkers. ASQ performance improved minimally, using higher thresholds, but not enough to be used alone. Provider’s knowledge of complexities inherent in women under their care is an important component in screening. As illicit drug use is an important predictor of problem drinking, identifying maternal risk factors associated with substance use was necessary. Increased rates of STD’s, untreated psychiatric disorders, binge drinking and heavy smoking were all identified as predictors of prenatal methamphetamine (MA) use. These factors, combined with high rates of unplanned pregnancies have serious adverse implications for the fetus. The most widely used method to screen for illicit substance use is based on a practice-based approach that relies heavily on maternal self-report. Most providers do not ask about alcohol and substance use in the absence of a high index of suspicion due to the assumption that patient will deny use. But evidence suggests that maternal account can be accurate in a supportive environment. The last study examines the agreement between self-reported data, in comparison to illicit drug use based on positive hair test results. A reasonable agreement between the two approaches of identification demonstrates that maternal self-report can be reliable in women who are motivated enough to seek prenatal care. No single approach is sufficient to effectively identify at risk women. However, combining two or more methods will improve screening and help reduce the number of alcohol-exposed pregnancies.

Fetal alcohol spectrum disorder (FASD) is the leading non-genetic cause of brain damage. In an effort to reduce alcohol-exposed pregnancies, steps are needed to identify at risk women as early as possible so that appropriate intervention can occur. The objective of this dissertation was to examine screening methods validated in identifying pregnant women at risk for consuming alcohol and illicit drugs during pregnancy. A systematic review identified three main approaches including maternal self-report, use of standardized questionnaires and detection via biological markers. Since most screening tools were developed in alcoholic women, it was important to examine performance in problem drinkers. Alcohol screening tools (ASQ), currently the best method of predicting prenatal problem drinking, were not effective in a cohort representative of problem drinkers. ASQ performance improved minimally, using higher thresholds, but not enough to be used alone. Provider’s knowledge of complexities inherent in women under their care is an important component in screening. As illicit drug use is an important predictor of problem drinking, identifying maternal risk factors associated with substance use was necessary. Increased rates of STD’s, untreated psychiatric disorders, binge drinking and heavy smoking were all identified as predictors of prenatal methamphetamine (MA) use. These factors, combined with high rates of unplanned pregnancies have serious adverse implications for the fetus. The most widely used method to screen for illicit substance use is based on a practice-based approach that relies heavily on maternal self-report. Most providers do not ask about alcohol and substance use in the absence of a high index of suspicion due to the assumption that patient will deny use. But evidence suggests that maternal account can be accurate in a supportive environment. The last study examines the agreement between self-reported data, in comparison to illicit drug use based on positive hair test results. A reasonable agreement between the two approaches of identification demonstrates that maternal self-report can be reliable in women who are motivated enough to seek prenatal care. No single approach is sufficient to effectively identify at risk women. However, combining two or more methods will improve screening and help reduce the number of alcohol-exposed pregnancies.

Magister Artium (Psychology) - MA(Psych) / Substance use is a worldwide health concern that has received significant attention as it is often related to deleterious outcomes. Various treatment programmes have been made available to assist people and their families who misuse substances, to aid rehabilitation and equip people with the necessary tools with the aim of preventing possible relapse. The Western Cape Province has been identified as experiencing the highest increase of substance use, with Cape Town being disproportionately affected. Substance use treatment and prevention programmes are therefore an increasingly important means of addressing substance use and related harms. This study aimed to explore the lived experiences of individuals in relation to the treatment they received at a treatment facility in the Cape Town area. As such, the researcher made use of the phenomenological approach as a theoretical framework as it aims to describe the lived experiences of individuals in relation to a particular phenomenon. Furthermore, a qualitative methodological framework was utilised to explore the experiences of individuals who received substance use treatment. Ten participants were purposively selected from an outpatient substance use treatment facility in Cape Town. Focus group discussions were used to collect data and the data were analysed using Interpretive Phenomenological Analysis (IPA). Findings suggest that there were various reasons participants sought treatment. This includes the challenges they experienced in both their personal and occupational lives as well as the realization of the negative effects substance use had on them physiologically. Findings also revealed that the environmental setting individuals were in fostered their treatment; the various aspects of the programme provided by the treatment facility had a significant contribution to their recovery and improved relationships with others; receiving support from family and friends were important in service providers treatment retention as well as individuals ability to identify the changes within themselves since receiving treatment. Overall, results indicate that the treatment programme helped participants in their recovery and enhanced personal relationships, self-perception as well as personal and occupational growth. Findings suggest that there are various reasons as to why people seek treatment and although this may differ, the treatment modality they were provided with contributed substantially to their recovery. Furthermore, this study will contribute to the literature and understanding the ways in which treatment fosters recovery, personal growth and relationships.

The exploitation of illicit substances, such as drugs and explosives, is on the rise. Special attention must therefore be considered to reduce the transportation and storage of these illicit substances by improving the capability of detection, even when hidden from view. Although analytical methods of detection for both drugs and explosives have improved over time, biological detectors, such as canines, are still commonly used. In comparison to humans, these canines have a larger number of olfactory receptors and a greater olfactory epithelium surface area, providing them with a more enhanced olfaction than that of humans. The premise for the detection of illicit drugs and explosives is based on the premise that these substances though hidden, will emit volatile organic compounds (VOCs). These VOCs are not often the parent drug or explosive, they are essentially a chemical associated with the source and provide a reliable indication of the illicit substance. Previous successful research has been conducted on the identification of the active odors present in the headspace of cocaine, methamphetamine, and MDMA but instead for marijuana and heroin there have been minimum success. Thus, in the present research a method using headspace solid-phase microextraction coupled to gas chromatography-mass spectrometry (HS-SPME-GC-MS) was optimized to identify the VOCs makeup of heroin and marijuana to further identify the active odor compound(s) responsible for the alert response of biological detectors (canines). A mixture of acetic acid and acetylsalicylic acid was identified as target odor mimic for heroin by certified detector canines, while a mixture of limonene and caryophyllene was recognized as odor mimic for marijuana by conducting ORTs. The training aids developed successfully mimic the scent of the actual illicit substance and can be used to improve the capabilities of both drug and explosive detection canines. Additionally, as growing threat of improvised explosives has created a worldwide concern and emphasized the requirement of a greater spectra of canine training aids that covers the complete range of explosives available, a new approach for the creation of training aids for IEDs have been evaluated. The use of a dynamic collection system have proved to be an option to develop fast and reliable canine training aids for IEDs.

Magister Psychologiae - MPsych / The purpose of the present study was to gather further external validity evidence towards the validity argument for an instrument designed to measure individual and contextual factors associated with adolescent substance use in low socio-economic status communities in the Western Cape, South Africa. The South African Substance Use Contextual Risk Instrument (SASUCRI) measures adolescents' subjective experiences of their own psycho-social and their communities' functioning. The present study uses secondary data analysis in order to further evaluate its external validity. Both content and structural evidence for the instrument has been gathered in the larger study in which the present study is located. Validity theory was used as the theoretical framework for the gathering of the different types of evidence in support of the validity argument for this instrument. The study employed non-probability purposive sampling to select schools from three education districts from which twenty-six schools were selected where the sample total was N=1959. English and Afrikaans versions of the instrument were administered to English- and Afrikaans home language, school-going adolescents, aged 12 to 21 years. All ethical standards were maintained throughout the research process. External evidence procedures were conducted using Discriminant Function Analysis (DFA) to evaluate the extent to which the instrument could discriminate between substance using and non-using adolescents. The DFA revealed that nine SASUCRI sub-scales totals can act as significant predictors to substance use among adolescents based on the predictive validity of sub-scales.

Today, over 15,000 Ion Mobility Spectrometry (IMS) analyzers are employed at worldwide security checkpoints to detect explosives and illicit drugs. Current portal IMS instruments and other electronic nose technologies detect explosives and drugs by analyzing samples containing the headspace air and loose particles residing on a surface. Canines can outperform these systems at sampling and detecting the low vapor pressure explosives and drugs, such as RDX, PETN, cocaine, and MDMA, because these biological detectors target the volatile signature compounds available in the headspace rather than the non-volatile parent compounds of explosives and drugs. In this dissertation research volatile signature compounds available in the headspace over explosive and drug samples were detected using SPME as a headspace sampling tool coupled to an IMS analyzer. A Genetic Algorithm (GA) technique was developed to optimize the operating conditions of a commercial IMS (GE Itemizer 2), leading to the successful detection of plastic explosives (Detasheet, Semtex H, and C-4) and illicit drugs (cocaine, MDMA, and marijuana). Short sampling times (between 10 sec to 5 min) were adequate to extract and preconcentrate sufficient analytes (> 20 ng) representing the volatile signatures in the headspace of a 15 mL glass vial or a quart-sized can containing ≤ 1 g of the bulk explosive or drug. Furthermore, a research grade IMS with flexibility for changing operating conditions and physical configurations was designed and fabricated to accommodate future research into different analytes or physical configurations. The design and construction of the FIU-IMS were facilitated by computer modeling and simulation of ion’s behavior within an IMS. The simulation method developed uses SIMION/SDS and was evaluated with experimental data collected using a commercial IMS (PCP Phemto Chem 110). The FIU-IMS instrument has comparable performance to the GE Itemizer 2 (average resolving power of 14, resolution of 3 between two drugs and two explosives, and LODs range from 0.7 to 9 ng). The results from this dissertation further advance the concept of targeting volatile components to presumptively detect the presence of concealed bulk explosives and drugs by SPME-IMS, and the new FIU-IMS provides a flexible platform for future IMS research projects.

Heroin use and dependency is a growing concern within South Africa, individuals face difficulty in remaining abstinent from the use of heroin due to constant relapse. The opioid antagonist known as the naltrexone pellet implant offers an alternative form of aid to relapse prevention in the recovery and abstinence from heroin dependency. This qualitative study explored the subjective experiences and perceptions of heroin dependent individuals, that made use of the naltrexone pellet implant. This study was rooted in the interpretive, qualitative paradigm where a phenomenological research design was used. Participants were selected using a purposive, snowball sampling technique and four individuals who had made use of the naltrexone pellet implant for the aid in heroin dependency for a minimum of three-months were interviewed. Interpretative Phenomenological Analysis (IPA) was used to extract recurrent themes across participants. The findings suggested that the use of the naltrexone pellet implant was beneficial in the aid for relapse prevention from heroin use. Furthermore, the exploration of difficulties that were faced in remaining abstinent, the attempt to make use of the naltrexone pellet implant and the physical and psychological aspects regarding the use of this alternative method of remaining abstinent were explored in this study. / Psychology / M.A. (Psychology (Research Consultation))