Context – The prevalence of problem substance use is a global concern, particularly for adolescents due to their ongoing developmental changes. Amongst other contributory factors, parenting styles adopted by parents and caregivers can either; increase the risks of their children developing substance misuse problems or prevent its onset. Knowledge about the needs and experiences of the caregivers of adolescents who misuse substances is limited and greatly under-researched. Brief interventions (BIs) have been identified as an effective means of tackling this problem-type behaviour among adolescents, including ‘Teen Intervene', which was developed in the US. This evidence-based intervention included a parent component which has been found to further enhance the interventions' positive outcomes. Rationale – In light of the unique caregiver structures in South Africa, the general neglect of their needs in the South African literature with regards to interventions and the high prevalence of adolescent substance misuse in the Western Cape, exploring these needs within the country's context is warranted and necessary. Design and data collection – This was a qualitative study and data for the study was collected in two main phases: through focus group discussions to identify caregivers needs and to explore perceptions of the intervention; and post-intervention interviews with caregivers and adolescents at a 1-month follow-up session. Findings – Template analysis revealed six main themes: 1) Access to knowledge about substance misuse; 2) Parenting skills; 3) Sources of emotional support; 4) Empowerment for female caregivers; 5) Financial concerns; and 6) Alternative solutions to adolescent's involvement in the justice system. Caregivers also reported various feelings that are a direct result of their experiences. Discussion – Caregivers have distinct needs that require designated responses, however, some of these needs can be addressed through their inclusion in treatment interventions for adolescents who misuse substances.

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Indiana University-Purdue University Indianapolis (IUPUI) / Deaths due to prescription painkillers and heroin have quickly become national, state, and local public health concerns. Studies using data from Medical Examiners or Coroner Offices throughout the United States have been conducted and are contributing to the understanding of this epidemic. However, the analysis of these fatalities are specific to the communities where the study was conducted and cannot be assumed that the decedents in one community are similar to decedents in another community. Many local governments and agencies throughout the U.S. are aware that this problem exists in their communities, but are not prepared to adequately respond to and intervene in these fatalities as an analysis of those who have died has rarely been conducted. This dissertation is a replication study of longitudinal epidemiological analyses of opiate related fatalities that was implemented in a location where an analysis of opiate-related fatalities had not been conducted, Marion County, Indiana. The purpose of the dissertation was twofold: (1) to describe the demographic characteristics of the decedents using publicly available data from the Marion County Coroner’s Office to be used in informing future preventative efforts to decrease opiate-related fatalities in Marion County and (2) to inform other communities on how to conduct a similar analysis in their own community. This dissertation describes the methods of the replication study, provides descriptive results of the people who died from opiate-related overdoses, and: (a) Report the types of opiates identified in blood toxicology reports and (b) Present the histories of opiate-related decedents as reported in the Deputy Coroner Field Officer’s Reports (DCFOR). Additionally, analysis was conducted to determine if decedent characteristics deferred depending on the type of opiate fatality based on the toxicology in 1) heroin alone, 2) painkillers alone, and 3) heroin and painkillers combined.

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This study investigates the misuse of prescription stimulants among undergraduates for a variety of different purposes, including: academic, other instrumental, and recreational. This research is important as existing literature as well as national level surveillance data indicates a substantial increase in this type of prescription drug misuse, especially among young adults aged 18-25. Drawing from several theoretical frameworks, this research focuses on how academic strain, social norms, and gender influence prescription stimulant misuse among undergraduates. Roughly 900 quantitative surveys were collected that specifically address undergraduate prescription stimulant misuse. The results indicate that college students are at an increased likelihood of misusing prescription stimulants if they experienced academic impediments and/or grade strain during the past academic year. Additionally, the findings show that undergraduates who have accepting attitudes of prescription stimulant misuse and who have peers that misuse prescription stimulants are also at an increased likelihood of misusing prescription stimulants. Furthermore, males were at an increased likelihood of prescription stimulant misuse for academic purposes if they had experienced grade strain during the past academic year in comparison to their female counterparts. Female undergraduates, on the other hand, were four times more likely than male undergraduates to obtain prescription stimulants from their close friends for free.

Many times, gaming starts as a hobby but can quickly transform into a costly and destructiveaddiction.The overall aim of this paper is to provide an overview of the research field concerninginterventions for adult individuals with gambling addiction through a literature review by doinga scoping study. Therefore, the research question is: What interventions are available for adultindividuals with gambling addiction and what is their effect? To achieve this, the study focusedon collecting data through systematically processing and analyzing 15 peer reviewed articles thatwere run in different countries. The results present a variety of methods with differentapproaches. Subsequently, the findings of the various interventions' effects are analyzed andpresented in themes. The results show that non-person-directed treatment models such as GHO,GA, and Your First Step to Change yielded comparable or superior outcomes compared toperson-directed treatment models such as CBT and MI. The study also shows that the intensityof interventions does not necessarily lead to better results, and they suggest that other research indifferent substance abuse areas demonstrates similar findings. The above findings are analyzedin the discussion with the assistance of the support theory founded by Irvin Yalom (1970) andthe systems theory founded by Bertalanffy (2015). By integrating these various approaches,individuals can benefit from a versatile and comprehensive support structure that enhances theirrecovery process.

Alcohol consumption is becoming an increasing concern among young adults. In 2018, approximately one-third of young adults in the United States reported binge drinking within the past month (Patrick et al., 2020). This peak in binge drinking during young adulthood raises concerns about physical and mental health. There are also societal implications of alcohol consumption, such as drunk driving, that are particularly evident among this age group (Stewart, 2023). As proposed by the Social Learning Theory (SLT) of alcohol use, there are many factors that motivate young adults to drink (Britton, 2004). Some engage in alcohol consumption to cope with stressful situations, while others are influenced by the perceived social norms of their peers. The current study advances SLT in regard to alcohol misuse by examining dating relationship satisfaction as a predictor of the various pathways that lead to alcohol consumption. In order to gain a better understanding of these associations, young adults were asked to complete an anonymous online survey. The survey consisted of the Alcohol Use Disorders Identification Test (Babor et al., 2001), the Drinking Motives Questionnaire-Revised (Cooper, 1994), the Relationship Assessment Scale (Hendrick, 1988), and a series of demographic questions. Results suggest that relationship satisfaction and coping motivations are particularly influential on alcohol consumption. The societal and individual implications of these results will be further discussed.

The region of Appalachia in the United States is a diverse region that is full of beauty, mountains, art, and culture. Due to a history of abuse from large corporations, the impact of the decline in coal mining and generational poverty, the region is currently on a road toward recovery. Substance misuse rates are disproportionality high, and there are limited resources available to address the issue. Literature suggests that church leaders may be a potential resource. The goal of the study was to provide a better understanding of the substance misuse epidemic through the eyes of church leaders. Interpretative Phenomenological Analysis guided this qualitative study. Church leaders (n = 10) were interviewed and four significant themes emerged: narratives used to describe their experiences with substance misuse, the stigma associated with substance misuse, the community impact that substance misuse has on Appalachia, and the lack of understanding and need for training on substance misuse for church leaders and healthcare practitioners. The results of the study are discussed and connected to discussions of the implications for clinical practice, recommendations for further research, and limitations of the study. / Doctor of Philosophy / Appalachia is a mountain range located in the eastern portion of the United States. It is a diverse region that is full of beauty, mountains, art, and culture. Due to a history of abuse from large corporations, the impact of the decline in coal mining and generational poverty, the region is currently on a road toward recovery. Substance misuse rates are disproportionality high, and there are limited healthcare resources available to address the issue. The goal of the presented study was to provide a better understanding of the substance misuse epidemic through the experiences of church leaders, which are abundant in the region. Church leaders, a sample of 10, were interviewed and four significant topics emerged from their stories shared: narratives used to describe their experiences with substance misuse, the stigma associated with substance misuse, the community impact that substance misuse has on Appalachia, and the lack of understanding and need for training on substance misuse for church leaders and healthcare practitioners. The results of this study suggest that church leaders may be used as a resource to help lower the impact of substance misuse. The experiences of the church leaders gained from this study can help provide training to church leaders and healthcare providers on ways to work together and lower substance misuse in Appalachia.