Master of Public Health - MPH / Substance abuse has become a significant public health concern in South Africa, more specifically in the Western Cape province. This has become a source of great alarm as South African Police Service (SAPS) statistics show that 80% of the crimes committed in the Western Cape are related to substance abuse. The Western Cape was the province that reported the highest number of persons treated during the 2008-2010 period. During the period January to June 2016, there were 2,976 admissions across all treatment centres in the Western Cape, which was a slight increase compared to the 2,674 admissions during the previous six-month review period. It has also been reported that substance abuse has increased the burden on an already challenged primary health care system in South Africa. The proportion of new treatment admissions amounted to 71% of all admissions during the period 2015-2019.

Using the 2009 National Survey of Substance Abuse Treatment Services (N-SSATS), this paper uses logistic regressions to explore the effect of facility ownership on a facility’s show of altruism. Facility’s show of altruism is operationalized as a facility offering free treatment to all its clients, free treatment to some of its clients, or a facility offering a sliding fee scale to its client base in order to absorb some of the cost of treatment based on a potential client's income. Region, receipt of public funds, and religious affiliation are added as covariates in order to gauge whether the potential relationship between facility ownership and a facility’s show of altruism is genuine. Results indicate that private, for-profit ownership status of a facility is associated with a lower likelihood that a substance-abuse treatment facility would engage in altruistic behavior. However, receipt of public funds acts as a mediating variable, in that, its inclusion raises the likelihood that a private, for-profit facility would engage in shows of altruism. Furthermore, it appears that religious-affiliation increases the likelihood that a facility would display altruism by providing free treatment, to some of its clients, or to all, but less likely to display altruism by employing a sliding fee scale. Overall, inclusion of region, receipt of public funds, and religious affiliation all produce statistically significant results, along with facility ownership. This suggests that there are a variety of variables, apart from facility ownership alone, that might be influential over a facility's show of altruism.

The 2021 “Community Health Needs Assessment” of Hawkins County, Tennessee conducted by regional hospital system, Ballad Health, identified mental health and substance abuse among the top 3 health priorities for the county. With input from community stakeholders, 5 ETSU medical students organized a 3-part intervention targeting 6th grade students (n=43) testing the hypothesis that individuals with competent coping skills and mental health awareness are less likely to turn to substances to manage life stressors. Lesson plans were crafted using Kolb’s experiential learning model and pre/post surveys collected at each session assessing participant awareness, self-efficacy, perceived stress, and feedback. Results indicated statistically significant improvements in student awareness of positive and negative coping skills and self-efficacy, along with favorable responses from students regarding lesson style. Continuation of the study with longitudinal assessments is needed to prove the hypothesis and indicate effectiveness of the intervention as a tool for reducing substance use in the region.

Non-medical drug use in rural communities in the United States is a significant and growing public health threat. Understanding what motivates drug users in rural areas to seek substance abuse treatment may help in addressing the problem. Perceived need for treatment, a construct indicative of problem recognition and belief in problem solution, has been identified as an important predictor of help-seeking behavior. This cross-sectional study used data collected through face-to-face interviews to examine factors associated with perceived need for drug abuse treatment among not-in-treatment, adult, illicit stimulant drug users (n = 710) in rural areas of Ohio, Kentucky, and Arkansas. More than one-quarter of the sample perceived a need for treatment. Results from a stepwise multiple regression analysis showed that white users, users with better physical and mental health status, and occasional users of methamphetamine were significantly less likely to see a need for treatment. Users with higher Addiction Severity Index composite scores for family/social problems or legal problems, and users with prior drug abuse treatment experience were significantly more likely to perceive a need for treatment. These findings have practical implications for efforts addressing substance abuse in rural areas.

Family-based treatments for adolescent substance abuse demonstrate efficacy and are becoming a treatment of choice. Family risk factors for substance abuse may present barriers to or suggest targets for modification during treatment. The sample included 149 adolescents presenting for substance abuse treatment and their parents. Structural equation modeling tested the hypothesis that parent psychological problems, parent substance use, and parenting behaviors influence adolescent psychological problems and substance use. This study is among the first to examine the unique impact of maternal and paternal variables on adolescent problems within one analytical model. Results indicated that parental psychological problems were directly associated with adolescent psychological problems after controlling for parent substance use and parenting behaviors. Paternal positive involvement and poor monitoring were also independently associated with adolescent substance use. Results suggest that both mothers' and fathers' symptoms of psychopathology play an important role in the symptoms of adolescents in treatment for substance abuse. Findings highlight the need for family-based assessment in adolescent treatment populations to address important clinical and research questions.

Forgiveness is argued to be highly relevant to problematic substance use, yet supportive empirical evidence is lacking. Findings are presented from a longitudinal study exploring the relationship between religiousness and spirituality (RS) variables and alcohol use disorders. We examined forgiveness of self (ForSelf), of others (ForOthers), and by God (ByGod), hypothesizing positive relationships with RS and negative relationships with alcohol use and consequences, at both baseline (N = 157) and six-month follow-up (N = 126). ForSelf scores were significantly lower than ForOthers and ByGod scores, and ForOthers scores increased modestly over time. ByGod was most consistently associated with other RS variables. ForSelf and ForOthers were associated with alcohol-related variables at both time points, and baseline ForSelf and ForOthers were associated with fewer drinking consequences at follow-up, but not after controlling for other pertinent variables. ForSelf may be most difficult to achieve and thus most important to recovery, thereby preventing full recovery and fostering relapses.

Objective: Gratitude, or thankfulness for positive aspects of life, is related to psychosocial well-being and decreased psychopathology, and may reduce suicide risk. We explored four potential hypotheses purported to explain the beneficial outcomes of gratitude (schematic, positive affect, broaden-and-build, and coping), hypothesizing that hopelessness (schematic), depression (positive affect), social support (broaden-and-build), and substance use (coping) would mediate the gratitude-suicide linkage. Participants: 913 undergraduate students from a mid-size, southeastern U.S. university. Methods: Respondents completed online self-report questionnaires including the Suicidal Behaviors Questionnaire-Revised, Gratitude Questionnaire, Beck Hopelessness Scale, Beck Depression Inventory, Duke Social Support Index, Alcohol Use Disorders Identification Test, and Drug Abuse Screening Test. Results: Supporting theory and hypotheses, gratitude was related to less suicide risk via beneficial associations with hopelessness, depression, social support, and substance misuse. Conclusions: The linkage between gratitude and suicide risk appears to be predicated on the beneficial association of gratitude to negative mood and interpersonal functioning.

Objective. To examine the extent to which theory of planned behavior (TPB) constructs and demographic characteristics explain pharmacy students’ dispensing intentions in ethically or legally gray areas involving potential substance misuse or abuse. Methods. Two cohorts of third-year Doctor of Pharmacy (PharmD) students (n5159) were provided with five written cases describing common “gray area” dispensing scenarios in community practice involving medications and devices with potential for misuse or abuse (eg, long-term buprenorphine maintenance prescription without evidence of tapering, early refill of a narcotic for an out-of-town patient, non-prescription sale of pseudoephedrine). Students completed a 12-item survey instrument for each case. Items assessed whether the student would dispense the medication or device in the given scenario, how many times in 10 similar scenarios the student would dispense the medication or device, attitudes regarding dispensing, and subjective norm and perceived behavioral control beliefs. Results. Wide variation in the percentages of students who would dispense the medications or devices was noted across the five scenarios (14% in the buprenorphine scenario to 61% in the pseudoephedrine scenario). Attitude scores significantly predicted dispensing decisions in all scenarios (p,.001), whereas subjective norm and perceived behavioral control beliefs were significant predictors of dispensing only in select case scenarios. Gender and community pharmacy work experience did not consistently predict dispensing intentions. Conclusion. Student attitudes consistently predicted intent to dispense across five gray practice scenarios. These findings can be used to inform development of educational interventions that influence students’ attitudes and self-awareness in community practice decision-making scenarios involving potential substance misuse or abuse.

Heritable and environmental factors contribute to an individual’s risk of substance abuse and psychosis. Individuals diagnosed with a mental disorder have greater vulnerability for substance abuse. Our laboratory established that neonatal treatment of rats with quinpirole (NQ), a dopamine (DA) D2-like agonist, results in a significant increase of DAD2 receptor sensitivity throughout the animal’s lifetime. An increase of DAD2 receptor sensitivity is relevant to a model of schizophrenia (SZ), although increases of DAD2 receptor activity also occur in a number of clinical disorders, including bipolar disorder, obsessive-compulsive disorder, panic disorder, and major depression. Common amongst these clinical conditions is a dramatic increase in cigarette smoking compared to the general population. We bred NQ-treated male and female rats with their NQ-treated or neonatal saline (NS)-treated counterparts once they reached adulthood to determine whether increases in DAD2 sensitivity were passed to the next generation. Offspring of these animals, regardless of whether one or both founders received NQ-treatment, also demonstrated increases of DAD2 receptor sensitivity both behaviorally and neurobiologically. RNASeq preliminary data revealed an increase in cortisol synthesis and release in F1 generation animals, demonstrating an enhanced response to stress, consistent with a model of drug abuse vulnerability. Consistent with this finding, F1 generation rats demonstrated enhanced nicotine conditioned place preference (CPP) and had an enhanced brain derived neurotrophic factor (BDNF) response to nicotine in the nucleus accumbens (NAcc), a brain area critical to drug reward. The DAD2 receptor forms a triple heteromer with the adenosine A(2A) and metabotropic glutamate type 5 (mGlu5) receptor, such that stimulation of either receptor results in a decrease of DAD2 activity. Therefore, we analyzed whether use of a positive allosteric modulator (PAM) of mGlu5 in the F1 generation would block nicotine CPP and improve sensorimotor gating deficits, which is a hallmark of psychosis. In both experiments, the mGlu5 PAM effectively blocked the enhanced rewarding effects of nicotine and also alleviated sensorimotor gating deficits in this model. In essence, we demonstrate in results reported here that there may be a common therapeutic target for the dual treatment of substance abuse and psychosis.

Introduction: Adolescents with substance abuse is a comprehensive subject area within social work, this group of adolescents are a vulnerable group with widely different needs and conditions. The substance abuse amongst adolescents can cause serious consequences in the shape of mental illness, failures at school and/or social problems. Mental illness, failures at school and difficulties during childhood such as family and relationship problems are the most central risk factors for young people to develop an addiction. Aim: The purpose of this study is to analyze why young people in Sweden develop an addiction and what the consequences the addiction might lead to. Method: This is a literature study that includes various scientific articles that concern the subject area of young people with substance abuse. Results: The results show that there is no single variable that causes an adolescent to develop substance abuse, but that the combination of different factors can affect the development of the problem. The three key variables for development of substance abuse are family problems, school problems and mental illness. These three variables prove to be not only risk factors for developing a substance abuse but are also consequences of the substance abuse itself. Conclusion: In summary, it is the combination of different risk factors that leads to an adolescent developing a substance abuse and that these complex risk factors also are consequences of the problem itself.