Thesis (M.S.)--Virginia Polytechnic Institute and State University, 1990. / Vita. Abstract. Includes bibliographical references (leaves 110-114). Also available via the Internet.

Magister Psychologiae - MPsych / Recent increases in intellectual, social, infrastructural and economic resources available for the treatment of substance related mental disorders in the Western Cape reflects the national surge towards health promotion and eradication of the burden created by substance abuse. This large number of people who relapse and return to active substance abuse after receiving treatment obstruct this aim. This study aimed to determine the differences in self efficacy and assess for the risk for relapse during the first twelve months of recovery. Albert Bandura’s social cognitive theory provided a suitable framework for the objectives of this study. A cross-sectional survey research design was implemented. Research participants were recruited from different aftercare groups across Western Cape using cluster sampling. The sample consisted of 105 English literate, consenting adult residents of Western Cape who completed an inpatient substance abuse rehabilitation program within twelve months spanning April 2014- April 2015. Data was collected from respondents using two instruments; a demographic information sheet, and an adapted alcohol abstinence self-efficacy scale (AASE). This instrument showed high validity and reliability during a pilot study conducted to ascertain its reliability in a South African sample. Ethics clearance and project registration was given by the Senate Research Committee of the University of the Western Cape. All ethics principles were adhered to and attention was paid particularly to ensuring confidentiality, informed consent, voluntary participation and the right to withdraw without risk of loss or negative consequence. The data was analysed using descriptive statistics, correlation matrices and regression analysis. The results indicated that self-efficacy was highest during the first days and weeks following discharge from a treatment facility. Respondents who remained gainfully employed during recovery reported higher overall self-efficacy and coped better with negative emotions, withdrawal, physical discomfort and urges to use. Respondents’ perceived ability to cope with negative emotions, and resist withdrawal and urges to use again decreased as post-discharge time increased, with females reporting lower self-efficacy than males and respondents’ age showing no significant effect on recovery outcomes. In conclusion, high abstinence self-efficacy has proven to be a predictor of sobriety. After care, interventions can focus on activities to strengthen abstinence self-efficacy levels. Employment stands out as a vital factor to consider in helping people maintain sobriety.

Purpose of this study was to investigate the Alcoholics Anonymous strengths and weaknesses, their policy of total abstinence after treatment and strategies for sobriety. The study was conducted by two focus group interviews with women and men living in a twelve-step treatment. Also a single interview was made with a woman from the staff at the women's homes. The results were analyzed with the theories of social mobilization and how group processes affect individuals. The result shows that the key strategies is to work in the twelve steps, going to meetings, and accept the concept of disease to achieve sobriety. Replacing unhealthy social circles is important. Community given in Alcoholics Anonymous give the individual strengths to break out of addiction. The analysis of a group perspective showed that the community has impact on the individual's choice. It thus leads also to change to new sober socializing, given within the movement, which can change behavior. / Denna studies syfte var att undersöka Anonyma Alkoholisters styrkor och svagheter, deras policy den totala avhållsamheten efter behandling och strategier för nykterhet. I studien genomfördes två fokusgruppintervjuer med kvinnor respektive män boende på ett tolv- stegsbehandlingshem. Även en enskild intervju gjordes med en kvinna ur personalen på kvinnornas hem. Resultatet analyserades med teorier om social mobilisering och om hur grupprocesser påverkar individer. Resultatet visar att centrala strategier är att arbeta i de tolv stegen, gå på möten, och acceptera sjukdomsbegreppet för att uppnå nykterhet. Byte av osunda umgängeskretsar är viktigt. Gemenskapen som ges inom Anonyma Alkoholister ger individen styrka att bryta sig ur missbruket. Analysen med ett grupperspektiv visade att gemenskapen har påverkan på individens val. Det leder således också att byte till nytt nyktert umgänge, som ges inom rörelsen, kan ändra en individs beteende.

Older men are an under-researched population in Counselling Psychology. This thesis explores how older men in sobriety experience their emotions in therapy and aims to understand the meaning of these experiences from a psychologically gendered subject perspective. Semi-structured interviews were carried out with six older men (aged 62 and above) and interview transcripts were analysed using Interpretative Phenomenological Analysis (IPA), a qualitative methodology that focuses on the lived experience and the meaning people give to these experiences. The analysis highlighted significant challenges for older men when attempting to unlock, process or discuss emotions in therapy. The analysis also revealed positive transformational effects by those who were able to transcend the confines of gendered constructs with concerted emotional investments. The two master themes are: (1) CONTROL/REGULATION OF EMOTIONS including subthemes: Challenges to unlocking emotion; Importance of therapeutic emotional containment; Role of Alcoholics Anonymous (AA) in the emotion sharing experience and (2) TRANSFORMATION/ALLEGIANCE TO SELF, including subthemes: Selfactualisation; Going into the heart of emotions as an emotional-spiritual journey. Participants expressed challenges to unlocking their emotions in therapy,which were mainly experienced as controlled or suppressed. Aging, masculinity and helpseeking theories, as well as addiction and recovery literature, are discussed in light of the findings along with suggestions for future research and implications in Counselling Psychology.

Heroin addiction is a growing epidemic in the United States. The need for proper treatment programs accessible by heroin users who wish to or are mandated to participate in recovery programs is a growing need, and pathways to sobriety for ex-offenders have presented in literature as understudied. The purpose of this study was to examine heroin-addicted offenders' experiences prior to and after release on their paths to sobriety. This study followed a qualitative phenomenological approach based on the theory of personal causation, which posits that individuals see events in life as either driven by themselves or caused by others, both of which affect internal motivation. An empirical phenomenological approach was used to explore how this group of individuals perceived or experienced heroin addiction and their subsequent attempts at sobriety A purposeful sample of 15 heroin-addicted offenders were interviewed in a jail in a rural county of Wisconsin. Upon re-entry, 4 participants completed follow- up interviews. The results showed that external motivators such as social and treatment factors were separate from internal factors, although external motivators could influence the way a person makes internal choices. Results were obtained by performing coding on the semi-structured interviews both by hand and within the Atlas-ti analysis program. The theory of personal causation supports and is supported by the findings of this study. Implications for positive social change include a better understanding of the needs of heroin-addicted offenders moving from incarceration to release in treatment program development, thereby reducing harm to the heroin user, family members, and communities by decreasing relapse, recidivism, and chances of overdose and death.

Road fatalities related to marijuana intoxication have steadily increased over the last 10 years (Drummer, 1994; Drummer, 1998; Drummer & Gerostamoulos, 1999). This has led to the introduction of sobriety testing in Victoria, Australia to test for driving impairment caused by marijuana and other psychotropic drugs. Surveys have reported an increase in community concern in Australia over the use of marijuana and an increase in the prevalence and use of marijuana (National Campaign Against Drug Abuse Survey; 1985, 1988, 1991, 1993; National Drug Household Survey; 1995, 1998). Commensurate with the increase in the use of marijuana in society, road statistics indicated that the number of road accidents and deaths involving the presence of THC (the active ingredient in marijuana) in driver specimens has also increased (Drummer & Gerostamoulos, 1999). Consistent with these mortality statistics, past research examining the effects of THC on driving ability indicate that THC impairs both car control (Moskowitz, 1985), and the maintenance of the lateral position of a vehicle (Ramaekers et al., 2000). Intoxication by THC is more likely to result in the crashing into obstacles on a driving course than when not intoxicated (Hansteen et al., 1976). These findings indicate that marijuana impairs driving ability and since the prevalence of marijuana use is increasing this poses a significant risk on our roads. It is essential therefore, that a tool that detects levels of THC in drivers, similar to breath analysis instruments used for the detection of alcohol in drivers, is introduced. To date, there is no such reliable instrument, that could be used on the roadside, and that accurately measures the level of THC in humans. For this reason, some government departments have considered the use of sobriety tests to detect impaired driving. In particular, the Standardised Field Sobriety test (SFSTs) that comprises the Horizontal Gaze Nystagmus test (HGN), Walk and Turn test (WAT) and the One Leg Stand test (OLS) were implemented in Victoria, Australia from December 1st 2000. The validity of these tests have been previously examined by other researchers and their conclusions suggest that sobriety tests have a varied accuracy in detecting impairment caused by drugs, ranging from 44% to 94% (Heishman et al., 1996; Compton, 1986). The present study examines the efficiency of sobriety tests to detect impairment in driving caused by marijuana. The SFSTs were examined, as well as the Romberg Balance test (RB) and the Finger to Nose test (FTN) taken from the Drug Evaluation and Classification Program (DECP) (Los Angeles Police Department, USA). The present study was conducted by Swinburne University, Victoria, Australia. The National Institute on Drug Abuse in the USA (NIDA) provided the marijuana cigarettes. The major objectives of the study were to examine the influence of cannabis on driving performance and on performance on the sobriety tests. The relationship between simulated driving performance and sobriety test performance was then examined to establish the accuracy of sobriety tests to predict driving ability. The present study also examined whether any differences in performance either on the driving tests or on the sobriety tests exist between regular cannabis users and non-regular cannabis users. Driving stress was an additional variable assessed to establish whether individuals with low, normal or high driver stress perform differently on the driving task after the consumption of a low and high dose of cannabis. We tested 40 participants comprising 14 females and 26 males. All participants completed a medical examination questionnaire, demographics questionnaire, Frequency of Cannabis Use Questionnaire and Intoxication Rating Questionnaire. All participants completed 3 marijuana sessions involving the administration of a placebo cigarette (0% THC, weight 702mg, .000gm ∆-9-THC; 0.0mg/kg THC), the administration of a low THC cigarette (1.74% THC, weight 779mg, .813gm ∆-9-THC; 0.2mg/kg THC) and the administration of a high THC marijuana cigarette (2.93% THC, weight 790mg, 1.776gm ∆-9-THC; 0.73mg/kg THC). All sessions were randomised (using Latin-square design), counter-balanced and double-blind. In each session, participants completed 3 sobriety tests and 2 driving simulator tests. Sobriety tests were scored by allocating a score of 1 for each sign (error, e.g., hopping during test performance to maintain balance) observed by the administrator. Generally, a score of 2 or more constituted impairment to a degree equivalent to a blood alcohol concentration (BAC) above 0.10%. The driving simulator test comprised 36 variables. Each time the participant performed an error, a loading factor was added to the corresponding variable (e.g., collision (variable) loading factor is 10, if a collision occurred twice a score of 20 was allocated to this variable). The sum of all 36 variables constituted the level of overall driving impairment. Blood samples were taken throughout each session approximately 20 minutes apart. Intoxication Rating Questionnaires revealed that participants reported that the subjective effect of placebo cigarettes was much weaker than the cigarettes that they usually smoke and that no psychological (such as time distortion) and physiological (such as increased heart rate) changes were experienced. For the low THC cigarettes most participants described the strength, and the effects, as similar to cannabis that they usually smoke. The high THC cigarette was described by most participants as being much stronger, and having some different symptoms, when compared to cannabis that they usually smoked. There were however, some differences in the description of the low THC and the high THC cannabis cigarettes between regular and non-regular cannabis users. Regular users reported that the high THC cigarette was more similar to the cannabis that they usually smoke, whereas non-regular users stated that this was more likely to be the case for the low THC cigarette. Results from the driving simulator task revealed that THC impaired the driving variables: �straddling the solid line� and �straddling the barrier line�. The results indicated that increasing levels of THC increasingly impaired the ability to maintain the steady position of a vehicle within the correct traffic lane. The consumption of low and high doses of THC resulted in two or more wheels of the vehicle moving over a solid line marked out for traffic moving in the opposite direction. Low and high doses of THC also resulted in two or more wheels of the vehicle moving over a broken/barrier line marked out for traffic moving in the same direction. Increasing levels of THC appear to impair both balance and attention required to control the position of a vehicle in traffic. These results are consistent with past research that indicates that THC impairs car control (Moskowitz, 1985) and increases the standard deviation of the lateral position of a vehicle (Smiley et al., 1981; Ramaekers et al., 2000). Research into the effects of THC on brain cannabinoid receptors indicate that THC interferes with normal functioning of the cerebellum, the brain region responsible for balance, posture, and the coordination of movement (Childers & Breivogel, 1998). When driving ability was impaired the level of THC in the blood was between 3 and 5 ng/ml. These findings are consistent with previous research that has reported that driving is maximally impaired by THC plasma levels of 13 ng/ml (approximately 8ng/ml in blood, using a multiplication factor of 1.6 (Giroud, et al., 2001) (Berghaus et al., 1995). The results of the present study also indicated that THC impairs performance on sobriety tests with more individuals impaired with increasing levels of THC (e.g., at Time 1; placebo: 2.5%, low THC: 23.1%, and high THC: 46.2%). Performances on the sobriety tests RB and FTN were unrelated to the level of THC. The test most related to the level of THC was the OLS test, where almost all signs of this test were observed, after the consumption of both low and high THC cigarettes. The accuracy of a �new� sign in the scoring procedure of the HGN test: head moves/jerks (HMJ) was also identified. Including HMJ increased the percentage of individuals scored as impaired after the consumption of low and high THC cigarettes (e.g., at Time 1; placebo: 2.5%, low THC: 38.5% and high THC: 56.4%). Including HMJ as a sign significantly improved the accuracy of the SFSTs to detect impairment associated with the level of THC. The mean level of THC in the blood, when the highest number of participants were classified as impaired, was 70 ng/ml. Differences in performance were observed between regular cannabis users and nonregular cannabis users. Non-regular cannabis users were more impaired on the driving simulator task after the consumption of low and high levels of THC when compared to regular users. Non-regular users recorded significantly longer RTs to emergency situations, more collisions, and shorter distances between the vehicle and an object (after an emergency stop) when compared to regular cannabis users. Signs exhibited during sobriety test performance were related to the level of THC more often for nonregular users compared to regular users. The level of THC in the blood was higher in regular users, compared to non-regular users, at all times in both THC conditions. When driving ability was impaired and significantly related to the level of THC, the SFSTs were also related to level of THC. Sobriety test performance was related to driving impairment, because, as driving impairment increased with the level of THC, so did the number of signs present during the performance of the sobriety tests. Since nonregular users performed more poorly on the driving task compared to regular users, it is no surprise that they exhibited a larger number of signs during the sobriety testing. Although there was a positive linear relationship between driving ability and sobriety tests, such as the relationship between straddling barrier lines and the OLS test, the validity of sobriety tests to predict driving impairment in part depends upon the size of this relationship. Using performance on the SFSTs to assess �impairment�, 46.7% of individuals in the high THC condition were impaired. A discriminant analysis was performed to determine whether the remaining 53.3% of participants were also impaired but not classified as impaired, or whether the SFSTs correctly classified them as not impaired. The results indicated that the sobriety tests (SFSTs; HGN, WAT and OLS) correctly assessed 76.3% of participants in the high THC condition as either impaired on driving or not impaired on driving. Specifically, this percentage included the correct identification of 84% of impaired drivers as impaired, but only 61.5% of unimpaired drivers as unimpaired. The best predictor of driving impairment was the OLS test. In the low THC condition the sobriety tests correctly classified 100% of impaired drivers as impaired, but this occurred at the expense of falsely classifying most unimpaired drivers as also impaired. This finding suggests that sobriety tests detect the presence of THC even when driving is not impaired. Examining the utility of including the �new� sign HMJ in the SFSTs indicated that when identifying impairment on the driving task performed at Time 2, in both the low and high THC condition, the SFSTs were a better predictor of driving impairment when HMJ was included than when the sign was not included. This finding suggests that the inclusion of HMJ in SFSTs scoring procedure increases the likelihood of detecting drivers who are impaired by THC. In conclusion, the results suggest that THC impairs driving ability by reducing one�s ability to maintain a safe position in traffic. At this time THC blood levels are between 3 and 5 ng/ml. THC also impairs driving ability differently for non-regular and regular users of cannabis, where non-regular users are more impaired by THC than regular users. When this occurs, THC blood levels in non-regular users are between 2 and 12 ng/ml, and in regular users between 5 and 16 ng/ml. Performance on the sobriety tests is also impaired by increasing levels of THC. The OLS test is the most sensitive test in detecting the presence of THC. In the present study the SFST battery and each individual test that it comprises are moderate predictors of driving impairment but do misclassify 16% of impaired individuals and 38.5% of not impaired individuals. In addition, the results suggest that sobriety tests are more sensitive to the presence of THC than actual driving impairment. This was revealed by the large number of individuals judged as impaired on driving in the low and high THC conditions even when driving was unaffected. It is important to note that when this occurred, the sobriety tests were accurate in detecting 100% of impaired individuals. Finally, the introduction of the �new� sign HMJ is likely to increase the accuracy of the SFSTs to detect individuals impaired by THC and this sign should be considered for inclusion by policing agencies.

A retrospective research study was conducted to determine the effectiveness of the Drug Evaluation and Classification Program (DECP) procedures in order to identify subjects under the influence of specific drug categories. The investigator wanted to determine if the procedures are reliable and whether a drug recognition expert (DRE) can properly apply the DECP procedures to consistently identify the drug category and have that opinion supported by toxicology. A total of 324 enforcement drug influence evaluations (DIEs) were obtained from the DRE data tracking system (DRE-DTS) that is maintained through the National Highway Traffic Safety Administration (NHTSA). Toxicology results related to each DIE were compared to the DRE??s drug category prediction. The objectives of the study were to determine if the 12-step DECP process enables DREs to identify drug categories and those most frequently identified and confirmed in Texas. Using the DECP, the DRE??s ability to identify specific drugs according to categories and to have the identification supported by toxicology was moderately accurate at best. Of the 324 evaluations that had toxicology results, the DRE correctly identified drug categories as follows: depressants, 60.5%; stimulants, 32%; hallucinogens, 12%; PCP, 46.6%; narcotic analgesics, 51.6%; inhalants, 14.2%; and cannabis, 64.9%. To determine which drug categories were called most frequently, the enforcement DIEs were analyzed according to each specific category. The investigator found the following drug categories were most frequently called by DREs who evaluated subjects: depressants, 182; cannabis, 142; narcotic analgesics, 83; stimulants, 62; PCP, 18; inhalants, 4; and hallucinogens, 1. To determine which drug categories were most frequently confirmed through toxicology, the enforcement DIEs were analyzed for the number of confirmations for each specific drug category. The investigator found the following drug categories were most frequently confirmed through toxicology: depressants, 176; cannabis, 140; stimulants, 106; narcotic analgesics, 99; PCP, 26; hallucinogens, 8; and inhalants, 4. The investigator was able to determine, based on the DRE-DTS data, that Texas DREs are only moderately accurate in identifying drug categories when utilizing the DECP procedures in enforcement settings. Furthermore, the DRE??s prediction of drug category was not consistently supported by toxicology results obtained from evaluated subjects.

Thesis (Ph.d.) - Swinburne University of Technology, 2001. / Submitted for the degree of Doctor of Philosophy, Swinburne University of Technology, 2001. Typescript. Includes bibliographical references (p. 160-169).

This study presents the results of an evaluation of the 24/7 Sobriety Program in Cass County, North Dakota, looking specifically at participants’ likelihood of receiving a conviction of Driving Under the Influence (DUI) both during and after exiting the program. Data was collected of participants who have been enrolled in the program from the start of the program in 2010 through 2018 and matched to public criminal records searches of each participant. Several analyses were run to determine whether substance choice (alcohol vs. drugs), gender (male vs. female), and duration in program influence a participant’s likelihood to recidivate. Findings for each measure are presented including potential changes that could be made, as well as, limitations of the study.

Syftet med denna studie är att undersöka hur individer tagit sig ut ett drogmissbruk och hur de håller sig nyktra. För att uppnå detta har det genomförts kvalitativa intervjuer med personer som själva identifierar sig som nyktra narkomaner. Den insamlade empirin har analyserats med hjälp av den transteoretiska modellen som utgår ifrån att förändring sker stegvis och genom processer. Resultatet visar att individen upplever negativa konsekvenser av droganvändningen och ofta når en personlig botten innan hen bestämmer sig för att sluta. Förändringsprocessen sker bland annat genom att individen får ett andligt uppvaknande. För att kunna bibehålla nykterheten visar studien att relationen till Gud och anhöriga är viktig. Att hitta en ny mening i livet där man hjälper andra människor är också av stor betydelse. / This study examines how individuals have emerged out of substance abuse and how they stay sober. To achieve this we have done qualitative interviews with sober drug addicts. The collected empirical data has been analyzed using the Transtheoretical Model (TTM) that assumes that change occurs gradually and through processes. The result shows that the individual experience negative consequences of the drug abuse and often reaches a personal rock bottom before he or she choose to terminate.  The process of change partly occurs through a spiritual awakening. To maintain the sobriety our study also shows that the relationship to God and relatives are important. Finding a new purpose in life where you help other people is also significant.