Mémoire numérisé par la Direction des bibliothèques de l'Université de Montréal.

INTRODUCTION: In Georgia, criminal justice (CJ) involvement is one of the costliest outcomes experienced by individuals with substance abuse problems. Approximately 8% of individuals in America have needed substance abuse treatment, and in Georgia CJ involvement commonly co-occurs. AIM: To examine the transition into the CJ system for those entering treatment, and, arrests of individuals in treatment. The aim is to determine defining characteristics exist for an individual who switches over into the CJ system, or an individual who has an arrest while in treatment. METHODS: Data from the Treatment Episode Data Set from 2011-2015 was examined. Demographics, drug types, frequency of use, poly drug use, number of treatment episodes, time between treatment episodes, and rural and urban geography are analyzed in relation to the dependent study variables. Analytic techniques used are independent samples t-tests and regression analyses. The dependent variables are any switchover into the criminal justice system upon reentering treatment, and any arrest before discharge from treatment. RESULTS: Factors associated with a switch into the CJ system upon admission are non-completion of high school, ever being unemployed or a student (18 yrs or older), poly drug use, more than one treatment episode, younger at age of first drug use, longer periods of time in treatment, a switch of primary drug to meth, crack-cocaine, opiates, marijuana, or alcohol. Attending self-help programs before entering treatment and living in rural areas also increases a switch to the CJ system. Higher risk of arrest is associated with younger at age of first drug use, being male, black or other non-white race, higher education levels, ever being a student or homeless, attending self-help programs, and living in urban areas. DISCUSSION: The results and interpretation of this study may help inform and direct one part of a criminal justice prevention strategy and evidence-based health policy, for individuals who are undergoing substance abuse treatment.

The ambition of the study Nyanser av beroende is to analyze and problematize the concept of addiction. A broader aim is to investigate if it in the Swedish population exists different patterns of addiction and how these patterns then look like. The empirical material constitutes of Negativa konsekvenser av ANDT-bruk i den svenska vuxna befolkningen 2014. The selection consists of 26 257 individuals with a response rate of 59, 3 percent (N=15 576). The individuals that at some time during the last year used any narcotic substance and fulfilled at least one of the addiction criterias in the diagnose manual DSM-IV are subjects to the analysis (N=560). By the analyze method of Latent klassanalys (LCA), patterns of addiction have been investigated. The theoretical framework consists of medical and social addiction theory. This to see how different patterns of addiction comply with the medical and social perspectives that can be found in DSM-IV. In the latent class analysis, four different groups with different patterns of addiction are identified: Kontrollförlust, Försökt minska intag, Hard core gruppen och Tolerans. The group’s patterns have further on been connected with sociodemographic factors and substance use. The result of this study indicate that addiction is not a homogeneous concept but that there are differences concerning patterns of use and sociodemographic factors.

Experiential avoidance (EA) is a process in which a person attempts to avoid, dismiss, or change experiences such as emotions, behaviors, and thoughts. EA is associated with a number of psychological disorders and is generally harmful to psychological well-being. Various studies have explored the role of EA as a mediator, while others have studied EA as a moderator. The current study aimed to further understand and broaden the knowledge of the role of EA in regard to trauma, substance abuse, aggression, and impulsivity by examining relationships between these variables with EA as a mediator and as a moderator. Experientially avoidant behaviors (i.e., substance abuse, aggression, and impulsivity) were related to higher levels of EA. EA was found to partially mediate the relationship between the number of traumatic experiences and posttraumatic stress disorder (PTSD) symptoms, as well as the relationship between substance abuse and PTSD. EA was also found to moderate the relationship between PTSD symptoms and aggression. Findings from the present study as well as its limitations and future directions for research are discussed.

Understanding the characteristics of research participants is crucial to ensuring sample representativeness and generalizability of findings to broader patient groups with substance use disorders. Using anonymous computer-administered health survey data, the present study had a unique opportunity to compare patients who chose to participate in an RCT for heavy/problem drinking or drug use (N=713; consenters) with those that chose not to participate (N=625; non-consenters). The sample was 40% male, 76% African American, and had a mean age of 45.2 years. Using multivariate regression, the most parsimonious model found older age, unemployment, prescription misuse, positive screen for drug problems (CAGE), having a grandmother with an alcohol problem, trouble falling asleep (past 30 days), health professional recommendation to go on a diet, and feeling unsafe due to a previous partner were all associated with consenting to participate. The present study provides benchmark data on sample representativeness in a clinical trial of SBIRT.

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What are the ordinary objects we sense? More precisely, how do we characterize the nature of their existence? In this exploration, we consider possible theories about the structure of concrete particulars, engaging with topics including attributes, universals, intrinsic unity, Identity of Indiscernibles, change, and more. Once we understand each theory, we evaluate it. In the end, can we find a suitable theory that coheres with our intuitive understanding of the ‘things’ we take for granted?

Class of 2007 Abstract / Objectives: To identify differences between patients diagnosed with a serious mental illness who test positive for cocaine and/or methamphetamine compared to patients who test positive or other abused substances. Methods: This retrospective study of clinical data obtained through a community mental health agency that provides outpatient services for patients with a serious mental illness. The study population was divided into two subgroups: positive cocaine and/or methamphetamine drug screen versus other positive drug screens and were compared over a 12- month period for the frequency and types of positive drug screens and blood alcohol levels, days of court-ordered treatment, the number of psychiatric hospitalizations and length of stay, primary psychiatric diagnosis, and the cost of care for services provided. Results: More females were in the “cocaine/methamphetamine” group versus more males in the “other substances of abuse” group, (p < 0.01). A higher proportion of patients diagnosed with psychotic disorders tested positive for “other substances” than for “cocaine and methamphetamine” (p < 0.01) and the “cocaine/methamphetamine” group had significantly more mood and anxiety disorders than the other group (p < 0.05). The frequency of patients testing positive for marijuana, methadone, and other opiates was higher in the “other substance abuse” group (p < 0.001). Patients in the “cocaine/methamphetamine” group had higher rates of polysubstance abuse (p < 0.001). The most commonly abused substance was cocaine (53.8%). Conclusions: Regular drug screening for substances of abuse and utilization of drug treatment programs should be recommended for SMI patients to improve their care and treatment outcomes.

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M.A. / Patterns of substance abuse within the family is a widespread phenomenon that occurs through generations. Although various factors can be a symptom of a dysfunctional family, the dynamics that maintain the transgenerational patterns of substance abuse are of great interest. The family in which the abuse of alcohol is repetitive through generations, is seen as a dysfunctional family system. It appears that a circular pattern exists in the family that maintains the alcohol abuse. Although the family as a whole has an influence on individual members, these individual members enter their families with their own preconceived mind maps of past experiences that also have a great influence on the family dynamics. Family dynamics are seen as those factors that impact either positively or negatively on the family and its individual members. The alcoholic parent and adult child of the alcoholic parent are the subjects of concern in this study because it is assumed that parental inputs have been the most influential in the respondent’s lives. A qualitative method of research was implemented to describe this explorative study and was decided on because it describes the phenomenon of transgenerational patterns of alcohol abuse from the viewpoint of the respondent. The aim of this research study was to determine the dynamics that contribute to transgenerational patterns of alcohol abuse, with specific reference to the respondent’s family history of alcohol abuse, their co-dependency (alcohol abuse) and the maintenance of these dynamics throughout generations. These dynamics will be explained in terms of the Living Systems Theory and the Object Relations Theory. These theories form the theoretical foundation from which these dynamics were explained. From these theories a strategy of data-gathering was developed with specific focus on the genogram, family tree and general questions. A focused sampling method was implemented in this research study, and the research units consisted of five respondents with families that have a history of alcohol abuse. Data-gathering was done through phenomenological and semi-structured interviews. The interviews were audiotaped and fieldnotes were made, although limited and only to confirm some of the findings of the research study. The data was analysed according to a specific strategy. Preliminary coding was done by using the audiotapes (transcriptions) and fieldnotes. After the preliminary coding was completed, these categories were used to derive central themes from the findings and all the categories were then divided under one or several of these themes. These central themes were compared with existing literature in order to confirm the findings of this research study and to enhance the trustworthiness. From the study, certain recommendations with regard to methodology and content were made. / Dr. E. Oliphant