Background: Substance use can have lifelong consequences for adolescents and the rates of substance use in Canadian adolescents are increasing. This is a serious public health issue which needs to be addressed. The purpose of this study is to determine the impact of public health unit (PHU) engagement in school-based substance use prevention programs on student substance use. Methods: Data was collected from the Cannabis, Obesity, Mental health, Physical activity, Alcohol use, Smoking and Sedentary behaviour (COMPASS) study over the 2018/19 data collection year. A multi-level logistic regression was used to analyze the associations between PHU engagement and student substance use. Results: The analyses found that 70% of schools had PHU engagement in substance use prevention programs. Overall, PHU engagement made no difference on student substance use. However, when PHU engagement was divided into five levels of engagement (with zero being no engagement and five being the highest level of engagement) it was found that students from schools where PHUs solved problems jointly (level two) had statistically significantly greater odds of binge drinking, alcohol use and cannabis use. Schools were also divided into low and high-use schools for each substance. It was found that students in low-use schools had statistically significantly greater odds of binge drinking, alcohol and cannabis use with some levels of PHU engagement and students from high-use schools had statistically significantly lower odds of cannabis and cigarette use with some levels of PHU engagement compared to a similar student from a school without PHU engagement. Conclusions: Our findings show that there is opportunity for greater PHU engagement with schools in substance use prevention programming. Furthermore, it is important that PHUs are working with schools to ensure school-based substance use prevention programs are evidence-based and tailored to the specific needs and risk-levels of the students. / Thesis / Master of Science in Nursing (MSN) / The purpose of this study is to determine the impact of public health unit (PHU) engagement in school-based substance use prevention programs on student substance use. Data for this study was collected from the Cannabis, Obesity, Mental health, Physical activity, Alcohol use, Smoking and Sedentary behaviour (COMPASS) study. The results show that 70% of schools had PHU engagement in substance use prevention programs. Across all schools, when PHUs and schools solved problems jointly an increase in student binge drinking, alcohol and cannabis use was found. When schools were divided into low and high-use schools, similar results were found when PHUs engaged with low-use schools whereas when PHUs engaged in high-use schools a reduced odds of student cannabis and cigarette use was found in some situations. These findings highlight the importance for PHUs to consider the specific needs and risk-levels of the students and schools they are engaging with.

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Stigmatization remains a significant barrier to the initiation and maintenance of treatment in patients with substance use disorders, with higher levels of stigma being associated with lower levels of treatment initiation and adherence. While societal stigma is frequently discussed, less discussed are the inherent biases expressed by healthcare providers. Healthcare providers often hold comparable or even higher levels of stigma against patients with substance use disorders compared to the general population, and this can have quite a significant impact on patient care. From improper treatment decisions stemming from fear and stigmatization of the medications used for opioid use disorders, to the development of mistrust and poor/worsening self-esteem secondary to poor patient-provider interactions. The effects of stigma on the substance use disorder patient cannot be understated and must be alleviated in the coming years to ensure that patients with SUDs receive the high-quality treatment that they deserve. Several interventions have been validated to help reduce stigma within healthcare providers, subsequently improving treatment outcomes. Words matter. Patient-first language is crucial; verbiage can strongly impact how not only the provider sees the patient, but how the patient views themselves (and as we know, poor self-esteem also hinders treatment outcomes). Education and normalization of SUD medications should be done at the healthcare provider level to ensure that all providers are comfortable with these medications. As higher frequency of interactions with substance use disorders has been shown to reduce levels of stigma seen within healthcare providers, it’s also crucial that trainees receive adequate exposure to this patient population. While these suggestions may take time to show effect, it’s imperative that we get the ball rolling on training future generations of healthcare providers that do not hold inherent biases and who will provide high-quality, care utilizing validated treatments. / Urban Bioethics

Intimate partner violence (IPV), substance use, and HIV are syndemic and have compounding risks that contribute to the collective physical and mental health burden among women in the United States. These syndemic factors may contribute to the significant gender-related disparities in substance use disorder (SUD) treatment. IPV is a source of stress and trauma for women, with known interactions with SUD; however, SUD services generally lack trauma-informed treatment modalities to address IPV-related health impacts. The goal of this dissertation was to improve the understanding of the associations between IPV, substance use behaviors, and SUD treatment utilization, and to inform the response to women’s needs related to IPV experiences and substance use within healthcare settings. We employed a mixed-methods approach to understand the interplay of IPV with subsequent substance use behaviors and utilization of SUD services, along with identifying differences by HIV status. We used quantitative methods to evaluate the association of specific forms of IPV (psychological, physical, and sexual) with subsequent substance use (Chapter 2) and SUD service utilization (Chapter 3), and qualitative methods to explore women’s perspectives on how IPV experiences influenced their substance use behaviors and SUD treatment and recovery (Chapter 4). The study in Chapter 2 found that incident IPV experiences were associated with increased risk of subsequent substance use, with physical IPV being more consistently associated than other IPV forms. The study in Chapter 3 found recent IPV experiences to be associated with increased SUD service utilization, whereas lifetime IPV experiences were associated with decreased utilization. Both quantitative studies highlight the complex relationship between IPV and substance use and SUD service utilization. This relationship varies by IPV form, with the syndemic interaction of IPV and HIV exacerbating adverse outcomes. In Chapter 4, qualitative findings explained mechanisms of IPV’s contribution to substance use behaviors and impediment of SUD service engagement and recovery. The interviews also highlighted the value of mental health and IPV supportive services, along with SUD treatment, for a successful SUD recovery. Overall, the findings of this dissertation emphasize the importance of using a trauma-informed approach to address IPV to facilitate women’s SUD recovery. / 2026-05-16T00:00:00Z

by Eric So Hon Kei. / Questionnarie in Chinese. / Thesis (M.Phil.)--Chinese University of Hong Kong, 1997. / Includes bibliographical references (leaves 63-66). / ABSTRACT --- p.ii / TABLE OF CONTENTS --- p.iii / LIST OF TABLES --- p.v / LIST OF FIGURES --- p.vi / LIST OF APPENDICES --- p.vii / CHAPTER / Chapter 1 --- INTRODUCTION AND LITERATURE REVIEW --- p.1 / Recent Condition of Adolescent Substance Use in Hong Kong --- p.1 / Contemporary Theories of Adolescent Substance Use --- p.2 / Temperament --- p.5 / Coping --- p.8 / Cognitive Motivations for Substance Use --- p.9 / General Deviance and Substance Use --- p.10 / Objectives of Present Study --- p.12 / Chapter 2 --- METHOD --- p.15 / Participants --- p.15 / Measures --- p.21 / Procedure --- p.25 / Chapter 3 --- RESULTS --- p.26 / Data Reduction: Factor Analysis of Negative Cognitive Motivation Scale --- p.26 / Internal Consistency of Measures --- p.26 / Comparison of Substance Use Variables --- p.29 / "Comparison of Temperament, BIS/BAS, Coping and Cognitive Motivation Measures" --- p.31 / Test of Bias in Cognitive Motivation Measures --- p.35 / Predicting Degree of Heroin Use in the Heroin User Inmates --- p.38 / Chapter 4 --- DISCUSSION --- p.48 / Cognitive Motivations for Substance Use --- p.48 / Bias in Cognitive Motivations for Substance Use --- p.50 / Temperament and Ways of Coping of Heroin and Non-heroin User Inmates --- p.52 / Prediction of Degree of Heroin Use --- p.56 / Implication for Substance Use Intervention --- p.58 / Limitations --- p.59 / Summary --- p.61 / REFERENCES --- p.63 / APPENDIX --- p.67

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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.