Thesis (M.S.)--University of Hawaii at Manoa, 2007. / Includes bibliographical references (leaves 88-100). / ix, 100 leaves, bound ill. 29 cm

Screening pregnant women for substance use appears unworthy of debate given the harmful impacts on the fetus, pregnancy outcomes, the woman herself and her offspring to adulthood. However while screening is routine for conditions such as impaired glucose control, obstetric care providers are often reluctant to intervene with substance use, citing knowledge deficits and a lack of effective screening tools. General negativity about the value of intervention and stereotypical views of substance users have also been identified. This study examined existing screening tools and investigated the World Health Organization’s ASSIST (Alcohol, Smoking and Substance Involvement Screening Test) Version 3.0, focussed on tobacco, alcohol and cannabis, the substances most used in the targetted public hospital clinics. The ASSIST Version 3.0’s performance in pregnancy was assessed using a two-pronged harm categorization: risk to the fetus and risk to the woman as an individual user. For the latter, levels of risk concordant with cut-offs for the general population were utilized. The ASSIST Version 3.0 performed only moderately well versus established self-report tools: the Revised Fagerstrom Tolerance Questionnaire (RTQ) for tobacco, the T-ACE for alcohol, and the Timeline FollowBack (TLFB) for cannabis. Most participants used tobacco (98 of 104); predominance of tobacco use was likely linked to the recognized difficulty in stopping, despite cessation of other substances. Kappa analyses of Specific Substance Involvement Scores (SSIS) on ASSIST Version 3.0 for tobacco did not support changing cut-offs for the woman as an individual user; however, ROC curves delineated an SSIS of 4 as indicative of fetal risk for both alcohol and cannabis. As all 98 tobacco users were ‘high risk’ users, a cut-off indicative of fetal risk for tobacco could not be determined but may be feasible by further research with first trimester women. Identifying tobacco use with an established tobacco-specific tool should be the first screening for pregnant women. If tobacco use is identified, screening for other substance use can be initiated and there may be a place for the ASSIST Version 3.0 in that context. Obstetric care providers need to then be willing and competent to address identified use, whilst avoiding unhelpful stereotyping. / Thesis (Ph.D.) -- University of Adelaide, School of Medical Sciences, 2010

The need for cultural competence in making services more responsive to the diverse needs of patients has been highlighted by many authors (NCCC, 2004b; Geiger,2001; Philleo and Brisbane, 1997; Ehrmin, 2005). Philleo and Brisbane (1997)argued that at a time of increasing globalisation and international communication,cultural competency is as important as computer literacy. This means that to be considered a competent professional, such as a nurse, drug worker, youth worker or social worker, one needs to take into account the wider cultural context of the person who is coming for help. A cultural dialogue, where the healthcare worker is able to communicate with people from a different cultural group, should be part of professional approach. With regard to the treatment of substance use problems,Philleo and Brisbane (1997) pointed out that a competent professional must know more than the harm alcohol and drugs can do to the body. Substance problems call for cultural solutions and a cultural dialogue, otherwise professionals are unlikely to achieve a change in their patients' behaviour. The need for better quality services for people from different cultural backgrounds has been recognised in a number of UK government policies, for example the Race Relations (Amendment) Act 2000 (RR(A)A 2000) (The Home Office (HO), 2000). These policies have pressurised organisations into promoting anti-racism and equal opportunities for both service users and staff, and to provide more accessible and culturally competent services. There has been much debate since the 1980s about how to make services more culturally aware and many training initiatives have been developed. Yet, there has been much confusion abuiot the focus of training such as, what needs to be addressed more: racism, discrimination, equal opportunity or diversity? There has been little discussion on the effectiveness of these training activities. Few have been evaluated to measure their impact, such as change in knowledge, attitude and behaviour of those trained, or their organisation's performance towards clients (Papadopoulos et al., 2004; Bhui et al., 2007). Consequently there is little evidence concerning the success of these educational activities. This PhD wants to make an original contribution to the debate surrounding cultural competence and educational practice by evaluating the effectiveness of an educational module to enhance the cultural competence of staff dealing with people with drug and alcohol problems. This study also includes an evaluation of the teaching and learning strategy used.

Thesis (M.S.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / 2031-01-01

TITLE: Gender differences in substance use and depression among caregivers AUTHOR INFO Memunat Ogunmefun Manik Ahuja Author Affiliations: College of Public Health, East Tennessee State University, Johnson City, TN 37614, United States Background: Around 20% of adults in the United States provide care for a loved one, with approximately 61% of these caregivers identifying as women. Typically, a caregiver is defined as someone who provides help and support to a family member or friend who is facing illness or disability as a result of a medical condition. Caregiving may be rewarding, but it can also cause significant psychological strain, leading to adverse consequences, such as turning to substance use to cope with stress. Increased levels of stress in caregivers can make them more susceptible to various health problems, such as depression and anxiety disorders, sleep disturbances, compromised physical health, cardiovascular disease, and substance use disorders. The aim of this study is to examine the gender differences in substance use and depression among caregivers using a nationally representative sample. Methods: We used cross-sectional data from the 2021 Behavioral Risk Factor Surveillance System a nationally representative U.S. telephone-based survey of adults aged 18 years and extracted data for non-metropolitan/rural counties. Logistic regression analyses were conducted separately to test the association between self-identified caregiver status and three outcomes, including depression and current alcohol use. We controlled for past month’s income, race, educational status, and age. Caregiver status was identified based on providing care or assistance to a friend or family member over the last 30 days. Results: Overall, 21.7% (n=13,653) of our participants self-identified as a caregiver, while 19.5% reported depression, past month alcohol use (48.2%), past month smoking (13.5%), and past month marijuana use (4.2%). Significant interactions were found between caregiver status and gender (p=.0001). We then stratified by gender. Among males, self-identified caregiver status was associated with higher odds of depression (OR=1.48, 95% CI, 1.41,1.55). Among females, caregiver status was associated with higher odds of depression (OR=1.48, 95% CI, 1.29, 1.39). Caregiver status did not predict alcohol use. Conclusion: Caregiving has been known to cause psychological strain which may be associated with alcohol use and depression. According to this study, being a caregiver may contribute to depression regardless of gender, but it does not necessarily affect alcohol consumption. The gender differences observed in this study highlight the need for interventions and support programs that are tailored to meet the unique needs and challenges faced by male and female caregivers. It is important for healthcare professionals to consider caregiver status and gender when assessing mental health risk factors.

This study aimed to gain insight into the clinical practices and attitudes of currently practicing play therapists working with children with a parent with a substance use disorder. Participants in the study were play therapists credentialed by the Association for Play Therapy, either as a Registered Play Therapist™ or Registered Play Therapist-Supervisor™. A total of 198 play therapists participated in the study. Results demonstrated that variables including prior education, caseload of children affected by parental substance use, and the number of years since obtaining a mental health licensure explained 16% of the variance in participant attitude scores on the Drug and Drug Problems Perceptions Questionnaire (DDPPQ). Specifically, education (β = -.335, rs2 = .884, p < .001) was found to be a significant predictor of play therapist attitudes towards substance users as it explained 88% of the variance accounted for in the effect. Additionally, although not found to be significant, caseload (β = -.134, rs2 = .325, p = .058) was found to explain 33% of the variance accounted for in the effect. This initial exploration of play therapists' attitudes towards substance users provides strong evidence towards the importance of education and training in substance use disorders. Further exploration of play therapists' educational backgrounds in substance use and clinical experiences of working with children affected by parental substance use.

Substance Use Disorder (SUD) is a chronic relapsing disease that afflicts 10% of the US population. Recidivism rates for SUD treatment in the United States (US) remain high. Couple therapy has be shown to be an effective treatment modality for SUD, and research consistently indicates that couple therapy is more effective than individual therapy in treating SUD. Still, most US treatment centers do not use couple therapy as a primary treatment modality. To explore the underuse of couple therapy and the barriers that prevent its use, individual, semi-structured interviews were conducted with twenty (N = 20) clinical directors of SUD treatment centers across the US. A theoretical thematic analysis was used incorporating Everett Rogers’ diffusion of innovations theory to assess barriers that hinder the use of couple therapy to treat SUD in addiction treatment centers. Issues related to observability, compatibility, and complexity of couple treatment were found to severely impede the implementation of couple therapy in addiction treatment centers. Recommendations include ongoing research to determine influences on agency programming, fostering pro-research environments in universities and agencies, removing barriers to access to evidence-based practice information, and promoting the federal initiative of technology transfer in SUD treatment. / Includes bibliography. / Dissertation (Ph.D.)--Florida Atlantic University, 2020. / FAU Electronic Theses and Dissertations Collection

The illicit drug overdose crisis is an ongoing epidemic that continues to take lives at unprecedented rates and British Columbia, Canada has been identified as the epicenter in Canada, where approximately five deaths per day are linked to unregulated substances most often including fentanyl (Service, 2022). In Victoria, British Columbia, community drug checking sites have been implemented as a public health response to the ongoing overdose crisis and the unregulated illicit drug market through a community-based research project called the Vancouver Island Drug Checking Project. In addition to providing anonymous, confidential, and non-judgmental drug checking services with rapid results, the project has conducted qualitative research aimed to better understand drug checking as a potential harm reduction response to the illicit drug overdose crisis and the unregulated illicit drug market (Wallace et al., 2021; Wallace et al., 2020). An analytical framework was utilized to understand the impact substance use stigma has on those accessing drug checking services, as well as those who avoid accessing these services as a direct result of substance use stigma. This study found that the risk of criminalization and the anticipation of being poorly treated appear to be the most significant barriers related to stigma, rather than actually experiencing stigma. Further, it appears the implementation of community drug checking creates tensions that need to be navigated as sites and services balance a hierarchy of substances and stigma; differing definitions of peers; public yet private locations; and, normalization within criminalization. The findings suggest the solution to substance use stigma and drug checking will not come from continuing as we are, but through making changes at all levels (individual, interpersonal, and structural) and thus for all people who access community drug checking. / Graduate

No description available.

Many substance users deny their substance use to avoid negative consequences, thus diluting the accuracy of assessment. To address this issue, indirect items are often included on substance use measures to identify those who deny their use. The purpose of this study was to examine the effect of complete denial and partial denial on substance use measures. Partial denial, also termed denial of effects, is the denial of substance use interfering in multiple domains of a person's functioning. The study used a mixed within- and between-subjects design with participants from a dual diagnosis inpatient unit. Each participant completed the study under two different conditions which include an honest condition and an experimental condition (either complete denial or partial denial). Results show that partial denial is distinctly different from complete denial across three self-report substance use measures. Importantly, substance users engaging in these denial conditions were often undetected by these measures.