Bakgrund   Personer som har problem orsakade av användandet av opioider kan påträffas inom vården i direkt koppling till deras användande av substansen eller vid uppsökande av vård av andra anledningar. Som sjuksköterska finns möjligheten att identifiera ett beroende eller riskbruk och stötta personen till en förändring i livsstilen eller till egenvård (Skärsäter & Wiklund, 2019). Genom att ge omvårdnad på den egna individens villkor respekteras individens värdighet och integritet vilket är avgörande för individens uppfattning av bemötandet (Svensk Sjuksköterskeförening, 2016).   Syfte   Syftet var att beskriva hur personer som använder opioider upplever mötet med hälso- och sjukvårdspersonal.   Metod   En icke-systematiskt litteraturöversikt utfördes och baserades på 17 vetenskapliga artiklar av kvalitativ design. Artiklarna eftersöktes i databaserna CINAHL och PubMed med hjälp av lämpliga sökord samt så genomfördes även en manuell sökning. Kvalitén på artiklarna granskades utefter Sophiahemmet Högskolas bedömningsunderlag och vidare användes en integrerad analys vilket resulterade i tre huvudkategorier och sex subkategorier.   Resultat  Resultatet bestod av tre huvudkategorier och sex subkategorier. Huvudkategorierna var Patienters upplevelser av vårdpersonalens kompetens, Patienters upplevelser av vårdpersonalens attityder och Patienters upplevelser av samarbetet med vårdpersonal. Subkategorierna var kunskap, kommunikation, stigmatisering, tillit, delaktighet och relationen mellan vårdpersonal och patient. Resultatet visade att majoriteten av patienter upplevt stigmatisering relaterat till deras bruk av opioider. Patienter upplevde även att de inte var delaktiga i sin vård samt förbisedda i sin behandling.   Slutsats  Resultatet från litteraturöversikten påvisade upplevd stigmatisering kring patienter som använder opioider. En stor del av stigmatiseringen kring patientgruppen grundade sig i okunskap hos hälso- och sjukvårdspersonal om “substance use disorder” (SUD). Ett starkt samband mellan vårdpersonalens kunskap om SUD och deras attityder till dessa personer uppmärksammades och det är därför viktigt att kunskapen hos vårdpersonalen ökar när det kommer till denna patientgrupp. Vidare har vårdpersonalens okunskap och stigmatiseringen kring SUD bidragit till att patienter inte tillåtits vara delaktiga i sin egen vård. / Background  People with problems caused by the use of opioids may be found in healthcare, either directly related to their use of the substance or when outreaching for other reasons. As a nurse, you have the opportunity to identify an addiction or risk use, and support the person to a change in lifestyle or to self-care (Skärsäter & Wiklund, 2019). By providing care on the individual's terms, the dignity and integrity of the individual are respected, which is crucial to the individual's perception of the treatment (Svensk Sjuksköterskeförening, 2016).   Aim  The aim was to describe how people who use opioids experience the encounter with health care professionals  Method  A non-systematic literature review was performed and based on 17 scientific articles of qualitative design. The articles were searched in the CINAHL and PubMed databases using the applicable keywords. A manual search was performed. Subsequently, the quality of the articles was examined according to Sophiahemmet University's assessment data and an integrated analysis was further used, resulting in three main categories and six subcategories.   Results  The result consisted of three main categories and six subcategories. The main categories were: Patients’ experiences of Healthcare Professionals competence, Patients’ experiences of Healthcare Professionals’ attitudes and Patients’ experiences of collaboration with Healthcare Professionals. The subcategories were knowledge, communication, stigma, trust, participation and the relationship between healthcare professionals and patients. The results showed that the majority of patients experienced stigma related to their use of opioids.   Conclusions  The results of the literature review show perceived stigma around patients using opioids. Much of the stigma surrounding the patient group has been based on ignorance among health professionals about substance use disorder (SUD). A strong link between healthcare professionals' knowledge of SUD and their attitudes towards these people was recognised and it is therefore important that the knowledge of healthcare professionals increases when it comes to this patient group. Furthermore, the ignorance of healthcare professionals and the stigma surrounding SUD have contributed to patients not being allowed to participate in their own care.

No description available.

Background: Whereas the role of externalizing disorders is relatively well established in predicting the onset of cannabis use (CU) or cannabis use disorder (CUD), the status of anxiety and mood disorders in predicting CU and CUD remains controversial. Objective: (1) To examine cross-sectional and prospective associations of CU and CUD with a range of mental disorders and whether anxiety and mood disorders are associated with CU/CUD after adjusting for externalizing disorders. Methods: N = 1395 community subjects aged 14–17 at baseline were followed-up at three waves prospectively over 10 years. Substance use, substance disorders and mental disorders were assessed using the DSM-IV/M-CIDI. Results: (1) The baseline prevalence rates where 19.3% at t0 for CU and 2.6% for CUD. Cumulative incidence rates at t3 were 54.3% for CU and 13.7% for CUD. (2) In cross-sectional and prospective analyses other substance use disorders, mood and anxiety disorders were associated with CU and CUD. (3) Associations of panic-anxiety with CU and of depressive and bipolar disorders with CU and CUD were significant after controlling for externalizing disorders. Conclusion: A range of psychopathological conditions, including depressive, bipolar and less consistently anxiety disorders as well as the degree of their comorbidity are significantly associated with incident CU and progression to CUD, even when controlling for externalising disorders. A better understanding of this complex interplay may result in better aetiological models and intervention strategies.

Background: Early substance use (SU) in adolescence is known to be associated with an elevated risk of developing substance use disorders (SUD); it remains unclear though whether early SU is associated with more rapid transitions to SUD. Objective: To examine the risk and speed of transition from first SU (alcohol, nicotine, cannabis) to SUD as a function of age of first use. Methods: N = 3021 community subjects aged 14–24 years at baseline were followed-up prospectively over 10-years. SU and SUD were assessed using the DSM-IV/M-CIDI. Results: (1) The conditional probability of substance-specific SU-SUD transition was the greatest for nicotine (36.0%) and the least for cannabis (18.3% for abuse, 6.2% for dependence) with alcohol in between (25.3% for abuse; 11.2% for dependence). (2) In addition to confirming early SU as a risk factor for SUD we find: (3) higher age of onset of any SU to be associated with faster transitions to SUD, except for cannabis dependence. (4) Transitions from first cannabis use (CU) to cannabis use disorders (CUD) occurred faster than for alcohol and nicotine. (5) Use of other substances co-occurred with risk and speed of transitions to specific SUDs. Conclusion: Type of substance and concurrent use of other drugs are of importance for the association between age of first use and the speed of transitions to substance use disorders. Given that further research will identify moderators and mediators affecting these differential associations, these findings may have important implications for designing early and targeted interventions to prevent disorder progression.

The COVID-19 pandemic adversely affected the lives of most Americans. People with Substance Use Disorder (SUD) were particularly vulnerable to the negative effects brought on by the pandemic. This study explored the increase in deaths due to opioid overdose during the pandemic exacerbated by factors such as increased stress, decrease in treatment options due to social distancing requirements and facility closures, social isolation, and an increase in spare time. Access to treatment for opioid use disorder (OUD) was interrupted by the measures meant to mitigate the spread of COVID-19. Through a systematic review of current literature, it was demonstrated that existing patients were able to maintain access to care, while few new patients were able to initiate treatment. Telehealth proved to be a vital means of assuring PWUD were able to access life-saving treatment amid a pandemic. Further research is needed to determine whether SUD treatment measures during the COVID-19 pandemic warrants changing the policies long term.

This study explored the predictors of community supervision failures amongst female offenders in the United States criminal justice system. Female offenders have, in comparison with male offenders, particular challenges for community reintegration. This study used the relational theory and Maslow's hierarchy of needs theory to investigate the effects of childhood trauma on adult female offenders' behaviors, including substance use disorder and mental health issues. Secondary archival data were obtained from the Court Services and Offender Supervision Agency's AUTO Screener and Supervision and Management Automated Record Tracking System; this data pool included information on 1,085 female offenders who had served at least one year on probation, supervised released, and/or parole. Hierarchical logistic regression was used to examine childhood trauma, adult substance use, and substance use and mental health treatments received for the study population. Additional demographic variables were also tested as predictors of community supervision failures. Age, marital status, and caregiving for dependent children were identified as significant predictors of community supervision failures. Results indicated that community supervision failures among female offenders are predicted by relational activities. Positive social change is implicated through programmatic changes offered to female offenders. It is recommended that criminal justice agencies equip female offenders with effective strategies that address relational needs such as childcare, parenting, and life skills assistance. Through these changes, female offenders are able to promote healthier lifestyles for themselves, families, and become productive members of their communities.

One in 4 children in the United States lives in a family impacted by the chronic, heritable disease of substance use disorder (SUD), also known as alcoholism or addiction. Recent research has demonstrated that resilience is a key protective factor against developing the disease in adolescence and adulthood and that the neurological roots of resilience lie in the child's experiences in early childhood. In spite of this, few resources related to family SUD or current models of resilience are included in preservice teacher preparation for early childhood educators. This study examined whether key components of Masten's model of resilience are found in fairytales, a form of literature commonly used in early childhood teacher preparation programs. A qualitative, descriptive, deductive content analysis was conducted on 24 fairytales from 22 different cultures, using a tool derived from Propp's morphology of fairytales and Masten's model of resilience. Results indicated that the texts of 96% of these stories contained multiple specific references to the 3 dominant evidence-based factors for resilience: attachment/relationships, initiative, and self-regulation. When broken into the 7 subcategories of these 3 protective factors, as identified by Masten, 9 fairytales contained examples of all 7 protective factors; 9 had examples of 6, and another 5 had examples of 5. The results of this study may be used to provide teacher educators with resources to better prepare preservice early childhood teachers to understand and nurture resilience in children, while addressing existing mandated learning objectives related to emergent literacy. This will benefit all children the teachers will work with, but especially those who are impacted by SUD and other forms of trauma.

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Title: It’s easy to quit - I’ve done it hundreds of times: A literary study of the correlation between free will and substance abuse The purpose of this bachelor's thesis was to examine, through an integrative literary study, how selected previous research on the two theories, The Brain Disease Model of Addiction and The Choice Model of Addiction, describe the significance of free will in the development of and recovery from substance use disorder. The findings indicate that free will is significant in all stages of substance abuse. The study suggests that the discourse surrounding voluntariness and addiction ought to become more nuanced. The study notes that clients are easily influenced by treatment providers and thus conversations concerning disease versus free will should be approached cautiously by the treatment provider. The study suggests that social workers could benefit from critically examining their own stance regarding free will and addiction, including moral responsibility. Future research should continue developing screening methods to measure motivation levels in clients and to find the best treatment for each individual. / Syftet med denna kandidatuppsats var att genom en integrativ litteraturstudie undersöka hur utvald tidigare forskning om de två teorierna The Brain Disease Model of Addiction och The Choice Model of Addiction beskriver betydelsen av fri vilja när det gäller utvecklingen av och tillfrisknandet från ett substansberoende. Huvudresultatet visar att fri vilja är av betydelse i alla stadier av ett substansberoende. Studien tyder på att diskursen kring frivillighet och beroende torde blir mer nyanserad och att beroendeforskningen torde se beroende på ett spektrum. Studien konstaterar också att klienter är lättinfluerade av behandlare och därför bör samtal om sjukdom kontra fri vilja hanteras försiktigt av behandlaren i klientmöten. Socialarbetare som arbetar med beroende bör kritiskt granska sin egen ståndpunkt gällande beroendets frivillighet, inklusive moraliskt ansvar. Förslagsvis bör framtida forskning fortsätta att utveckla screeningmetoder för att bättre kartlägga motivationsnivån hos klienter och för att hitta den bästa behandlingsplanen för varje individ.

Drug addiction is at crisis level in the United States. Nurses caring for persons affected by substance use disorder (SUD) have a resource in Mr. Ming Ho Liu's testimony on Good TV (Taiwan)—translated and summarized in this article—of his addiction experiences and successful treatment at Operation Dawn, a Christian drug rehabilitation center. Recovery from SUD is possible by God's power. In Mr. Liu's case, his recovery was accomplished without medication.