This project assesses the feasibility of establishing a substance abuse treatment program that provides services to women and their children in the Morongo Basin area of the California Desert.

Adolescent substance use is a key public health problem in rural Ohio. Primary care nurses lack substance use screening knowledge and skills. Early screening and detection of possible substance use issues aids in directing patients to appropriate health services. This project involved the implementation of an educational intervention on the CRAFFT screening tool for primary care nurses in rural Ohio. Guided by Kurt Lewin's 3-step model to emphasize prevalence of substance use and need for screening among adolescents, the purpose of this project was to provide training on the CRAFFT screening approach and share guidelines to implement routine substance abuse screening for adolescents seen in this rural primary healthcare setting. The project, based on a pretest and posttest design, was implemented among a sample of 7 nurses to evaluate whether the educational intervention had a significant impact on nurses' knowledge on using the CRAFFT screening tool. Data were collected using a questionnaire and were analyzed using descriptive and inferential statistics. The results showed a significant increase in the pretest scores (M =51.43, SD = 19.51) and the posttest score (M =94.29, SD = 7.868); t(6)=7.039, p = .000). The project findings support that the benefit of this educational intervention to improve the nurses' substance use screening knowledge using a lunchtime educational training to ensure that vulnerable adolescent patients with substance use receive early and appropriate preventive and treatment measures. For positive social change, early identification of substance use among adolescents may inform the adoption of preventive and treatment measures such as referral to mental health specialists, thereby improving adolescent health outcomes.

MENTALLY ILL CAREGIVERS AND DIFFERENTIAL PATTERNS OF SUBSTANCE ABUSE IN A SAMPLE OF UNIVERSITY STUDENTS Teliyah A. Cobb1, Alyssa P. Gretak1, MA, Kelcey L. Puszkiewicz1, MA, Jill D. Stinson1, PhD, and Megan Quinn2, DrPH, MSc, East Tennessee State University, Johnson City, TN 1Dept. of Psychology, College of Arts and Sciences 2Dept. of Biostatistics and Epidemiology, College of Public Health Existing literature demonstrates a dose-responsive relationship between adverse childhood experiences (i.e., abuse, neglect, and household dysfunction) and the risk of problematic substance use later in life. While controlling for the effects of early adversity, a recent study found that childhood household dysfunction independently increased the risk of excessive alcohol use in adulthood. However, there are few studies focusing specifically on differences in substance use behaviors in individuals who had a caregiver with a mental health diagnosis. This study aims to fill this gap by examining whether having a caregiver with mental illness during one’s childhood increases the risk of abusing alcohol and illegal or prescription drugs in adulthood in a college sample. Our sample includes University students in the Southeastern U.S. (N = 995) who are mostly Caucasian (84%) and female (63%). Participants completed an online, anonymous survey for course credit. Approximately 23% (n = 227) reported having a caregiver with mental illness or who attempted or died by suicide. Regarding substance abuse, nearly 11% of the sample (n = 106) reported abuse of alcohol, 13% (n = 126) indicated abuse of illegal drugs, and almost 5% (n = 47) reported abuse of prescription medication. Pearson Chi-square tests were conducted to analyze the relationship between caregiver mental illness, including a caregiver who attempted or died by suicide, and abuse of alcohol, illegal, and prescription drugs in adulthood. Interestingly, individuals with a mentally ill caregiver were less likely to abuse alcohol, c2 (1, N = 983) = 12.56, p = .000, and illegal drugs, c2 (1, N = 984) = 22.68, p = .000, as an adult, compared to those without a mentally ill caregiver. In contrast, students with a mentally ill caregiver were more likely to abuse prescription drugs as adults, c2 (1, N = 979) = 32.54, p = .000, compared to those without a caregiver suffering from a mental illness. Thus, findings suggest that having a mentally ill caregiver differentially impacted the risk of abusing varying types of substances. Additional analyses examining the influence of mental illness in biological versus non-biological caregivers (e.g., stepparent, foster parent) and further discussion of implications will be included.

This series of poems documents the speaker’s experience working as a wilderness field guide for a substance abuse program in North Carolina. The poems explore what it looks like to work direct care and to hold responsibility for a group of women’s physical and emotional wellbeing. There is a secondary narrative that interrogates the speaker’s relationship to substances as well as the speaker’s father’s identity as a recovering alcoholic.

Theories of the neurobiological basis of Attention-Deficit/Hyperactivity Disorder (ADHD) have largely focused on dysregulation of central dopaminergic function. However, other neurotransmitter systems may be implicated in specific cognitive deficits in ADHD. Interest in the potential involvement of nicotinic cholinergic systems in ADHD has arisen in part from the observation that adolescents and adults with ADHD smoke cigarettes at significantly higher rates than people without this disorder. In addition, several studies report that nicotine alleviates ADHD symptoms, and recent neuro-genetics studies indicate that cholinergic systems may be altered in persons with ADHD. In this review, we describe the evidence for a role of central nicotinic cholinergic systems in cognitive deficits in ADHD. We also propose mechanisms by which alterations in cholinergic function may contribute directly and/or indirectly to these deficits. Finally, we identify specific paradigms and models to guide future investigations into the specific involvement of nicotinic cholinergic systems in ADHD, possibly leading to the development of more effective pharmacotherapies for ADHD.

Includes bibliographical references / The Substance Use Risk Profile Scale (SURPS) is a relatively new questionnaire that assesses individual personality risk for substance-related problems. Preliminary findings have indicated that the SURPS is a useful measure for identifying characteristics predisposing some individuals to alcohol and other drug (AOD) use. High levels of hopelessness, anxiety sensitivity, sensation seeking, and impulsivity are each associated with specific patterns of substance use caused by underlying motivational susceptibilities. Furthermore, incorporating these traits into tailored prevention and treatment efforts have shown value in other countries. The present study enrolled a community sample in Cape Town, South Africa and asked respondents about their demographics, history of AOD use, personality as measured by the SURPS, and other mental health indicators. This information was used to identify personality risks in the local population and validate the utility of the SURPS for the first time in Sub-Saharan Africa. Results found that sensation seekers had a significantly higher risk for alcohol, tobacco, cannabis, cocaine, and hallucinogen use compared to other personality groups and controls. As expected, respondents demonstrating anxiety sensitivity also showed high-risk use of alcohol, but less high-risk illicit drug use . Finally, the hopelessness group exhibited a higher risk for opioid use but overall, hopelessness and impulsivity had little impact on concurrent substance use, which contrasts with other literature. Unlike findings from mostly European and North American samples that indicate generalizability, this study did not find structural or concurrent validity for the SURPS. This provides evidence against it being adopted as a culturally appropriate assessment tool in a diverse South African population.

Submitted in partial fulfillment of the requirements for the Degree of Masters of Arts in the Department of Social Work University of Zululand, South Africa, 1993. / This study analyses relapse behaviour among some African alcohol abusers and alcoholics in certain areas of the Lower Umfolozi Magisterial district- It also describes and examines the treatment approaches used professionally to deal with such clients/patients, as well as the institutional programmes available for them. An explorative-descriptive research approach was used. Data was gathered from both primary and secondary services. Interviewing was the major research technique used for collecting primary data. Structured and unstructured interviews were held with clients/patients, some family members, and a few professional people. The researcher intended to obtain a comprehensive picture of the problem. The field study was undertaken over a three months period. Literature study and perusal of files stretched over a year to gain familiarity with the subject under study. A sample of eighty respondents was selected through the simple random procedure using a table of random numbers. A comprehensive interview schedule consisting of mainly closed-ended questions soliciting information on (i) family of the respondent client/patient, (ii) the influence of friends on his/her behaviour, (iii) relation to work, (iv) the type and extent of professional help received by the client/patient, and (v) the respondent's feelings about his condition was also used. The data obtained was analysed both quantitatively and qualitatively. The findings indicated that there were more male alcoholics and alcohol abusers compared to females. The majority of the client/patient respondents were relatively young. below the age of forty years. They were mainly the minimally or lower educated people. Many of them were either married or had been married- The majority had, of course, lost their employment, or had been unemployed for a long time. The problem of alcohol abuse and alcoholics is complicated both for the client/patient, his family his/her immediate social and work environment. The response of treatment programmes both at in-patient and out-patient levels had not produced the desired results. Co-ordination of treatment services and a strong functional network of services and support did not appear to be clearly available for these African clients and patients. Culturally related, and sensitive treatment by professionally social workers was not as yet practised. A clear focus on these clients/patients as a special category was not evident. They did not appear to identify with any particular service point or structure as a helping medium for them. A lot still needs to be done to organize and distribute the services for these clients/patients. All the problems cited above receive the recommendation of the study. Further in-depth research on the treatment procedures and programmes for these clients/patients are clearly indicated.

A dissertation submitted to the Faculty of Education in fulfillment of the requirements for the Degree of Masters in Educational Psychology in the Department Of Educational Psychology and Special Needs Education at the University of Zululand, 2018 / The study examined the experiences of high school educators in dealing with substance abuse at uThungulu District schools. Data for the study was gathered through survey. A structured questionnaire was designed and used to obtain information from school educators who served as teachers and principals in selected schools. The descriptive design approach was employed in this study. Purposive sampling technique was employed to select five secondary schools in uThungulu Districts, while simple random sampling technique was used to select 176 educators from the five schools. The quantitative data collected through questionnaire were analysed using descriptive statistics of percentage and frequency counts. The results of the quantitative data were displayed as tables and graphs, followed by discussions of each result. The overall results revealed that substance abuse affects both mental and psychological wellbeing of learners, which later develops into poor academic performance. The Educators that participated in the study attested to this when they responded affirmatively that excessive use of drug affects physical coordination of learners in classes, mental disconnection, and permanent brain damage. The study recommends the inclusion of Education for Substance Abuse Avoidance and Treatment as part of the core subjects in South African schools, and such should be offered in local languages. In addition, interactive teaching methods such as brainstorming, open discussions, and role-playing are recommended for all learners, including those who abuse substance and those addicted. Lastly, the study recommends the engagement of the professional Guidance and Counsellors in the South African schools whose primary assignment would be to counsel learners not only on substance abuse but also on career choice and future professional guidance.

Submitted in partial fulfillment of the requirements for the degree MASTER IN EDUCATION in the Department of Educational Psychology of the Faculty of Education at the University of Zululand, 2009. / The aim of the study was to investigate the effect of substance abuse amongst secondary school learners. This was achieved via a literature study and an empirical study. In the light of the findings certain recommendations which can assist educators, principals, parents and the Department of Education to plan and take action in order to combat drug abuse and addition amongst secondary school learners, were formulated. Schools have always had and will always have significant influence on learner’s lives and must therefore be the focus of any effective implementation of arresting strategies. The secondary school community has in the past and to a certain extend in the present not treated the increasing use of drugs as a priority. This could possibly be because of the many types of legitimate drugs that are available, and which are said to cure, prevent or slow down diseases and enable people to lead longer, healthier and happier lives. Antibiotics have improved the treatment of infections and vaccines have prevented the spread of diseases such as measles, while analgesics have lessened or eliminated pain. However, it should be the harmful and illegal drugs that parents and the community should be made aware of. Illegal and harmful drugs infiltrate all levels of society, asking no name, title or gender. They come in many names and forms and they will negatively impact on health, sanity, families and finally people’s lives. The literature study found that that substance abuse affected the physical, psychological (cognitive and affective), social and normative development of the secondary school learner. For the purpose of the empirical investigation, a self-structured questionnaire for educators was utilized. The data obtained from the completed questionnaires was processed and analyzed by means of descriptive statistics. The findings confirmed that substance abuse has a negative effect on the development of the secondary school learner. The following are some of the recommendations that were made: • The Department of Education must develop a practical formal policy on the use of drugs in school in collaboration with Sanca, the National Department of Health, the Police Service and other relevant stakeholders. • Sufficient human and financial resources must be made available by the Department of Education for the Training, supervision and monitoring of the drug policy in all school. • The Department of Education in collaboration with teacher unions, principal forums, school management teams, education organization and Sanca must conduct workshops for the educators in which the following aspects, concerning drugs abuse will receive attention:  Reasons why learners use drugs.  How to identify learner drug abusers.  Procedures to follow when a learner is suspected of being a drug user.

Contingency management (CM), an intervention that typically provides financial incentives for abstinence, has also been applied to treatment engagement. However, little is known about the magnitude of treatment effects when financial incentives are provided for attendance. A systematic search was conducted to identify studies that included incentives for attendance, either in isolation or in combination with incentives for abstinence. Meta-analysis was used to estimate the effect sizes on treatment attendance and abstinence. A total of 10 studies including 12 CM treatments (6 incentives for attendance only and 6 incentives for both attendance and abstinence) with 1,673 participants were identified. Results indicated a moderate effect (d = 0.47, 95% confidence interval (CI) [0.24, 0.68]) on attendance relative to non-reward active comparison conditions, p <.001. Frequency of incentives for attendance was significantly associated with larger effect sizes. Results also indicated a small effect (d = 0.22, 95% CI [0.11, 0.32]) on abstinence relative to non-reward comparisons, p <.001. Overall, this meta-analysis supported financial incentives for attendance to increase treatment engagement, with smaller effects on abstinence compared to those observed in meta-analyses on financial incentives for abstinence. Although financial incentives for attendance increased clients' attendance, the impact on abstinence was weaker than conditions that included both incentives for attendance and abstinence. Clinics implementing CM should consider these differential effects in the selection of reinforcement targets.