Against the backdrop of debates and contestations in the literature on the efficacy of interventions of Faith-based organisations (FBOs) with regard to vulnerable people, this study subjects the social reintegration programmes of three selected FBOs working with recovering drug-addicts in South-western Nigeria to a sociological scrutiny so as to understand the social character, effectiveness and local appropriateness of their programmes. Specifically, the study examined the key attributes of the social reintegration programmes offered by the selected FBOs as well as the level and extent of compliance of such programmes with the prescriptions and idealisations as enunciated in relevant global and national policies and institutional frameworks. The theoretical underpinning of this study was derived from assumptions of structural-functionalism of Durkheim and Expectancy disconfirmation theory. Adopting an exploratory approach, the study utilised a blend of survey, key informant interviews, in-depth interviews, observation and document review to gather data. Survey data were collected from a random sample of 156 inmates of the social reintegration facilities of three (3) FBOs in Oyo, Ogun and Lagos states in South-West Nigeria. Qualitative data were sourced through 15 in-depth interviews, 9 key informant interviews and scientific information generated from observation and document review. The quantitative data gathered were analysed using descriptive statistics, while the qualitative data were processed with the use of content analysis. Findings from the study indicate that the selected FBOs have only recorded little success in terms of addressing the social needs of the inmates. For one thing, FBOs’ detoxification programme for recovering drug-addicts tilted more towards human rights violation than serve as an exercise that aided recovery. One key finding was that there was a huge disconnect between global prescriptions on social reintegration services and what the selected FBOs offered to the inmates. The study concluded from its findings that any social reintegration programmes aimed at protecting recovering drug-addicts from further social exclusion and facilitate their social inclusion in South-West Nigeria must extend beyond mere spiritual provisioning to upholding their rights to human dignity and providing opportunities and tools that address their crucial social needs in terms of housing, education, vocation and employment.

Background: This thesis explores, in-depth, the experience and sense-making of transactional analyst psychotherapists working with clients who present with Internet addiction (IA). It engages with the therapist’s broad experience and understanding of Internet addiction presentation, therapeutic assessment, ‘diagnosis’ and ‘treatment’ rather than the singular experience, expression, and meaning-making of the individual client. Method: As a counselling psychologist trainee, I was particularly interested in sampling highly experienced therapists, with an extensive range of skills developed through a robust clinical training. Four therapist participants, all professional members of the European Association of Transactional Analysis (EATA), were interviewed using semi-structured, one-to-one interviews and the material was analysed using interpretive phenomenological analysis (IPA). Findings and Discussion: Four higher-order concepts emerged within this study. They concerned: the complexity of IA; aetiological and predisposing factors; functions and features of IA; and treatment factors. Practical and theoretical implications for future research, clinical supervision, treatment, psycho-educational and political programmes are presented. Of the key emergent findings the Internet was understood by participants as a conduit or medium for addiction given a high prevalence of an underlying ‘disorders’. All of the participants believed in the existence of childhood aetiological roots which underpinned comorbidity with IA. Attachment difficulties in childhood would often predispose individuals to develop issues around loneliness, low self-esteem, control, loss and instability, and cognitive dissonance later in life. Participants believed a relationship existed between depression, low self-esteem and escapism as contributing factors. Conclusion: A systematic review of the extant research is proposed, along with quantitative studies to specifically evaluate the strength of this relationship. Further empirical research is particularly recommended to explore how these factors can predispose individuals to developing sub-types of IA, and especially in the context of historic childhood abuse and / or neglect. The complex nature and aetiology of IA can demand a high level of clinical expertise from professionals who would benefit from specific trainings concerning childhood attachment difficulties. Integrating a psychodynamic approach, or being aware of transference processes, could possibly enhance treatment effectiveness, and help safeguard both clients and therapists from counter-therapeutic interventions.

Bakgrund: Internationell forskning visar på problematik kring smärtlindring av patienter med opiatberoende. Det framkommer att otillräckliga doser analgetika administreras till denna patientgrupp och att vårdpersonal saknar kunskap gällande smärtlindring av patienter med opiatberoende. Forskning visar även att vårdpersonal kan ha en negativ inställning till drogberoende patienter och ofta misstror deras motiv gällande förfrågan om analgetika. Vidare visar forskningen att denna patientgrupp upplever sig få en sämre vård än patienter utan drogberoende. Syfte: Studiens syfte var att belysa faktorer som har inverkan på smärtlindringen av patienter med opiatberoende på en beroendeavdelning. Metod: Empirisk studie med deskriptiv kvalitativ ansats baserad på strukturerade intervjuer med fyra sjuksköterskor verksamma vid en beroendeavdelning i en svensk storstad. Data analyserades genom manifest innehållsanalys. Resultat: Under analysen utkristalliserades tre kategorier och elva underkategorier, vilka beskriver faktorer som har inverkan på smärtlindringen av patienter med opiatberoende: (I) Förhållningssätt omfattar (1) Att inte döma och (2) Bemötande. (II) Förutsättningar omfattar (3) Restriktivitet, (4) Tolerans, (5) Ångest, (6) Personalbrist och (7) Kunskap. (III) Metoder omfattar (8) Smärtskattning, (9) Lindra ångest, (10) Kämpa för patienten och (11) Interprofessionalitet. Slutsats: Studiens resultat tyder på att ett respektfullt och tillmötesgående bemötande gentemot patienterna utgör en central roll i smärtbehandlingen. Vidare visar studien att sjuksköterskornas möjlighet att smärtlindra patienter i beroendevården begränsas av kunskapsluckor, restriktiva regler, resursbrist samt en patientgrupp som är svår att smärtlindra. Studiens resultat tyder på vikten av att lindra patienternas ångest samt vinsterna med ett interprofessionellt samarbete kring smärtlindring. Klinisk betydelse: Studien kan öka medvetenheten kring de hinder som identifierats för smärtlindring av patienter med opiatberoende. Sjuksköterskornas metoder i den aktuella studien skulle kunna utnyttjas i betydligt större utsträckning i beroendevården och i andra vårdkontexter vilket därigenom skulle bespara patientgruppen onödigt vårdlidande. / Background: International research indicates several difficulties concerning pain relief for patients with opioid dependence. It appears that inadequate doses of analgesics are administered to patients with substance dependence and that health professionals lack knowledge regarding pain management of patients with opioid dependence. Research also shows that health professionals may have a negative attitude towards drug-dependent patients and often distrust their motives regarding request for analgesics. Furthermore, research shows that opioid dependent patients feel that they get poorer care than patients without drug addiction. Aim: The aim of the study was to examine factors that have an impact on pain relief in patients with opioid dependence from nurses’ perspective at a drug dependence treatment clinic. Method: Empirical study with descriptive qualitative approach based on structured interviews with four nurses working at a drug dependence treatment clinic in a major Swedish city. Data were analyzed with manifest content analysis. Results: During the analysis three categories and eleven subcategories emerged: (I) Attitude is comprised of (1) To not judge, and (2) Treatment. (II) Conditions is comprised of (3) Restrictivity, (4) Tolerance (5) Anxiety, (6) Staff shortage and (7) Knowledge. (III) Methods is comprised of (8) Pain assessment, (9) Relieving anxiety, (10) Fighting for the patient, and (11) Interprofessionalism. Conclusion: The study's results suggest that a respectful attitude towards patients plays a key role in pain management. Furthermore, the study shows that the nurses’ opportunity to relieve pain of patients in addiction treatment is limited by gaps in knowledge, restrictive regulations, lack of resources and patients that are difficult to pain relieve. The study's findings indicate the importance of alleviating the patients' anxiety and the benefits of interprofessional collaboration regarding pain treatment. Clinical significance: This study can increase the awareness of the barriers to pain management identified for patients with opioid dependence. Nursing practice in the current study could be used to a much greater extent in addiction services and other care contexts and thereby save the patients unnecessary suffering.

This paper explores the discourse surrounding the introduction of supervised injection facilities (SIF) in New York City following their recent introduction in November 2021.  The contemporary debate surrounding SIF in New York is more diverse than may be assumed, even within a seemingly liberal city in the United States, as there are many competing perspectives which make broad categorizations of the discourse difficult. Nevertheless, supporters of SIF have continued to emphasize the efficacy of this program and its potential to prevent overdoses in a largely uniform manner.  In contrast, critics of SIF in NYC have demonstrated a multiplicity of oppositional narratives, which take the forms of traditional abstinence perspectives, localism/not in my backyard rhetoric, law and order beliefs, and social justice evaluations that question the equality of such programs. Nearly all sentiments regarding SIF are founded in the individual perceptions of addiction, specifically whether the individual views it as a disease or a moral failing.        The United States is slowly continuing to adopt more dynamic approaches to substance abuse and move away from the punitive policies established through the War on Drugs strategies advanced throughout the previous decade.  This pilot program can be viewed as a continuation of existing harm reduction policies such as syringe exchange programs.  While the introduction of SIF signifies a substantial evolution of the existing harm reduction policies and provides the basis for national expansion of the program, the current socio-political environment does not prove conducive to its evolution.  Overall, this study explores the diverse range of narratives surrounding SIF, their informing ideology, and attempts to situate these opinions within their broader sociological and historical backgrounds, providing the basis for further research regarding this subject.

The aim of the study was to examine how social workers investigate and assess addiction cases whether gender matters or not. The following questions were asked in the study;•Does the gender of the client influence whether a case is opened after the first meeting at the Addiction Unit?•Do social workers consider there is a difference in handling an addiction treatment investigation when the client is a man or a woman? •Do divergences exist in the assessment and the final decision process when the case concerns a man or a woman?The study is based on the qualitative method. The material is gathered from semi-structured interviews with social workers. Their job tasks include assessment and evaluation of addiction cases. The empiric interview material has been analyzed from a gender perspective. The results show that the social workers unanimously agree; the gender does not affect the investigation, assessment and whether a case is opened or not when a client asks for addiction treatment. The social workers almost agree; it is primarily the client’s point of view and treatment needs that decide the focus in the investigation, assessment and decision. However, gender may influence the selection of available treatments for the individual client. According to two social workers gender may influence reception, how the social workers at the Units talk about their clients, the severity and need.

This dissertation advances our understanding of the variability and contingency of addiction treatment, a consequential social institution that simultaneously helps and regulates populations within criminal justice and healthcare systems. To do so, this dissertation draws on administrative and survey data, as well as archival and ethnographic research. I show that addiction treatment is structured by social, institutional, and historical contexts within which Americans are embedded. Together, the three chapters demonstrate the utility of venturing across time and place as a method of interrogating the distinction between care and control. Using macro-sociological theory and research, aspects of the project also help broaden our understanding of addiction treatment as vital to the enactment of contemporary state governance. I refer to this as therapeutic statecraft. Chapter 1 looks at how legal coercion is used to force people into rehab and how this practice is influenced by the interplay between state welfare and punishment systems. I find that coerced treatment is less common in states with broad and benevolent welfare systems that offer alternative pathways for residents to receive care and avoid minor encounters with the criminal justice system. Moreover, the extent to which poverty affects a state’s reliance on the criminal justice system as a referral source is contingent upon the degree of interpersonal surveillance facilitated by the broad administrative reach of state welfare systems. Furthermore, coerced treatment typically has a more disruptive, institutional character under punitive state contexts (i.e., strong-arm rehab). Chapter 2 reveals how racial disparities in state-mandated, community-based drug treatment referrals are exacerbated in places with racially punitive criminal justice systems and surveillance-oriented welfare systems. These systems work together to discreetly extend penal power in the name of recovery for a population segment. Chapter 3 examines changes in the care of sexual minorities at a specialized drug treatment facility over the past 30 years. The study finds that while staff members previously saw sexual stigma and discrimination as the source of addiction, current staff members use sexual stigma to regulate patients' "addictive tendencies," and may risk exacerbating stigma and inequality by losing sight of the broader underlying causes of addiction. Taken as a whole, the project’s findings contribute to our understanding of the significance of addiction treatment in contemporary times, particularly within the context of social policy and population management in the United States.

With overdose deaths and residential addiction treatment admittance increasing, more treatment options are necessary to meet the demand of services. Equine assisted psychotherapy and learning (EAPL) is a relatively new therapeutic tool in addiction treatment for individuals battling substance use disorder (SUD), and thus, lacks a solid evidence base to be implemented consistently and effectively. The purpose of this dissertation was to determine the effectiveness of EAPL in creating an emotionally safe environment for learning for college-age young adults with a particular focus on those struggling with SUD. This was accomplished in a series of projects focused on: 1) implementing evaluation methodology for tracking emotional safety and learning in young adults participating in equine interaction activities without therapeutic intentions, 2) determining the relationship between physiological responses and emotional safety and learning in young adults participating in outpatient EAPL programming for SUD, and 3) evaluating the treatment outcomes associated with emotional safety and learning for young adults with SUD participating in EAPL at a residential treatment facility. Each project utilized the same three evaluations for evaluating emotional safety and learning: 1) emotional safety evaluation, 2) equine knowledge exam, and 3) physical skills evaluation. In each of the studies, a correlation was found between emotional safety and equine knowledge and handling skills for college-age young adults, however, equine interaction with therapeutic intentions revealed a stronger correlation indicating it is not just the horse that provides the mental health benefits. An emotionally safe environment for learning, was established for college-age young adults within a residential treatment facility, this was not dependent on the length of stay or level of participation suggesting this is an efficient therapeutic option for SUD for this population. Emotional safety for the college-age young adults participating in EAPL was correlated to vital sign measurements, but vital sign measurements of young adults were independent of the vital signs of the therapy horse. Each of the three projects provided vital information filling the gap of knowledge surrounding EAPL as an effective clinical intervention strategy for SUD in college-age young adults and created a basis for further research using more objective measures.

Syftet med studien var att få fram personliga betraktelser av olika kategorier kopplat till intag av narkotika, alkohol och receptbelagda mediciner av personer med egenupplevda erfarenheter. Kategorierna missbruk och självmedicinering står i fokus men det lämnas även plats för andra kategoriseringar av intag. Detta för att undersöka hur kategoriseringar kan påverka behandlingsarbete. Sex personer intervjuas om deras upplevelser av narkotika- och alkoholintag samt hur de ser på olika kategoriseringar inom detta område. Det undersöks hur intervjupersonerna definierar sitt intag eller före detta intag av alkohol och narkotika samt hur denna kategorisering har kommit till. Studien är kvalitativ och har sex semistrukturerade intervjuer som underlag för resultatet. Studien börjar med en genomgång av olika begreppsdefinitioner gällande missbruk samt en genomgång av narkotikastrafflagen. Därefter redovisas forskning som tar upp attityder angående missbruk ur professionella behandlares perspektiv. I teoridelen tas tre teorier upp, Culture in action-teorin, självmedicinerings-hypotesen och stämplingsteorin. Resultatet visar respondenternas egna berättelser vilket är empirin som vår analys bygger på. Analysen görs ihop med de teorier som redovisats. Resultatet visar att många upplever självmedicinering som ett relevant begrepp och att den hårda kategoriseringen av missbrukare påverkar de stämplade starkt. Kategoriseringen av intag ser olika ut beroende på i vilket livsstadie personen befinner sig. Något som också spelar stor roll är i hur stor utsträckning intaget tagit över personens liv. Det framkom tankar om att den hårda kategoriseringen inom behandlingar upplevs som nedtryckande och stämplande. En mer individanpassad missbruksvård var önskad. Det framkom även vissa paralleller mellan respondenterna och självmedicinerings hypotes. / The purpose of this study was to reach personal views on categorization of the intake of natcotics, alcohol and prescription drugs by people with personal experiences on the subject. The categories drug abuse and self medication where the core categories but there where room for other categorization of intake. The purpose was to see how categorization can affect addiction treatment. Six persons where interviewed on their experiences of drugs and alcohol and their views on the categorization of these topics. The persons tell how they define their intake (or former intake) of drugs or alcohol and how this categorization came to be. This is a qualitative study the result is based on six semi structured interviews. It starts with a review on different definitions of addiction and the Swedish drug laws. Thereafter there is a presentation on research about the attitudes of professional addict treaters. The study contains three theories. The culture in action theory, the self-medication hypothesis and the labeling theory. The result shows the respondents own testimony witch is the foundation the analysis rests upon. The analysis is done together with the mentioned theories. The result shows that most respondents see self medication as a valid concept and that the harsh categorization in addict treatment has an impact on those facing it. The categorization of intake differs depending on the life situation of the person that does the categorization. Another important aspect is how much the intake is ruling the intakers life. The harsh categorization in addict treatment is seen as suppressive and labeling. A more individualized addict treatment where wanted. The study shows some parallels with the self-medication hypothesis.

This is a sub-study project on the effect of ADHD on selected mental functioning, life skills and quality of life of clients recovering from addiction in therapeutic communities (Miovský et al ., 2014), which aims, among other things, describe the negative effects of ADHD on the treatment process in the therapeutic community. The incidence of ADHD symptoms in the treatment of methamphetamine dependence is a major complication of treatment. The aim of this thesis is to describe methamphetamine sub-group specifics in the research sample, their assessment in the TC's treatment process and ADHD diagnosis specifity in this group, constitutes up to 70 % of all treatment demand clients (Mravčík, et al., 2014). The method used for data acquisition are: questionnaire, test, interview, observation, computerization of data (IBM SPSS Statistics 20 was used). For data analysis was used descriptive statistics (descriptive and mathematical-statistical analytical processing). Qualitative data were analyzed by using method of clustering, text coloring and simple enumeration. The research sample consisted oh 116 respondents (83 men and 32 women) aged 16-47 years. All agreed to participate the study and had a history of methamphetamine use. Methamphetamine female users started using the drug on average two years...

MASTER'S DISSERTATION ABSTRACT Name: Pavlína Bíliková Field of study: Addictology Supervisor: doc. MUDr. PhDr. Kamil Kalina CSc. Number of pages: 76 Name of dissertation: Sex and partner relationship in therapeutic community Master's dissertation abstract Presumptions: Therapeutic communities for drug users define the so-called cardinal rules for their clients in order to ensure their safe environment. In case of breaching these rules the client is usually expelled from the community. One of these cardinal rules is the one prohibiting sex or partner relationship between members of community. There is an active discussion amongst specialist about its conception and exact content. The presumptions of this dissertation are the ambiguities in the conception of the rule, its content, classification and ways of use. Aims: The aim of this work is the analysis and evaluation of the nature of the rule prohibiting sex and relationship in communities from the point of view of therapists from Czech communities for drug users. Furthermore, the author aims to map the contemporary state of interpretation of the given rule and the way of its use in Czech therapeutic communities. Methods used: The theoretical part of this work uses document analysis. The practical part is constituted by a qualitative study. The data were...