Marijuana is the most prevalent illicit drug used in the world and among Turkish juveniles. Although studies have examined marijuana use among Turkish juveniles, none has tested Hirschi's social bonding theory, one of the most frequently tested and applied criminological theories in the United States and other Western and developed countries. This study investigated the empirical validity and generalizability of Hirschi's theory to juveniles' marijuana use in Turkey, a non-Western and developing country. Data on 2,740 Turkish tenth grade students from the 2006 Youth in Europe survey were used. Results from binary logistic regression analyses were generally consistent with the propositions of Hirschi's theory and the findings of previous empirical studies. Regarding the attachment component of the theory, Turkish juveniles who lived in two-parent families and those who were closely monitored by their parents were less likely to have tried marijuana. In addition, teens who were strongly attached to their school and religion were also less likely to have used the drug. As for the commitment component, language grade was negatively associated with marijuana use. None of the involvement items had significant effects on marijuana use in the predicted direction. Participation in club sports had a positive effect on marijuana use. Belief items, such as acceptance of societal norms, values, and rules, had the predicted inhibiting effects on teens' marijuana use. Of the six sociodemographic/controls included in the analyses, only gender had a significant effect; male students were more likely to have tried marijuana than the female peers. Policy implications of the results for adolescents, parents, and schools are discussed.

Magister Artium (Child and Family Studies) - MA(CFS) / Substance abuse among adolescents is a global problem and South Africa is no exception. In the Western Cape there is an alarming popularity and increased use of an illicit highly addictive substance, locally known as 'tik-tik'/methamphetamine. Adolescents are particularly vulnerable to the neurotoxic effects of this substance and there is an urgent need to address the 'tik-tik' problem in the Westen Cape. Tik/methamphetamine has thus become a great concern to educators, social workers and health practitioners in the province. The goal of this study was to explore the life-world of the adolescent methamphetamine/'tik-abusers' in order to describe their experiences of personal, social and environmental issues in the process of tik-addiction. / South Africa

Social capital, or social cohesion or group connectedness, can influence both HIV risk behavior and substance use. Because recent immigrants undergo a change in environment, one of the consequences can be a change in social capital. There may be an association among changes in social capital, and HIV risk behavior and substance use post immigration. The dissertation focused on the interface of these three variables among recent Latino immigrants (RLIs) in South Florida. The first manuscript is a systematic review of social capital and HIV risk behavior, and served as a partial background for the second and third manuscripts. Twelve papers with a measure of social capital as an independent variable and HIV risk as the dependent variable were included in the analysis. Eleven studies measured social capital at the individual level, and one study measured social capital at the group level. HIV risk was influenced by social capital, but the type of influence was dependent on the type of social capital and on the study population. Cognitive social capital, or levels of collective action, was protective against HIV in both men and women. The role of structural social capital, or levels of civic engagement/group participation, on HIV risk was dependent on the type of structural social capital and varied by gender. Microfinance programs and functional group participation were protective for women, while dysfunctional group participation and peer-level support may have increased HIV risk among men. The second manuscript was an original study assessing changes in social capital and HIV risk behavior pre to post immigration among RLIs in South Florida (n=527). HIV risk behavior was assessed through the frequency of vaginal-penile condom use, and the number of sexual partners. It was a longitudinal study using secondary data analysis to assess changes in social capital and HIV risk behavior pre immigration to two years post immigration, and to determine if there was a relationship between the two variables. There was an 8% decrease in total social capital (p ˂ .05). Reporting of ‘Never use’ of condoms in the past 90 days increased in all subcategories (p ˂ .05). Single men had a decrease in number of sexual partners (p ˂ .05). Lower social capital measured on the dimension of ‘friend and other’ was marginally associated with fewer sexual partners. The third manuscript was another original study looking at the association between social capital and substance use among RLIs in South Florida (n=527). Substance use with measured by frequency of hazardous alcoholic drinking, and illicit drug use. It was a longitudinal study of social capital and substance-use from pre to two years post immigration. Post-immigration, social capital, hazardous drinking and illicit drug use decreased (p˂.001). After adjusting for time, compared to males, females were less likely to engage in hazardous drinking (OR=.31, p˂.001), and less likely to engage in illicit drug use (OR=.67, p=.01). Documentation status was a moderator between social capital and illicit drug use. ‘Business’ and ‘Agency’ social capital were associated with changes in illicit drug use for documented immigrants. After adjusting for gender and marital status, on average, documented immigrants with a one-unit increase in ‘business’ social capital were 1.2 times more likely to engage in illicit drug use (p˂.01), and documented immigrants with one-unit increase in ‘agency’ social capital were 38% less likely to engage in illicit drug use (p˂.01). ‘Friend and other’ social capital was associated with a decrease in illicit drug use among undocumented immigrants. After adjusting for gender and marital status, on average, undocumented immigrants with a one-unit increase in ‘friend and other’ social capital were 45% less likely to engage in hazardous drinking and 44% less likely to use illicit drugs (p˂.01, p˂.05). Studying these three domains is relevant because HIV continues to be a public health issue, particularly in Miami-Dade County, which is ranked among other U.S. regions with high rates of HIV/AIDS prevalence. Substance use is associated with HIV risk behavior; in most studies, increased substance use is associated with increased chances of HIV risk behavior. Immigration, which is the hypothesized catalyst for the change in social capital, has an impact on the dynamic of a society. Greater immigration can be burdensome on the host country’s societal resources; however immigrants are also potentially a source of additional skilled labor for the workforce. Therefore, successful adaption of immigrants can have a positive influence on receiving communities. With Florida being a major receiver of immigrants to the U.S, this dissertation attempts to address an important public health issue for South Florida and the U.S. at large.

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Background: Treatment providers have applied contingency management (CM) treatment, an intervention that often rewards individuals for drug abstinence (i.e., ABS CM), to treatment engagement as well. However, we know little about the magnitude of treatment effects when providers target attendance behaviors (i.e., ATT CM). Methods: This study conducted a systematic search to identify studies that included ATT CM, either in isolation or in combination with ABS CM. The study used meta-analysis to estimate the effect size of ATT CM and ABS CM + ATT CM on treatment attendance and drug abstinence. We identified a total of 10 studies including 12 CM treatments (6 ATT CM and 6 ABS CM + ATT CM) with 1841 participants. Results: Results indicated a moderate effect (d = 0.47, 95% confidence interval (CI) [0.25, 0.69]) of ATT CM on attendance relative to non–reward active comparison conditions. Frequency of rewards was significantly associated with larger effect sizes. Results also indicated a small effect (d = 0.22, 95% CI [0.12, 0.33]) of ATT CM on abstinence outcomes relative to nonreward comparisons, p < 0.001. The study found no significant differences in attendance or abstinence between ATT CM and ABS CM + ATT CM (p's > 0.05). Conclusion: Overall, the results supported ATT CM for increasing treatment engagement, with smaller effects on abstinence. Effects on abstinence were smaller than those observed in prior meta-analyses focused on ABS CM. No significant differences existed in attendance or abstinence outcomes between ATT CM and ABS + ATT CM. However, future studies are needed to experimentally compare ABS CM + ATT CM to ABS CM, and ATT CM to determine additive effects. Clinics implementing CM should consider the differential effects between ATT CM and ABS CM when selecting target behavior(s).

Objective: This study was completed as a follow up to research regarding buprenorphine Medication Assisted Therapy (MAT) in Johnson City Tennessee for-profit clinics. We wished to determine the practice patterns over the last three years. Methods: Johnson City for-profit Medical Assisted Therapy clinics were called with a telephone survey. When the clinic representative answered the phone, they were asked questions regarding patient costs for therapy, insurance coverage, counseling offered on site, and opportunities for tapering while 20 weeks pregnant. Results: At all the MAT clinics contacted, the representative informed us that tapering in pregnancy could be considered contrary to current national guidelines. 43% of the clinics are now accepting insurance as compared to 0% in the 2016 study. The average weekly cost per visit remained consistent. Conclusion: The concept of tapering buprenorphine during pregnancy appears to have become a standard of care for this community and it is offered at all of the clinics that were contacted, some even require it, even though national organizations such as American College of Obstetricians and Gynecologists and American Society of Addiction Medicine; do not recommend this approach. Patients who have insurance including government funded insurance, are now able to obtain buprenorphine with no out of pocket expense at numerous clinics. The high cost for the uninsured patient continues to create an environment conducive to buprenorphine diversion.

Background: The main source of the thesis is John Bowlby's Attachment Theory and Erik Erikson's theory The Eight Ages of a Man. The thesis works with the assumption that the separation or loss of the mother figure, in this case by transition to institutional care, affects the personality development. Aim: The aim of this work is to find out whether separation from the parent figure or its complete loss is the main reason for their dependence on addictive substances, eventualy which other factors were present in their lives. The partial goal is to find out how the respondents are doing in relationships. File and methods: The thesis analyzes the life story of respondents through the application of selected theories. The sample consists of four clients of the SANANIM drop in center. A case report was elaborated through consulting sessions. Special attention is paid to institutional care, family environment and client's relationships. Results: Respondents perceive their stay in an institution care facilities as one of the factors that led to the substance abuse and their current lifestyle. It has been found that they find it more difficult to establish healthy relationships and deal with negative emotions, which may be one of the reasons of substance abuse. Key words: addictive substance, addiction,...

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There are two previous reports of Candida dubliniensis endophthalmitis in North America. Here, we report a third case of C. dubliniensis endogenous endophthalmitis in a 31-year-old male patient who complained of left-sided decreased visual acuity. He had an associated mitral and tricuspid valve endocarditis, in the setting of intravenous drug use. Blood and sputum cultures were positive for C. dubliniensis. Fundoscopic examination was consistent with a fungal endophthalmitis. He was treated with fluconazole followed by intravenous liposomal amphotericin B for 6 weeks. C. dubliniensis is an important but rare cause of endophthalmitis in intravenous drug abusers.