The motivation for this study is the increase of treatment needs of heroin dependents at SANCA, (South African National Council of Alcohol and Drug Abuse) Witbank. SANCA Witbank wants to ensure that the most effective treatment can be supplied. Research goals are to:  Do a literature study of out-patient treatment programmes.  Assess the needs of heroin out-patient dependents with regard to out-patient treatment programmes.  Make recommendations with regard to out-patient treatment programmes for heroin dependents. It was an exploratory research subject and the data collection methods were qualitative and quantitative. Interview schedules were used as research tools. Schedule B was completed by the researcher with heroin dependents that visited SANCA Witbank for the period 31 January 2005 to 4 February 2005. Schedule A was completed by the researcher with personnel of SANCA out-patient clinics and the questions were discussed and completed telephonically. The conclusion is that the treatment programme of SANCA Witbank is in line with the rest of the drug dependent field and only minimal recommendations were made. / Social Work / MA(SS)(MENTAL HEALTH)

The thesis provide an analysis of environment that might influence processes of socialization of youth people. Next to this description of socially and/or pedagogically working organizations and institutions that focus on youth and their parents in the area of risk behaviour with an aim to prevent dependence on mind-altering substances is provided. Theoretical part of the thesis discusses socio-cultural factors. Therefore roles especially of family as primary institution responsible for socialization as well as of socio-pedagogically working organizations in drug prevention targeting youth and their parents is described. Empirical part of the thesis addresses ways that parents of young users of drugs used to prevent risky behaviour of their children, what sources and types of informations about drugs they used, and to what extend they have been prepared to solve potential problems that might result in drug dependence. Also with the use of a narrative analysis it is discussed where parents sought professional help and what was their opinion about quality of socio- pedagogical intervention delivered by individual organizations.

The dissertation describes a novel method for plant drug discovery based on mutation and selection of plant cells. Despite the industry focus on chemical synthesis, plants remain a source of potent and complex bioactive metabolites. Many of these have evolved as defensive compounds targeted on key proteins in the CNS of herbivorous insects, for example the insect dopamine transporter (DAT). Because of homology with the human DAT protein some of these metabolites have high abuse potential, but others may be valuable in treating drug dependence. This dissertation redirects the evolution of a native Lobelia species toward metabolites with greater activity at this therapeutic target, i.e. the human DAT. This was achieved by expressing the human DAT protein in transgenic plant cells and selecting gain-of-function mutants for survival on medium containing a neurotoxin that is accumulated by the human DAT. This created a sub-population of mutants with increased DAT inhibitory activity. Some of the active metabolites in these mutants are novel (i.e. not detectable in wild-type cells). Others are cytoprotective, and also protect DAergic neurons against the neurotoxin. This provides proof-of-concept for a novel plant drug discovery platform, which is applicable to many different therapeutic target proteins and plant species.

Introduction: Malgré des taux d’efficacité comparable du traitement antiviral de l’hépatite C (VHC) entre utilisateurs de drogues par injection (UDIs) et non-UDIs, il y a encore d’importantes barrières à l’accessibilité au traitement pour cette population vulnérable. La méfiance des UDIs à l’égard des autorités médicales, ainsi que leur mode de vie souvent désorganisé ont un impact sur l’initiation du traitement. L’objectif de cette étude est d’examiner les liens entre l’initiation du traitement du VHC et l’utilisation des services de santé chez les UDIs actifs. Methode: 758 UDIs actifs et séropositifs aux anticorps anti-VHC ont été interrogés durant la période de novembre 2004 à mars 2011, dans la région de Montréal. Des questionnaires administrés par des intervieweurs ont fourni des informations sur les caractéristiques socio-économiques, ainsi que sur les variables relatives à l’usage de drogues et à l’utilisation des services de santé. Des échantillons sanguins ont été prélevés et testés pour les anticorps anti-VHC. Une régression logistique multivariée a permis de générer des associations entre les facteurs relatifs aux services de santé et l’initiation du traitement contre le VHC. Resultats: Parmi les 758 sujets, 55 (7,3%) avaient initié un traitement du VHC avant leur inclusion dans l’étude. Selon les analyses multivariées, les variables significativement associées à l’initiation du traitement sont les suivantes: avoir vu un médecin de famille dans les derniers 6 mois (Ratio de Cote ajusté (RCa): 1,96; Intervalle de Confiance à 95% (IC): 1,04-3,69); plus de 2 ans sous traitement de la dépendance à vie, sans usage actuel de méthadone (RCa: 2,25; IC: 1,12-4,51); plus de 2 ans sous traitement de la dépendance à vie, avec usage actuel de méthadone (RCa: 3,78; IC: 1,85-7,71); et avoir déjà séjourné en prison (RCa: 0,44; IC: 0,22-0,87). Conclusion: L’exposition à des services d’aide à la dépendance et aux services médicaux est associée à l’initiation du traitement du VHC. Ces résultats suggèrent que ces services jouent leur rôle de point d’entrée au traitement. Alternativement, les UDIs ayant initié un traitement du VHC, auraient possiblement adopté une attitude proactive quant à l'amélioration de leur santé globale. D’autre part, l’incarcération ressort comme un obstacle à la gestion de l’infection au VHC. / Introduction: In spite of comparable hepatitis C virus (HCV) treatment efficacy between injection drug users (IDUs) and non-IDUs, there are still important barriers impeding antiviral treatment access in this vulnerable population. Mistrust between IDUs and health care providers, along with IDU disorganised lifestyle, affect HCV treatment uptake. The objective of this study is to examine the association between HCV treatment initiation and the use of healthcare services among active IDUs. Methodology: 758 active IDUs, seropositive for anti-HCV antibody, were surveyed from November 2004 to March 2011 in Montreal. Interviewer-administered questionnaires elicited information on socio-demographic factors, drug use related behaviors and health care service utilization. Blood samples were collected and tested for HCV antibodies. Multivariate logistic regression analysis was conducted to identify the health service correlates of HCV treatment initiation. Results: Among the 758 subjects, 55 (7.3%) had initiated an HCV treatment prior to enrolment. In multivariate analysis, variables independently associated with treatment initiation included: having seen a general practitioner in the last 6 months (adjusted Odds Ratio (aOR): 1,96; 95% Confidence Interval (CI): 1,04-3,69); more than 2 years of lifetime addiction treatment exposure without current methadone use (aOR: 2,25; CI: 1,12-4,51); more than 2 years of lifetime addiction treatment exposure with current methadone use (aOR: 3,78; CI: 1,85-7,71); and having spent time in prison (aOR: 0,44; CI: 0,22-0,87). Conclusion: Exposure to addiction and medical services is associated with HCV treatment initiation. These results suggest that such services efficiently play their role as entry points for HCV treatment. Alternatively, IDU who have initiated HCV treatment, regardless of the viral response outcome, may have adopted a proactive stance towards improving their overall health. Incarceration on the other hand seems to be an obstacle to HCV treatment uptake.

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The motivation for this study is the increase of treatment needs of heroin dependents at SANCA, (South African National Council of Alcohol and Drug Abuse) Witbank. SANCA Witbank wants to ensure that the most effective treatment can be supplied. Research goals are to:  Do a literature study of out-patient treatment programmes.  Assess the needs of heroin out-patient dependents with regard to out-patient treatment programmes.  Make recommendations with regard to out-patient treatment programmes for heroin dependents. It was an exploratory research subject and the data collection methods were qualitative and quantitative. Interview schedules were used as research tools. Schedule B was completed by the researcher with heroin dependents that visited SANCA Witbank for the period 31 January 2005 to 4 February 2005. Schedule A was completed by the researcher with personnel of SANCA out-patient clinics and the questions were discussed and completed telephonically. The conclusion is that the treatment programme of SANCA Witbank is in line with the rest of the drug dependent field and only minimal recommendations were made. / Social Work / MA(SS)(MENTAL HEALTH)