Research suggests evidence of an association between sociodemographic determinants and illicit drug use. However, these data do not take into consideration the effect an economic obstacle, such as a recession, could have on an individual's urge to cope with this stressful period with illicit drugs. Furthermore, there is no research to suggest how clinicians and/or treatment institutions can forecast whether the use of monetary resources will be sustainable due to private and/or governmental fund reductions during an economic recession. Based on theories of social learning and social disorganization within an ecological framework, this study employed a quantitative trend analysis to explore the impact the 2007-2009 economic recession had on illicit drug use throughout the United States. A sample of respondents from the Substance Abuse and Mental Health Data Archive from 2006 to 2010 surveys was used to run the statistical analysis. Based on the analyses, age and gender (covariates) and all variables (social disorganization and Gross Domestic Product) were found to be significant predictors of illicit drug use. Although methamphetamine was not significant for prevalence over time, total drug use, cocaine, and heroin were prevalent over time based on predictors. These findings suggest local, state, and federal policies regarding the prosecution and imprisonment of nonviolent and minor drug offenders should be reprioritized towards the rehabilitation of addicts while enforcing firmer laws upon the most disruptive and severe aspects of the drug trade in order to promote a genuine positive change towards social organization.

Aims: Study I: Identify substance use disorders (SUDs), psychiatric disorders, and psychosocial risk (PSR) in adolescence, to predict SUD after 5 years in 147 adolescents who sought treatment at a misuse-clinic. Study II: Identify alcohol risk use (ARU) and its association with psychiatric symptoms and PSR in 960 adolescents who sought treatment in general psychiatric care. Study III: Examine the effect of antisocial behavior (ASB) on the association between inattention, hyperactivity, impulsivity, and alcohol use in 3,864 adolescent students. Study IV: Examine the veracity of drug use reports comparing responses in questionnaires, in-depth interview, and hair analysis in 200 adolescent students. Results: Study I: SUDs in adolescence persisted into early adulthood. Predictors for SUD: girls who had mothers with alcohol use disorder, victimization, criminality, SUD, or SUD treatment. Study II: Prevalence of ARU was 20%. ARU increased with the number of psychiatric symptom domains. Probability of psychiatric symptoms increased with ARU. Most ARU was found in: ASB and sexual abuse. Most common in ARU: symptoms of ADHD, depression, and anxiety. Study III: ASB reduced association between inattention, hyperactivity, impulsivity, and alcohol use for boys, and hyperactivity and impulsivity for girls. Girls’ inattention continued to affect alcohol use despite the presence of ASB. Study IV: Twice as many participants reported drug use in interviews compared to questionnaires. Questionnaires and hair-analysis showed low sensitivity and high specificity. Responses from participants in less privileged socioeconomic circumstances were less reliable. Conclusions: Study I: Treatment-as-usual experienced difficulties preventing the persistence of SUD. Participants’ comorbidity and PSR must be attended to. Study II: ARU in general psychiatric care is prevalent and associated with other psychiatric symptoms, and all symptoms must be attended to simultaneously. Study III: ASB should be screened for when symptoms of ADHD are present. Inattention in girls might require special attention to prevent alcohol use. Study IV: Interviews might be an alternative to questionnaires. Hair analysis was less useful in this population, but a physical measure might function as a pipeline procedure. Responses from participants in less privileged circumstances might be interpreted with caution.

Long distance truck drivers are considered a special interest group in terms of drug----- driving research and policy due to high rates of use, involvement of drugs in truck accidents and the link between drug use and work related fatigue. Qualitative interview data was collected from 35 long haul truck drivers in South East Queensland and analysed using NVivo 2.0. High rates of licit and illicit drug use (particularly amphetamines) were reported. However, unlike previous studies which focus on fatigue, this research found overlapping and changing motivations for drug use during individual lifetimes. Using Becker's model of a drug use 'career' it was revealed that some drivers begin illicit drug use before they begin truck driving. As well as fatigue, powerful motives such as peer pressure, wanting to fit the trucking 'image', socialisation, relaxation and addiction were reported. These may need to be considered along side fatigue in the development of effective drug prevention or cessation policies for truck drivers.

Using thematic analysis, this qualitative study investigates desistance from illicit drug use from the perspective of patients within opioid substitution treatment (OST). Wikström's theoretical framework was used to explain this process. From semi-structured reflective interviews with 12 patients admitted to an OST clinic in Sundsvall, three main themes were identified as relevant to the research aim. These main themes were labelled as follows: Motives for desistance, Perspectives on OST and Recipe for successful desistance. The findings were similar to those of previous research. The participants expressed criticism on specific regulations within OST, but were positive to the treatment in general. They felt a lack of emotional support from OST, but still reported an improvement in mental well being. While varied views on diversion of OST medication were expressed, a majority believe dillicitly used opioids to originate from sources other than OST. In conclusion, the participants viewed OST as an essential method for desistance from illicit drug use. Having a sincere will to desist and perceiving the past illicit opioid use as problematic were also deemed necessary for the treatment to be successful. / <p>2017-06-01</p>

Over the past decade, public policy making and implementation in some European and North American countries have been in the form of networks of public, private and voluntary sector organisations. The changing nature of governance, to governing with and through networks, is known as ‘network governance’ (Rhodes, 1997). Nonetheless, it is ambiguous if network governance is a global phenomenon or merely applicable to the developed world context. Since the evidence of network governance from developing countries is hitherto scarce in the literature, this research, therefore, fills the current knowledge gap by examining network governance in Thailand. The research explores and explains the presence (or absence) of network governance in Thailand through Resource Dependence Theory, using illicit drug policy implementation in Chiang Mai province as a case study. A quantitative survey (N = 217) and a qualitative semi-structured interview (N = 31) were employed to accumulate primary data. The findings reveal that governance in the case under consideration had not shifted towards networks. Although it was found that there is a moderate degree of resource interdependence between state and non-state organisations involved in the policy, it was not sufficient to verify the existence of network governance. This was because power asymmetry existed in the relationship, with the state sector being the power-advantaged one. State agencies avoided collaborating with the non-state sector due to the fear of an expected loss of autonomy, whereas non-state organisations did not perceive resources from the state sector as being of critical importance. Thus, network governance was mainly absent from this case. This research joins broader intellectual debates that network governance is not a global phenomenon but rather a case-specific one, which suggests that public administration scholars should take the distinctiveness of context into account. Moreover, this study contributes to the illicit drug policy making in Thailand by recommending that deregulations of some bureaucratic rules and cross-sector organisational learning are vital to facilitate network governance.

The primary purpose of this study was to perform a follow-up quantitative investigation of foodservice employees’ illicit drug use behaviors, experiences with illicit drug use prevention efforts, and perceived negative outcomes associated with illicit drug use as compared to the non-foodservice labor force. An online survey was designed for this study to collect data and independent t-tests were conducted to analyze the data and test the hypotheses. Results indicated foodservice employees are more likely to use illicit drugs and are more concerned with short-term negative outcomes as a result of illicit drug use than the non-foodservice labor force. Furthermore, illicit drug use prevention efforts are less prominent in the foodservice industry than in other workplaces. This study provides foodservice industry professionals with further insight regarding illicit drug use, and offers practical implications that may help mitigate this phenomenon.

The current opioid crisis has, among other things, resulted in soaring rates of fatal overdose across Canada, prompting officials to turn to harm reduction in hopes of combatting the epidemic. The Coroners Service of British Columbia issued a statement in March 2017 reporting an 80% increase in the number of deaths resulting from illicit drug use in 2016 from 2015 (Coroners Service of British Columbia, 2017). Despite the abundance of evidence demonstrating the effectiveness of supervised injection services (SIS) in Canada and worldwide, the implementation of this intervention has remained highly controversial, particularly in Ottawa. Guided by Michel Foucault’s theory of governmentality, this thesis explores the obstacles hindering the implementation of supervised injection services in Ottawa, Ontario. Through eight qualitative semi-structured interviews with front-line workers of harm reduction programs, this thesis identifies and explores several obstacles to the implementation of SIS, primarily bureaucratic obstacles stemming from the enactment of the Respect for Communities Act (2015).

This diploma thesis provides a complex analysis of illicit drug trade in Latin America and Colombia and it describes its causes and trends. It also focuses on evaluation of anti narcotics strategies applied in Colombia. The first part of the thesis describes the illicit drug market and its global character and it concentrates on cocaine market in Latin America. The second part is devoted to Colombia and the historical development of illicit drug trade in said country. It contains analysis of several actors dominating the illicit drug market and of their roles and positions. It also describes anti narcotics policies in Colombia. The last section is an analysis of results and impacts of the policies applied in Colombia. It provides an overview of the current situation in Colombia and possible scenarios of future development of illicit drug trade.

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.

ABSTRACT Background: Few studies have focused on early alcohol, tobacco and drug use prior to 18 years of age and their relationship with anxiety; while no study has checked the gender differences of these factors with anxiety. Methods: This study included 6,057 adults with anxiety in the past year and 71,868 controls from the combined data of 2013 and 2014 National Survey on Drug Use and Health (NSDUH). The weighted multiple logistic regression analyses were used to estimate the associations of early alcohol, tobacco and drug use prior to 18 years of age with anxiety. The odds ratios (ORs) with 95% confidence intervals (CIs) were estimated. Results: The overall prevalence of anxiety was 6.8% (4.4% and 9.1% for males and females, respectively). Weighted multiple logistic regression showed that cigarettes use, inhalant use, marijuana use and other illicit drugs use revealed significant associations with anxiety (OR = 1.18, 95% CI = 1.04-1.33, OR = 1.31, 95% CI = 1.10-1.56, OR = 1.16, 95% CI = 1.01-1.32, and OR = 1.31, 95% CI = 1.17-1.48, respectively). Stratified by gender, cigarettes use, inhalant use, marijuana use and other illicit drugs use were associated with anxiety in females only. Conclusion: Early tobacco and drug use prior to 18 years of age were found to be associated with increased odds of adult anxiety and that such associations differed by gender.