Purpose: To evaluate the effectiveness of the West Virginia Prescription Drug Abuse Quitline (WVPDAQ). Methods: Descriptive data and inferential analyses are provided for the period of operations from 9/11/2008 to 3/1/2010. Chi-square tests for Independence compared differences between callers completing at least one follow-up survey against callers completing only the baseline intake survey were observed. A Wilcoxon signed rank sum test tested differences between the scores of intake callers and follow-up callers at the one-week (n=177) and one-month (n=89) intervals. Results: A total of 1,056 calls were received, including 670 intakes, 177 1st follow-ups, 89 2nd follow-ups, and 36 3rd follow ups, and 84 caller satisfaction surveys. Chi-square analyses determined that callers who only completed the intake survey tended to have initiated drug use at a younger age ([less than or equal to] 39 years of age, [chi square]=7.63, p=.02). Longitudinal findings indicated significant self-reported declines in daily drug use (p<.0001), increased intentions to quit in the next 30 days (p<.0001), and declines in requesting a referral for treatment (p<.0001) at the one-month follow-up. Finally, approximately 19% (n=17) of callers reported obtaining a counseling/ treatment appointment as a result of calling the WVPDAQ at the one-month follow up. Conclusions: Preliminary results suggest the WVPDAQ has established itself as a meaningful resource to combat prescription drug abuse in West Virginia. Sustainable funding and greater integration of the WVPDAQ into existing and developing treatment infrastructure could provide more affordable options for the state of West Virginia and its citizens.

The selective serotonin reuptake inhibitors appear to have a much wider margin of safety than most other classes of antidepressants. Although there is limited experience with acute overdoses of fluoxetine alone, few serious adverse effects have been reported. There has been almost no experience, however, with significant fluoxetine overdoses in children. This report describes the accidental ingestion of as much as 43 mg/kg of fluoxetine by a 4-year-old child. In this case, serum blood levels of the drug and its major metabolite were consistent with a large ingestion and are among the highest reported in the medical literature. Toxic effects were relatively mild and consisted of a brief spell of unresponsiveness, sinus tachycardia, and moderate psychomotor agitation and dyskinesia. Supportive care was provided and the child recovered completely.

YWCA Hamilton’s Safer Drug Use Space (SUS) is one of only two gender-specific safe consumption spaces in Canada, and the only one integrated into an emergency drop-in program. It is widely acknowledged in both the scholarly literature and by social service and healthcare providers that women and non-binary people are vulnerable to violence and coercion when using substances around men. They also have different needs from harm reduction programs that are not always met in all-gender safe consumption sites. Furthermore, the integration of safe consumption sites in emergency shelters and drop-ins has been found to lower the number of drug poisonings in the area. This study sought to build upon this existing body of literature by speaking with service users from SUS about how they have been supported by the program in its first year of operation, and how it could be improved. Five service users were engaged in individual, qualitative interviews conducted by one of the front-line staff at SUS who is also a student at McMaster University. The “in-between” position of the researcher and previously established rapport with the participants generated nuanced insights to come out of these conversations. Four themes came out of the data: (1) the importance of positive service user/staff relationships; (2) staff knowledge and expertise; (3) SUS being considered a “safe” place and like a “home” to service users; and (4) accessibility of the space for service users being a contributor to why people return to SUS. This study revealed that aligning their harm reduction framework to include safe consumption onsite has meant SUS staff and service users develop more trusting relationships with each other. This allows them cooperate in unique ways to keep the community safe and connect service users to necessary social and healthcare supports. / Thesis / Master of Social Work (MSW)

This study explores the experiences of people who have lost loved ones due to socially stigmatized deaths. Drawing from eight individual interviews, the author argues that the stigma associated with death due to drug overdose, suicide, substance abuse, or murder can cause traumatic or prolonged grief and can complicate the way the bereaved talk about grief as a part of their healing process. With the mortality rate in the U.S. rising, there is an epidemic of disenfranchised grief affecting millions of bereaved individuals. Using Coordinated Management of Meaning and Communication Privacy Management theories, the author uncovers strategies the traumatically bereaved employ to manage interactions and relationships with others. A qualitative analysis of participant interviews revealed that social stigma, whether experienced or anticipated, affects the way the bereaved communicate and can cause self-silencing. Findings indicate a need for safe, supportive, and non-judgmental spaces for the traumatically bereaved to share their stories.

The ongoing overdose problem in the United States, particularly exacerbated by the widespread use of fentanyl, and polydrug use, represents a critical public health challenge. This thesis explores how people who use drugs (PWUD) in Orlando, Florida, are responding to the overdose problem in their community. Drawing on ethnographic research conducted at a syringe services program in Summer 2023, I argue that PWUD in Orlando actively take measures to prevent overdose and overdose deaths but are faced with many obstacles that challenge their overdose prevention efforts. I examine overdose narratives of PWUD to show how factors preventing effective overdose prevention are not just systemic but also cultural. In particular, the prevailing stigma of opioid use hinders the creation of a supportive environment for preventing overdoses and perpetuates the ostracization of PWUD in Orlando. Recognizing the profound influence of stigma towards the PWUD with whom I conducted research, I make the case for reimagining overdose prevention as a comprehensive effort in Orlando to equip PWUD, their families, first responders, and the broader community with the knowledge, skills, and tools to address overdose. Such efforts also have the potential to recalibrate cultural misconceptions and biases toward PWUD. As Florida and the nation continue to experience an overdose problem, understanding local cultural and structural challenges remains pivotal. This project demonstrates that by integrating comprehensive training and combating stigmatization of PWUD, Orlando communities can prevent overdose and save lives more effectively.

No description available.

No description available.

There is increasing concern about hepatitis C virus (HCV) and potential HIV transmission among ethnic Vietnamese injecting drug users (IDUs) in Australia. To date ethnic and cultural differences in vulnerability to blood-borne viruses (BBV) have received little attention and few studies have attempted to explore the role of cultural beliefs and values in influencing injection risk behaviour. This study aimed to systematically explore the cultural beliefs and behavioural practices that appear to place ethnic Vietnamese IDUs at increased risk of BBV infection, identify barriers to this group accessing health and preventive programs, and document antibody HIV and HCV prevalence and associated risk behaviours. The first component of the research consisted of an ethnographic study designed to explore underlying explanatory models of health and illness employed by Vietnamese IDUs and identify cultural influences on risk behaviours and vulnerability to BBVs. These data were subsequently used to inform the development of the instrument used in the second component ??? a cross-sectional survey and collection of capillary blood samples designed to assess risk behaviours and antibody HIV and antibody HCV prevalence. Analysis of data from both components indicates that cultural beliefs and practices influence risk-taking and health-seeking behaviours and suggests pathways through which this influence occurs. Relevant cultural characteristics include those pertaining to spiritual and religious beliefs, the role of the family and traditional Vietnamese family values, cultural scripts of self-control and stoicism, the importance of ???face??? and non-confrontational relationships, trust and obligation, and a reluctance to discuss problems with outsiders. Vulnerability to BBVs is influenced by these cultural characteristics, together with Vietnamese IDUs??? perceptions of risk, knowledge about HIV and HCV, and situational and environmental factors. Main factors contributing to the under-utilisation of health services include the use of self-managed care practices, ambivalence surrounding Western medicine, long waiting times, concerns in relation to confidentiality, stigmatisation of drug use, and limited knowledge of BBVs. The data indicate a need for interventions based on understanding of culturally specific meanings and contexts of health, illness and risk in order to better meet the needs of this vulnerable group.

There is increasing concern about hepatitis C virus (HCV) and potential HIV transmission among ethnic Vietnamese injecting drug users (IDUs) in Australia. To date ethnic and cultural differences in vulnerability to blood-borne viruses (BBV) have received little attention and few studies have attempted to explore the role of cultural beliefs and values in influencing injection risk behaviour. This study aimed to systematically explore the cultural beliefs and behavioural practices that appear to place ethnic Vietnamese IDUs at increased risk of BBV infection, identify barriers to this group accessing health and preventive programs, and document antibody HIV and HCV prevalence and associated risk behaviours. The first component of the research consisted of an ethnographic study designed to explore underlying explanatory models of health and illness employed by Vietnamese IDUs and identify cultural influences on risk behaviours and vulnerability to BBVs. These data were subsequently used to inform the development of the instrument used in the second component ??? a cross-sectional survey and collection of capillary blood samples designed to assess risk behaviours and antibody HIV and antibody HCV prevalence. Analysis of data from both components indicates that cultural beliefs and practices influence risk-taking and health-seeking behaviours and suggests pathways through which this influence occurs. Relevant cultural characteristics include those pertaining to spiritual and religious beliefs, the role of the family and traditional Vietnamese family values, cultural scripts of self-control and stoicism, the importance of ???face??? and non-confrontational relationships, trust and obligation, and a reluctance to discuss problems with outsiders. Vulnerability to BBVs is influenced by these cultural characteristics, together with Vietnamese IDUs??? perceptions of risk, knowledge about HIV and HCV, and situational and environmental factors. Main factors contributing to the under-utilisation of health services include the use of self-managed care practices, ambivalence surrounding Western medicine, long waiting times, concerns in relation to confidentiality, stigmatisation of drug use, and limited knowledge of BBVs. The data indicate a need for interventions based on understanding of culturally specific meanings and contexts of health, illness and risk in order to better meet the needs of this vulnerable group.

Självdestruktiva handlingar innebär att medvetet tillfoga sig skada. Hos personer som avsiktligt självskadar sig är suicidtankar vanligt förekommande men syftet kan vara ångestlindring och uttryck för psykiskt illabefinnande. Mellan 2005-2014 vårdades 77371 personer inom slutenvård på grund av avsiktlig självdestruktiv handling och risken för suicid är höjd efter en självdestruktiv handling. Syftet med denna studie var att undersöka intensivvårdssjuksköterskans upplevelse av att vårda patienter som avsiktligt överdoserat läkemedel i självdestruktivt syfte. Fem kvalitativa intervjuer med semistrukturerad intervjuguide analyserades med innehållsanalys och materialet utmynnade i fem kategorier samlade under ett tema: Att vilja men inte alltid kunna. Kategorierna var: Att känna hjälplöshet i den psykiatriska omvårdnaden, Att ha kännedom om patientens sammanhang, Att prioritera bort samtal, Att attityder påverkar samarbetet med kollegor, Att ha behov av samverkan och stöd från psykiatrin. Studien visade att upplevelsen av att vårda patienter som överdoserat läkemedel i självdestruktivt syfte påverkades av patientens bakgrund, social kontext och livssituation. Bakgrund i missbruk, låg ålder och kvinnligt kön medförde att handlingen upplevdes mer impulsartad. Upplevelsen av att vårda var komplex och intensivvårdssjuksköterskan kände sympati, frustration och otillräcklighet i omvårdnaden av patienten. Samarbetet på intensivvårdsavdelningen påverkades av attityder inom personalgruppen där intensivvårdssjuksköterskan kände sig ensam ansvarig för samtal kring självdestruktivitet och mående. Det förelåg svårigheter i det multiprofessionella teamarbetet samt i förmågan att uppnå holistisk och personcentrad vård. Intensivvårdssjuksköterskorna upplevde att samarbetet med psykiatrin var bristfälligt och hade negativ påverkan på upplevelsen. Intensivvårdssjuksköterskans upplevelse var att slitas mellan sympati och frustration. Den moraliska stressen kan leda till att patienten får bristfällig omvårdnad och risken för framtida suicid kan öka.