The research study aimed to identify the factors contributing to premature termination of treatment for addiction. The study took the form of a differential research design based on archival data and sought to establish patient-related predictors of treatment adherence and premature drop-out. One independent variable and 14 dependent variables were chosen. The data comprised a variety of characteristics which predispose certain addicts seeking treatment to drop out of the treatment programme before completion. The most significant finding was that a history of general abuse of medication has a negative influence on treatment outcome. The limitations of the study are discussed and recommendations are made regarding further research on the topic. / Dr. J.T.R. Beuster

Substance abuse has a severe impact on the South African population. Various organizations, governmental and non-governmental, take on the challenge to assist in the treatment of substance abuse. Several gaps have been identified in dealing with substance abuse in South Africa. One of these gaps includes regular audits of treatment services and prevention programmes. One of the major concerns is that most primary prevention programmes appear to be implemented in the absence of evidence on their effectiveness and are mostly implemented on an ad hoc basis. The respondent organizations appear to display a poor understanding of evaluation. It was evident that there is a need for a systematic review of what works in the context of substance abuse prevention among the South African population as well as the development of an effective regulatory regime regarding primary prevention activities. Evaluation can be an important tool to provide monitoring, as well as a tool to identify strengths and weaknesses in treatment programmes. In light of the above, the South Coast Recovery Centre, a substance abuse treatment centre that operates in the private sector, was approached to evaluate the effectiveness of its treatment programme. The research focused on gaining insight into and exploring the strengths and weakness of the programme based on how patients experienced the programme and how satisfied they were with it. The use of multimethod approach which included positivist and interpretative approaches to evaluation was viewed as an appropriate method to use for the study in facilitating an understanding of the patient’s experience of the programme and how satisfied they were with the intervention they received. The study is both qualitative and quantitative in nature and used questionnaires and focus group interviews as data sources. All participants in the study were inpatients at the South Coast Recovery Centre. Frequency distributions, chi square analysis, as well as a thematic analysis were used to analyze the data of the study. The study concluded that patients were in general satisfied with the treatment programme. The programme provided opportunity for behavior changes and introspective learning. They were satisfied with professionals’ skills and behaviours, 6 types of interventions provided, efficacy and accessibility. Areas that patients were not satisfied with included: the facilitated involvement of relatives, the provision of information, and the large amount of residents in the programme. Recommendations were made with regards to programme improvement. The recommendations included the following: a. A coherent programme with clear links between outcome objectives and programme activities should be created. b. The number of counsellors in the programme should be reconsidered. c. The number of patients that should be allowed in the programme should be reconsidered. d. A platform for counsellors to deal with their personal emotions and counter transference should be created. e. Counsellors’ emotional involvement with patients should be addressed and exposed. f. More structured leisure activities that use interactive learning styles could be implemented in order to facilitate the learning of social skills. g. An awareness of possible comorbid mental disorders should be developed. h. Patients can be more involved with the cost aspect of the programme in order to facilitate more ownership of their treatment process. i. Provision should be made in the programme to allow for more involvement of relatives. / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2009.

INTRODUCTION: In Georgia, criminal justice (CJ) involvement is one of the costliest outcomes experienced by individuals with substance abuse problems. Approximately 8% of individuals in America have needed substance abuse treatment, and in Georgia CJ involvement commonly co-occurs. AIM: To examine the transition into the CJ system for those entering treatment, and, arrests of individuals in treatment. The aim is to determine defining characteristics exist for an individual who switches over into the CJ system, or an individual who has an arrest while in treatment. METHODS: Data from the Treatment Episode Data Set from 2011-2015 was examined. Demographics, drug types, frequency of use, poly drug use, number of treatment episodes, time between treatment episodes, and rural and urban geography are analyzed in relation to the dependent study variables. Analytic techniques used are independent samples t-tests and regression analyses. The dependent variables are any switchover into the criminal justice system upon reentering treatment, and any arrest before discharge from treatment. RESULTS: Factors associated with a switch into the CJ system upon admission are non-completion of high school, ever being unemployed or a student (18 yrs or older), poly drug use, more than one treatment episode, younger at age of first drug use, longer periods of time in treatment, a switch of primary drug to meth, crack-cocaine, opiates, marijuana, or alcohol. Attending self-help programs before entering treatment and living in rural areas also increases a switch to the CJ system. Higher risk of arrest is associated with younger at age of first drug use, being male, black or other non-white race, higher education levels, ever being a student or homeless, attending self-help programs, and living in urban areas. DISCUSSION: The results and interpretation of this study may help inform and direct one part of a criminal justice prevention strategy and evidence-based health policy, for individuals who are undergoing substance abuse treatment.

Thesis (Ph. D.)--University of Wisconsin--Madison, 2004. / Includes bibliographical references (p. 208-221). Also available on the Internet.

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M.Cur. (Psychiatric Nursing) / Globally, the use of substances which seem to be harmful in all life dimensions appear to be an alarming problem. Recent studies indicate that the use and abuse of these substances is more prevalent among adolescents than any other age group. This is so because there are enormous changes to the physical, psychological and social dimensions at this stage. The use of these substances is a daily occurrence and reality for many people. However, for some individuals, the use of drugs can become overwhelming and be the focus of their lives and their existence. Among all abused substances, alcohol remains the dominant substance of abuse across sites. In South Africa too, adolescents abuse substances than other age groups. Substance abuse is commonly observed among adolescents who dropped out of school before completion of matric, those who completed matric but failed to go for tertiary education due to financial constraints, and those who are already in tertiary institutions thus making it difficult for them to complete their careers. Adding up on alcohol as commonly used substances are marijuana and hallucinogens. Some contributing factors of adolescent substance abuse have been identified as family environment factors, conflicting parental monitoring, peer group influence, psychiatric conditions and attention. To explore this problem of adolescents, the researcher conducted a study on the life stories of adolescents who abuse substances. The objectives of the study were to:- -Explore and describe the life stories of adolescents who abuse substances. -Describe the guidelines for advanced psychiatric nurses to facilitate the mental health of adolescents who abuse substances. This study was undertaken within the framework of Caplan's model of health promotion and prevention of illness based on the resources of community mental health care (Kaplan & Sadock 2003:1376). A qualitative, explorative and descriptive research design was used to answer the research questions. In depth, semi-structured phenomenological interviews were conducted with adolescents who met the sample criteria. Steps were taken throughout the research to ensure trustworthiness. Data analysis was done according to (Cresswell 1994:155) Tech's model. The results of this study indicate that adolescents abuse substances in certain behaviours which lead to substance abuse, face challenges in the physical, social and psychological dimensions. However, positive feelings of determination and courage to quit the substance abuse behaviour are also expressed. Conclusions were drawn and recommendation made concerning psychiatric nursing practice, nursing education and nursing research.

A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in partial fulfillment of the requirements for the degree of Masters of Medicine. Johannesburg 2019 / Background: The high level of co-morbid TB/HIV cases with severe organ failure on presentation in South Africa, results in an increased number of ICU admissions often with a poor prognosis at presentation. In this study, the aim was to identify patients admitted with HIV/TB co-infection and calculate the APACHE II scores and SOFA scores for each patient. Predicted percentage mortality was compared with actual mortality. Predictors of mortality were further identified, as well as the benefit of initiating ARV treatment in patients who are ARV naive upon admission to ICU. Methods: A retrospective audit of consecutive cases over a 24 month period was completed. Patient demographics; CD 4 count; ARV treatment status; ICU and 30 day mortality; the APACHE II Score; SOFA scores and correlating predicted percentage mortality were documented. The survival of patients was assessed using Kaplan Meier survival curves, and a univariate analysis was performed to identify risk factors for mortality. Calculated predicted mortality was compared with actual mortality to validate each scoring system and infer which was the better tool. Results: Of 75 patients admitted with pulmonary (43 cases) or extra-pulmonary (32 cases) TB, 23 died in the ICU (mortality 30,7%), and a further 10 died in the first 30 days of hospitalisation (30 day mortality 44%). A survival analysis established ARV treatment and CD 4 counts greater than 50 cells/mm3 were associated with a higher survival rate at any point of the analysis. In the entire study period, only 2 patients were initiated on ARV therapy during their ICU stay, 1 survived to discharge and 1 died in ICU. The APACHE II Predicted Mortality was within the 95% Confidence Intervals for all groups while the SOFA score was outside the upper bound limit of the 95% confidence intervals of actual mortality for those patients taking ARV treatment (52%, 95% CI 43,1% - 59,5% vs actual mortality 30%, 95% CI 17,7% - 46,1%), those with a CD 4 count of more than 50 (53,5% 95% CI 45,4% - 60,6% vs actual mortality 34%, 95% CI 22,1% - 48,4%) and female patients (51,2%, 95% CI 41,6% - 58,1% vs actual mortality 35,1%, 95% CI 21,4% - 50,4%). Conclusion: The study found that both the APACHE II and SOFA scoring systems were both statistically significant in prognosticating mortality in the study population. The APACHE II scoring system however showed a slightly improved prognostication in specific cohorts who had improved survival. It was also confirmed that patients with a CD 4 count of more than 50 cells/mm3, and those on ARV therapy had a statistically significant improved mortality. Further studies reviewing survival benefit of ARV initiation in ICU are warranted. ACKNOWLEDGEMENTS Supervisor: Prof GA Richards Co-Supervisor: Dr SHH Mohamadali Statistician: Mr MH Zondi Assistant - Data Collection: Ms S Madanlall / E.K. 2019

Despite the fact that much information is available in the literature regarding adolescents with a substance abuse problem, little exists that focuses on the parents' personal experience dealing with this problem. Not many researchers actually interviewed parents--when they did, it was usually for parents' observations of their adolescent or their views of treatment success--and seemingly none did so for the purpose of allowing parents to tell their own story in their own words. Furthermore, most of the existing literature has tended to see such parents in terms of their deficits, even when advocating the importance of their being included in the treatment process. Through the lens of a Family Systems perspective and by allowing parents to speak for themselves, this preliminary study explores what it was like for three parents to have had their sons go through a residential substance abuse treatment program. Six categories emerged from the semi-structured interviews: initial departure, settling in, homecoming, resources, costs and losses, and advice to other parents and professionals. The findings expand the primarily negative view of such parents to include a richer and more complex understanding. / Master of Science

This study was designed to explore the cognitive-perceptual roots of attrition from substance abuse treatment. Previous research on interpersonal issues among substance abusers and attachment theory suggested areas for investigation: the perception of early parental care, current interpersonal functioning, and perception of the substance abuse treatment program.

No description available.