This research addresses the use of canine animals in substance abuse treatment. There is research that addresses the importance of animals regarding therapy and mental illness, as well as research on the comorbidity of severe mental illness and substance abuse disorder. However, there is no research that looks at utilizing canines in substance abuse therapy. The purpose of this research was to examine the utilization of canine animals in rehab for those with substance abuse issues. The theoretical foundation for this study is the theory of contextualism. This theory focuses on humans with animals. To address the gap in research, this quasi-experimental quantitative study looked at two independent variables, presence or absence of a canine during treatment, and gender. The method of data collection was obtaining charts of 130 discharged clients, along with retrieval of data regarding days authorized by insurance for treatment. Information was obtained on the number of days that the client stayed in treatment. There was a comparison of the numbers that created a standardization for treatment. There was not significant difference in the average duration of substance abuse treatment when comparing people who attend treatment with their canine compared to those who do not attend treatment with a canine nor was there a difference between the genders. This research may create positive social change by providing an alternative to substance abuse disorder treatment. Not only will this create a positive environment for the client, but it will also provide them the ability to have comfort in a critical time in their lives. This research shows that canines provide something to mankind that we cannot always provide to one another.

Quality substance abuse treatment is needed to help fight the battle against drug addiction. This qualitative study was designed to explore some of the approaches to eye movement desensitization (EMDR) therapy that therapists trained in Parnell's adapted EMDR model use in conjunction with treatment for addictions. The purpose of this narrative inquiry was to investigate the experience of therapists who incorporate substance abuse treatment with Parnell's adapted EMDR model when treating trauma and substance use disorders. The population studied comprised licensed mental health therapists who had completed Parnell's EMDR training and implemented Parnell's modified EMDR protocol in their professional practice. The data from 9 participant interviews were coded and NVIVO data analysis software was used to identify key concepts and themes including deviations from Parnell's modified protocol, incorporating addiction treatment within the modified protocol, and the importance of the resourcing phase in the modified protocol. The study findings provided a deeper understanding of the types of addiction therapies that therapists are using in conjunction with Parnell's EMDR model. The results also showed that that participants perceived Parnell's EMDR model, combined with addiction therapeutic techniques and approaches, as beneficial in treating those with trauma and substance use disorders. By integrating addiction therapies with Parnell's EMDR protocol, EMDR certified trainers may better educate EMDR trainees about useful strategies for treating dual diagnosed clients. The strategies may shorten the client's time in treatment and provide a strong foundation for therapists as they conduct therapy for dual diagnosed people.

Substance use disorders (SUD) and mental health disorders are often thought of as completely separate problems even though these disorders commonly co-occur. Among adolescents who seek treatment for substance use problems, co-occurring mental health problems (MHP) are common. This is concerning because co-occurring disorders among adults have been associated with more severe MHPs, relapsing to substance use sooner, being less likely to maintain abstinence, and other problems. Despite the awareness that co-occurring disorders are problematic for adolescents, few studies have been conducted to understand these problems with an adolescent sample. The purpose of this study was to understand if factors commonly related to co-occurring disorders among adults were the same for adolescents and to examine two measurement models for the dependent variable, substance use. This secondary analysis of data first examined characteristics that are related to MHPs among a sample of adolescents (N=801) who use substances. Factors in three domains were examined: demographics, substance use, social factors. The results indicated that among these adolescents, MHPs were common. Two key factors related to having a MHP were gender and the severity of the SUD. Females and adolescents with more severe SUDs, like dependence, were more likely to have MHPs. Furthermore, severity of the SUD partially mediated the relationship between several of the other factors and MHPs. The type of substance an adolescent reported using was also important. In addition, adolescents who had more peers and more family members who participated in deviant activities had more severe substance use problems and were more likely to have a MHP. In addition to examining the factors related to mental health problems among a substance using population, this study modeled the dependent variable in two different ways which had not been done before and allowed for variance in the measure to be accounted for in the model. MHPs were measured both continuously and categorically. The results of the comparison indicated that there were not major differences between the two models. Implications for social work practice, policy and research are discussed.

Bakgrund Missbrukssyndrom är vanligt förekommande i samhället och innebär en skadlig användning av olika substanser t.ex. alkohol och droger. Användningen pågår trots negativa konsekvenser för personens livssituation och ökar risken för en instabil hälsa. Vilket leder till ett ökat behov av hälso- och sjukvård. Forskning har visat att personer med missbrukssyndrom upplevde utanförskap, stigmatisering och skam vid kontakt med sjukvården.  Syftet Att beskriva sjuksköterskors upplevelser av att möta personer med missbrukssyndrom och sjuksköterskans attityder i vårdmötet, samt att beskriva inkluderade artiklars undersökningsgrupper.  Metod En beskrivande litteraturstudie. Tio artiklar inkluderandes i resultatet. Artikelsökning gjordes i databaserna PubMed och Cinahl. Diskussion fördes mellan författarna för att sammanställa ett objektivt resultat.   Huvudresultat Sjuksköterskor hade skilda meningar om missbrukssyndrom var en sjukdom. Personer med missbrukssyndrom ansågs som oansvariga över sitt hälsotillstånd enligt sjuksköterskor. Sjuksköterskorna beskrev hur de upplevde patientgruppen som oberäknelig och manipulativ samt att den orsakade ökad arbetsbelastning. Vidare uppkom en känsla av frustration över den egna misstron och osäkerheten kring patientgruppen. Önskemål om utbildning uttrycktes. Enligt sjuksköterskorna var tålmodighet och att vara stödjande viktiga delar i vårdandet samt att inte spegla det egna tyckandet.   Slutsatser Beroende på om sjuksköterskor såg missbrukssyndromet som ett sjukdomstillstånd eller som självförvållat, framkom positiva eller negativa attityder och upplevelser. Kunskap och utbildning inom missbrukssyndrom behövs för att upprätthålla ett etiskt förhållningssätt i sjuksköterskans profession. / Background Substance-use disorder is common in society and involves harmful use of different substances, for example. alcohol and drugs. The use is in progress despite adverse consequences for the person's life situation and increases the risk of unstable health. Which leads to an increased need for healthcare. Research has shown that people with substance-use disorder experience exclusion, stigma and shame in contact with healthcare   Aim To describe nursing experience of meeting people with substance-use disorder and the nurse's attitudes in the healthcare meeting, as well as describing the survey articles of the included articles.   Method A descriptive literature study. Ten items are included in the result. Article search was made in the PubMed and Cinahl databases. Discussion was conducted between the authors to compile an objective result.   Results Nurses had different opinions about if substance-use disorder were a disease or not. Persons with substance-use disorder were considered irresponsible for their health status according to nurses. Nurses described how they experienced the patient group as erratic and manipulative and that caused increased workload. Furthermore, a sense of frustration arose over their own missile and the uncertainty surrounding the patient group. Requests for education were expressed. According to the nurses, patience and support were important parts of care and to not reflect their own opinion.   Conclusion Depending on whether nurses saw the substance-use disorder as a state of illness or as self-inflicted, positive or negative attitudes and experiences have emerged. Knowledge and education in substance-use disorder is necessary to maintain an ethical approach within the nurse's profession.

Bakgrund: I bakgrunden beskrivs aspekter på sjuksköterskans yrkesroll samt omvårdnadsansvar inom både vården i allmänhet och beroendevården. Vidare beskrivs patientgruppen och dess problematik samt begreppet medberoende och hur det kan försvåra valet av omvårdnad. Syfte: Syftet med denna undersökning var att undersöka sjuksköterskans syn på vad som kännetecknar god omvårdnad och medberoende inom den slutna beroendevården samt vad som skiljer dem åt. Metod: Studien har en kvalitativ design med induktiv ansats. Sju sjuksköterskor intervjuades på en beroendeenhet i Stockholm enligt ostrukturerad metod. Materialet analyserades sedan med kvalitativ innehållsanalys. Resultat: Resultatet utmynnade i tre kategorier: Sjuksköterskans syn på vad som utgör god omvårdnad inom beroendevården, Sjuksköterskans syn på fenomenet medberoende inom beroendevården samt Sjuksköterskans uppfattning kring var gränsen går mellan god omvårdnad och medberoende. I resultatet kom det bland annat fram att sjuksköterskan inte har några större problem med att skilja på de båda begreppen god omvårdnad och medberoende, men att det är svårare i praktiken. Diskussion: Resultatet i studien diskuterades i relation till tidigare forskning, relevant litteratur och Ida Jean Orlandos interaktionsteori. I diskussionen kommer det bland annat fram hur sjuksköterskans omvårdnadsansvar kan gå över i ett medberoende. / Background: The background describes aspects of the nurse’s profession and care responsibility within both general care and in dependent care. Furthermore, it describes the patient group with its problems, the concept of co-dependency and how it can impact the choice of nursing.   Aim: The aim of this study has been to explore nurses’ view of what characterizes good care and co-dependency within the closed depending care. Method: This study has a qualitative design with an inductive approach. Seven nurses at a   depending care unit in Stockholm were interviewed using an unstructured method. The material was then analyzed using qualitative content analysis. Results: The result from the interviews developed into three categories: The nurse’s view of what   constitutes good care within depending care, The view of the phenomenon of co-dependency within depending care and finally, The nurse’s perception of what differentiates good care and co-dependency. The result reveals, among   other things, the fact that while the nurse, intellectually, had no major problems in separating the concepts of good care and co-dependency, in practice it proved to be harder to implement. Discussions: The results are discussed in the context of previous research, other relevant literature and from Ida Jean Orlando’s interaction theory. In the discussion it reveals, among other things, how the nurses responsibility of care can develop into co-dependency.

Multiyear trends showing high rates of alcohol and opioid-related misuse as well as opioid-related deaths have renewed attention on both access to and the quality of substance use treatment. In response, diverse healthcare systems that care for the Medicaid population have begun implementing large-scale transformations including new services and provider training requirements. The Centers for Medicaid and Medicare Services has urged state Medicaid programs to use Sections 1115 waiver demonstrations as vehicles for substance use treatment delivery system transformation. For many states, undertaking the Section 1115 waiver demonstration means moving from very limited benefits to a full continuum of new services. States’ ability to achieve such transformations is unknown since demonstration processes are under-reported and considered implementation “black boxes”. Substance use treatment delivery changes are also occurring at the community level, where several hospitals systems have implemented new services to meet the needs of their patient population. However, the influence of these new care models on patient service utilization is unknown. In this dissertation, I use comparative case study design and qualitative content analysis to examine the pre-implementation decision-making processes that Medicaid policymakers in California, Virginia and West Virginia experienced when deciding to enhance their substance use treatment service delivery systems using Sections 1115 waivers. I qualitatively describe how broad sociocultural and local organizational factors influenced Medicaid agencies’ ability to expand access to treatment. I also present a taxonomy of implementation strategies used to translate Medicaid policy into clinical services available in the community. Finally, I present a latent transition analysis to reveal how the nature of substance use treatment services available to patients may influence their service utilization over time. This final quantitative analysis is set within the context of a safety net hospital that provides a comprehensive, low barrier access model for substance use treatment, and primarily serves Medicaid beneficiaries. Results of this dissertation illuminate processes and outcomes associated with pre-, mid-, and post-implementation activities targeting improvements in the delivery of substance use treatment services. / 2023-01-19T00:00:00Z

The aim of this study is to investigate professionals’ working experience with elderly peoplewith substance use disorders and how drug or alcohol abuse affects their work with theirclients. The most important areas of focus are professionals’ views on older clients’ substanceand alcohol abuse, moral or ethical dilemmas in relation to work and the elderly’s needs forsupport and help according to professionals. To identify these problems, a qualitative methodwas used with semi-structured interviews, interviewing a total of 8 professionals in twonursing homes specializing in older clients with substance use disorder and a rehabilitationcenter aimed at ages 40 to 70. Interview data was analyzed with thematization and coding.Analysis of the material was carried out using theories such as care perspectives, ethics forsocial workers and ageism. The results of the study indicate that most professionals whowork with this target group lack the knowledge of geriatrics combined with substance abuseknowledge. A comparison is drawn between the two institutions and their organizationalrules regarding alcohol or drug consumption by clients. The study further highlights thestaff's experience of finding themselves between organizational rules, professional rules andtheir own values ​​and beliefs. The results show that professionals are struggling with the lackof rules. In addition to that the results of this study show that stereotypical perceptions ofolder people tend to influence professionals as well as other social institutions that work withthis target group. The study also addresses the issue of inadequate treatment efforts aimed atolder people and a mapping of their alcohol and drug habits.

<p>Despite data suggesting that current substance use disorder treatments are largely effective in reducing substance use, most adolescents in SUD treatment experience relapse after finishing treatment. Understanding the factors proximal to relapse is crucial to understanding the course of substance use disorder and how best to improve recovery among adolescents. The current study represents part of a novel line of research using qualitative data analysis to examine these factors. Data for the present study were 200 de-identified node-maps, completed by high school students at Hope Academy, a recovery high school in Indianapolis, Indiana. The reported age in this sample ranged from 14-20 years (64.1% male, 89.1% White), with a mean age of 16.8 years (SD = 1.9 years). After a four-phase process of qualitative data sorting, primary people, places, and things most frequently described included using with others (n=153, 76.5%), away from home (n=156, 78.0%), and in response to negative affect (n=93, 48.4%). Eleven relapse pathways emerged: escaping (n=16), self-medicating (n=3), coping with tragedy (n=5), critical mass (n=6), unexpected activation (n=8), unexpected offer (n=22), planned use (n=19), resistant to recovery (n=5), not in recovery (n=22), passive agency (n=30), and acting out (n=15). Recovery is a system made up of many interrelated parts, including those related to the individual person in recovery, their thoughts, beliefs, feelings, and emotions; and those related to external factors, their environment, adverse life events, and the actions of other people. By considering the pathways together for their common features, they can each be said to represent one of three critical failures related to those three overarching facets of the system: failure to cope, failure to guard against temptation, and failure of belief. Identifying these overarching failures in the system is helpful because the failures contain in themselves the seeds of their solution, so by examining them as critical components to a relapse event, it may be possible to gain insight into how to prevent the same type of relapses from occurring in the future. </p>

Magister Artium (Psychology) - MA(Psych) / Western Cape has the highest prevalence rates of Substance Use Disorder (SUD) with prevalence rates of 18.5%, versus the national average of 13.3%. Existing studies have emphasised that SUD is associated with exposure to trauma and Post-traumatic Stress Disorder (PTSD). In addition, demographic factors such as gender, race and socio-economic status have been correlated with SUD. However, limited research exists on the correlates of SUD among inpatients at substance abuse rehabilitation facilities in the Western Cape Province. The study aimed to address this gap in the literature by investigating the correlates of SUD among inpatients at SUD rehabilitation treatment facilities.

Alcohol-related Liver Disease (ALD) represents almost half of all deaths attributable to liver disease (LD) in the US. Despite the large proportion of deaths from ALD, however, only 1.4% of all liver transplants were for patients with ALD. ALD presents a range of medical and ethical concerns for those who drive the policy and practices of liver transplantation (LT). While, historically, stringent eligibility criteria for LT precluded many with ALD from receiving a transplant, more recent research suggests such criteria may be misguided. The following review compares LT outcomes between ALD and non-ALD recipients and finds that LT recipients with ALD have equal, if not better, survival rates than those with non-ALD. The findings of this review suggest a need for revisiting transplant criteria for patients with ALD to ensure parity.