Spelling suggestions: "subject:"substanceuse disorders"" "subject:"substanceabuse disorders""
51 |
Sexual Orientation and Substance Use Treatment Outcomes Across Five Clinical Trials of Contingency ManagementZajac, Kristyn, Rash, Carla J., Ginley, Meredith K., Heck, Nicholas C. 01 January 2019 (has links)
Lesbian, gay, and bisexual (LGB) individuals have elevated rates of substance use disorders and present to treatment with more severe substance use problems. Despite this health disparity, recent reviews highlight the paucity of studies reporting sexual orientation in substance use research (e.g., Flentje, Bacca, & Cochran, 2015). Using data from 5 clinical trials of contingency management (CM), the current study investigated the impact of sexual orientation on 3 substance use outcomes: treatment retention, longest duration of abstinence, and percent negative samples submitted. Participants (N = 912; mean age = 36.6 years; 51.1% female; 45% African American, 42.2% Caucasian) were randomized to standard care in community-based intensive outpatient treatment (IOP) or the same plus CM. Patients identifying as LGB made up 10.6% of the sample. A significant proportion identified as bisexual (8.2% of the total sample). Regardless of sexual orientation, participants receiving CM achieved better treatment outcomes than those receiving IOP alone. There were no statistically significant differences between LGB and heterosexual participants in their response to IOP in general, and CM specifically, across all 3 treatment outcomes (ps < .05). However, equivalence testing revealed that outcomes were not statistically equivalent for LGB and heterosexual participants, with the exception of percentage of negative samples, which was equivalent within the CM group only. Differences in treatment response to CM and standard community-based IOP do not reach the level of statistical significance; however, in most cases, we cannot conclude that treatment response is equivalent for LGB and heterosexual individuals.
|
52 |
Structure, Content and Reliability of the Munich-Composite International Diagnostic Interview (M-CIDI) Substance Use SectionsLachner, Gabriele, Wittchen, Hans-Ulrich, Perkonigg, Axel, Holly, Alexandra, Schuster, Peter, Wunderlich, Ursula, Türk, Dilek, Garczynski, Ela, Pfister, Hildegard January 1998 (has links)
After reviewing currently available diagnostic assessment instruments for substance use disorders this paper describes the format and structure of the Munich-Composite International Diagnostic Interview (M-CIDI) substance disorder section. In addition, the test-retest reliability of diagnoses and criteria for nicotine, alcohol, illegal and prescription drugs, is reported. Findings obtained in community sample of adolescents and young adults indicate that the substance section is acceptable for almost all types of respondents, efficient in terms of time and ease of administration as well as reliable in terms of consistency of findings over time. The test-retest reliability over a period of an average of 1 month, as examined by two independent interviewers indicates good-to-excellent kappa values for all substance disorders assessed, with significant kappa values ranging between 0.55 for drug abuse and 0.83 for alcohol abuse. There was also fairly consistently high agreement for the assessment of single DSM-IV diagnostic criteria for abuse and dependence as well as the M-CIDI quantity-frequency and time-related questions. To conclude, although – unlike previous studies – this study was conducted in a community sample and not in patients and used considerably longer time intervals of more than a month between investigations, our M-CIDI reliability findings are at least as high as those from previous studies.
|
53 |
Substance Use and Substance Use Disorders in a Community Sample of Adolescents and Young Adults: Incidence, Age Effects and Patterns of UsePerkonigg, Axel, Pfister, Hildegard, Höfler, Michael, Fröhlich, Christine, Zimmermann, Petra, Lieb, Roselind, Wittchen, Hans-Ulrich January 2006 (has links)
Objective: We present the prevalence and incidence rates of alcohol, nicotine, and illicit substance use, abuse, and dependence in a sample of German adolescents and young adults. Patterns of onset, cohort trends, and use of various substance classes are also analyzed.
Method: A prospective longitudinal epidemiological study with a representative sample of adolescents and young adults (n = 3,021; baseline age range = 14–24 years) was conducted in Munich, Germany. Participants were assessed between 1995 and 1999 with the Munich-Composite International Diagnostic Interview.
Results: Cumulative lifetime incidence (up to age 28) of any substance abuse or dependence was 43.8%, and 12-month prevalence of any substance abuse or dependence was 24.4%. The lifetime incidence of nicotine dependence was most frequent (24.8%), followed by alcohol abuse (19.3%) and alcohol dependence (9.2%); 61.7% endorsed the regular use of a substance for at least one circumscribed period during their lifetime. Age-specific incidence rates and age at onset of substance use disorders differed by age cohorts. Furthermore, nicotine dependence was significantly associated with illicit substance use disorders (HR = 2.6, 95% CI 1.7–4.0). An interactive relationship between age, age at onset of nicotine dependence, and subsequent onset of illicit substance use disorders was found.
Conclusions: Since the baseline investigation in 1995, high incidence rates of substance use disorders and substance use have been observed in this young German sample. Especially younger cohorts report significantly earlier ages at onset of abuse and dependence. There also seems to be a trend towards a secondary age at onset peak of nicotine dependence after the onset of illicit drug use disorders. Further investigations are needed to study these patterns in younger samples. However, results emphasize the need for a combined prevention of illicit drugs and nicotine dependence. / Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.
|
54 |
Patienters upplevelse av hälso- och sjukvårdens bemötande när substansbrukssyndrom föreliggerBergenstråle, Emelie, Brolin, Maria January 2021 (has links)
Bakgrund: Personer med substansbrukssyndrom (SUD) är en stigmatiserad och marginaliserad population i samhället som har ett stort vårdbehov. Tidigare forskning visar på att hälso- och sjukvårdspersonal har stigmatiserade fördomar och attityder gentemot denna patientgrupp. Denna studies syfte var att undersöka och belysa hur personer med SUD upplever hälso- och sjukvårdens bemötande vid vårdkontakter. Metod: Med hjälp av en deskriptiv litteraturöversikt, har material samlats in från tre databaser, PubMed, PsycInfo och CINAHL. Elva artiklar valdes ut och analyserades för att identifiera individer med SUD och deras upplevelse av bemötande inom hälso- och sjukvården. Resultat: Både positiva och negativa upplevelser rapporterades av deltagarna. Av resultatet framkom det att upplevd stigmatisering, en sämre kommunikation mellan patient och personal, en upplevd misstro och en negativ relation med personalen bidrog till ett sämre uppfattat bemötande. Det kunde bidra till att deltagarna var mindre angelägna att uppsöka vård. Ett gott bemötandet beskrevs som öppet och empatiskt, icke-dömande, en god kommunikation och en relation med vårdpersonalen som grundades på tillit. Det kunde resultera i att deltagarna var mer angelägna att uppsöka vård. Åtta teman och fyra subteman framkom när materialet studerades och resultatet presenteras utifrån dessa teman. Slutsats: Hälso- och sjukvården har en betydande roll i sitt inflytande på denna patientgrupp och har en stor möjlighet att lindra lidandet samt främja en god omvårdnad genom sitt bemötande. / Background: People with substance use disorders (SUD) are stigmatized and marginalized in society with a great need for care. Previous research shows that healthcare professionals have stigmatized prejudices and attitudes towards this patient group. This study aimed to investigate and shed light on how people with SUD experience the health service’s treatment at care contacts. Method: Using a descriptive literature review, the material has been collected from three databases, PubMed, PsycInfo and CINAHL. Eleven articles were selected and analyzed to identify individuals' with SUD experience of treatment in healthcare. Results: The results showed that perceived stigma, poorer communication between patient and staff, perceived mistrust and a negative relationship with the staff contributed to a more negative experience of the encounter. This could contribute to the participants being less likely to seek care. The better encounter was described as open and empathetic, non-judgmental, good communication and a relationship with the care staff that was based on trust. This could result in the participants being more likely to seek care. Eight themes and four sub-themes emerged when the material for this study was reviewed, and the results are presented based on these themes. Conclusion: Healthcare has a significant role in its influence on this patient group and has a great opportunity to alleviate suffering and to promote good care through its treatment.
|
55 |
Gender Differences in HIV Sexual Risk Behaviors Among Clients of Substance Use Disorder Treatment Programs in the U.S.Pan, Yue, Metsch, Lisa R., Wang, Weize, Wang, Ke Sheng, Duan, Rui, Kyle, Tiffany L., Gooden, Lauren K., Feaster, Daniel 01 May 2017 (has links)
This study examined differences in sexual risk behaviors by gender and over time among 1281 patients (777 males and 504 females) from 12 community-based substance use disorder treatment programs throughout the United States participating in CTN-0032, a randomized control trial conducted within the National Drug Abuse Treatment Clinical Trials Network. Zero-inflated negative binomial and negative binomial models were used in the statistical analysis. Results indicated significant reductions in most types of sexual risk behaviors among substance users regardless of the intervention arms. There were also significant gender differences in sexual risk behaviors. Men (compared with women) reported more condomless sex acts with their non-primary partners (IRR = 1.80, 95 % CI 1.21–2.69) and condomless anal sex acts (IRR = 1.74, 95 % CI 1.11–2.72), but fewer condomless sex partners (IRR = 0.87, 95 % CI 0.77–0.99), condomless vaginal sex acts (IRR = 0.83, 95 % CI 0.69–1.00), and condomless sex acts within 2 h of using drugs or alcohol (IRR = 0.70, 95 % CI 0.53–0.90). Gender-specific intervention approaches are called for in substance use disorder treatment.
|
56 |
Patienters med substansberoende upplevelser av stigma vid möten med vården : en litteraturstudie / Patients with substance abuse perception of stigma in health care settings : a literature reviewBergstrand, Christina, Berggren, Malin January 2022 (has links)
Bakgrund En kartläggning av stigma med stigmas underliggande betydelser såsom diskriminering, exklusion, makt underläge, etikettering, stereotypisering och fördomar, och hur dessa har en inverkan på personer med beroende när det uppsöker vården. Med en teoretisk utgångspunkt i personcentrerad vård, där mötet mellan patienter och hälso- och sjukvårdspersonal är i fokus. Syfte Att belysa upplevelser av stigma för patienter med substansberoende i mötet med hälso- och sjukvården utifrån ett patientperspektiv. Metod En icke-systematisk litteraturstudie, bestående av 17 peer-reviewed artiklar med ett urval av kvalitativa, kvantitativa och mixad metod, funna i CINAHL och PubMed. Kvalitetsgranskade efter Sophiahemmet Högskolas bedömningsunderlag för vetenskaplig klassificering samt kvalitet avseende studier med kvantitativ och kvalitativ metodansats. Resultat Patienternas utsagor om tydliga fall då de upplevt stigma, diskriminering, bristande eller utebliven behandling på grund av sitt missbruk, i olika vård och omsorgs sammanhang. Med data och utsagor om bra och dåliga möten, samt förslag på förbättring för hur ett möte kan gå till för att minska stigma. Följder som blir av ett förväntat eller upplevt stigmatiserat bemötande, där utebliven vård, uppföljning och ovilja till rehabilitering är allvarliga biverkningar. Slutsats Det finns en stor misstro mellan personal och patienter, från bådas håll. Patienterna upplever att de inte får den vård och omsorg de har rätt till och enbart bli bemötta som problem. Det uppkommer brister i behandling då patienter inte får den abstinens eller smärtlindring de anser sig behöva. Denna bristande behandling leder till att många patienter ger sig av från sjukhusen utan att fullfölja sin behandling. / Background Mapping of stigma with stigma's underlying meanings such as discrimination, exclusion, power disadvantage, labelling, stereotyping and prejudice, and how these have an impact on people with addiction when they seek care. With a theoretical starting point in person-centred care, where the meeting between patients and health care personnel is in focus. Aim To describe experiences of stigma in patients with substance addiction in the encounter with healthcare from a patient perspective. Method A non-systematic literature review, consisting of 17 peer-reviewed articles with a selection of qualitative, quantitative, and mixed methods, found in CINAHL and PubMed. Quality reviewed according to Sophiahemmet University's assessment tool for scientific classification and quality regarding studies with a quantitative and qualitative method approach. Results The patients' statements about clear cases when they experienced stigma, discrimination, lack of or non-existent treatment due to their addiction, in various care and medical care contexts. With data and statements about good and bad meetings, as well as suggestions for improvement for how a meeting can be done to reduce stigma. Consequences of an expected or perceived stigmatized treatment, where failure to provide care, follow-up, and reluctance to rehabilitate are serious side effects. Conclusions There is a great deal of mistrust between staff and patients, from both sides. The patients feel that they do not receive the care and concern they are entitled to and are only treated as a problem. Deficiencies in treatment arise when patients do not get the abstinence or pain relief, they think they need. This lack of treatment leads to many patients leaving the hospital without completing their treatment.
|
57 |
The US National Comorbidity Survey: Overview and future directionsKessler, Ronald C., Anthony, James C., Blazer, Daniel G., Bromet, Evelyn, Eaton, William W., Kendler, Kenneth S., Swartz, Marvin, Wittchen, Hans-Ulrich, Zhao, Shanyang January 1997 (has links)
This report presents an overview of the results of the US National Comorbidity Survey (NCS) (Kessler et al., 1994) and future directions based on these results. The NCS is a survey that was mandated by the US Congress to study the comorbidity of substance use disorders and nonsubstance psychiatric disorders in the general population of the US. (...)
|
58 |
Patterns in Allegations of Workplace Discrimination Filed by Americans with Substance Use Disorders under Title I of the Americans with Disabilities ActLeslie, Mykal J. 02 May 2018 (has links)
No description available.
|
59 |
Unpacking Societal and Healthcare Provider Perpetuated Stigma Regarding Patients with Substance Use DisordersRojas, Jordan Michael 05 1900 (has links)
Stigmatization remains a significant barrier to the initiation and maintenance of treatment in patients with substance use disorders, with higher levels of stigma being associated with lower levels of treatment initiation and adherence. While societal stigma is frequently discussed, less discussed are the inherent biases expressed by healthcare providers. Healthcare providers often hold comparable or even higher levels of stigma against patients with substance use disorders compared to the general population, and this can have quite a significant impact on patient care. From improper treatment decisions stemming from fear and stigmatization of the medications used for opioid use disorders, to the development of mistrust and poor/worsening self-esteem secondary to poor patient-provider interactions. The effects of stigma on the substance use disorder patient cannot be understated and must be alleviated in the coming years to ensure that patients with SUDs receive the high-quality treatment that they deserve. Several interventions have been validated to help reduce stigma within healthcare providers, subsequently improving treatment outcomes. Words matter. Patient-first language is crucial; verbiage can strongly impact how not only the provider sees the patient, but how the patient views themselves (and as we know, poor self-esteem also hinders treatment outcomes). Education and normalization of SUD medications should be done at the healthcare provider level to ensure that all providers are comfortable with these medications. As higher frequency of interactions with substance use disorders has been shown to reduce levels of stigma seen within healthcare providers, it’s also crucial that trainees receive adequate exposure to this patient population. While these suggestions may take time to show effect, it’s imperative that we get the ball rolling on training future generations of healthcare providers that do not hold inherent biases and who will provide high-quality, care utilizing validated treatments. / Urban Bioethics
|
60 |
Exploring Substance Use Disorders Community Outpatient Counselors’ Experiences Treating Clients with Co-Occurring Medical Conditions: An Interpretative Phenomenological AnalysisCathers, Lauretta 18 September 2013 (has links)
Abstract EXPLORING SUBSTANCE USE DISORDERS COMMUNITY OUTPATIENT COUNSELORS’ EXPERIENCES TREATING CLIENTS WITH CO-OCCURRING MEDICAL CONDITIONS. AN INTERPRETATIVE PHENOMENOLOGICAL ANALYSIS Lauretta Anne Cathers, Ph.D. A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy at Virginia Commonwealth University. Virginia Commonwealth University, 2013 Major Director: Amy Armstrong, PhD, Chair, Rehabilitation Counseling The Interpretative Phenomenological Analysis study presents the findings from a qualitative study examining substance use disorders (SUD) community outpatient treatment counselors’ experiences treating clients with co-occurring medical conditions. Interviews from five SUD community outpatient treatment counselors resulted in four emerging super-ordinate themes. The findings illustrate the relationships between SUDs, medical conditions and other predisposing, enabling and need factors. In order to assist clients in focusing on therapy, counselors work to identify resources to treat the basic needs of the clients, including medical care. Challenges included limited resources, complex system processes, and client fear and apathy. In addition, various unique challenges related to medical conditions treated by potentially habit forming medications and traumatic brain injury were identified. Counselors discussed how their roles and responsibilities have expanded to include case management and additional responsibility for the overall well-being of the clients they serve. They encouraged SUD educators to include more education on counselor self-care, trauma, pain conditions and the assessment process. Implications from the study highlight the need for integrated behavioral and physical health care.
|
Page generated in 0.1026 seconds