An approach to heroin use disorder intervention within the South African context: A content analysis study

<p>Abstract</p> <p>Background</p> <p>The field of heroin use disorder intervention has been in transition in South Africa since the outbreak of the heroin epidemic. Yet despite growing evidence of an association between heroin users' use of supplementary intervention services and intervention outcomes, heroin use disorder intervention programmes in South Africa generally fail to meet international research-based intervention standards.</p> <p>Methods</p> <p>Semi-structured interviews with ten heroin use disorder specialists were conducted and the interviews were subjected to content analysis.</p> <p>Results and Discussion</p> <p>In terms of theory and practice, findings of the study suggest that the field of heroin use disorder intervention in South Africa remains fragmented and transitional. Specifically, limited strategic public health care polices that address the syndromes' complexities have been implemented within the South Africa context.</p> <p>Conclusions</p> <p>Although many interventions and procedures have begun to be integrated routinely into heroin use disorder clinical practice within the South African context, comorbidity factors, such as psychiatric illness and HIV/AIDS, need to be more cogently addressed. Pragmatic and evidence-based public health care policies designed to reduce the harmful consequences associated with heroin use still needs to be implemented in the South African context.</p

O alcoolismo, suas causas e tratemento nas representacoes sociais de profissionais de Saude da Familia = Alcoholism, its causes and treatment in the social representations constructed by Brazilian Family Health professionals

Health sciences define alcoholism as a multifaceted syndrome. Guidelines for treatment include adoption of the harm reduction paradigm and the essential role of Primary Health Care (PHC) towards the wide range of alcohol problems. This research aimed at understanding the social representations of alcoholism constructed by Brazilian PHC professionals, working at Family Health Centers (FHC). We conducted semi-structured interviews with 40 graduated health professionals who worked in 11 different FHC located in a municipality in southeast Brazil. Data were treated with thematic content analysis. We highlight the following results: professionals objectified the alcoholic as a patient who did not search for treatment and/or who threatened the normal functioning of the FHC; professionals considered social and psychological factors as the main causes of alcoholism; they did not mention the concept of harm reduction, nor well-defined treatment protocols. The causal attribution and the representational field inherent to the social representations contributed to anchor alcoholism as a "plague" of poverty. The FHC were perceived simultaneously as important and impotent towards alcoholism. We conclude that the implementation of alcohol-related care strategies must consider the intergroup relations between professionals and patients

Registratie biologische veebedrijven niet op orde

Het blijkt onmogelijk om aan te geven hoeveel dieren er worden gehouden op biologische bedrijven. Noch de ketenorganisatie van de biologische landbouw, noch controlerende instanties blijken hier precieze gegevens over te kunnen verstrekken

Bivariate Trajectories of Substance Use and Antisocial Behavior

Substance use and antisocial behavior are complex, interrelated behaviors. The current study identified model trajectory classes defined by concurrent substance use and antisocial behavior and examined trajectory associations with emerging adult outcomes. Participants from a high-risk sample of youth (n=536; 73% male) completed interviews at baseline (mean age= 16.1 years) and followup (mean age= 22.6 years). Latent class growth analyses identified five trajectory classes based on alcohol/drug use (AOD) and antisocial behavior (ASB): Dual Chronic, Increasing AOD/Persistent ASB, Persistent AOD/Adolescent ASB, Decreasing Drugs/Persistent ASB, and Resolved. Many individuals (56%) exhibited elevated/increasing AOD, and most (91%) reported ASB decreases. Those associated with the Dual Chronic class had the highest rates of substance dependence, antisocial personality disorder (ASPD), and negative psychosocial outcomes. There were no differences in adult role attainment across classes. Conjoint examination of these behaviors provides greater detail regarding clinical course and can inform secondary prevention and intervention efforts

Therapists' understandings and experiences of working with clients with problems of addiction: a pilot study using Q methodology.

This pilot study aims to increase our understanding of therapists' subjective attitudes, beliefs, and experiences of working with clients with problems of addiction. The study yielded useful clarifications, arising from the finding that opinions about the nature of addiction support different approaches to therapy. In addition, it seems that diverse or conflicting attitudes and beliefs are likely to impact on the ability of therapists to work together effectively. Another objective was to test the feasibility of using Q methodology in this study and more broadly in qualitative research in psychotherapy. Participants were 13 therapists from a variety of backgrounds and working in a range of agencies. Using Q methodology, four distinctive factors were identified, indicating divergent understandings of addiction. Each factor is shown to be a multifaceted construct which does not correspond to any single theory or therapeutic orientation. It is suggested that the results have significant implications for therapists' training and supervision. In addition, this study demonstrates the capacity of Q methodology to identify commonalities and diversity in viewpoints which do not conform to a priori conceptualisations. As a pilot study, this paper invites further discussion and research

The Use of Motivational Interviewing in Conjunction With Adapted Dialectical Behavior Therapy to Treat Synthetic Cannabis Use Disorder

Little empirical information is established about synthetic marijuana, including the treatment of related disorders. Similar to organic marijuana, chronic synthetic use can lead to a variety of functional impairments, including diminished academic and workplace productivity and performance. Many traditional approaches emphasize treating co-occurring disorders separately, but the present case examines concurrent treatment for Diagnostic and Statistical Manual of Mental Disorders (4th ed., DSM-IV) Synthetic Marijuana Dependence and Generalized Anxiety Disorder by using Motivational Interviewing (MI) and Relapse Prevention (RP) in conjunction with an adapted form of Dialectical Behavior Therapy (DBT). A model for treatment and its potential effects are discussed

Trajectories of Drinking Urges During Individual- and Couple-Based Cognitive-Behavioral Treatment for Alcohol Use Disorders

Individuals receiving treatment for alcohol use disorders (AUDs) often experience urges to drink, and reductions in drinking urges during cognitive-behavioral therapy (CBT) predict better treatment outcomes. However, little previous work has examined patterns of daily drinking urges during treatment. The present study examined patterns of change in daily drinking urges among participants in two randomized clinical trials of males (N = 80 with 4401 daily recordings) and females (N = 101 with 8011 daily recordings) receiving individual- or couples-based CBT. Drinking urges were common during treatment, occurring on 45.1% percent of days for men and 44.8% for women. Drinking urges and alcohol use for both genders decreased substantially during the course of treatment. Both genders had increases in drinking urges as more time elapsed since attending a treatment session. For men, this increase was most pronounced at the beginning of treatment, but for women it was most pronounced near the end of treatment. Alcohol use and drinking urges were both more likely to occur on weekends. The results suggest that these times may lead to higher risk for drinking, and clients may benefit from high-risk planning that is focused on these times