Relapse into opiate and crack cocaine misuse: A scoping review

Aims International statistics show that relapse rates associated with opiate and crack cocaine (OCC) misuse remain high. This has led to an increased scientific interest in the topic of relapse. However, there are limited studies reflecting on the state of this field. This review provides an overview of the topic and directions for future research. Method: Guided by the overall question of how relapse into OCC misuse is understood, a scoping review was conducted using Arksey and O’Malley’s framework. A total of 126 studies between 1972 and 2019 were included. The literature was thematically grouped into relapse definitions, theories, associated factors and treatment approaches. Results: This review found that the majority of relapse understandings were derived from the USA and UK, and that these studies predominantly used quantitative research designs. Relapse definitions were controversial with the majority using biomedical concepts of disease. Theories on relapse were based on psychological theories and developed through clinical and neuroscientific research. Findings show that the majority of the literature focused on relapse risk factors with very few papers focusing on protective factors. Findings on treatment approaches indicate a steer toward harm-minimization strategies over relapse management strategies. Conclusions: This review demonstrates that drug relapse research needs to grow more diverse, inter-disciplinary and user-centred in perspective so as to respond to relevant challenges ahead

Problematising ‘Recovery’ in Drug Policy within Great Britain: A Comparative Policy Analysis between England, Wales and Scotland

Drug strategies in the United Kingdom emphasize the notion of recovery, with the concept being central in England, Wales and Scotland. There are however tensions, with recovery being defined differently across jurisdictions. In this study we aim to address this dilemma by critically interrogating how the term recovery is represented, how these presentations are shaped and what effects are subsequently had. We applied an adapted version of Bacchi’s (2009) What’s the Problem Represented to Be? (WPR) poststructuralist approach to policy analysis to the latest English, Welsh and Scottish drug strategies. We identified three dominant themes: a) recovery as ‘a problem of goals and ambitions’, underpinned by notions of service user responsibility; b) recovery as ‘a problem of product quality’, shaped by the implicit notion of service provider responsibility and the disease model of addiction; c) recovery as ‘a problem of service collaboration and teamwork’, underpinned by the bio-psycho-social model of addiction. We conclude that the problematisations found in the UK’s current drug policies have the ability to shape the drug policy-making process which may limit mainstream knowledge of recovery, and thereby unintentionally contribute to a narrow understanding of how to effectively support the service user community in their recovery from problematic drug use

Problematising ‘Recovery’ in Drug Policy within Great Britain: A Comparative Policy Analysis between England, Wales and Scotland

Drug strategies in Great Britain emphasize the notion of recovery, with the concept being central in England, Wales and Scotland. There are however tensions, with recovery being defined differently across jurisdictions. In this study we address this dilemma by critically interrogating how the term recovery is represented, how these presentations are shaped and what effects are subsequently had. We applied an adapted version of Bacchi's What's the Problem Represented to Be? (WPR) policy analysis approach to the 2017 UK Drug Strategy, the 2008–2018 Welsh Drug Strategy and the 2008 Scottish Drug Strategy notions of service user responsibility; (b) recovery as ‘a problem of product quality’, shaped by the implicit notion of service provider responsibility and the disease model of addiction; (c) recovery as ‘a problem of service collaboration and teamwork’, underpinned by the bio-psycho-social model of addiction. We conclude that the problematisations found in GB’s current drug policies have the ability to shape the drug policy-making process which may limit mainstream knowledge of recovery, and thereby unintentionally contribute to a narrow understanding of how to effectively support the service user community in their recovery from problematic drug use

Obstacles to Graduation: A Look at Poverty’s Effect on Academic Work

Our presentation was aimed at providing a thorough overview of concepts that interfere with an adolescent’s ability to stay in school and graduate. Additionally, the presentation addressed what other factors of poverty, such as risk-taking behaviors (e.g., marijuana use, binge drinking, or sexual activity), might carry over into college life and affect a student’s academic career. Variables connected to family community, family responsibilities, and adolescents’ self-esteem were described as well. Finally, the presentation discussed factors that play into a student’s willingness to seek out college campus resources for support. With this paper, we hope to outline variables that lead to academic drawbacks within our youth and to raise awareness about the multi-faceted phenomenon of retention of students

The use of body-mapping in interpretative phenomenological analyses:A methodological discussion

The increasing popularity of Interpretative Phenomenological Analysis (IPA) in social research brings an increasing criticism about its validity, robustness and, more recently, its lack of expressive features. Recently, the novel arts-based research approach called body-mapping was recognized as enhancing social science research in creative and nuanced ways. Body-mapping allows for unique insights into participants’ lived experiences, the meaning thereof, and into how meaning is impacted by their socio-cultural contexts. This article provides new understandings about the potential use of body-mapping as part of an IPA framework by drawing upon existing literature to critically discuss their philosophical and methodological congruence. The following discussion demonstrates how particular strengths of body-mapping align with weaknesses of IPA and that, when merged, they may be especially useful for research with vulnerable and hard-to-reach populations. Limitations of this discussion and implications for future research are provided

Multiple relapses into opiate and crack misuse among people in recovery:An interpretative phenomenological analysis

Relapsing multiple times back into opiate and crack cocaine misuse significantly increases the risk for overdose death, of which rates continue to soar worldwide. This study aims to provide an in-depth understanding of opiate and crack relapse from the lived experience perspectives of people in recovery from substance misuse. Semi-structured interviews were held, and interpretative phenomenological analysis was used to analyze the data. Findings revealed two superordinate themes which highlighted the impact of relapse on an individual's sense of self, their conceptualizations of relapse, and their approach to recovery thereafter. The study offers implications and future directions for mental health authorities and addiction professionals

Optimal stopping problems with expectation constraints

In this thesis we investigate optimal stopping problems with expectation cost constraints. We focus on reducing the set of stopping times as well as on deriving a partial differential equation for the value function. If the process to stop is a time-homogeneous Ito-process, we show, by introducing a new state variable, that one can transform the problem into an unconstrained control problem and hence obtain a dynamic programming principle. We characterize the value function in terms of the dynamic programming equation, which turns out to be an elliptic, fully non-linear partial differential equation of second order. In addition, we prove a classical verification theorem and apply it to several examples. Furthermore, we consider the problem of optimally stopping a one-dimensional regular continuous strong Markov process with a stopping time satisfying an expectation constraint. We show that it is sufficient to consider only stopping times such that the law of the process at the stopping time is a weighted sum of 3 Dirac measures. The proof uses results on Skorokhod embeddings in order to reduce the stopping problem to a linear optimization problem over a convex set of probability measures. We apply the results to analyze a sequential testing problem and show that in this problem the optimal stopping times are given by at most two consecutive exit times of intervals. Finally, using the theory of Tchebycheff systems we examine when we can reduce the set of stopping times in the constrained problem to first exit times of intervals. In this case, the law of the process at the stopping time is a weighted sum of at most 2 Dirac measures.In der vorliegenden Arbeit werden optimale Stoppprobleme mit Restriktionen an ein durch- schnittliches Kostenfunktional der Stoppzeit untersucht. Das Ziel ist es, sowohl die Menge der Stoppzeiten zu reduzieren als auch eine partielle Differentialgleichung für die Wertfunktion herzuleiten. Ist der zu stoppende Prozess ein zeithomogener Itˆo-Prozess, können wir das Stoppproblem durch Erweiterung des Zustandsraumes in ein optimales Kontrollproblem ohne Nebenbedingungen überführen und so ein dynamisches Programmierungsprinzip erhalten. Die Wertfunktion wird durch eine elliptische nichtlineare partielle Differentialgleichung zweiter Ordnung charakterisiert. Wir beweisen ein klassisches Verifikationstheorem und wenden es auf mehrere Beispiele an. Des Weiteren betrachten wir optimale Stoppprobleme für eindimensionale reguläre stetige starke Markovprozesse, wobei der Erwartungswert der Stoppzeiten beschränkt ist. Wir zeigen, dass es ausreichend ist, Stoppzeiten zu betrachten, sodass die Verteilung des Prozesses zur Stoppzeit einer gewichteten Summe von 3 Diracmaßen entspricht. Der Beweis basiert auf Ergebnissen zur Skorokhod Einbettung und überführt das Stoppproblem in ein lineares Optimierungsproblem über einer konvexen Menge von Wahrscheinlichkeitsmaßen. Die Ergebnisse werden in der Analyse eines sequentiellen Testproblems angewendet. Wir zeigen, dass die optimalen Stoppzeiten in diesem Problem durch höchstens zwei aufeinanderfolgende Austrittszeiten gegeben sind. Abschließend untersuchen wir mit Hilfe der Theorie der Tchebycheffsysteme, unter welchen Voraussetzungen die Menge der Stoppzeiten auf erste Austrittszeiten aus Intervallen reduziert werden kann. Die Verteilung des Prozesses zur Stoppzeit ist in diesem Fall eine gewichtete Summe von 2 Diracmaßen

Stopping with expectation constraints: 3 points suffice

We consider the problem of optimally stopping a one-dimensional continuous-time Markov process with a stopping time satisfying an expectation constraint. We show that it is sufficient to consider only stopping times such that the law of the process at the stopping time is a weighted sum of 3 Dirac measures. The proof uses recent results on Skorokhod embeddings in order to reduce the stopping problem to a linear optimization problem over a convex set of probability measures

Leadership during a racial microaggression on campus

The study aimed at understanding students’ perspectives on university response to a racial microaggression on a campus. Responses were collected in the form of an online survey and analyzed using qualitative data analysis to identify themes from students’ perspective. Insights about how students processed the incident were gained. Although students were thankful of the university response, concern for another incident, and how leadership will equip students to handle situations lingers. Implications for educators are provided