Significance of Self-Transcendence for Rehabilitation and Relapse Prevention among Patients with Substance Use Disorder: A Qualitative Study

This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https:// creativecommons.org/licenses/by/ 4.0/).A complex variety of restrictive and promoting factors are in play when people with substance use disorder face challenges concerning rehabilitation and relapse prevention. Selftranscendence sources are strongly associated with meaningfulness, and meaningfulness is found to be associated with less alcohol and drug use severity and relapse prevention. The aim of the present qualitative study was to investigate self-transcendence among patients with substance use disorders and to discuss its significance for treatment and relapse prevention. An exploratory qualitative research design was employed, with individual interviews in a strategic sample of four patients with substance use disorder recruited from a religiously founded rehabilitation clinic in Southeast Norway. The transcribed material was analysed through systematic text condensation. A search for objects beyond immediate needs through self-transcendence was revealed, related to generativity and an unselfish prosocial commitment to family and the surroundings, strengthening the participants’ selfefficacy, confidence, and safety. Spirituality and confidence in a higher power or destiny generated order in life. The use of rituals contributed to tranquillity. Values gave new directions, and private confession helped to start over in life. For patients in rehabilitation aiming at relapse prevention, self-transcendence seems to be significant as part of the recovery process. Possible implications for rehabilitation and relapse prevention are discussed.publishedVersio

Deep Learning and Linear Programming for Automated Ensemble Forecasting and Interpretation

This paper presents an ensemble forecasting method that shows strong results on the M4 Competition dataset by decreasing feature and model selection assumptions, termed DONUT (DO Not UTilize human beliefs). Our assumption reductions, primarily consisting of auto-generated features and a more diverse model pool for the ensemble, significantly outperform the statistical, feature-based ensemble method FFORMA by Montero-Manso et al. (2020). We also investigate feature extraction with a Long Short-term Memory Network (LSTM) Autoencoder and find that such features contain crucial information not captured by standard statistical feature approaches. The ensemble weighting model uses LSTM and statistical features to combine the models accurately. The analysis of feature importance and interaction shows a slight superiority for LSTM features over the statistical ones alone. Clustering analysis shows that essential LSTM features differ from most statistical features and each other. We also find that increasing the solution space of the weighting model by augmenting the ensemble with new models is something the weighting model learns to use, thus explaining part of the accuracy gains. Moreover, we present a formal ex-post-facto analysis of an optimal combination and selection for ensembles, quantifying differences through linear optimization on the M4 dataset. Our findings indicate that classical statistical time series features, such as trend and seasonality, alone do not capture all relevant information for forecasting a time series. On the contrary, our novel LSTM features contain significantly more predictive power than the statistical ones alone, but combining the two feature sets proved the best in practice

Meaning-Making, Religiousness and Spirituality in Religiously Founded Substance Misuse Services—A Qualitative Study of Staff and Patients’ Experiences

This is a peer reviewed, scientific article licensed under the Creative Commons Attribution License 4.0 (CC BY) and originally published Open Access in Religions. You can access the article by following this link: http://dx.doi.org/10.3390/rel6010092Dette er en vitenskapelig, fagfellevurdert artikkel som opprinnelig ble publisert Open Access i Religions. Artikkelen er publisert under lisensen Creative Commons Attribution License 4.0 (CC BY). Du kan også få tilgang til artikkelen ved å følge denne lenken: http://dx.doi.org/10.3390/rel6010092The Norwegian health authorities buy one third of their addiction treatment from private institutions run by organizations and trusts. Several of these are founded on religious values. The aim of the study was to investigate such value-based treatment and the patients’ experiences of spirituality and religiousness as factors of meaning-making in rehabilitation. The study was performed in an explorative qualitative design. Data were collected through focus-group interviews among therapists and in-patients at a religiously founded substance misuse service institution. The analysis was carried out by content analysis through systematic text-condensation. Through different activities and a basic attitude founded on religious values, the selected institution and the therapists facilitated a treatment framework which included a spiritual dimension and religious activity. The patients appreciated their free choice regarding treatment approaches, which helped them to make meaning of life in various collective and individual settings. Rituals and sacred spaces gave peace of mind and confidence in a situation that up to now had been chaotic and difficult. Sermons and wording in rituals contributed to themes of reflection and helped patients to revise attitudes and how other people were met. Private confessions functioned for several patients as turning point experiences influencing patients’ relations to themselves and their surroundings. Spirituality and religious activity contributed to meaning-making among patients with substance use disorder and had significance for their rehabilitation

Sámi álbmotbeaivi

This article is based on the current debate about whether or not the official Sami flag day 6 February may and should be referred to as "Sami Day" or "Sami National Day." While the Norwegian government is consistently referring to the Sami as a people (folk), the Sami decided in 2005 that the celebration referred to the Sami as a nation. The use of the term “nation” by the Sámi Parliament has created reactions among parts of the non Sami population, especially in current and historical Sami core areas, and in some political parties, especially representatives from the Progress Party (Fremskrittspartiet). The negative statements in connection with the national identity of the Sami, reflects specific attitudes to the power relationship between the majority community and the Sami. In light of these criticisms, it may be useful to see the historical development of the Sámi political mobilization and the common European tradition from which it was born. The Sami National Consciousness grew up in the early 1900s, equivalent to Norwegian nationalism in the wake of union resolution with Sweden. At first glance, The Sami opposition in the period after 1905 seems to be in the business and cultural spheres, but looking at the sources, there is a language that was also indicative of the Norwegian majority community in the same period. The Sami opposition to the Norwegian authorities developed early strategies to respond to assimilation and cultural imperialism. Although the pressure of the Sami opposition fell in periods, it was an important self-awareness of the Sami as political subjects. The Sami initiative is important symbols of Sami political commitment and the national consciousness. The Sami resistance struggle testifies that the conditions of the Sami not only came under the reconciliation policy of the Norwegian authorities, but that Sami demands for rights and respect for language and culture have been fought through well over hundred years. The fact that the Sami nation-building process has been overlooked in Norwegian history writing is arguably an important reason why the idea of a Sami nation seems alien, provocative and partly revolutionary from a majority point of view. However, the Sami nation constitutes itself first and foremost as a cultural nation (cultural heritage, languages, myths, folklore, customs and history), not through demands for political independence

The burden of somatic diseases among people with alcohol- and drug use disorders are influenced by mental illness and low socioeconomic status. A registry-based cohort study in Norway

Objectives: Persons with alcohol use disorder (AUD) and drug use disorder (DUD) have a lower life expectancy than the general population. We examined the burden of somatic diseases among persons with AUD or DUD and investigated impact of socioeconomic status (SES) and mental health disorders on the co-occurrence of somatic diseases in these groups. Methods: We performed a retrospective, register-based cohort study with a 6-year follow-up of persons (aged ≥18 y) with AUD (13,478) or DUD (16,659). Cox regression analyses were used to estimate hazard ratios (HRs) of somatic diseases. Results: Patients with DUD were, on average, 10 years younger at the point of diagnosis than patients with AUD. Mental illnesses were prominent in both groups (AUD: 40.5%, and DUD: 46.9% vs 3.5% in controls). Adjusting for mental disorders, the risk of all somatic diseases among the AUD and DUD groups was reduced by 30%. Some of the elevated risk of somatic diseases among persons with AUD and DUD is explained by low SES, though less than that explained by the presence of mental disorders. The diseases with highest risk among AUD patients were metabolic disorders (16.9-fold) and hypertension (14.8-fold), and among AUD patients, viral hepatitis (23.3-fold), after adjusting for low SES and mental disorders. Conclusions: Persons with AUD had a higher risk of most somatic diseases, while those with DUD had specific risks for infections and viral hepatitis. Mental health disorders and SES adjusted the associations regarding most somatic diseases. In general, improvement of socio-economic conditions, preferably in combination with professional support to self-manage mental health problems, will reduce the risk of somatic illness in both groups. For DUD patients, available sterile user equipment will reduce the risk of viral hepatis. Keywords: Alcohol use; Diseases; Drug use; Mental illness; Socioeconomic status; Somatic © 2023 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).The burden of somatic diseases among people with alcohol- and drug use disorders are influenced by mental illness and low socioeconomic status. A registry-based cohort study in NorwaypublishedVersio

Incidence of SARS-CoV-2 and all-cause mortality in persons with co-occurring substance use disorder and mental illness during the pandemic: a Norwegian cohort study

Purpose - Most people were affected by the COVID-19 pandemic. Persons with co-occurring substance use disorder (SUD) and mental illness (MI) are already a marginalized group, with above average mortality. Thus, the study aim was to investigate SARS-CoV-2 incidence and mortality among persons with SUD/MI during the first two years of the pandemic. Methods - This historical cohort study merged data from the Norwegian Patient Register, the Norwegian Surveillance System for Communicable Diseases and census data from Statistics Norway. We calculated crude mortality rates for persons with SUD and mild/moderate vs. severe MI and compared them to persons with physical illnesses or healthy controls. The incidence rate ratios for SARS-CoV-2 infection and mortality were estimated using Poisson regression models. Results - Compared to healthy controls, the SARS-Cov-2-infection rate was marginally lower in persons with SUD and mild/moderate MI (IRR,1.19 [95%CI,1.09–1.30]) as in persons with physical illness (IRR,1.35 [95%CI, 1.23–1.47]), whereas persons with SUD and severe MI showed a lower rate compared to healthy controls. Crude mortality rates for persons with SUD/MI were substantially higher and increased much more during the pandemic than for persons with physical illnesses or healthy controls. The IRR for mortality in persons with SUD and mild/moderate MI was 10.61 (95%CI,7.19–15.67) and 11.44 (95%CI,7.50-17.45) for SUD and severe MI, compared to 5.03 (3.34–7.57]) for persons with physical illnesses only. Conclusion - The analysis showed excess mortality during COVID-19-pandemic for SUD/MI, but without higher SARS-CoV-2 infection rates in this group. Consequently, excess mortality among persons with SUD/MI was not due to SARS-CoV-2 infection

Smoking among inpatients in treatment for substance use disorders: prevalence and effect on mental health and quality of life

Background - Smoking is still prevalent among people with substance use disorders. The objective of this study was to investigate the prevalence of smoking among patients in treatment for substance use disorders and to analyze the effect of smoking both at baseline and follow-up on drop-out, mental health and quality of life. Methods - One hundred and twenty-eight inpatients (26% female), mainly with alcohol use disorder, staying at three different rehabilitation clinics in Eastern Norway, were interviewed at admission, and at 6 weeks and 6 months follow-up. The interview contained mental health-related problems, trauma, questions on alcohol and other substances and quality of life. Non-parametric tests were used to test group differences and unadjusted and adjusted linear regression to test the associations between smoking and the main outcome variables, while logistic regression was used to test the association between smoking and drop-out. Results - At admission, 75% were daily smokers. Compared to non-smokers at baseline, the smokers had higher drop-out rates (37% vs. 13%), more mental distress, and lower quality of life from baseline up to 6 months follow-up. Those quitting smoking while admitted improved in mental distress and quality of life at the same rate as non-smokers. Alcohol-related factors did not differ between smokers and non-smokers. Conclusions - Smoking was associated with mental distress, quality of life and treatment drop-out among patients in primary alcohol use disorder treatment. The results indicate that smoking cessation should be recommended as an integral part of alcohol use treatment both before and during inpatient treatment to reduce drop-out

ADHD symptoms as risk factor for PTSD in inpatients treated for alcohol use disorder

Attention deficit hyperactivity disorder (ADHD) and post-traumatic stress disorder (PTSD) are more common in alcohol use disorder (AUD) patients than in the general population. Still, there is a lack of knowledge about the relationship between the two conditions in these patients. The main objective of this study was to examine the prevalence of ADHD symptoms, and the relationship between ADHD symptoms and PTSD in AUD inpatients in treatment. Data from 85 AUD patients were collected. The Adult ADHD Self-Report Scale (ASRS) was used to measure ADHD symptoms in all patients. Differences between groups split by PTSD diagnosis and by ASRS clinical cut-off were described, and the relationship between ADHD symptom level and PTSD was tested in a multiple regression model. Almost half the patients scored above ASRS cut-off and 14% had PTSD. Of the patients whose score was above cut-off on the ASRS 23% had PTSD, versus 7% among those below cut-off. Higher ASRS score was associated with PTSD even when age, sex and trauma were adjusted for. This study confirms the high level of ADHD symptoms in AUD patients in treatment. Diagnostic evaluation of PTSD is recommended in patients with ADHD attending inpatient treatment programs for AUD