Aim: To complement existing stakeholder surveys by exploring addiction researchers’ views on the implications of brain-based explanations of addiction and the responsibilities of addicted persons. ...Methods: A total of 190 researchers from 29 countries (13.2%) participated in a LimeSurvey. Their perspectives on implications of brain-based explanations of addiction were explored qualitatively using open-ended questions. In addition, respondents could indicate their views on the responsibility of addicted individuals for their condition and actions using a Likert scale and a free-text field (“mixed methods light”). Qualitative analyses inductively identified the most frequent themes and deductively assessed the overall impact (positive, negative or both/ambivalent). Quantitative analyses included frequencies and proportions. Results: The major themes mentioned were medicalisation and the neglect of other factors, better treatment options and access, (reduced) stigma and (impaired) agency of affected persons. The overall evaluation yielded 46% positive, 33% negative and 16% ambivalent views. Approximately 60% of the participants considered addicted persons to be responsible for their condition and 80% for their actions. Conclusions: According to researchers, a brain-based approach to addictions has positive and negative implications. In particular, the neglect of factors other than biomedical seems to be of concern. Thus, a re-consideration of research priorities as well as affected individuals’ agency and role in treatment and care seems warranted.
Aim: Non-medical use of tramadol and other prescription opioid use has become a great concern in many countries, including Sweden. This study examines key components in young people's accounts of ...attempting to quit drugs, focusing on non-medical use of tramadol. Methods: Repeated qualitative interviews were conducted with 12 individuals aged 19–24 years with experiences of problems related to non-medical tramadol use. The analysis used the concepts of autonomy, competence, and relatedness from self-determination theory. Results: Three themes emerged from the young people's accounts: (1) quitting initiated by parents and professionals; (2) being willing, but unable; and (3) between ambivalence and determination. These themes demonstrate conflicting emotions towards drug use along with a significant external pressure to quit, but also difficulties in quitting due to experiences of dependence, withdrawal symptoms, and mental health issues. For most participants, however, an increasing autonomous will and ability to abstain from drugs gradually developed, with the support from trusted relationships with professionals, family, and friends playing a crucial role. Conclusion: The process of trying to quit non-medical tramadol use can be challenging and involve a complex interaction between willingness and capability, where external influence can be either facilitating or hindering. This study highlights the importance of taking into account young people's own perspectives in treatment efforts, where trust is a key component.
Stale rosnący odsetek recydywistów wśród osób odbywających karę pozbawienia wolności zmusza do zastanowienia się dlaczego osoby opuszczające zakłady karne ponownie do nich wracają w wyniku ...popełnienia przestępstwa. W niemal wszystkich zakładach karnych prowadzone są różne programy mające pomóc osobom zwalnianym w readaptacji społecznej. Jaka jest zatem ich skuteczność, skoro osoby opuszczające zakłady karne nie potrafią funkcjonować w społeczeństwie, przestrzegając norm współżycia społecznego i nadal popełniają przestępstwa. Sami byli skazani jako przyczynę podają iż „piętno” przestępcy utrudnia im znalezienie pracy, mieszkania i wejścia w środowisko osób niekaranych, gdyż ludzie nie mają do nich zaufania i zawsze będą „pierwszymi” podejrzanymi, gdy dojdzie do jakiegoś przestępstwa.W poniższym opracowaniu przedstawiono wyniki badań dystansu społecznego jaki wobec osób karanych przyjmują studenci, którzy po ukończeniu studiów będą być może świadczyli pomoc takim osobom. W badaniu przeprowadzonym w styczniu 2019 r. wzięło udział 381 studentów AEH, UKSW i ABIiP. Jako metodę zastosowano zmodyfikowaną skalę Borgardiusa. Jak wykazały badania z całkowitym brakiem akceptacji niemal we wszystkich rolach społecznych spotkały się osoby karane za znęcanie się nad rodziną, zgwałcenia i wykorzystywanie seksualne osoby małoletniej. Duży dystans społeczny badani studenci zadeklarowali również wobec osób karanych za przestępstwa przeciwko życiu i zdrowiu, a także przeciwko mieniu. Duży dystans badani przyjęli również wobec osób systematycznie nadużywających alkoholu i upijających się, oraz systematycznie używających narkotyków.
Aim:
There is limited knowledge about how inpatients anticipate factors that facilitate the transition between specialised inpatient treatment for substance use disorder (SUD) and the post-discharge ...period. This study explores factors that inpatients anticipated would facilitate such a transition period.
Method:
A focus group study, consisting of four group interviews with individuals in inpatient SUD treatment, was conducted to explore their expectations for the transition and post-discharge period ahead of them. The transcribed interview material was analysed using thematic analysis.
Findings:
The analytical process led to three themes: “Belonging”, “Intrapersonal processes” and “Predictability”. Correspondence between inpatients’ expectations and the services they are offered in the transition and post-discharge period may serve as proper support for inpatients ahead of a vulnerable phase, such as the transition and post-discharge period.
Conclusions:
Findings from the current study highlight overarching elements that inpatients envisioned to be facilitating, such as social support, motivation, self-efficacy, self-awareness and predictability in basic elements such as employment, housing and personal finances. Findings from this study and previous ones imply that certain factors appear to facilitate in vulnerable phases, such as service level transitions. These facilitating factors should be taken into consideration and used as steppingstones through the transition and post-discharge period after inpatient SUD treatment.
Youth Substance Abuse and Co-occurring Disorders not only offers hands-on techniques for diagnosing and treating adolescents with SUD, it advocates for continued clinical and research investment in ...the dual-diagnosis domain, making it a must for clinicians, researchers, and addiction specialists.
Background
Synthetic cannabinoids in smoking mixtures (such as Spice) or as raw powder are sold for recreational use as an alternative to herbal cannabis (hashish and marijuana). Although clinical ...case studies have documented an array of side effects, there is also information available at Internet based drug discussion forums.
Aim
Our study investigates experiences of side effects from use of synthetic cannabinoids, as described and anonymously shared on Swedish online discussion forums.
Methods
A systematic search yielded 254 unique and publicly available self-reports from the Swedish forum flashback.org. These texts were analysed thematically, which resulted in 32 sub-themes, which were combined into three overarching themes.
Results & Conclusion
The experiences of negative side effects were described as (1) Adverse reactions during acute intoxication; (2) Hangover the day after intoxication; (3) Dependency and withdrawal after long-term use. The first theme was characterized by an array of fierce and unpredictable side effects as tachycardia, anxiety, fear and nausea. The acute intoxication reactions were congruent with the side effects published in clinical case studies. The day after intoxication included residual effects of dullness, apathy, nausea and headache. Long-term use resulted in dependency and experiences of being emotionally numb and disconnected. Furthermore, withdrawal was described as sweating, shaking, loss of appetite and insomnia. Both the hangover and the long-term effects have previously been given little scientific attention and need to be investigated further. Drug related Internet discussion forums constitute an overlooked source of information which can aid in the identification of previously unknown risks and effects.
Substance use and addiction is an increasing problem amongst older people. The identification of this problem is often more difficult in older patients and is frequently missed, particularly in the ...primary care context and in emergency departments, but also in a range of medical and psychiatric specialties. Substance Use and Older People shows how to recognise and treat substance problems in older patients. However, it goes well beyond assessment and diagnosis by incorporating up-to-date evidence on the management of those older people who are presenting with chronic complex disorders, which result from the problematic use of alcohol, inappropriate prescribed or over the counter medications, tobacco, or other drugs. It also examines a variety of biological and psychosocial approaches to the understanding of these issues in the older population and offers recommendations for policy. Substance Use and Older People is a valuable resource for geriatricians, old age psychiatrists, addiction psychiatrists, primary care physicians, and gerontologists as well as policy makers, researchers, and educators. It is also relevant for residents and fellows training in geriatrics or geri-psychiatry, general practitioners and nursing home physicians.
Aim
To analyse the Swedish drug question by examining dominant concepts used to portray the problem in the years 1839-2011. Theoretically, we understand these concepts as ideological tools that shape ...the political initiatives and administrative efforts to deal with the problem. The study is based on two kinds of source material: articles in medical journals from the years 1839-1964 and public reports on vagrancy, the alcohol problem, mental health and the drug problem from the years 1882-2011.
Findings
During the nineteenth century and the first part of the twentieth century the drug problem remained an individual problem handled by doctors. When the Swedish drug problem was established as a political question from the 1960s on, it also came to disengage itself from the medical frame of understanding. Medically oriented descriptions of “dependence” and “addiction” have appeared adequate or attractive when, for example, the socially motivated coercive treatment solution has been discredited (as in the 1970s), when there has been a desire to connect with an internationally accepted terminology (as in the 1990s) or when a new organisational model with a stronger professional support has been on the agenda (as in the 2010s). But otherwise the social problem description has called for concepts that have more or less explicitly dissociated themselves from speculations in physiological or psychological predispositions for substance abuse.
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