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Article

Christos Kouimtsidis, Daniel Stahl, Robert West and Colin Drummond

The purpose of this paper is to develop a brief outcome expectancies questionnaire applicable across nicotine, alcohol, opioid and stimulant users seeking or willing to…

Abstract

Purpose

The purpose of this paper is to develop a brief outcome expectancies questionnaire applicable across nicotine, alcohol, opioid and stimulant users seeking or willing to seek treatment and to assess its construct and predictive validity.

Design/methodology/approach

The items were generated using semi-structured interviews. A cross-sectional study was used to determine the factor structure and internal reliability, to compare the factor structure across the groups and to assess construct validity. Scores were used to predict reduction in dependence at three-month follow-up.

Findings

The qualitative study produced 98 items. For the cross-sectional study 99 nicotine, 96 alcohol, 98 opioid and 77 stimulant misusers were recruited. Factor analysis produced a two-factor (positive and negative expectancies) solution, similar across groups. A 28-item common version had scale correlations above 0.94 with the long versions of each group, and high internal consistency (Cronbach's α>0.90). The Positive expectancies sub-scale was positively correlated with urges across all groups, and negatively correlated with self-efficacy in three groups. Negative sub-scale scores were positively correlated with motivation sub-scales and self-efficacy in three groups. Urges and negative expectancies predicted reduction of dependence at three months.

Research limitations/implications

The study suggested that outcome expectancies are similar across substance sub-groups. The new tool appears to have good construct and predictive validity. Further validation with larger samples is required.

Originality/value

This is the first tool to measure outcome expectancies across substances, facilitating relevant research with poly-substance users.

Details

Drugs and Alcohol Today, vol. 14 no. 4
Type: Research Article
ISSN: 1745-9265

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Article

Judith Aldridge

The purpose of this paper is to introduce the five papers comprising this special issue on post‐millennium trends in young people's substance use in the UK. The positions…

Abstract

Purpose

The purpose of this paper is to introduce the five papers comprising this special issue on post‐millennium trends in young people's substance use in the UK. The positions taken by the authors of each of the papers in the issue are compared with respect to their conclusions on how best to reduce harmful outcomes for young people in relation to their substance use, and what role exists for health education in this process.

Design/methodology/approach

The approach takes the form of a narrative review of the papers in the issue.

Findings

Across substances (alcohol, tobacco and illicit drugs), the authors identify slight downward trends in population prevalence of use by adolescents and young adults since 2000. This downward trend follows some fairly steep rises during the 1990s, resulting in levels of use remaining historically relatively high. The importance of global and demographic changes is identified as being important in understanding the (arguably somewhat limited) scope for changing youthful behaviour. The different recommendations for how to reduce harmful outcomes for young people are discussed: modifying the context/environment of use (for alcohol and tobacco), drugs treatment (for drug‐using offenders), tackling inequality and disadvantage (for heroin and crack cocaine).

Practical implications

Two key roles for health educators are identified: first, supporting mechanisms already known to be effective in reducing use/harmful use such as smoke‐free environments; second, providing an “expert” source of information used by the vast majority of young people who both want and require this on their lifelong health and drug “journeys”. Health education should have a harm reduction role; measuring success in terms of reducing population prevalence of substance use may be inappropriate and unrealistic.

Originality/value

Important insights are gained into substance use trends by young people when UK trends are set alongside international trends, and when all the psychoactive substances consumed are considered together.

Details

Health Education, vol. 108 no. 3
Type: Research Article
ISSN: 0965-4283

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Article

Julian Strizek, Alexandra Karden and João Matias

The purpose of this paper is to assess the relevance of cryptomarkets, characteristics of purchasers and possibilities for survey research by approaching users directly on…

Abstract

Purpose

The purpose of this paper is to assess the relevance of cryptomarkets, characteristics of purchasers and possibilities for survey research by approaching users directly on cryptomarkets.

Design/methodology/approach

Cross-country comparison of the results from the European Web Survey on Drugs (EWSD) and summarizing lessons learned during the data collection was carried out.

Findings

Purchasers of drugs on cryptomarkets are still a rather small segment of all drug purchasers, and most people who use cryptomarkets also use other sources of supply to buy drugs. The percentage of people using cryptomarkets is unevenly distributed across countries and substances. Purchasers on cryptomarkets in most countries are more likely to be men and more likely, on average, to use more substances. Other characteristics such as age or place of residence do not show a consistent pattern across countries. Recruitment of respondents on cryptomarkets calls for specific techniques and procedures. Specific attention should be paid to build trust and guarantee credibility and anonymity.

Research limitations/implications

Interpretation of the quantitative results is limited by nonprobabilistic sampling and different recruitment strategies in different countries.

Practical implications

Users of cryptomarkets show some specific characteristics, providing a challenge for research and prevention agencies to keep up with digital technology. Increasing knowledge about characteristics of users of cryptomarkets may help to create adequate responses for harm reduction measures in different supply settings. However, collecting self-reported data from users on cryptomarkets is limited owing to significant privacy concerns and requires specific skills and strategies.

Originality/value

The EWSD provides a rare opportunity for detailed analyses of consumption patterns and characteristics of active drug users across several European countries. Furthermore, experiences of a new recruitment strategy are discussed.

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Article

Alice Bennett and Melanie Hunter

This paper aims to describe: the need for substance misuse treatment with high risk, personality disordered prisoners, and the implementation of two evidence-based…

Abstract

Purpose

This paper aims to describe: the need for substance misuse treatment with high risk, personality disordered prisoners, and the implementation of two evidence-based psychological interventions aimed at addressing substance misuse within a high secure, personality disorder treatment unit and potential future evaluation options.

Design/methodology/approach

In addition to the literature base evidencing the need for substance misuse treatment with this population, the Iceberg and ‘InsideOut’ interventions are presented. These interventions adopt a risk reduction and health intervention approach respectively. This includes explanations of how they came to be implemented within a prison based personality disorder treatment service and potential ways to evaluate these services.

Findings

Evidence-based psychological interventions can be implemented for this population whilst being responsive to changing government priorities for substance misuse treatment. The organisation’s research strategy includes an intention to evaluate these interventions in order to inform future delivery.

Practical implications

The high levels of co-morbidity between personality disorder and substance misuse disorders in the high security prison estate highlights the need for substance related treatment for this population. Given the responsivity issues relevant to personality disordered offenders, the format of delivery of evidence-based psychological interventions has to be considered.

Originality/value

This paper discusses the application of evidence-based psychological interventions for substance use within a high secure, personality disordered population which has developed as a result of ministerial changes within the treatment of both substance misuse and personality disorder.

Details

Advances in Dual Diagnosis, vol. 9 no. 2/3
Type: Research Article
ISSN: 1757-0972

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Article

Andrea M. Sevene, John E. Edlund and Caroline J. Easton

The purpose of this paper is to address a possible interaction of cognitive distortions associated with substance dependency and intimate partner violence (IPV), and the…

Abstract

Purpose

The purpose of this paper is to address a possible interaction of cognitive distortions associated with substance dependency and intimate partner violence (IPV), and the effects on subsequent behavior. The primary focus was to investigate the relationship between offender perception (i.e. perception of family problems (FP) and perception of need for treatment for family problems (FPTx)) and treatment outcome (i.e. substance use and violence), among a unique sample of substance dependent male offenders of IPV. An additional investigation included the change in perception from baseline to the end of treatment.

Design/methodology/approach

In total, 63 participants were randomly assigned to one of two treatment conditions and assessed across 12 weeks of treatment.

Findings

Participants in the (FP+) (i.e. those who perceived family problems at baseline) and (FPTx+) (i.e. those who perceived a need for treatment for family problems at baseline) conditions reported a significantly greater change in the number of days of violence from baseline to the end of treatment, compared to participants in the (FP−) (i.e. those who did not perceive family problems at baseline) and (FPTx−) (i.e. participants who perceived no need for treatment at baseline) conditions. (FP+) and (FPTx+) participants had significant decreases in any violent behavior from pre- to post-treatment.

Originality/value

The results of this study highlight the importance of techniques aimed at improving clients’ ability to recognize and admit to problem behaviors, a critical component of cognitive-behavioral therapy, in an effort to increase their motivation for treatment, thus leading to greater treatment success.

Details

Advances in Dual Diagnosis, vol. 10 no. 2
Type: Research Article
ISSN: 1757-0972

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Article

Cassandra M. Berbary, Cory A. Crane and Caroline J. Easton

The purpose of this paper is to investigate whether aggression and substance use assessed during treatment differ based on risk level for substance-using male offenders of…

Abstract

Purpose

The purpose of this paper is to investigate whether aggression and substance use assessed during treatment differ based on risk level for substance-using male offenders of intimate partner violence (IPV).

Design/methodology/approach

Secondary analyses were conducted using data from Easton et al.’s (2017) study on substance-dependent IPV offenders. A cluster analysis was utilized in order to classify participants into typology groups. Analyses of covariance were conducted in order to determine group differences in aggression and substance use during treatment.

Findings

The paper provides results-related response to treatment based on offender typology. Results appear to reflect two typology groups with significant differences in psychopathy among groups. High-risk offenders demonstrated higher rates of violence throughout treatment compared to moderate- and low-risk offenders; however, no differences in substance use outcomes were found.

Research limitations/implications

A limitation of the study is the extent to which the results can be generalized beyond substance using IPV offenders. Further investigation of treatment outcomes including alternate measures is needed in order to better translate theoretical typologies to clinical settings.

Practical implications

Results provide support for differentiating treatment for substance-using male offenders of IPV based on typology as those with low/moderate risk level appear to be distinctly different and have different treatment outcomes compared to high risk level offenders.

Originality/value

Although the relationship between risk level and treatment outcomes has been researched with Drug Court Offenders, treatment outcomes based on typology has not been evaluated among substance using male offenders of IPV.

Details

Advances in Dual Diagnosis, vol. 11 no. 4
Type: Research Article
ISSN: 1757-0972

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Book part

Betty G. Brown, Julie A. Baldwin and Margaret L. Walsh

Purpose – The purpose of this chapter is to provide a comprehensive overview of the substance use disparities among American Indian/Alaska Native (AI/AN) youth, the…

Abstract

Purpose – The purpose of this chapter is to provide a comprehensive overview of the substance use disparities among American Indian/Alaska Native (AI/AN) youth, the contributing factors to these disparities, proven and promising approaches through strengths-based methods, barriers to implementation of prevention and treatment efforts, and future recommendations for effective programs and research.

Approach – We have conducted a thorough literature review of relevant research studies, as well as a review of government, tribal, and community-based curricula and resources. This review of programs is not exhaustive but provides several examples of best practices in the field and suggestions for future directions.

Social implications – We strongly advocate that to accurately explore the true etiology of substance abuse and to respond to the concerns that AI/AN have prioritized, it is necessary to utilize a strengths-based approach and draw upon traditional AI/AN perspectives and values, and active community participation in the process. More specifically, prevention and treatment programs should use methods that incorporate elders or intergenerational approaches; foster individual and family skills-building; promote traditional healing methods to recognize and treat historical, cultural, and intergenerational and personal trauma; focus on early intervention; and tailor efforts to each Native nation or community.

Value – Ultimately, to reduce substance abuse disparities in AI/AN youth, we must find better ways to merge traditional Native practices with western behavioral health to ensure cultural competency, as well as to develop mechanisms to effect system- and policy-level changes that reduce barriers to care and promote the well-being of AI/AN youth, families, and communities.

Details

Health Disparities Among Under-served Populations: Implications for Research, Policy and Praxis
Type: Book
ISBN: 978-1-78190-103-8

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Book part

Justin T. Denney, Zhe Zhang, Bridget K. Gorman and Caleb Cooley

Purpose: In the current work, we provide a portrait of heavy alcohol use, cigarette smoking, mental health, and suicide ideation by sexual orientation among a large sample…

Abstract

Purpose: In the current work, we provide a portrait of heavy alcohol use, cigarette smoking, mental health, and suicide ideation by sexual orientation among a large sample of US adults aged 25 years and older.

Design/methodology/approach: We produce a repository of information on sexual orientation, substance use, mental well-being, and suicide ideation for adults aged 25 years and older using Behavioral Risk Factor Surveillance System (BRFSS) surveys for nine US states from 2011 to 2018. We establish baseline differences on these outcomes for gay, lesbian, and bisexual (GLB), relative to heterosexual, adults and then use regression techniques to adjust the estimates for important sociodemographic, socioeconomic, and relationship status variables.

Findings: Disparities by sexual orientation across substance use, mental health, and suicide ideation are concerning, some alarmingly so. Bisexuals, particularly women, face pronounced challenges across outcomes. Sexual minority men and women report significantly more poor mental health days and much higher odds of suicide ideation. To illustrate, gay men, lesbians, and bisexual men and women, relative to their heterosexual counterparts, have odds of seriously contemplating taking their own lives that are two to four times higher even after adjusting for relevant controls.

Originality/value: Existing knowledge connecting GLB identity and mental well-being has focused largely on adolescent and young adults. We provide a representative study on older adult differences across four different behavioral health outcomes by sexual orientation. The scale of the disparities we report here, and their implications for overall well-being across groups, deserves national attention and action.

Details

Sexual and Gender Minority Health
Type: Book
ISBN: 978-1-83867-147-1

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Article

Sarah Elison, Glyn Davies, Jonathan Ward, Samantha Weston, Stephanie Dugdale and John Weekes

The links between substance use and offending are well evidenced in the literature, and increasingly, substance misuse recovery is being seen as a central component of the…

Abstract

Purpose

The links between substance use and offending are well evidenced in the literature, and increasingly, substance misuse recovery is being seen as a central component of the process of rehabilitation from offending, with substance use identified as a key criminogenic risk factor. In recent years, research has demonstrated the commonalities between recovery and rehabilitation, and the possible merits of providing interventions to substance-involved offenders that address both problematic sets of behaviours. The purpose of this paper is to provide an overview of the links between substance use and offending, and the burgeoning literature around the parallel processes of recovery and rehabilitation.

Design/methodology/approach

This is provided as a rationale for a new treatment approach for substance-involved offenders, Breaking Free Online (BFO), which has recently been provided as part of the “Gateways” throughcare pathfinder in a number of prisons in North-West England. The BFO programme contains specific behaviour change techniques that are generic enough to be applied to change a wide range of behaviours, and so is able to support substance-involved offenders to address their substance use and offending simultaneously.

Findings

This dual and multi-target intervention approach has the potential to address multiple, associated areas of need simultaneously, streamlining services and providing more holistic support for individuals, such as substance-involved offenders, who may have multiple and complex needs.

Practical implications

Given the links between substance use and offending, it may be beneficial to provide multi-focussed interventions that address both these behaviours simultaneously, in addition to other areas of multiple and complex needs. Specifically, digital technologies may provide an opportunity to widen access to such multi-focussed interventions, through computer-assisted therapy delivery modalities. Additionally, using digital technologies to deliver such interventions can provide opportunities for joined-up care by making interventions available across both prison and community settings, following offenders on their journey through the criminal justice system.

Originality/value

Recommendations are provided to other intervention developers who may wish to further contribute to widening access to such dual- and multi-focus programmes for substance-involved offenders, based on the experiences developing and evidencing the BFO programme.

Details

Journal of Criminological Research, Policy and Practice, vol. 2 no. 4
Type: Research Article
ISSN: 2056-3841

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Article

Jennifer Holly and Gemma Lousley

Against Violence & Abuse (AVA) and DrugScope undertook research into good practice interventions for supporting women involved in street-based prostitution and substance

Abstract

Purpose

Against Violence & Abuse (AVA) and DrugScope undertook research into good practice interventions for supporting women involved in street-based prostitution and substance use. The purpose of this paper is to report on the findings of a survey of service providers and interviews with both service users and providers about women's involvement in prostitution and substance use, their associated support needs and how these can be met by services.

Design/methodology/approach

As part of a mixed methods study, this paper focuses on the findings of interviews with 19 women involved in prostitution and of a survey of and interviews with 64 services that support women involved in prostitution.

Findings

Generic substance misuse services are more likely to associate women's involvement in prostitution with funding their own or their partner's substance use. By comparison, specialist sex work projects are more likely to report women using substances to manage the emotional and physical pain of selling sex. These beliefs impact on the interventions delivered, with specialist services offering a more diverse package of care than generic services.

Research limitations/implications

This study covered predominantly two English regions. A more systematic study of service provision across the UK would be welcomed and could be used to inform guidance for national and local policymakers.

Originality/value

This paper adds to the existing evidence base of “what works” in supporting women involved in prostitution. It is novel in its focus on women involved in prostitution who also use substances and in offering a detailed picture of the types of support currently available in England.

Details

Advances in Dual Diagnosis, vol. 7 no. 2
Type: Research Article
ISSN: 1757-0972

Keywords

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