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This paper aims to present the theoretical foundation and practical approach of “open-target addiction treatment” (OTAT). Traditional treatment programmes are usually-oriented towards fixed predefined goals (abstinence, reduced consumption and harm reduction) and often focus on one substance only (e.g. alcohol). However, as a rule, people who use drugs consume several substances and sometimes additionally exhibit behavioural addictions. For many of these addictions, there is more or less motivation for change, but commonly it is not abstinence as a consistent goal. The paradigm of OTAT systematically considers multi-substance use, expects high readiness to change and is aware that commonly clients lack the willingness to abstain permanently.

The theory and practice of OTAT involve three components, namely, first, to create a systematic inventory of all psychoactive substances consumed and addictive behaviours performed, second, to clarify, which substance-related change goals clients pursue and third, to choose adequate treatment options matching the substance-specific goals of the clients. Furthermore, OTAT includes didactic tools to support working along with these three steps (e.g. a set of cards to gain an overview over the psychoactive substances used and addictive behaviours performed).

The systematic implementation of OTAT requires fundamentally different concepts about addiction and its treatment, specific competencies of the staff and a corresponding portfolio of interventions within the treatment facilities.

Future research should focus more on patients’ goal preferences and their impact on their willingness to take up treatment and its outcomes.

To implement OTAT treatment, institutions have to undergo a systematic process of team and organizational development.

OTAT has the potential to reduce the treatment gap and to serve severely addicted individuals in a more comprehensive way.

The OTAT approach has not been described in the addiction treatment literature so far.

The Philippines’ nationwide campaign on drugs has been under the limelight due to its controversial approaches in dealing with the problem of addiction. Despite the government’s current efforts, substance use disorders continue to persist within the population. The purpose of this paper is to provide recommendations for addressing the issue of substance use disorder treatment through a modification of the therapeutic community (TC) in the Philippine context.

This conceptual paper reviews the existing facts about the Philippines’ campaign against drugs, the approaches implemented by the government, current state and research developments of TCs, and its resulting impact on contemporary evidence-based treatment for addiction in the country.

A treatment framework outlining a recovery-oriented therapeutic community (ROTC) is presented. The ROTC aims to address addiction as a chronic, relapsing disease. This alternative approach for addiction treatment in the Philippines is based on the concept of recovery, principles of effective substance use disorder treatment, and recent developments in TC best practices from the international community.

This paper discusses different recommendations for policy development, interventions and research, aimed at improving the odds of securing recovery for people suffering from addiction.

Evidence suggests that the percentage of men seeking treatment for substance use disorders and other addictive behaviours is significantly higher than that of women. This fact raises several crucial questions concerning the field of addictions. This paper aims to emphasize to the study of addiction in the light of gender studies and especially in the light of theories of dominant/hegemonic masculinity.

The perspective of dominant/hegemonic masculinity in the field of addictions raises a number of questions: Can the dominant/hegemonic masculinity perspective contribute to the understanding of the phenomenon of addiction? What are the implications of male-dominated and male-centred treatment services on meeting the needs of other populations? Are androcentric approaches ultimately helpful for heteronormative men? This paper investigates the emerging questions through a critical review of the literature including the disciplines of psychology, sociology and anthropology.

The perspective of hegemonic masculinity can make an important contribution to the understanding of addiction as it sheds light on a dimension that is not well researched and used in the field of addictions. The influences of the androcentric approach to addiction treatment are significant and pose problems both in accessing and serving the needs of other populations. The androcentric approach to treatment is not helpful for heteronormative men either as there is a risk of not addressing the toxic dimensions of dominant/hegemonic masculinity that are directly linked to the problem of addiction.

This paper poses interesting research questions for further research in the field.

This paper raises important issues for practitioners in the field and at the same time suggests alternative perspectives on the interpretation and treatment of addiction.

The gender perspective that should further enrich psychosocial interventions is crucial for the equal access of all people with an addiction problem to appropriate support structures.

Gender studies can make an important contribution to further understanding of addiction problems and to the development of effective practices for dealing with it. The fact that in substance abuse treatment programmes the vast majority of participants are heteronormative men raises a number of concerns. These concerns relate to the extent to which structures are directed at meeting the needs of these men and whether because of this orientation the needs of other populations such as heteronormative women and those who do not meet the norms of heteronormativity are left uncovered. These concerns are linked to broader considerations of the role that dominant/hegemonic masculinity plays in the aetiology of addiction and in creating barriers to help-seeking for heteronormative men themselves.

Substance abuse is a major public health concern, with over millions of people suffering from it worldwide. Although there is an abundance of treatment options, many of these rehabilitative trajectories are subject to “drop-out”. In addition, “drop-out” is a significant risk factor for relapse. There is an urgent demand for effective treatment, which would enable patients to reduce abuse and prevent relapse. Takiwasi is an addiction treatment centre that combines traditional Amazonian plant medicine with conventional western medicine and psychotherapy. The purpose of this paper is to explore whether socio-demographics factors, such as education level and occupation, psychiatric comorbidities and primary drug use, are associated with treatment non-completion of Ayahuasca (AYA)-assisted addiction therapy.

Data on the first treatment episode of 121 patients were collected from the patient database from the years 2012 to 2017. To determine whether there is an association between the variables of interest and treatment non-completion, a χ² analysis and a logistic regression analysis were performed.

Of the 121 patients analysed, 48.2 per cent completed their treatment, whilst 51.8 per cent did not. Students compared to those who are employed showed significantly higher odds for treatment non-completion (p=0.006; OR=3.7; 95% CI=1.5–9.6). Other variables in the multivariable analysis showed no significant relationship with treatment non-completion. While several limitations restricted the study, the findings suggest that the AYA-assisted treatment in Takiwasi may benefit from additional support for patients who are students. Moreover, it is advised to conduct more long-term follow-up of patients in order to gain better insight into the outcome of treatment at an AYA-assisted treatment centre.

It appears that AYA-assisted therapy in a therapeutic community is a feasible type of treatment for addiction, for which further studies should elucidate the role of motivation in relation to socio-demographic factors and type of addiction in the risk of treatment non-completion.

The purpose of this paper is to show that despite welfare retrenchment and political rhetoric towards welfare, spending on residential addiction treatment should be protected.

Examining benefits in context of costs, the research used social return on investment to monetise benefits and compare with costs. Based at a residential addiction centre, the research used questionnaires and focus groups with residents and former residents.

The centre created almost £4 of benefit for every £1 of cost. Whilst the bulk of savings came from health, housing and criminal justice, there was also a regenerative impact for the local economy.

Sampling in sensitive themes is always problematic, however, the research had contact with many respondents, achieved data saturation and used the centre's success rate as a guide to weight the findings.

The benefits of addiction treatment go beyond health outcomes and raise questions about how this should be reflected in cost distribution. Consequently, this has implications for the ways in which addiction services should be measuring their successes beyond solely health outcomes.

Existing research has largely overlooked the benefit of addiction treatment to the local economy and the fact that, as an investment, this benefit will continue to grow as more people enter the labour market over time.

The research recognises the political context of funding and measures success beyond solely health outcomes. Furthermore, the research recognises the regenerative impact of addiction treatment, which is often overlooked in similar research.

With expanded technologic and communication resources there is growing awareness worldwide of the public health problems caused by alcohol, tobacco, and other drug use, misuse, abuse and addiction. Trends vary by culture and region but use of tobacco and alcohol is almost universal and is associated with high rates of mortality and morbidity. While nurses have not universally embraced the prevention and treatment of substance‐related disorders as their province, this is changing as a function of organisations, World Health Organization (WHO) and national initiatives, and the strengthening of nurse education. Actions to promote consensus, identify and review competencies for nurses must consider national and cultural variations, traditions of social change and the need for evidence‐based practice. Collective action by nurses in newly formed and existing organisations, which focus on addictions prevention and treatment, have resulted in initial professional steps. Such progress can be facilitated if achieved in the context of larger international policies and initiatives and in collaboration with members of other professional disciplines.

CrossFit has been popularized for the high intensity workouts it provides and the sense of community it facilitates; however, its potential as an adjunctive treatment for addiction is unknown, as is has not been published in traditional peer-reviewed literature. Therefore, the purpose of this study was to determine the potential for CrossFit to benefit individuals in addiction recovery.

A search was conducted using the search terms “CrossFit,” “addiction” and “addiction recovery.” A tool was created to categorize key information within articles such as type(s) of addiction described, mention of support/community, main narrative type (personal story, information about a treatment centers, etc.), mental health described as a comorbidity, and if the exercise program(s) was(were) used to prevent, sustain or support recovery.

Nearly half of the articles reviewed (48 per cent) described personal stories related to using CrossFit as a means to overcome addiction, and 26 per cent were about CrossFit gyms targeting addiction recovery. A key finding was that 62 per cent of all articles mentioned the community and social component of CrossFit as an important mechanism of the recovery process. Finally, 33 per cent of articles recognized mental health as a comorbidity to addiction and therefore also proposed CrossFit as a suitable way to improve mental health.

Although this was a review of gray literature, the findings reveal how CrossFit may be an innovative approach for supporting addiction recovery.

The potential benefits identified in the articles demonstrate the positive impact that CrossFit may have on recovering addicts. Empirical research is needed to objectively study the impact of key aspects that CrossFit can provide to individuals overcoming addiction.

This study provides an example of how anecdotal evidence of addiction recovery can be used for analysis, thus providing a strategy to be implemented in addiction treatment facilities. CrossFit has been widely popularized by the fitness community, but the social support and exercise it provides may be a leverage point for supporting individuals in recovery.

The purpose of this paper is to examine the shifting roles of medical professionals as stakeholders in opioid substitution treatment (OST) policies and practices in Denmark and the UK within the past 15 years.

The paper is based on literature reviews, documentary analyses and key informant interviews with a range of stakeholders involved in OST and policy in Denmark and UK. The study is part of the EU-funded project: Addictions and Lifestyles in Contemporary Europe: Reframing Addictions Project.

Denmark and the UK are amongst those few European countries that have long traditions and elaborate systems for providing OST to heroin users. The UK has a history of dominance of medical professionals in drugs treatment, although this has been recently challenged by the recovery movement. In Denmark, a social problem approach has historically dominated the field, but a recent trend towards medicalisation can be traced. As in all kinds of policy changes, multiple factors are at play when shifts occur. We examine how both countries’ developments around drugs treatment policy and practice relate to broader societal, economic and political changes, how such divergent developments emerge and how medical professionals as stakeholders enhanced their roles as experts in the field through a variety of tactics, including the production and use of “evidence”, which became a key tool to promote specific stakeholder’s perspectives in these processes.

The paper contributes to current policy and practice debates by providing comparative analyses of drug policies and examination of stakeholder influences on policy processes.

Heterogenic care of addicted detainees in the various prisons in the Netherlands triggered the National Agency of Correctional Institutions of the Ministry of Justice, to order the Dutch Institute for Health Care Improvement (CBO) to formulate the first national guideline titled ‘Pharmacological care for detained addicts’. This article presents the content of this guideline, which mainly focuses on opioid‐dependent addicts. In the Netherlands, approximately 50% of the detainees are problematic substance abusers, while again half of this group suffers from psychiatric co‐morbidity. In addition, somatic co‐morbidity, especially infectious diseases, is also common. Due to the moderate outcome seen with voluntary drug counselling regimes in prison, there is a policy shift to extent utilization of legally enforced approaches. Continuity of care is of great importance. In case of opioid addicts this, in general, means continuation of methadone maintenance treatment. Aftercare immediately after detention and optimalization of medical information transfer is crucial. This guideline aims to realize optimal and uniform management of addiction disorders in the Dutch prison system.

The purpose of this paper is to explore the prevalence and profile of mothers among women who sought treatment for drug addiction, as well as the therapeutic progression of these patients.

A sample of 180 Spanish women with addiction problems was assessed. Information was collected on the patients’ socio-demographic characteristics, consumption variables and psychological symptoms.

Of the total sample, 22.2 per cent (n = 40) of the women seeking treatment for substance use disorder were mothers. Compared with women without children, mothers scored significantly higher on several EuropASI and psychological variables. Specifically, mothers presented with more medical problems, worse employment/financial situations, and more severity in alcohol use. Moreover, having a history of lifetime physical and/or sexual abuse was related to belonging to the group of mothers. Regarding therapeutic progression, no statistically significant differences in the retention rate were found between mothers and non-mothers.

The results of this study show that mothers generally have more severe problems than non-mothers. Therefore, comprehensive, continuum-based, and client-centred care for mothers is paramount for effective treatment in mothers. The implications of these results for further research and clinical practice are discussed.