Search results

Housing First (HF) is an evidence-based practice effective in reducing homelessness among those who experience chronic homelessness. However, a strong synthesis evaluating the effectiveness of this intervention is lacking for people who use drugs. The purpose of this study is to explore international literature databases to identify the effectiveness of the HF programme among people who use drugs.

A modified framework from Arksey and O’Malley (2005) was used, namely: identifying the research question; developing inclusion and exclusion criteria; identifying relevant studies for study selection; charting the data; and collating, summarising and reporting the results.

Three main themes were identified: substance use related outcomes, housing-related outcomes and social outcomes. There is strong evidence that HF increases housing retention and reduces homelessness among chronically homeless people who use drugs. However, literature relating to substance use and social outcomes for this population report mixed and inconclusive findings.

This scoping review concludes that additional research is required to conclusively determine whether HF is an effective intervention for homeless substance users. Future researchers must use formal assessments of substance use and ensure clear reporting of the HF intervention is accomplished. It is recommended for researchers and policymakers to consider the specific needs of the people who use drugs before implementation of HF for this population.

Differential effectiveness of HF through diagnostic subgroups such as alcohol use and drug use is varied with alcohol use being found to decrease due to the HF programme, but findings relating to other drug use outcomes are varied. As most previous studies used the Addiction Severity Index (ASI) to measure substance use among participants, however, the ASI, a self-reporting measure has unstable criterion validity and can cause under or over reporting of substance use. Structured toxicology or diagnostic assessments of substance use must be used for research instead to assist researchers in making firm conclusions about the reported rates.

The slightly poorer housing outcomes among people who use substances indicate that this group may need more intensive approaches to finding and maintaining housing. Additional services for the group that address comorbid problems and consequences relating to substance use are required. It is suggested that housing should be provided within an integrated model that offers additional support services such as case management as when well matched to clients, case management appears to be an effective intervention among homeless sub-populations, as it reduces substance use, improves quality of life and health outcomes, improves social connectedness and increases housing tenure and satisfaction.

This scoping review concludes that additional research is required to conclusively determine whether HF is an effective intervention for homeless substance users. Future researchers must use formal assessments of substance use and ensure clear reporting of the HF intervention is accomplished. It is recommended for researchers and policymakers to consider the specific needs of the people who use drugs before HF implementation for this population.

Psychedelic drugs can induce altered states of consciousness characterised by changes in visual perception, tactile sensation, cognition, and emotion. Although there is a history of misinformation surrounding these drugs, recent investigation has reinvigorated interest. However, little research has assessed the attitudes of psychedelic consumers regarding these substances. The current study aims to explore the attitudes and perceptions of people with experience with psychedelic drugs, specifically surrounding psychedelic drugs themselves and their use within Aotearoa New Zealand.

Nineteen individuals with experience of psychedelic use were recruited to participate across eight groups in semi-structured, exploratory interviews, where a range of topics associated with psychedelics were discussed. Reflexive thematic analysis of the data focussed on participants’ current perceptions and attitudes.

Four themes were produced: (1) a negative historical influence on current perceptions of psychedelics; (2) knowledge is key but not everyone has it; (3) prohibition is not working, policy needs to change; (4) psychedelics have therapeutic potential. These themes emphasise key features of people with experience of psychedelic drugs’ current views and highlight potential areas for future investigation and intervention.

Findings indicate a need for greater public knowledge and awareness of psychedelics in Aotearoa society. Findings also inform information, education and policy, which in turn will reduce the stigma and associated harm that those who have used or use psychedelic drugs may experience.

To the best of the authors’ knowledge, qualitative research aiming to understand attitudes and perspectives surrounding psychedelic drugs and their use from a drug users’ perspective have not yet been assessed.

Cannabis as a recreational drug is prohibited in Nigeria. Consequently, the open use of cannabis attracts both formal and informal sanctions. As such, there is much stigma on users' faces across social spaces. This has led to innovations in drug use. Recently, non-medical use of tramadol has been rising across each of the gender categories. This study aims to understand (1) tramadol use prompts, (2) the sudden surge in gendered recreational use of tramadol and (3) the gendered challenges of recreational tramadol use among Nigerian university students.

Data were collected between December 2021 and October 2022. The researcher conducted 20 semi-structured interviews, with participants chosen purposefully from acquaintances and others selected through chain referral. The selection criteria included knowledge of a particular tramadol tablet and willingness to participate. This study got ethical approval from the Anambra State Ministry of Health (Ref: MH/AWK/M/321/354) and oral consent was obtained before the interviews. The participants were assured of confidentiality. The interviews were conducted in English (the formal Nigerian language) and lasted between 30 and 65 min. The data collected were transcribed and coded manually, and themes generated.

Findings suggest that peer pressures accounted for entry-level drug use. However, cannabis-related stigma is attributed to the surge in tramadol use across gender categories. Furthermore, academic pressure and sexuality are major reasons for tramadol use. The challenges associated with tramadol use include headaches and addiction.

This study, to the best of the author’s knowledge, presents alternative data on the surge in tramadol use among Nigerian university students.

Additive manufacturing (AM), also known as three-dimensional (3D) printing technology, has been used in the health-care industry for over two decades. It is in high demand in the health-care industry due to its strength to manufacture custom-designed and personalized 3D constructs. Recently, AM technologies are being explored to develop personalized drug delivery systems, such as personalized oral dosages, implants and others due to their potential to design and develop systems with complex geometry and programmed controlled release profile. Furthermore, in 2015, the US Food and Drug Administration approved the first AM medication, Spritam® (Apprecia Pharmaceuticals) which has led to tremendous interest in exploring this technology as a bespoke solution for patient-specific drug delivery systems. The purpose of this study is to provide a comprehensive overview of AM technologies applied to the development of personalized drug delivery systems, including an analysis of the commercial status of AM based drugs and delivery devices.

This review paper provides a detailed understanding of how AM technologies are used to develop personalized drug delivery systems. Different AM technologies and how these technologies can be chosen for a specific drug delivery system are discussed. Different types of materials used to manufacture personalized drug delivery systems are also discussed here. Furthermore, recent preclinical and clinical trials are discussed. The challenges and future perceptions of personalized medicine and the clinical use of these systems are also discussed.

Substantial works are ongoing to develop personalized medicine using AM technologies. Understanding the regulatory requirements is needed to establish this area as a point-of-care solution for patients. Furthermore, scientists, engineers and regulatory agencies need to work closely to successfully translate the research efforts to clinics.

This review paper highlights the recent efforts of AM-based technologies in the field of personalized drug delivery systems with an insight into the possible future direction.

This study aims to evaluate the delivery of a virtual community-based mental health and substance use program for Filipino drug users during the COVID-19 pandemic.

It used a randomized control longitudinal design with data collected prior to the program and every two months for 10 months. The programs focused on building recovery skills, life skills and family modules. Program length ranged from a brief intervention of three sessions to 24 sessions depending on whether clients were low risk, moderate risk or those arrested for drug use.

Results revealed significant improvements in recovery skills of participants in the treatment group compared to those in the control group. Mental health illness symptoms decreased for both control and treatment groups; however, no differences were found in recovery capital and cravings.

The lack of significant changes in certain variables, such as recovery capital, requires more data to understand the barriers to enable greater recovery. The study was limited to virtual delivery of rehabilitation services conducted during the COVID-19 pandemic. Future studies may wish to compare modalities of online and onsite delivery to enable a comparison of effectiveness.

Results suggest the feasibility of virtual delivery of mental health and substance use treatment implemented by trained paraprofessionals. However, it also highlights the necessity to build the capacity of service providers and address connectivity challenges.

Stigma and discrimination prevent people who use drugs from seeking treatment. Virtual delivery of mental health and substance use treatment can provide a platform where people can seek help while maintaining some privacy.

The study provides evidence from under-represented populations – persons who use drugs in the Philippines.

The pharmaceutical industry is facing significant pressure to tackle antimicrobial resistance (AMR). Other ecological, societal and regulatory pressures are also driving the industry to “go green”. While such a (green) transition could be possible through appropriate green practices’ implementation, the present understanding about it is superficial and vague. A key reason is the lack of green practices’-related studies on pharmaceuticals, which are also insufficiently comprehensive. This knowledge gap is sought to be addressed.

A systematic literature review (SLR) was conducted with 73 carefully selected articles, then subjected to thematic content analyses for synthesising the relevant themes and sub-themes.

Around 76 operational-level green practices covering all key stakeholders across the drug lifecycle were identified. It was revealed that designing drugs having accelerated environmental degradability is important to combat AMR. Also, redesigning existing drugs is environmentally more resource-intensive than developing new ones with significant cost-saving potential in solvent recycling and flexible manufacturing, both of which are not common at present. With regards to green-related barriers, stringent quality requirements on drugs (and therefore risks in making relevant green-oriented modifications) and time-consuming and costly regulatory approvals were found to be the key ones.

The operational green practices’ framework developed for individual pharmaceutical supply chain stakeholders could help practitioners in benchmarking, modifying and ultimately, adopting green practices. The findings could also assist policymakers in reframing existing regulations, such as Good Manufacturing Practices or GMP-related, to promote greener drug development.

This work is the first systematic attempt to identify and categorise operational-level green supply chain practices across stakeholders in the pharmaceutical sector.

• •

  Biodegradability of drugs is more important than environmental degradability.

• •

  Flexible manufacturing process design (or quality by design) reduces resource wastage.

• •

  Ecopharmacovigilance is effective in combating PIE and AMR-related issues.

• •

  Upstream and downstream coordination is key to greening pharma operations.

• •

  Costly and time-consuming regulatory approval is a key barrier to greening pharma processes.

Biodegradability of drugs is more important than environmental degradability.

Flexible manufacturing process design (or quality by design) reduces resource wastage.

Ecopharmacovigilance is effective in combating PIE and AMR-related issues.

Upstream and downstream coordination is key to greening pharma operations.

Costly and time-consuming regulatory approval is a key barrier to greening pharma processes.

Anchored with turbulence emanating from the COVID-19 pandemic, the work environment has become more stressful with debilitating effects on the well-being of employees. Employees rely on varying means of coping including drug abuse. However, the association between drug abuse and suicidal thoughts among employees in Ghana is unknown. Therefore, this study sought to examine the relationship between drug abuse and suicidal thoughts among employees in Ghana.

In a cross-sectional survey, this study purposively sampled 470 employees from three sectors of the Ghanaian economy (telecommunication, banking and manufacturing). The data was analysed using the multivariate analysis (MANOVA), Pearson’s r test and hierarchical regression.

Analysis of data revealed a positive relationship between drug abuse and suicidal thoughts, indicating that drug abuse is a risk factor for suicidal thoughts. Besides, it was also revealed that banking sector employees have a higher risk of having suicidal thoughts than employees in the telecommunication and manufacturing sectors.

Managers of organisations need to redesign work to embrace the challenging circumstances brought about as a result of COVID-19 and post-COVID implications. The work environment needs to be more supportive to shield employees from the physical and emotional demands of work during and after this period of the COVID-19 pandemic. Today than ever, investment in the implementation of employee-assisted programmes (EAPs) and employee well-being programmes (EWPs) to equip employees with the needed skills to cope with stressful conditions has been more than justified.

From a broader perspective, this study identifies drug abuse as a key risk factor for suicidal thoughts among employees, thereby highlighting the fact that smoking cessation programs and drug management therapies are an integral part of well-being programmes aimed at establishing equilibrium and gradually creating a wide gap between employees and suicidal thoughts.

Drug prevention programs typically focus on providing information on the effects of drugs and developing refusal skills. However, there is evidence that adolescents use substances to cope with stress. As such, integrating mental health literacy is important in prevention programs. The purpose of this study was to test a video-based mental health and substance prevention program for Filipino youth.

The study used a cluster randomized trial and mixed methods design with 623 Filipino adolescents from 12 to 18 years old. The program consisted of six sessions focusing on stress, adaptive coping, effects of substances and drug refusal skills. It uses short psychoeducation videos along with self-reflection, and discussions to increase learner engagement.

Results revealed a significant increase in knowledge and negative attitudes toward substance of participants in the intervention group compared to the control group. Those in the intervention group reported improved use of adaptive coping skills particularly cognitive reappraisal, social support, problem-solving and relaxation compared to the control group.

This study adds to the literature on prevention from under-represented and non-Western contexts such as the Philippines. This study highlights how technology-mediated and integrated mental health and substance use programs can be useful in countries with few resources for mental health.

New psychoactive substance (NPS) use in mental health and addiction health-care services is a common co-morbidity. This paper aims to explore the survey responses with health-care professional’s (HCPs) engagements and experiences towards people who use NPS in five health-care services.

A theoretically adapted online survey design explored the engagements and experiences of participants towards people who use NPS across (n = 3) community and (n = 2) rehabilitation mental health and addiction health-care services consisting of (n = 1,027) service users.

A total of 92 participants (of 120 participants) completed the survey and 28 did not. Most (56.33%) reported neutral to poor experiences and engagements and a lack of NPS-related policies, procedures and educational training. Participants (99%) recognised the harmful effects of NPSs and (87%) requested clinical assessment procedures. The participants are unable to identify and manage acute intoxication by NPS, lack knowledge of NPS adverse effects and requested NPS-specific training on drug legislation.

The sample may not be representative with the broader UK population. The study’s methods are comparable to similar research surrounding NPS in health-care services. Similar studies may advance the findings.

The implications for practice include NPS awareness trainings, educational updates through seminars and conferences. Participants requested clearer NPS assessment, referral and management processes. Several policy-making and procedural opportunities exist to ensure a better health outcome for people who use NPS.

To the best of the authors’ knowledge, this is the first theoretically adapted survey to explore participant’s engagements and experiences with people who use NPS in addiction and mental health settings.

The correctional system continues to face challenges with responding to and managing methamphetamine use among incarcerated individuals. This study aims to uncover what resources and policies could better help correctional workers deal with these challenges. The authors also examined methamphetamine’s impact on correctional work and staff well-being.

An online survey was distributed to correctional workers (n = 269) in Manitoba, Canada, featuring questions about their experiences related to methamphetamine use in populations under their care, what supports are needed to adequately address the concern, and the potential effects on self and their occupational responsibilities. Using NVivo software, survey responses were analysed using an emergent theme approach.

Correctional workers believed policies and protocols for managing methamphetamine use and withdrawal are currently inadequate. Correctional workers reported having monthly contact with incarcerated individuals experiencing methamphetamine withdrawal, posing safety concerns to them and other incarcerated individuals. Respondents proposed more education and training on managing incarcerated people withdrawing from methamphetamines, related to the symptoms of use and withdrawal and how to support persons detoxing. Increased human and material resources were reported as being needed (e.g. more nurses onsite and better screening devices). Respondents also desired more medical intervention, safe living spaces for methamphetamine users and programming to support addiction.

The current study unpacks correctional workers’ perspectives, support desires and their experiences managing methamphetamine use amongst incarcerated people. The authors discuss the required knowledge to respond to gaps in prison living, re-entry and related policy needs.