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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.

As prison drug use continues to be a concern worldwide, harm reduction practices serve as an alternative approach to traditional abstinence-only or punishment-oriented methods to address substance use behind bars. The purpose of this study is to present a summary of research surrounding prison-based harm reduction programs.

This narrative review of the international literature summarizes the harms associated with prison drug use followed by an overview of the literature surrounding three prison-based harm reduction practices: opioid agonist therapy, syringe exchange programs and naloxone distribution.

A collection of international research has found that these three harm reduction programs are safe and feasible to implement in carceral settings. Additionally, these services can effectively reduce some of the harms associated with prison drug use (e.g. risky injection practices, needle sharing, fatal overdoses, etc.). However, these practices are underused in correctional settings in comparison to their use in the community.

Various policy recommendations are made based on the available literature, including addressing ethical concerns surrounding prison populations’ rights to the same standard of health care and services available in the community. By taking a public health approach to prison drug use, harm reduction practices can provide a marginalized, high-risk population of incarcerated individuals with life-saving services rather than punitive, punishment-oriented measures.

Problematic substance use is associated with adverse outcomes that extend beyond the individual, resulting in significant cost to the community through health care, criminal justice and other psychosocial factors, including child protection and family support. These factors create concerns for treatment services, with an increasing demand for cost‐effective solutions to this problem. This paper seeks to address these issues.

This prospective cohort study examined the effect of client variables on retention within a short‐term (56 days) modified therapeutic community (MTC) in the Australian Capital Territory. A total of 28 residents (17 males, 11 females) took part in the study, which included quantitative and qualitative measures.

Results demonstrate a trend in favour of dynamic client variables as effective predictors of retention, with substance use severity being a significant predictor (p=0.023, d=0.91). Content analysis demonstrates that those with severe substance use have more intentions to engage in aftercare.

Short term treatments are seen as providing a gateway to further treatment, especially for chronic substance‐using clients.

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.

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.

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.

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.

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.

The purpose of this paper is to inform the development of an evidence-based and effective rehabilitation programme to address substance use disorders in a population of patients with severe mental illness and mental disorders detained in a secure forensic psychiatric facility. A clinical review identified a high prevalence of substance use disorders in the patient population at a secure forensic facility in Sydney, Australia with only a limited number of patients being assessed and offered interventions for substance use problems.

A literature review was undertaken specifically looking at articles between 2009 and 2017 that considered models of care or approaches to substance use rehabilitation in patients with co-morbid psychiatric disorders. Articles were considered based on their relevance to the purpose and the environment of a secure forensic facility.

The literature review emphasised the need for a cohesive model of care integrating substance use rehabilitation with mental health care. Comprehensive assessment and individualised approaches that incorporated patient choice and stages of change were considered essential components to any dual diagnosis rehabilitation programme.

The literature regarding rehabilitation approaches for those with severe mental illness and co-morbid substance use disorders was reasonably consistent with the models of care used in relation to criminal offenders and mental illness generally. Integrated and individualised rehabilitation approaches for dual diagnosis patients could play a significant role in forensic settings.

Limited robust evidence for substance use rehabilitation has been published. The authors consider the existing evidence base and the underlying theory behind substance use rehabilitation to propose a model for rehabilitation in secure forensic settings. This is the first known review of substance use rehabilitation involving mentally ill offenders with dual diagnoses in secure forensic settings. This paper is the original work of the authors.

Young people receiving services for substance use problems often experience high rates of other psychosocial problems in addition to mental disorders. This has implications for design of effective interventions. There is a lack of concisely organised practical information to help organisations serving this population establish contextually relevant and rigorous approaches to the design of evidence‐based interventions. This paper aims to focus on these issues.

Drawing on literature from clinical and implementation science, this paper describes a new approach to the development and implementation of evidence‐based practice (EBP). Contributions of innovators, early adopters, evaluators, and other scholars are reviewed and synthesized.

Traditional approaches to EBP relying on manualised programs targeting discrete diagnoses have not yielded meaningful progress in the dissemination of EBP to services that specialise in treatment and support for young people experiencing complex psychosocial needs. Recent initiatives are moving away from reliance on manualised programs and adopting a modular practice elements approach that enables maximum flexibility in responding to the unique needs of individual clients. This approach has potential to mitigate barriers to implementation of EBP in resource poor environments.

The complexity of needs presented by young people with dual mental health and substance use problems is increasingly recognised, but there is little information available that supports the formulation evidence‐based interventions that directly address this complexity. This paper applies knowledge from research to the practical challenges faced by practice leaders in real‐world services.

Substance use plays a significant role in the perpetration of much intimate partner violence (IPV). However, responses to these two issues are rarely integrated. Single focus programme responses can lead to poor outcomes for men as well as their families experiencing these intersecting issues. This scoping paper aims to establish the current state of knowledge on contextual factors influencing the development and implementation of combined programmes.

Four electronic databases were systematically searched in May 2021 and December 2021. Twenty-one peer-reviewed studies reporting on ten programmes were included.

This scoping review revealed that combined programme responses are an underdeveloped area of research and evaluation. The limited evidence base indicated systemic barriers hindering services’ capacity to expand this field of work, affecting implementation and outcomes. Support is required from the wider service systems to intervene in men’s perpetration of IPV in the context of substance use.

Findings in this scoping review demonstrate the importance of fostering a coordinated and collective response to IPV in the context of substance use. Combined programmes have the potential to reduce siloed practices, enabling more holistic responses for men with intersecting issues. However, researchers and policymakers must also address contextual issues hindering or enabling combined programmes’ implementation and development.

Mapping the evidence based on combined programmes provides direction for further development and research to expand this field of inquiry.

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.

Post-traumatic stress disorder (PTSD) and substance use disorder (SUD) frequently co-occur (PTSD+SUD). The onset of these disorders often occurs during adolescence. There is limited understanding of the perspectives of service providers working with this population. The purpose of this paper is to identify the practices, attitudes, experiences and training needs of Australian service providers treating adolescents with PTSD+SUD.

Service providers in Australia were invited to complete an anonymous online survey regarding their experiences working with adolescents who have PTSD+SUD. Ninety participants completed the 48-item survey that comprised multiple choice and open-ended questions.

Service providers estimated that up to 60 per cent of their adolescent clients with PTSD also have SUD. They identified case management, engaging with caregivers and difficult client emotions as specific challenges associated with working with this population. Despite this, providers rated treating PTSD+SUD as highly gratifying for reasons such as teaching new coping skills, developing expertise and assisting clients to achieve their goals. There were mixed perspectives on how to best treat adolescents with PTSD+SUD, and all participants identified a need for evidence-based resources specific to this population.

This is the first survey of Australian service providers working with adolescents who experience PTSD+SUD. The findings improve our understanding of the challenges and rewards associated with working with this population, and provide valuable information that can enhance clinical training and guide the development of new treatment approaches for this common and debilitating comorbidity.

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.

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.

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.

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.

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.