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The purpose of this paper is to estimate the share of multiple substance disorders among clients entering treatment for substance-related problems, to identify the most frequent combinations of the substances involved and to investigate the profiles of the clients involved.

Data were taken from the Swiss treatment monitoring system act-info applied among inpatient and outpatient facilities (reporting years 2013–2015). All cases with information on multiple substance disorders, according to a definition close to the diagnosis F19 from the ICD-10 classification of disease were included. The measurements comprised designated primary substance, existing multiple substance use disorder, substances involved and basic socio-demographics.

From 10,009 clients included in the study, 1,653 (16.5 per cent) were reported as having multiple substance use disorders. A great variety of substance combinations was identified and alcohol was found in the majority of them.

Treatment strategies targeting accurately substance-related disorders as a whole complex should be promoted. In particular the alcohol-related aspect of the disorder should not be neglected when the focus is on illegal drugs.

Multiple substance use was until recently not sufficiently documented in treatment monitoring systems. A recent version of the European treatment demand indicator (TDI) has introduced the notion of “polydrug use problem” as complementary information to the primary substance, which remains the key variable for reporting treatment demand. This study represents a first attempt to explore systematically this new data.

The purpose of this paper is to explore polydrug use and the factors that motivate the use of multiple substances among selected young adults.

A total of 23 male and female participants (aged 23-29 years) who use illicit drugs and prescription pharmaceuticals for non-medical purposes were recruited through snowball sampling. Qualitative interviews were conducted, and the data were analysed thematically.

The use of drug “concoctions” and cocktails was widespread among the participants. Some used what they called Codeine Diet (codeine-based cough syrup mixed with a Coca-Cola^® product or malt drink), while others took Gutter Water (a cocktail of cannabis, codeine, tramadol, vodka and juice or water). The use of Monkey Tail (a mixture of local gin, cannabis leaves, stems, roots and seeds) and petrol mixed with glue and La Casera^® (carbonated soft drink) combined with Tom-Tom^® (menthol-flavoured candy) was also revealed. Pleasure, better highs, the need to experience prolonged intoxication and the use of one drug to douse the effects of another substance motivated polysubstance use.

The findings revealed that the reasons why codeine-based cough syrups are mixed with soft drinks (Codeine Diet) include avoiding social discrimination and evading law enforcement agencies. Results suggest that these drug use practices require specifically tailored public health interventions. Social stigmatization against substance users and the use of extra-legal measures by the police should be discouraged to facilitate harm reduction.

This study represents the first qualitative research to explore polydrug use among an understudied Nigerian population.

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.

Public perception has been found to be influenced by the words used to describe those with behavioral health disorders, such that using terms like “substance abuser” can lead to higher levels of stigma. The purpose of this paper is to identify additional stigmatizing and empowering terms that are commonly used by different stakeholders.

Using digital Delphi groups, the paper identifies positive and negative terms related to substance use disorder (SUD) from three distinct stakeholder groups: individuals in recovery, impacted family members and loved ones, and professionals in the treatment field.

Participants identified 60 different terms that are considered stigmatizing or positive. Previously identified stigmatizing terms (abuser, addict) were present for all stakeholder groups, as was the positive term person with a SUD. Additional stigmatizing terms for all groups included junkie and alcoholic. Additional positive terms for all groups included long-term recovery.

The results suggest that the continued use of terms like addict, alcoholic, abuser and junkie can induce stigma in multiple stakeholders. The use of more positive terms such as person with a SUD or person in recovery is suggested to reduce stigma.

The use of digital Delphi groups to solicit feedback from multiple stakeholder groups from the substance use community is innovative and allows for the comparison of linguistics among and between the groups.

Substance misuse that is co‐morbid with mental disorder may increase the risk of crime, particularly of a violent nature. It is therefore essential that dual‐diagnosis patients in forensic services receive adequate intervention and treatment to minimise future substance use and potential for criminal behaviour. One such intervention is the Relapse Prevention Programme (Saying No; Coping and Social Skills Programme) developed in a high secure forensic hospital. An evaluation of the programme was conducted, with pre‐ and post‐ intervention using four measures, the Drug Taking Confidence Questionnaire (DTCQ), the Multidimensional Locus of Control Questionnaire, the Stages of Change Questionnaire and the Rosenberg Self‐Esteem Scale, with 83 male participants who had completed the programme. Results indicate that there was significant change in the DTCQ post‐treatment while no other measures yielded a statistically significant result. Possible reasons, implication for practice and limitations of the current study are discussed.

Objective. To report on the patterns of substance use in newly admitted male and female South Australian prisoners using the WHO‐ASSIST screening tool (Alcohol, Smoking and Substance Involvement Screening Test) and observe the feasibility of using the ASSIST and associated Brief Intervention in this population. Data sources. Results of the first 518 prisoners screened using ASSIST in South Australian reception prisons. Results. In the first 10 months of the implementation of the WHO ASSIST, 518 clients were assessed in the 3 metropolitan intake prisons in Adelaide, Australia. This represents 31% of all male and 35% of all female prisoners admitted over this period. Injecting drug use was reported in the previous 3 months by 55% of men and 51% of women. The six most common substances used at high and moderate risk levels, in order of prevalence (from high to low) in males were tobacco, cannabis, amphetamines, opiates, alcohol, and sedatives. In women the order was tobacco, amphetamines, cannabis, opiates and sedatives equal, and alcohol. Fifty percent of men and 33% of women were using four or more substances. Overall rates of substance use related risk amongst men coming into prison are slightly greater than for women. Accessing prisoners for screening within the first few days is difficult with 55% already being released or at court or other external appointments.

Over the course of their service, veterans are exposed to elevated levels of chronic stress that contribute to a greater prevalence of mental illness than observed in the general population. When mental illness is present, comorbidity is normative. Convergent evidence suggests that co-occurring substance use and mental illness is among the most prevalent forms of comorbidity within veteran samples. The purpose of this paper is to explore issues associated with dual diagnoses among veterans in the USA.

Research on dual diagnoses among veterans was reviewed and consolidated for presentation into three substantive content areas consisting of prevalence, associated conditions, and treatment of dual diagnoses.

Dually diagnosed veterans represent a group at particularly high risk for myriad adverse biopsychosocial and treatment outcomes, including poor health, suicidality, violence or aggressive behavior, arrest, homelessness, and unemployment. A comprehensive strategy has been implemented within the Veterans Health Administration to address dual diagnosis and related problems. Additional research is required to more readily identify co-occurring substance use and mental illness and to refine integrated intervention approaches to minimize burden while improving treatment outcomes for veterans and their families.

The current review includes a wide range of research spanning more than two decades and describing dual diagnosis among combat veterans of all modern eras. Areas in need of further research (e.g. dual diagnosis among female veterans; early detection of psychopathology and fully integrated care among returning veterans) are identified and discussed.

Therapeutic communities (TCs) are one of the existent social responses in helping drug users overcome addiction and pursue social reintegration. The purpose of this paper is to present and discuss the general characteristics of about 200 drug users and their addiction and those of addicts abroad treated in a TC and clinically discharged. The analysis now presented is the first empirical approach to capture social regularities and singularities that are present in these individuals’ reintegration strategies.

The data have a ten-year range – from 1999 to 2009 – and were statically analysed.

They show a group of individuals with low qualifications reflected in their professional occupation, from which family is an essential support. These data also show a significant prevalence of heroin, alcohol, cocaine and polydrug uses, highlighting the need to consider new use patterns and new synthetic substances.

TC have been little studied, mainly in Portugal.

This study aims to provide data on substance use amongst young people in Scotland to inform policy and practice for an age group who generally do not access specialist alcohol and drug services. The main objectives of the study were to assess the problem severity scores of items from a modified version of the DAST-10 brief screening instrument among respondents; examine correlations between a range of variables in relation to DAST-10 problem severity scores; and explore respondent knowledge of how and where to seek help.

A fixed quantitative design methodology recruited a non-probability sample of 4,501 respondents from an online survey made available by “We are With you” Scotland.

The survey was ethically approved by the School of Education and Social Sciences, University of the West of Scotland. It consisted of 32 questions exploring substances used within the past 12 months, and 12 weeks, and included the DAST-10. We further explored help seeking, and knowledge of support available to respondents.

Substance use patterns were markedly different from people currently known to specialist alcohol and drug services. Over half of respondents were under 25, and 62% report being employed. The most commonly used substances were cannabis and cocaine. One third of respondents recorded substantial or severe problem severity scores and reside in Scottish Local Authorities with high concentrations of socio-economic inequality.

Secure accommodation, stable relationships and being employed are protective factors in relation to reported negative health consequences associated with problem substance use.

Just under one third (27%) of respondents report knowing where to seek help for substance use problems; however, they are unwilling to attend existing specialist alcohol and drug services.

A non-probability sample of the Scottish population has a potential for response bias due to how and what way the survey was made available to respondents. It is acknowledged that while useful as a method of generating drug use data, there are limitations in how recently the substance use occurred, and in relation to the types of substances reported (cannabis, cocaine and ecstasy).

The study provides data to inform wider public health measures in relation to accessing support and addressing societal discrimination associated with the use of substances. The study provides data on service design for young people who do not access specialist alcohol and drug services.

The study informs substance use policy in the Scottish context in relation to a population of young people who use licit and illicit substances. Data contributes to evidence supporting correlations between problematic substance use and socio-economic inequality. Data indicates that existing specialist services require redesign.

The study is the first to be conducted within a Scottish context.

This study aims to review the presentation of substance use disorders in older adults, how addiction intertwines with neurocognitive disorders and how to approach this vulnerable population.

Electronic data searches of PubMed, Medline and the Cochrane Library (years 2000–2021) were performed using the keywords “neurocognitive,” “dementia,” “substance use,” “addiction,” “older adults” and “elderly.” The authors, in consensus, selected pivotal studies and conducted a narrative synthesis of the findings.

Research about substance use disorders in older adults is limited, especially in those with superimposed neurocognitive disorders. Having dual diagnoses can make the identification and treatment of either condition challenging. Management should use a holistic multidisciplinary approach that involves medical professionals and caregivers.

This review highlights some of the intertwining aspects between substance use disorders and neurocognitive disorders in older adults. It provides a comprehensive summary of the available evidence on treatment in this population.