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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.

Sex and gender are regarded as critical structural determinants of mental health and mental illness. Mental illness is a complex phenomenon, and risky behaviour and substance use commonly occur simultaneously or subsequent to one another. A gendered vulnerability in biological, environmental, and behavioural risk factors has been registered in the development and escalation of mental illness. Studies have found that women who use drugs experience greater physical and mental health repercussions than men. Women who use drugs present higher rates of depression and anxiety, suicidal tendencies, isolation and general psychological distress. This chapter addresses the most common mental illnesses associated with women who use drugs: depression, anxiety, trauma-related disorders, and eating disorders.

The purpose of this paper is to explore addiction service users’ experiences of psychological interventions for depression symptoms, with an emphasis on understanding obstacles to engage with treatment.

This was a thematic analysis of semi-structured interviews with ten people who took part in a randomised controlled trial of cognitive and behavioural interventions; four of whom never engaged with treatment.

Five prominent obstacles to access therapy were: memory deficits, becoming overwhelmed by multiple demands and appointments, being housebound due to fluctuations in mental health problems, tendency to avoid the unfamiliar, and contextual life problems related to deprivation and social conflict.

The authors note some possible limitations related to overreliance on telephone interviews and interviewers’ field notes. The authors discuss the findings in light of epidemiological research, cognitive, behavioural and motivational enhancement theories.

The authors propose it is important to recognise and address multiple obstacles to therapy. Offering therapy appointments that are co-located within addiction services and time-contingent to other social/medical interventions may help to address some of these obstacles.

The present qualitative results complement the prior experimental research and enrich the understanding of how to maximise engagement with psychological interventions.

The purpose of the current study is to conduct a systematic review of peer-reviewed work on culturally tailored interventions for alcohol and drug use in Indigenous adults in North America. Substance use has been reported as a health concern for many Indigenous communities. Indigenous groups experienced the highest drug overdose death rates in 2015, the largest percentage increase in the number of deaths over time from 1999 to 2015 compared to any other racial group. However, few Indigenous individuals report participating in treatment for alcohol or drug use, which may reflect the limited engagement that Indigenous groups have with treatment options that are accessible, effective and culturally integrative.

Electronic searches were conducted from 2000 to April 21, 2021, using PsycINFO, Cumulative Index to Nursing and Allied Health Literature, MEDLINE and PubMed. Two reviewers classified abstracts for study inclusion, resulting in 18 studies.

Most studies were conducted in the USA (89%). Interventions were largely implemented in Tribal/rural settings (61%), with a minority implemented in both Tribal and urban contexts (11%). Study samples ranged from 4 to 742 clients. Interventions were most often conducted in residential treatment settings (39%). Only one (6%) intervention focused on opioid use among Indigenous people. Most interventions addressed the use of both drugs and alcohol (72%), with only three (17%) interventions specifically intended to reduce alcohol use.

The results of this research lend insight into the characteristics of culturally integrative treatment options for Indigenous groups and highlight the need for increased investment in research related to culturally tailored treatment across the diverse landscape of Indigenous populations.

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.

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.

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.

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.

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

The model of methadone maintenance treatment (MMT) in the United States has (for better or for worse) influenced the development of MMT elsewhere. This paper sheds light on the origins and progression of MMT and its application today. This perspective may prove helpful to persons and agencies attempting to develop MMT or whose MMT programmes are being subject to ever‐increasing restrictions. The demographics, social and economic risk factors, impact of poly‐substance use and co‐occurring psychiatric disorders (dual diagnosis), and existing evidence supporting dosing and therapeutic interventions in MMT are reviewed and illustrated with a case study.

Capgras Syndrome is a subcategory of delusional disorder. People affected by this syndrome believe that a close associate such as a friend or family member has been replaced by an identical imposter. This case report describes a 23-year-old woman with no prior psychiatric history, whom developed Capgras syndrome, via folie a deux, in the setting of poly-substance use. In this patient, a combination of Aripiprazole 10 mg daily and Escitalopram 10 mg daily were effective in resolving symptoms. Clonazepam was utilized for anxiety and Omega-3 fatty acids 1 g for anti-oxidative effects. Further studies are needed to investigate the effects of a variety of causes and treatments for Capgras Syndrome.

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.

The purpose of this paper is to examine the content of the strategy and assess its claims to be evidence based.

This study is a close-reading of the text with commentary on specific content and reference to wider contexts.

The strategy makes use of evidence in its sections on treatment. Much evidence, including that of the UK ACMD, is dismissed or ignored. The issue of funding in times of austerity is not considered in the strategy. The range and complexity of drug use and users are not fully considered.

The strategy can be seen as an idealised ambition with little basis in reality without funding to support its aims.

There is no consideration of the impact of macro-economic policy on the extent of drug misuse.

Other commentaries on the strategy are emerging. This paper is a more extensive consideration than has so far appeared.