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Book part
Publication date: 12 December 2007

Matthew E. Archibald

Despite continuing socioeconomic and racial/ethnic gaps in many health care services, the National Healthcare Disparities Report (2004) documents parity in substance abuse

Abstract

Despite continuing socioeconomic and racial/ethnic gaps in many health care services, the National Healthcare Disparities Report (2004) documents parity in substance abuse treatment provision among individuals of varying socioeconomic and racial/ethnic backgrounds. This study investigates that achievement by analyzing the relationship between community socioeconomic and racial/ethnic disadvantage and organizational provision of substance abuse treatment, treatment need and utilization across United States counties, 2000, 2002 and 2003. Results confirm equity in service provision in poorer communities and those with higher concentrations of African Americans. Significant disparities remain, however, in communities with higher concentrations of Hispanics, youth and female-headed households. Limitations and implications for future studies of health care provision are discussed.

Details

Inequalities and Disparities in Health Care and Health: Concerns of Patients, Providers and Insurers
Type: Book
ISBN: 978-0-7623-1474-4

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Article
Publication date: 15 June 2020

Stijn Vandevelde, Freya Vander Laenen, Benjamin Mine, Eric Maes, Lana De Clercq, Lies Deckers and Wouter Vanderplasschen

This paper aims to report the findings of an evaluation study concerning the Central Registration Points (CRPs) for drug users in Belgian prisons. CRPs support drug users…

Abstract

Purpose

This paper aims to report the findings of an evaluation study concerning the Central Registration Points (CRPs) for drug users in Belgian prisons. CRPs support drug users to link with community-based services.

Design/methodology/approach

The study applied a multi-method approach that involved an exploratory literature review; a secondary analysis of the CRPs’ databases; a qualitative study of the perceptions of a diverse sample of stakeholders with regard to the functioning of CRPs; and a prospective registration study.

Findings

One-third of the clients never attended an outpatient or residential substance abuse service before prison entry. This illustrates that the CRPs managed to reach clients who were not previously reached by (substance abuse) treatment services. All interviewed actors emphasized the added value of the CRPs in terms of informing, contacting, motivating and referring prisoners with a substance abuse problem.

Practical implications

Based on the research findings, two issues seem to be of paramount importance in the successful practice of CRPs: the confidentiality and specific expertise on (substance abuse) treatment. Given the complex situation of drug users in prison, an independent positioning and categorical assistance with drug-specific expertise seem to be essential.

Originality/value

CRPs can be considered to be one of the “building blocks” that contribute to high-quality care and continuity of care for drugs users in detention.

Details

International Journal of Prisoner Health, vol. 17 no. 1
Type: Research Article
ISSN: 1744-9200

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Article
Publication date: 13 April 2015

Robert Balich, Jane Warren, Jennifer Weatherford, Noor Syamilah Zakaria and Diana Schwede

The purpose of this paper is to examine the effects of education and experiential learning on counseling student’s perceptions of substance use and counseling those with…

Abstract

Purpose

The purpose of this paper is to examine the effects of education and experiential learning on counseling student’s perceptions of substance use and counseling those with substance-related problems. Some counselors report having had negative experiences and beliefs about substance use, abuse, and persons with substance related-problems. A counselor’s negative beliefs and experiences can impair their capacities of working effectively and empathetically with persons who seek help for substance abuse problems. Research reports that education can assist helping professionals to be able to work more efficiently with clients with substance abuse struggles by increasing awareness of substance abuse problems, enhancing empathy, increasing professional’s ability to relate with what clients may be experiencing, training in appropriate interventions, and referral skills.

Design/methodology/approach

This study measured changes in students’ attitudes toward addictions following completion of a 15-week addictions counseling course, which incorporated multiple experiential activities in conjunction with information about the effects of various substances and different treatment modalities.

Findings

The results revealed significant changes in treatment intervention and non-stereotyping.

Originality/value

These changes suggest education might affect attitudes toward substance abuse. The implications of this study can guide counselor educators in designing effective addictions courses and can lead to future discussions on how to use experiential learning in the classroom.

Details

Journal of Applied Research in Higher Education, vol. 7 no. 1
Type: Research Article
ISSN: 2050-7003

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Book part
Publication date: 24 July 2012

Betty G. Brown, Julie A. Baldwin and Margaret L. Walsh

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…

Abstract

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.

Details

Health Disparities Among Under-served Populations: Implications for Research, Policy and Praxis
Type: Book
ISBN: 978-1-78190-103-8

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Article
Publication date: 18 May 2012

Gail Gilchrist, Alicia Blázquez and Marta Torrens

This paper's aim is to examine the relationship between intimate partner violence, childhood abuse and psychiatric disorders among 118 female drug users in treatment in…

Abstract

Purpose

This paper's aim is to examine the relationship between intimate partner violence, childhood abuse and psychiatric disorders among 118 female drug users in treatment in Barcelona, Spain.

Design/methodology/approach

Secondary analysis of a cross‐sectional study of the psychiatric, behavioural and social risk factors for HIV. DSM‐IV disorders were assessed using the Spanish Psychiatric Research Interview for Substance and Mental Disorders; the Composite Abuse Scale assessed intimate partner violence and the Child Maltreatment History Self‐Report assessed childhood physical and sexual abuse.

Findings

The odds of experiencing intimate partner violence were 2.42 times greater among those with any depressive disorder (95 per cent CI 1.13, 5.20), over three times greater for those who reported ever attempting suicide (OR 3.20; 95 per cent CI 1.29, 7.94), met criteria for borderline personality disorder (OR 3.05; 95 per cent CI 1.31, 7.11), had been abused in childhood (OR 3.38; 95 per cent CI 1.45, 7.85) or currently lived with a substance user (OR 3.74; 95 per cent CI 1.29, 10.84). In multiple logistic regression, only living with a substance user (OR 3.42; 95 per cent CI 1.08, 10.86) and a history of childhood abuse (OR 2.87; 95 per cent CI 1.05, 7.86) remained significant in the model examining intimate partner violence victimisation.

Research limitations/implications

The small sample size, together with the fact that the study was not originally powered to examine differences in intimate partner violence may have increased the possibility of type II errors.

Originality/value

Histories of psychiatric disorders, intimate partner violence and childhood abuse are common in female substance users in treatment. Research suggests that such histories result in poorer treatment outcomes. Histories of intimate partner violence and childhood abuse should be identified and addressed in substance abuse treatment to enhance treatment outcomes.

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Article
Publication date: 12 March 2010

Morten Hesse

Assessment of personality disorders in substance abusing patients may produce important insights. Little is known about the value of routine personality disorder…

Abstract

Assessment of personality disorders in substance abusing patients may produce important insights. Little is known about the value of routine personality disorder assessment in a clinical context. Adults with past‐year substance dependence seeking treatment at a centralised intake unit for substance abusers in the City of Copenhagen were randomised to assessment of personality disorders and individual psychoeducation vs. attention placebo (n=75). All patients received psychoeducation for attention deficit hyperactive disorder (ADHD) and anxiety/depression when indicated. Patients were followed at three and six months post‐treatment. The psychoeducation for personality disorder did not result in improved functioning. Significant differences indicated a larger drop in substance use in the experimental group. Assessing personality disorders and providing psychoeducation is a promising treatment in a clinical context. There is a need for relevant treatment options to improve functioning and quality of life for this group of patients.

Details

Drugs and Alcohol Today, vol. 10 no. 1
Type: Research Article
ISSN: 1745-9265

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Article
Publication date: 1 September 2002

Madeline Naegle

With expanded technologic and communication resources there is growing awareness worldwide of the public health problems caused by alcohol, tobacco, and other drug use…

Abstract

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.

Details

Drugs and Alcohol Today, vol. 2 no. 3
Type: Research Article
ISSN: 1745-9265

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Article
Publication date: 1 September 2002

Marianne Marcus and Linda Stafford

Substance use disorders are considered to be the nation's number one health problem. These continue to cause more deaths, illnesses, and disabilities than do other…

Abstract

Substance use disorders are considered to be the nation's number one health problem. These continue to cause more deaths, illnesses, and disabilities than do other preventable health problems, providing ample support for the need for developing health professional competence in this area. This paper describes the specific steps used by The University of Texas‐Houston Health Science Center School of Nursing to infuse substance abuse content into the undergraduate curriculum, design a graduate subspecialty in addictions nursing, and offer continuing education on substance use disorders to nurses in acute care and community settings. The paper provides guidelines for other academic institutions engaged in the important task of increasing nursing competence related to substance use disorders.

Details

Drugs and Alcohol Today, vol. 2 no. 3
Type: Research Article
ISSN: 1745-9265

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Article
Publication date: 23 April 2018

Pernille Pinderup

Studies have shown that mental health professionals find working with patients with dual diagnosis challenging, and the purpose of this paper is to examine some of these…

Abstract

Purpose

Studies have shown that mental health professionals find working with patients with dual diagnosis challenging, and the purpose of this paper is to examine some of these challenges.

Design/methodology/approach

In total, 85 mental health professionals from 8 different mental health centres in Denmark were interviewed. The data analysis was inspired by a grounded theory approach.

Findings

Different challenges in the dual diagnosis treatment were identified and they suggested that the focus of treatment was mainly on the mental illness rather than the substance use disorder. The single focus of the treatment made it challenging to treat patients with dual diagnosis sufficiently. While several studies explain the single focus by inadequate competencies among professionals, the present study suggests that the single focus is also explained by the way that the treatment is organised. For instance, standardized treatment packages and insufficient guidelines on substance abuse treatment make it challenging to treat patients with dual diagnosis.

Originality/value

This paper suggests that a more flexible, and a longer period of, treatment, together with more sufficient guidelines on dual diagnosis treatment and a more formalized collaboration with the substance abuse treatment centres, will make it a less challenging issue to treat patients with dual diagnosis.

Details

Advances in Dual Diagnosis, vol. 11 no. 2
Type: Research Article
ISSN: 1757-0972

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Article
Publication date: 7 September 2010

David H. Cook

The purpose of this paper is to present the first of two articles about substance abuse as a human disorder that defies resolution, with the primary care physician the…

Abstract

Purpose

The purpose of this paper is to present the first of two articles about substance abuse as a human disorder that defies resolution, with the primary care physician the intended audience.

Design/methodology/approach

The paper is about the phenomenon of relapse as an extension of the formation of the underlying addictive‐oriented thinking. Both relapse and acceptance are about the “why” of substance abuse and not the “what.”

Findings

According to the Substance Abuse and Mental Health Services Administration, the number of US adults who were classified as having substance dependence or abuse in 2008 based on criteria specified in the DSM‐IV was 22.2 million. Subtract on a mutually exclusive basis the 1.2 million who participate in Alcoholics Anonymous (AA) and the 1.7 million persons who are in some configuration of institutional therapy and this leaves 19.3 million persons as a potential pool of need.

Research limitations/implications

Focusing on the primary care physician is no more trivial than the two topics to be discussed.

Social implications

The potential pool of need in the USA is much larger than the 19.3 million persons on the strength of what is implied by the to‐be‐developed views of relapse and acceptance as the “why” of substance abuse, as a subset of addictive‐oriented thinking.

Originality/value

While the paper is in line with the World Health Organization's position that substance abuse is the most serious health problem globally, the advocated approach to the resolution of addiction is the efficiency of the relationship between the primary care physician and the patient.

Details

International Journal of Sociology and Social Policy, vol. 30 no. 9/10
Type: Research Article
ISSN: 0144-333X

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