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This study aims to examine the relationship between medication for opioid use disorder (MOUD) among pregnant individuals, referral source, mental health, political affiliation and substance use policies in all 50 states in the USA.

This study describes MOUD receipt among pregnant people with an opioid use disorder (OUD) in 2018. The authors explored sociodemographic differences in MOUD receipt, referrals and co-occurring mental health disorders. The authors included a comparison of MOUD receipt among states that have varying substance use policies and examined the impact of these policies and the political affiliation on MOUD. The authors used multilevel binary logistic regression to examine effects of individual and state-level characteristics on MOUD.

Among 8,790 pregnant admissions with OUD, the majority who received MOUD occurred in the Northeast region (71.52%), and 14.99% were referred by the criminal justice system (n = 1,318). Of those who were self-referred, 66.39% received MOUD, while only 30.8% of referrals from the criminal justice system received MOUD. Those referred from the criminal justice system or who had a co-occurring mental health disorder were least likely to receive MOUD. The multilevel model showed that while policies were not a significant predictor, a state’s political affiliation was a significant predictor of MOUD.

The study has some methodological limitations; a state-level analysis, even when considering the individual factors, may not provide sufficient description of community-level or other social factors that may influence MOUD receipt. This study adds to the growing literature on the ineffectiveness of prenatal substance use policies designed specifically to increase the use of MOUD. If such policies are consistently assessed as not contributing to substantial increase in MOUD among pregnant women over time, it is imperative to investigate potential mechanisms in these policies that may not facilitate MOUD access the way they are intended to.

Findings from this study aid in understanding the impact that a political affiliation may have on treatment access; states that leaned more Democratic were more likely to have higher rates of MOUD, and this finding can lead to research that focuses on how and why this contributes to greater treatment utilization. This study provides estimates of underutilization at a state level and the mechanisms that act as barriers, which is a stronger assessment of how state-specific policies and practices are performing in addressing prenatal substance use and a necessary step in implementing changes that can improve the links between pregnant women and MOUD.

To the best of the authors’ knowledge, this is the first study to explore individual-level factors that include mental health and referral sources to treatment that lead to MOUD use in the context of state-level policy and political environments. Most studies estimate national-level rates of treatment use only, which can be useful, but what is necessary is to understand what mechanisms are at work that vary by state. This study also found that while substance use policies were designed to increase MOUD for pregnant women, this was not as prominent a predictor as other factors, like mental health, being referred from the criminal justice system, and living in a state with more Democratic-leaning affiliations.

The purpose of this paper is to examine lived experiences of opioid agonist treatment (OAT) during and immediately following release from detention in prisons in England and Scotland.

Surveys were completed by serving prisoners in both countries and by those recently released from prison (England only). The survey findings were discussed in focus groups of people with lived experience. The combined findings from the surveys and focus groups were shared with an expert group of prison OAT providers and people with lived experience with the purpose of making recommendations for more accessible and effective OAT in custodial environments and continuity of OAT on release

The quality and accessibility of OAT varied considerably between establishments. It was reported to be harder to access OAT in Scottish prisons. It was often hard for people in prison to get the dosage of OAT they felt they needed and it was generally harder to access buprenorphine than methadone in English prisons. Only Scottish people in prison were aware of long-lasting forms of buprenorphine. People in English prisons had mixed experiences of the help available in prison, with no improvement recorded since a 2016 study. People in Scottish prisons were more likely to rate the help available as poor.

The number of people accessed while actually in prison (73) was reduced by the impact of the pandemic, making it more difficult to access people in prison and because some were resistant to participating on the basis that they had already been consulted for a wide variety of research projects focused on the impact of COVID. The Scottish cohort (a total of 19 individuals comprising 14 survey respondents and five focus group members) is clearly too small a number on which to base robust claims about differences in OAT provision between the English and Scottish prison systems..

The study identifies key barriers to accessing OAT in prisons and suggests key components of more user-friendly approaches.

This study provides an overview of the recent lived experiences of people accessing OAT in prison and on release and offers valuable recommendations on how to make service provision more effective and consistent.

This study provides an overview of the recent lived experiences of people accessing OAT in prison and on release in England and Scotland and offers valuable recommendations on how to make service provision more effective and consistent.

This study explores the determinants of police officer support for pre-arrest/booking deflection programs that divert people presenting with substance use and/or mental health disorder symptoms out of the criminal justice system and connect them to supportive services.

This study analyzes responses from 254 surveys fielded to police officers in Delaware. Questionnaires asked about views on leadership, approaches toward crime, training, occupational experience and officer’s personal characteristics. The study applies a new machine learning method called kernel-based regularized least squares (KRLS) for non-linearities and interactions among independent variables. Estimates from a KRLS model are compared with those from an ordinary least square regression (OLS) model.

Support for diversion is positively associated with leadership endorsing diversion and thinking of new ways to solve problems. Tough-on-crime attitudes diminish programmatic support. Tenure becomes less predictive of police attitudes in the KRLS model, suggesting interactions with other factors. The KRLS model explains a larger proportion of the variance in officer attitudes than the traditional OLS model.

The study demonstrates the usefulness of the KRLS method for practitioners and scholars seeking to illuminate patterns in police attitudes. It further underscores the importance of agency leadership in legitimizing deflection as a pathway to addressing behavioral health challenges in communities.

This paper aims to determine whether tax evasion savings qualify as unlawful proceeds for money laundering purposes. Litigators, regulators and academics have debated the question for decades. A common argument is that tax evasion allows a bad actor to save money that the perpetrator already has on hand. It does not produce a new inflow of wealth that could properly be classified as proceeds. This paper addresses the validity of this argument by using a substance-based approach.

This paper applies the substance-over-form principle and two specialized judicial doctrines to the matter: the economic-substance and step-transaction doctrines.

This paper finds that in substance, tax evasion savings qualify as unlawful proceeds. The opposing argument may be valid on the surface, but it does not withstand the scrutiny of the substance-based principle and insights from the doctrines.

The finding of this paper implies that any courts which value substance can embrace tax evasion savings as unlawful proceeds. Government prosecutors can adopt the position with confidence that substance backs them up. National regulators can push the point. The United Nations’ Financial Action Task Force can consider the option to more explicitly recommend treating tax evasion savings as unlawful proceeds for money laundering.

Using a unique substance-based approach, this paper demonstrates that a dollar of tax evasion savings is substantively equivalent to a dollar of unlawful tax refund proceeds for money laundering purposes. Focusing on an unlawful tax refund overcomes many of the common concerns raised against the treatment of tax evasion savings as unlawful proceeds.

The purpose of this paper is to examine recovery through lived experience. It is part of a series that explores candid accounts of addiction and recovery to identify important components in the recovery process.

The G-CHIME model comprises six elements important to addiction recovery (growth, connectedness, hope, identity, meaning in life and empowerment). It provides a standard against which to consider addiction recovery, having been used in this series, as well as in the design of interventions that improve well-being and strengthen recovery. In this paper, a first-hand account is presented, followed by a semi-structured e-interview with the author of the account. Narrative analysis is used to explore the account and interview through the G-CHIME model.

This paper shows that addiction recovery is a remarkable process that can be effectively explained using the G-CHIME model. The significance of each component in the model is apparent from the account and e-interview presented.

Each account of recovery in this series is unique and, as yet, untold.

Stigma is a major impediment to human rights in health care that causes discrimination, isolation and the exclusion of individuals from essential health-care services. It fosters fear, leading to negative stereotyping of individuals based on their social, cultural or health status and undermines their dignity and respect, consequently violating their right to health. Therefore, the purpose of this study is to evaluate the moderating role of psychological flexibility in the relationship between stigma (enacted, anticipated and internalized), mental health and the quality of life of substance users.

This study was based on a cross-sectional design and included 200 male patients with an age range of 18–65 years from 23 rehabilitation centers in four cities in Pakistan. The purposive sampling technique was used, and the sample size ranged from 4 to 23 participants for each site. Four scales were used to measure stigma, general mental health, quality of life and psychological flexibility in substance users.

The data were analyzed using SPSS and Smart PLS, which showed that stigma (enacted, anticipated and internalized) had a detrimental effect on substance users’ mental health and quality of life. Additionally, psychological flexibility acts as an efficient moderator between them.

This research unveils the moderating role of psychological flexibility in mitigating stigma’s adverse effects on individuals with substance use disorders. Future investigations should prioritize interventions aimed at enhancing psychological flexibility to ameliorate the repercussions of stigma, ultimately enhancing the well-being and quality of life of substance users.

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.

This study aims to use the dual-continuum model of mental health to explore mental health in Australian construction apprentices from the perspective of key stakeholders in the apprenticeship model. In particular, this study explored how construction apprentices, Vocational Education and Training (VET) teachers, industry employers and mental health workers understood the construct of mental health, factors associated with the dimension of psychological distress/symptoms of mental illness, and factors associated with the dimension of mental wellbeing.

This study used an exploratory qualitative research design. Data from 36 semi-structured interviews were analysed using thematic analysis. Participants comprised 19 Australian construction apprentices, 5 VET teachers, 7 industry employers and 5 mental health workers.

In total, 14 themes were generated from the data set. Participants across stakeholder groups reported a limited understanding about mental health. Participants cited a range of negative personal, workplace and industry factors associated with psychological distress/symptoms of mental illness, but only reported a few factors associated with mental wellbeing.

To the best of the authors’ knowledge, this study is one of the first to use the dual-continuum model of mental health to explore the mental health of Australian construction apprentices, and to explore the factors associated with both dimensions of this model from the perspective of key stakeholders in the Australian construction apprenticeship model.

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.

The transtheoretical model (TTM) has been applied to varying areas of physical health, e.g. diabetes. However, research into its applicability to psychotherapy is mixed. The TTM is applied through the University of Rhode Island Change Assessment (URICA). Investigating the utility of the URICA is needed to improve patient care and outcomes. This study aims to assess whether the URICA scores relate to patient outcomes; patient attendance; practitioner ratings of patient readiness, appropriateness, insight, motivation and potential for improvement; and to explore practitioner’s perspectives on the URICA.

Correlational methods were used to assess the relationship between the URICA and therapeutic outcome, attendance and practitioner-rated areas. Content analysis was used to analyse practitioner qualitative data.

The URICA did not correlate with either therapeutic outcome or attendance. A significant negative correlation was found between the URICA and practitioner-rated appropriateness of the referral. This means practitioners perceived individuals with lower URICA scores to be a more appropriate referral, despite the score indicating a reduced readiness to change. Qualitative categories included positive views, negative views, ambivalence and changes to measure and process. To conclude, the URICA does not explain a patient’s outcome or attendance. The URICA may not be appropriate to use in its current format in mental health services; therefore, assessing the TTM verbally may be more helpful.

This study provides research into suitability of using the URICA to assess the TTM and its applicability to attendance and outcome in psychological therapies.