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Through association with a family member who uses substances, stigma and shame can be experienced by children and young people whose parents use substances. Such stigma and induced shame can lead to fear of being treated unfairly and for some young people the experience of bullying and discrimination from peers, adults, and practitioners. Within my research, young people often described feeling that they had ‘survived’ within their experiences of parental substance use, rather than ‘thrived’, leaving them feeling lonely and isolated from support. Stigma played a role in this survival. By understanding the stigma experienced by young people whose parents use substances, we can move beyond young people only surviving their experiences to supporting them to thrive. Within this chapter, experiences of delivering interactive workshops and teaching practitioners about the lived experiences of children and young people whose parents use substances are reflected upon. Young people who experience parental substance use want practitioners and learners to have four key takeaways when supporting or working with young people: realisation and awareness of the impacts on young people, recognition of ways young people cope, responding in ways of understanding, and resisting further stigmatisation and isolation of young people.

Repetitive transcranial magnetic stimulation (rTMS) is a well-established treatment with efficacy for several psychiatric disorders and has yielded promising yet mixed data showing reductions in craving for substance use. Patients with substance use disorders and comorbid depression may encounter obstacles to receiving rTMS in outpatient settings for treatment of depression. In turn, implementation of rTMS in residential substance use programs would greatly benefit those with comorbid treatment resistant depression. This paper aims to provide recommendations for implementing rTMS within residential substance use treatment centers.

Using PubMed, the authors conducted a narrative review of manuscripts using various combinations of the following search terms: rTMS, depression, substance use and substance use disorder. The authors read manuscripts for their methodology, outcomes and adverse events to synthesize their results, which correspond to their recommendations for patient selection, safely implementing rTMS in residential substance use facilities and optimal rTMS protocols to start with.

Advantages of this approach include increased compliance, monitoring and access to care. Recommendations to safely incorporate rTMS in residential substance use disorder treatment centers revolve around selection of patients eligible for rTMS, allowing for sufficient time to elapse prior to commencing rTMS, monitoring for signs of recent substance use or withdrawal and using rTMS protocols compatible with the therapeutic programming of a treatment center.

This paper details the challenges and benefits of implementing rTMS for patients with dual diagnosis and provides recommendations to safely do so. To the best of the authors’ knowledge, this is a novel and unpublished endeavor.

This study is a radical interactionist analysis of family conflict. Drawing on both a negotiated order perspective and Athen's theory of complex dominative encounters, this study analyzes the role that domination plays in conflicts among intimates. As the family engages in repeated conflicts over roles, the family also engages in negotiations over the family order, what role each party should play, interpretations of past events, and plans for the future. These conflicts take place against a backdrop of patriarchy that asymmetrically distributes power in the family to determine the family order. The data from this study come from a content analysis of mothers with substance use problems as depicted in the reality television show Intervention. The conflicts in these families reveal that these families develop a grinding family order in which families engaged in repeated conflict but also continued to operate as and identify as a family. These conflicts are shaped by and reinforce patriarchal expectations that mothers are central to family operation. The intervention at the end of each episode offered an opportunity for the family to engage in a concerted campaign to try to force the mother into treatment and reestablish the family order.

Illicit drug use is a well-known global problem that has been noticed to be increased significantly among medical students. This study aims to assess the prevalence and consequences of illicit drug use among medical students in the country of Jordan using the validated Drug Abuse Screening Test-10 (DAST-10).

The authors used a cross-sectional, descriptive design to conduct this study. A total of 2,104 participants from six medical schools were included. A structured online-based English self-administered questionnaire was used for data collection.

Out of 2,104 included participants, 242 (11.5%) reported using illicit drugs in the past year. More than three-quarters (77%) of the drug users suffer from various degrees of problems related to drug use, ranging from risky (41%) to severe risk (6%). Drug use was found to be associated with gender, planned specialty and exposure to psychiatry training.

The cross-sectional design prevents from drawing cause-and-effect relationships and confirming how the tendency toward substance use is affected by the psychological state, sleep quality and exposure to psychiatry. Also, although it is important to measure the subjective observation of distress and sleep, objective estimates of psychological distress and sleep including actigraphy and sleep diary could be helpful to strengthen the findings. Also using an online survey with convenience sampling are some inevitable limitations with the present COVID-19 restrictions. Also, the nature of DAST-10 closed-ended questions precluded from accurately exploring the consequences of substance abuse.

Appropriate screening to identify medical students at risk for substance abuse and provide them with treatment referrals are strongly recommended in this study. In addition, medical schools should provide a comfortable environment that encourages a healthy lifestyle with a responsible attitude toward using drugs.

There is a dearth of information about illicit drug use among medical students, especially in the country of Jordan. The nature of their studies, the different stresses they experience and the impact imposed by other factors such as sociocultural all are likely to make medical students more susceptible to drug abuse. To the best of the authors’ knowledge, this is the first cross-national study of its kind in Jordan with a representative sample of 2,104 participants. We assessed the prevalence and consequences of self-reported illicit drug use and the sleep quality of medical students from all schools of medicine in Jordan.

The police often respond to persons who are not in direct violation of the law, but are rather undergoing behavioral crises due to mental illness or substance abuse disorders. The purpose of this study is to examine how police behavior influences civilian bystanders' emotional responses and perceptions of procedural justice (PPJ) when officers interact with these populations, which traditionally have been stigmatized in American culture.

Using a factorial vignette approach, the authors investigate whether perceived public stigma moderates the relationship between police behaviors (i.e. CIT tactics, use of force) and PPJ. The authors also investigate whether emotional reactions mediate the relationship between police behaviors and PPJ.

Regardless of suspect population (mental illness, substance use), use of force decreased participants' PPJ, and use of CIT tactics increased PPJ. These effects were consistently mediated by anger, but not by fear. Interactive effects of police behavior and perceived public stigma on PPJ were mixed.

Fear and anger may operate differently as antecedents to PPJ. Officers should note using force on persons in behavioral crisis, even if legally justifiable, seems to decrease PPJ. They should weigh this cost pragmatically, alongside other circumstances, when making discretionary decisions about physically engaging with a person in crisis.

This paper aims to describe the development, implementation and evolution of a multi-media educational tool to improve health profession students’ knowledge and awareness of stigma and ageism on the treatment of older adults with substance use disorder (SUD). In addition, this paper outlines the relationship between mental health and SUD and the impact of health provider stigmatization of older adults with behavioral health needs and the relationship between SUD and mental illness.

A literature review was conducted and initial project outlines was developed. Ten interviews were completed with content experts. The draft video was reviewed and minor revisions were incorporated. The facilitator guide accompanying the video was developed. A draft of the facilitator guide was shared with several interprofessional university faculty and the older adults with SUD. The video was presented to groups of health professions students, and following each video viewing, discussion content was used to provide additional edits.

The educational resources created for this project are appropriate for health professions curriculums related to older adults. Interprofessional health professions students are developing a basic foundation of knowledge on SUD through their standard coursework. More compassionate vocabulary is slowly being incorporated into health provider. Knowledge related to treatments and resources to treat SUD is lacking. In addition, health professions students need more education focused on assessment and interventions for individuals suspected of problematic substance use.

This paper fulfills an identified need to facilitate discussion and education around SUD for health professions students.

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.

Prisonersare at disproportionate risk of suffering substance-related harms. The administration of naloxone is essential to reversing opioid overdose and minimizing substance-related harms in prison and the community. The purpose of this study is to examine how naloxone administration is practiced and perceived in prison settings.

The authors conducted surveys with correctional workers in Manitoba, Canada (n = 257) to examine how they understand and feel about the need for and practice of administering naloxone in their everyday work with criminalized populations.

Respondents reported feeling a great need to administer naloxone, but most did not feel adequately trained to administer naloxone, creating the perception that criminalized populations remain at enhanced risk.

Findings provide emerging evidence of the need for training and accompanying policies and procedures for correctional workers on how to access and administer naloxone.

Those who care for people with schizophrenia and substance use disorders (PLS-SUD) are faced with the complex demands of a long journey to recovery. For the carers, this translates into specific needs related to various areas of their lives. However, few studies have contributed to the understanding of these carers’ needs. The purpose of this qualitative evaluative study is to identify, understand and prioritize the needs of PLS-SUD carers in the context of intervention design from the viewpoint of carers themselves (n = 9), those they were accompanying (n = 5) and other key actors involved (n = 10).

A design of action research was employed. Data analysis was done in three phases: concept map analysis, thematic analysis and transversal analysis of the results from two focus groups, 28 interview transcriptions and a logbook.

Over 60 needs were identified. After review, 39 of those were selected for prioritization. For needs related to the carers’ role as clients of the health-care system, the committee prioritized the needs for support, sharing with other carers and improving their own well-being. For the role of supporter, knowledge about substance use disorders and their interactions with psychotic disorders as well as skills such as communication and problem resolution were considered priorities. Needs to be prioritized relating to the role of partner were fewer.

The results of this study highlight the diversity and complexity of the needs experienced by carers.

This is among the first needs surveys carried out by stakeholders to describe the needs of PLS-SUD carers.

Involving People with Lived Experience (PwLE) in the development and delivery of teaching provides a more in-depth insight and authenticity to students learning about important social concerns like substance use. Involving PwLE is recognised as an approach to teaching and collaboration which is beneficial for those involved as learners and (if done correctly) for those who gift their time to sharing their opinions and experiences. More is known within the literature about the benefits for academics and students in relation to involving PwLE in the development, design, and delivery of teaching, less is known about how PwLE experience their involvement and how they prepare for their involvement in the process. In this reflective chapter, we utilise our own collective experiences of working with and/or supporting the involvement of PwLE in the development of teaching resources and teaching practices. The reflections contained here are based upon own highly subjective experiences of working with and supporting PwLE to get involved in the development of resources and delivery of teaching content. From these reflections, we hope that you the reader is able to understand more about how PwLE and this will encourage you to become engaged with this process. In doing so, we hope you also gain some insights into your own teaching practices and learning needs.