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Evaluating the prevention, intervention, and treatment programme is critical to understanding the decision-making behaviour of substance abusers. The study interweaves behavioural health economics with the extended PRECEDE–PROCEED Model and examines the effectiveness of treatment settings for substance users in New Jersey Drug and Alcohol Abuse Treatment (13,775 samples). The study also identifies the factors that are associated with substance users’ recurrence to the treatment centre. The results concluded that educational attainment, counselling services from health care providers, mental agency services, and detoxification treatments have a significant impact on preventing relapse behaviour.

This chapter explores processes of stratification in reproductive healthcare and considers the ways in which mechanisms of inclusion/exclusion shape reproductive opportunities and experiences. First, I consider the process of “selective inclusion” among sexual minority women. This examination questions the schisms that exist within the sexual minority population in regard to their visibility and legibility in medical, scientific, and public health discourses and constructions of reproductive health. The second process I examine is that of “exclusionary inclusion” among substance using pregnant women who have been collectively deemed “bad breeders” by medical and state authorities and whose reproduction is explicitly monitored, regulated, and criminalized. The final process I discuss is “side-stepping inclusion” which describes the healthcare and consumer decisions of women who circumvent medicalized childbirth experiences by employing the services of a midwife for their pregnancy and birth care. This chapter examines how medicalization, biomedicalization, and de-medicalization dynamically work together to expand and delimit inclusionary processes, emphasizing the spectral and interconnected quality of these processes. By exploring various processes of inclusion that shape reproductive experiences of these disparate and differentially marginalized populations, this chapter provides a conceptual and critical meditation on the ways in which “respectable reproduction” is deployed in reproductive care. In considering these processes of inclusion and the ways in which they are co-produced by medical discourses and practices, scholars may more clearly grasp some fundamental mechanisms of stratification in reproductive healthcare and knowledge production.

In Nigeria, family is most important. It is usually made up of people who are related by blood, marriage, or adoption. Family plays a major role in influencing the use of psychoactive substances by adolescents and can help protect the adolescents or the reverse. Family differs in so many ways, for example, in the extent of support for education, children’s upbringing, monitoring peer activities among others. There are certain family situations where values are not being instilled, parental and social guides are not in place to ensure that children are well brought up. High levels of economic hardship (such as unemployment), family conflict, poor communication skills, domestic violence, parental divorce or single parenting, death, parental criminal activity among others disrupt parenting which reduces adolescents’ emotional security and reinforce the use of aggression and interpersonal hostility which in turn expose them to certain risks of psychoactive substance use. It is in this context that this chapter examines how family factors affect the use of psychoactive substances among adolescents in Nigeria. Empirical investigations were carried out through a review of literature search. The findings show family factors having a significant influence on the use of psychoactive substances among adolescents in Nigeria. In addition, proper parental relationship through training of moral values, teachings of the immense danger attributed to the use of psychoactive substances through counseling and communication skills could serve as a control measure that will discourage the future use and thus improve the health, safety and the general well-being of the adolescents.

Research on the social determinants of health demonstrates that workers who feel insecure in their jobs suffer poorer health as a result. However, relatively few studies have examined the relationship between job insecurity and illegal substance use, which is closely related to health. In this study, we develop a theoretical model focusing on two intervening mechanisms: health and life satisfaction. Additionally, we examine differences in this relationship between women and men. We test this model using logistic regression models of substance use for women and men based on longitudinal data from the National Survey of Midlife Development in the United States. The results indicate that job insecurity is associated with a significantly higher probability of illegal substance use among women but not men. We interpret this as further evidence of the gendering of precarious employment. This relationship is not channeled through health or life satisfaction, but there is evidence that job insecurity has a stronger association with illegal substance use for women with poorer overall health.

It is dangerous in relation to practice and safeguarding to conclude that risks exist, or do not exist, in relation to a particular type of parental behaviour and family functioning. Using parental alcohol use as an illustrative topic this chapter explores definitions of alcohol use, the significance of parental use and the mechanisms and ways it is believed alcohol use leads to harms and then affects children and their educational experiences. In doing so this chapter recognises that it can be challenging and difficult to identify different thresholds of harms and risk from parental substance use alone. It also recognises and concludes by critically reflecting on the role teachers and educational staff have to play in assessing need, reducing pupil and parental stigma and shame around alcohol use, understanding the position of the parent and what children need to encourage their involvement and discussion around concerns like parental alcohol use.

“Disparity” implies the existence of a “markedly distinct in quality or character,” difference between one group and another. Some groups, due to elevated stigma associated with group membership, are invisible as a disparate minority and therefore, while there may be a great inequity in healthcare between that group and the normative population, the invisible minority is ignored. This chapter addresses the issue of healthcare for the transgender-identified population. We address how the normative viewpoint of mental illness and unacceptable religious status, along with lifelong perceived and actual abuse and violence, creates a socially sanctioned inequality in healthcare for this population.

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.

Purpose – To examine video gamers’ attitudes about and perspectives on the controversial topic of video game “addiction.”

Approach – Ethnographic interviews and participant observation with a group of 52 regular video gamers, most also reporting considerable experience with substance use and/or dependence.

Findings – Gamers tended to endorse one of two explanations for video game addiction, either arguing that games operate on the same reward centers in the brain as drugs or that gamers who do become addicted are weak, unintelligent, or actively pursue an addictive state. Several rejected the category of addiction as applied to video gaming due to the lack of withdrawal symptomatology or the confusion of pleasure-seeking with pathology. None offered sociostructural explanations for the phenomenon, despite the relative oversampling of poor and minority participants with low degrees of education.

Research implications – Future research should attend to ideologies of causality and agency among populations affected by behavioral “addictions.”

Practical implications – The perspectives of video gamers themselves are critical to research and advocacy that departs from a position of slightly greater sensitivity, both to the formal dimensions of those games held to be most habit-forming and to the ideological dimensions of video gamers’ thinking about what constitutes “addiction.”

This chapter concludes the volume. This is done in two capacities. First, the contributing chapters within in each theme are brought together through a reflexive discussion on current debates on anti-doping approaches, health and risk, doping arenas and communities, and the gendering of doping. Second, the interrelationships between the themes are discussed, pointing to new research directions.