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This study investigates associations between Facebook (FB) conversations and self-reports of substance use among youth experiencing homelessness (YEH). YEH engage in high rates of substance use and are often difficult to reach, for both research and interventions. Social media sites provide rich digital trace data for observing the social context of YEH's health behaviors. The authors aim to investigate the feasibility of using these big data and text mining techniques as a supplement to self-report surveys in detecting and understanding YEH attitudes and engagement in substance use.

Participants took a self-report survey in addition to providing consent for researchers to download their Facebook feed data retrospectively. The authors collected survey responses from 92 participants and retrieved 33,204 textual Facebook conversations. The authors performed text mining analysis and statistical analysis including ANOVA and logistic regression to examine the relationship between YEH's Facebook conversations and their substance use.

Facebook posts of YEH have a moderately positive sentiment. YEH substance users and non-users differed in their Facebook posts regarding: (1) overall sentiment and (2) topics discussed. Logistic regressions show that more positive sentiment in a respondent's FB conversation suggests a lower likelihood of marijuana usage. On the other hand, discussing money-related topics in the conversation increases YEH's likelihood of marijuana use.

Digital trace data on social media sites represent a vast source of ecological data. This study demonstrates the feasibility of using such data from a hard-to-reach population to gain unique insights into YEH's health behaviors. The authors provide a text-mining-based toolkit for analyzing social media data for interpretation by experts from a variety of domains.

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.

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.

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.

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.

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.

Therapeutic communities (TCs) are one of the existent social responses in helping drug users overcome addiction and pursue social reintegration. The purpose of this paper is to present and discuss the general characteristics of about 200 drug users and their addiction and those of addicts abroad treated in a TC and clinically discharged. The analysis now presented is the first empirical approach to capture social regularities and singularities that are present in these individuals’ reintegration strategies.

The data have a ten-year range – from 1999 to 2009 – and were statically analysed.

They show a group of individuals with low qualifications reflected in their professional occupation, from which family is an essential support. These data also show a significant prevalence of heroin, alcohol, cocaine and polydrug uses, highlighting the need to consider new use patterns and new synthetic substances.

TC have been little studied, mainly in Portugal.

The purpose of this paper is to explore polydrug use and the factors that motivate the use of multiple substances among selected young adults.

A total of 23 male and female participants (aged 23-29 years) who use illicit drugs and prescription pharmaceuticals for non-medical purposes were recruited through snowball sampling. Qualitative interviews were conducted, and the data were analysed thematically.

The use of drug “concoctions” and cocktails was widespread among the participants. Some used what they called Codeine Diet (codeine-based cough syrup mixed with a Coca-Cola^® product or malt drink), while others took Gutter Water (a cocktail of cannabis, codeine, tramadol, vodka and juice or water). The use of Monkey Tail (a mixture of local gin, cannabis leaves, stems, roots and seeds) and petrol mixed with glue and La Casera^® (carbonated soft drink) combined with Tom-Tom^® (menthol-flavoured candy) was also revealed. Pleasure, better highs, the need to experience prolonged intoxication and the use of one drug to douse the effects of another substance motivated polysubstance use.

The findings revealed that the reasons why codeine-based cough syrups are mixed with soft drinks (Codeine Diet) include avoiding social discrimination and evading law enforcement agencies. Results suggest that these drug use practices require specifically tailored public health interventions. Social stigmatization against substance users and the use of extra-legal measures by the police should be discouraged to facilitate harm reduction.

This study represents the first qualitative research to explore polydrug use among an understudied Nigerian population.

The purpose of this paper is to explore the adoption and implementation of computer-assisted therapy (CAT) using Breaking Free Online (BFO) in a social care and health charity working with people affected by drugs and alcohol dependence, Crime Reduction Initiatives (CRI).

Semi-structured interviews were conducted with service managers, practitioners, peer mentors and service users. Data were thematically analysed and themes conceptualised using Roger's Diffusion of Innovation Theory (Rogers, 1995, 2002, 2004).

A number of perceived barriers to adoption of BFO throughout CRI were identified within the social system, including a lack of IT resources and skills. However, there were numerous perceived benefits of adoption of BFO throughout CRI, including broadening access to effective interventions to support recovery from substance dependence, and promoting digital inclusion. Along with the solutions that were found to the identified barriers to implementation, intentions around longer-term continuation of adoption of the programme were reported, with this process being supported through changes to both the social system and the individuals within it.

The introduction of innovations such as BFO within large organisations like CRI can be perceived as being disruptive, even when individuals within the organisation recognise its benefits. For successful adoption and implementation of such innovations, changes in the social system are required, at organisational and individual levels.

The learning points from this study may be relevant to the substance misuse sector, and more widely to criminal justice, health and social care organisations.

This study is the first of its kind to use a qualitative approach to examine processes of implementation of CAT for substance misuse within a large treatment and recovery organisation.

In recent years there has been a proliferation of computer-based psychotherapeutic interventions for common mental health difficulties. Building on this, a small number of such interventions have now been developed to address substance dependence, one of which is Breaking Free Online (BFO). A new “eTherapy” self-help service, which was set up by the UK mental health charity Self-Help Services, has provided access to BFO to service users presenting with comorbid mental health and substance misuse difficulties. The purpose of this paper is to evaluate a range of clinical outcomes in the first cohort of service users accessing this dual diagnosis service.

A number of standardised psychometric assessments were conducted with service users at baseline and post-treatment at discharge from the service. Outcome data were available for 47 service users out of an original cohort of 74.

Statistically significant improvements were found in terms of measures of social functioning, depression, anxiety, alcohol and drug use and social anxiety. Clinically relevant gains were also identified, with fewer service users reaching threshold scores for depression and anxiety at post-treatment compared to baseline. Effect sizes also indicated that the identified improvements across the psychometric measures were robust and significant.

These findings provide further support for the clinical effectiveness of BFO, and also provide evidence that an eTherapy self-help service may be appropriate for some individuals presenting with dual diagnosis. Further research is underway with larger and alternative clinical populations to examine the effectiveness of BFO and also this novel eTherapy self-help approach.

This paper has provided initial data to support effectiveness of a novel eTherapy service for dual diagnosis.

This study is a post hoc service level investigation into the efficacy of a forensic dual diagnosis intervention. The treatment programme incorporated the principles of cognitive behavioural therapy and Motivational Interviewing, and was comprised of three stages: psycho-education into the links between mental/physical health, substance use and offending, the cultivation of coping strategies and relapse prevention planning. The paper aims to discuss these issues.

Treatment outcome was tracked using pre- and post- stage 1 and 2 measures, and included self-report questionnaires that probed service users’ readiness for change, motivations for treatment and perceived effectiveness of coping strategies (n=80 and 37 patients for stages 1 and 2, respectively). In addition, service users undertook a knowledge “quiz”, which probed information retention.

The results show that whilst psycho-education (stage 1) increased service users’ knowledge of key issues, this had no parallel effects on other measures. In contrast, completion of stage 2 led to an increase in external motivation for treatment, although this did not translate into a shift in service users’ readiness for change.

These findings are consistent with the Motivational Interviewing literature and highlight the need for a shift in internalised motivation for treatment if change is to be elicited. Further, they point towards the viability of using self-report measures to monitor treatment outcome in a secure forensic setting.

These findings have a number of implications for the design and on-going evaluation of forensic dual diagnosis services, an area of research that is currently under-represented in the literature.

The purpose of this paper is to study the social representations of polydrug use in the Finnish mainstream media. Social representations are shared ways of talking about socially relevant issues and have ramifications on both individual and socio-political levels.

The social representations theory and the “What’s the problem represented to be?” analysis provided the theoretical framework. In total, 405 newspaper articles were used as data and analysed by content analysis and thematic analysis. The key tenets of the social representations theory, anchoring, objectifying and naturalisation, were used in data analysis.

The study found that polydrug use was written about differently in articles over the study period from 1990 to 2016. Three social representations were introduced: first, polydrug use as a concept was used to refer to the co-use of alcohol and medical drugs. This was seen as a problem for young people, which could easily lead to illicit drug use. Second, illicit drugs were included in the definitions of polydrug use, which made the social representation more serious than before. The typical polydrug user was portrayed as a person who was addicted to substances, could not quite control his/her use and was a threat to others in society. Third, the concepts were naturalised as parts of common language and even used as prototypes and metaphors.

The study provides a look at how the phenomenon of polydrug use is conceptualised in everyday language as previous research has concentrated on its scientific definitions. It also adds to the research of media representations of different substances.

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.

The purpose of this paper is to examine gender differences in lifetime substance use and non-substance use (non-SUD) psychiatric disorders among illicit drug users and determine factors associated with non-SUD psychiatric disorders independently for males and for females.

Secondary analysis of five cross-sectional studies conducted in Barcelona, Spain during 2000-2006. Lifetime DSM-IV substance use and non-SUD psychiatric diagnoses were assessed using the Spanish Psychiatric Research Interview for Substance and Mental disorders (PRISM) among 629 people who use substances (68 per cent male) recruited from treatment (n=304) and out of treatment (n=325) settings. Odds ratios (OR) and 95% confidence intervals (CI) were calculated using binary logistic regression.

The prevalence of any lifetime psychiatric (non-SUD) disorder was 41.8 per cent, with major depression (17 per cent) and antisocial personality disorder (17 per cent) being the most prevalent disorders. After adjusting for age and study, the odds of having any lifetime non-SUD (OR 2.10; 95%CI 1.48, 2.96); any mood disorder (OR 2.13; 95%CI 1.46, 3.11); any anxiety disorder (OR 1.86; 95%CI 1.19; 2.92); any eating disorder (OR 3.09; 95%CI 1.47, 6.47); or borderline personality disorder (OR 2.30; 95%CI 1.36, 3.84) were greater for females than males. Females were less likely than males to meet criteria for antisocial personality disorder (OR 0.59; 95%CI 0.36, 0.96) and attention deficit disorder (OR 0.37; 95%CI 0.17, 0.78).

Psychiatric disorders are common among people who use substances, with gender differences reported for specific disorders. Gender-sensitive integrated treatment approaches are required to prevent and to address comorbidity psychiatric disorders among this population.

This secondary analysis of five cross-sectional studies included a large sample size allowing sufficient power to examine the differences between men and women. An additional strength of the methodology is the use of the gold standard PRISM which was used to assess disorders.