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Purpose: This chapter aims to illuminate the cultural perceptions of illicit alcohol and to examine the role of cognitive polyphasia in changing the perceptions and legitimacy of market practices.

Methodology/Approach: An ethnographic study of the Kenyan illicit alcohol market, which combined digital news media data analysis, with observation and interview data.

Findings: Cognitive polyphasia serves to delegitimize illicit alcohol by portraying it as incongruent with existing cultural beliefs, values, and assumptions. Illicit alcohol is portrayed as a contaminated product, a cursed business, a practice that causes cultural breech, and a scheme of witchcraft/sorcery used to enslave consumers. Findings also show that cognitive polyphasia involves drawing on traditional knowledge to explain misfortune and difficult social phenomena such as addiction. The delegitimation of illicit alcohol induces behavior and perception change. Consumers play an important role in this change process.

Research Implications: This research proposes the incorporation of cultural language into alcohol policy and education.

Social Implications: By illuminating social representations in the cultural-cognitive arena, a theory for applying these factors to change markets/behavior is proposed.

Originality/Value of Paper: The chapter highlights the delegitimation of market practices, unlike previous research that focuses on legitimation processes. This chapter also demonstrates how cognitive polyphasia, a scarcely researched concept in consumer research, can induce behavior change. This chapter also contributes to the literature on market/behavior change by revealing potential cultural-cognitive barriers to change.

Illicit substance use can have a detrimental effect on a young person's life, abilities, psychosocial well-being, educational participation, attainment and outcomes. It is associated with and can lead to increased vulnerability and be a serious safeguarding concern. This chapter explores the concept of illicit substance as a process of ‘normalisation’ among children and young people. It also explores the concept of ‘game playing’, poly and tertiary substance use and considers some of the implications of illicit substance use and of young people becoming involved in ‘County Lines’. Understanding the nature, scale, extent and consequences of illicit substance use, and how young people are portrayed and stigmatised by those around them are important in relation to responding appropriately to need, and in assessing safeguarding concerns. This chapter will also discuss these concerns and conclude by critically considering the implications of illicit substance use for teachers and schools, whilst considering appropriate responses which identify and reduce risk.

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.

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.

There have been few studies about the prevalence of substance abuse and links to offending behaviour among those with intellectual disabilities. This paper aims to address this issue.

This baseline audit describes: the prevalence of alcohol and substance misuse in patients within a forensic intellectual disability service; and the introduction of a Drug and Alcohol Awareness Course. In total, 74 patients were included in the audit.

Roughly half of the patients audited had co‐morbid harmful use or dependence with the problem being equally prevalent in men and women. Whilst alcohol and cannabis were the commonest drugs of abuse, cocaine, stimulants and opiates were abused by a small but significant number. Of those with harmful use or dependence, 35 per cent had used the drug in the immediate lead up to their index offence. A diagnosis of personality disorder and past history of convictions for violent offences was significantly more likely to be present in the group with harmful use or dependence. There were no differences on major mental illnesses or pervasive developmental disorders.

The high prevalence of substance abuse makes it an important risk factor that could determine treatment outcomes. Forensic intellectual disability units need replicable substance abuse targeted treatment programmes that can be formally audited and evaluated.

Findings are discussed in relation to service planning and treatment outcomes from forensic intellectual disability services.

Alcohol and other drug (AOD) use is common worldwide. There is a wide spectrum of AOD issues that pose a major threat to public health, safety and the wellbeing of communities, families and individuals. There is no doubt that nurses have primary roles in identifying, preventing and addressing AOD use issues in emergency departments and general hospital units, clinics, specialist mental health and drug and alcohol services, sexual health services, youth services and community settings where people seek health care and other assistance. Nurses have credibility and are trusted by communities for their ability to address many health issues, including AOD health problems. Despite the enormous economic burden associated with AOD use across the world, the nursing profession has yet to fully acknowledge and embrace this serious issue for nurses.

The purpose of this paper is to identify and report on the mental health needs of those attending substance misuse services (SMS) adhering to the diagnostic criteria as defined in DSM 5 with reference to common mental health disorders. It also examines differences in the numbers of appropriately trained cognitive behaviour therapy (CBT) therapists and highlights the lack of provision of CBT reflected in the much smaller number of accredited therapists in Wales compared to other parts of the UK.

This population was identified by way of an audit of data collected via the out-patient clinics conducted by the author.

The paper identifies a high proportion of patients who attended SMSs as having complex psychological need as a consequence of co-morbidity.

The results of the audit may have limitations but the implications from the findings suggest potential value in looking more at clinical outcomes following evidence-based psychological interventions.

A conclusion from the findings is suggested value in a more structured approach to looking at clinical outcomes.

This audit was undertaken in North Wales. There is no IAPT or matrix-structured Level II CBT training programmes available in Wales. The audit identifies the need for more evidence-based psychological interventions such as CBT linked to the development of such services. The apparent lack of political will to change the status quo is also highlighted as a problem.

The purpose of this paper is to examine correlates and predictors of hazardous drinking behaviour, that may be considered evidence of generalised strain, in a sample of incarcerated non-Aboriginal males in New South Wales, Australia.

Data were collected from 283 non-Aboriginal male inmates as part of a larger epidemiological survey of inmates in NSW undertaken in 2015 by the Justice Health and Forensic Mental Health Network. Data relating to a range of social factors were selected with reference to relevant literature and assessed with regards their predictive value for scores from the Alcohol Use Disorders Identification Test (AUDIT). To facilitate regression analysis, variables were logically organised into historical factors or adult factors.

Almost all participants reported some history of alcohol consumption. Hazardous drinking was common among participants. While parental alcohol problems and adult drug use were the only correlates of AUDIT scores, parental misuse of alcohol was shown to be an important predictor of AUDIT scores in regression analysis. The role of parent gender was inconclusive. Previous incarceration as an adult, employment status, and drug use as an adult also predicted AUDIT scores.

Alcohol abuse is common among inmates and the use of alcohol is implicated in the commission of many offences. A better understanding of its genesis may inspire novel approaches to treatment, leading to improved health outcomes for inmates.

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.

Road policing is a key method used to improve driver compliance with road laws. However, the authors have a very limited understanding of the perceptions of young drivers regarding police enforcement of road laws. The paper aims to address this gap.

Within this study 238 young drivers from Queensland, Australia, aged 17-24 years (M=18, SD=1.54), with a provisional (intermediate) driver’s licence completed an online survey regarding their perceptions of police enforcement and their driver thrill-seeking tendencies. This study considered whether these factors influenced self-reported transient (e.g. traveling speed) and fixed (e.g. blood alcohol concentration) road violations by the young drivers.

The results indicate that being detected by police for a traffic offence, and the frequency with which they display P-plates on their vehicle to indicate their licence status, are associated with both self-reported transient and fixed rule violations. Licence type, police avoidance behaviors and driver thrill seeking affected transient rule violations only, while perceptions of police enforcement affected fixed rule violations only.

This study suggests that police enforcement of young driver violations of traffic laws may not be as effective as expected and that the authors need to improve the way in which police enforce road laws for young novice drivers.

This paper identifies that perceptions of police enforcement by young drivers does not influence all types of road offences.