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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.

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.

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.

Women are exposed to vulnerabilities that can lead to drug use or hinder recovery. However, there is a dearth of studies on recovery programs for women. This study aims to add to the literature by examining the feasibility of a women-only aftercare program for recovering users in the Philippines.

The study used a mixed-method design with pre and post-program surveys used to measure changes in participants’ recovery capital. Focused group discussions elicited participants’ context, their reactions, perceived outcomes and suggestions on the program.

Women in the program shared narratives of pain, trauma and abuse before treatment. Participants reported significant improvements in personal, community and family recovery capital dimensions. The program enabled personal growth in the form of new knowledge, skills and self-confidence. The women-only program also provided a safe space for women, to receive support from other women, community members and family. However, the women continue to face continuing challenges related to stigma and discrimination and a lack of livelihood opportunities.

A limitation of the study was its small sample size and the lack of a control group. Another limitation was the variability in treatment received by the women, which could have affected overall outcomes. Future studies using a randomized control trial and longitudinal designs may provide more robust conclusions on the effectiveness of the program.

Given punitive contexts, gender-sensitive and trauma-informed programs and services for women involved in drug use could potentially mitigate the abuse, stigma and vulnerabilities they experience.

This study contributes to the sparse literature on women-only aftercare, particularly in countries that criminalize drug use.

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.

Domestic violence is an intimate relationship that causes physical, sexual or mental suffering. The ongoing coronavirus pandemic has had a ruinous effect globally, particularly in increasing the rate of domestic violence. Thus, this study aims to assess the prevalence of domestic violence against women during the COVID-19 pandemic and its associated factors.

A community-based cross-sectional study was conducted on Bench Sheko Zone residents from May to June 2021. Participants in the study were selected by multistage sampling technique. The collected data were coded, entered into EpiData 3.1 and analyzed by using SPSS version 20. Bi-variable and multiple logistic regression analysis models were fitted. Odds ratio was used at a 95% confidence level, and P-value < 0.05 was used to declare statistical significance.

A total of 1,512 eligible women participated, with a 98.3% response rate. The proportion of domestic violence against women was 42.5%. The prevalence of psychological violence was 30.4%, followed by physical violence at 20.2% and sexual violence accounted for 9.6%. Variables, such as rural residency, women with no formal education, partner who had no formal education, women with monthly income of less than 25,00 Ethiopian birr and partner who was current substance user, were found to be associated with domestic violence against women.

Domestic violence against women is still an important public health problem in Ethiopia. Special attention should be paid to identified predictors to reduce domestic violence beyond designing prevention and control strategies along with coronavirus pandemic intervention plan.

The findings of this study show domestic violence against women is still an important public health problem in Ethiopia. Special attention should be paid to identified predictors to reduce domestic violence beyond designing prevention and control strategies, along with the coronavirus pandemic intervention plan.

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.

Following the trend in the world over and on the African continent, the Parliament of Ghana passed a new law in 2020, the Narcotics Control Commission Act (Act 1019) that eased the legal restrictions on cannabis cultivation and use, subject to obtaining license from the relevant authority/authorities. This paper aims to examine the implications of Ghana’s decision to legalise the cultivation of cannabis for industrial purposes for the production of fibre and for medicinal purposes.

The author adopted the qualitative analysis critical review methodology in sourcing information from peer-reviewed articles, coupled with the author’s own professional knowledge, background and training, to critically analyse and review the reasons behind Ghana’s decision to legalise cannabis cultivation and the implications such a major policy change/shift.

It was found that, while the law mentions industrial and medicinal purposes for the legalisation of cannabis, the real reason, at least in the immediate term, is mainly economic. This agrees with those of other African countries that have legalised cannabis cultivation but appears to contrast with those of Europe and America.

This research is limited to Ghana and the few African countries that have legalised cannabis cultivation so far. The main reason for the legalisation (economic benefits) may also change in the future when the economics of scale turn in the favour of the country. Therefore, Ghana’s case may not represent the case of all countries legalising cannabis cultivation.

The research implication of this paper is that it brings to the world the law on cannabis cultivation in Ghana. It provides a professional and scientific position paper on Ghana’s drug law regime regarding cannabis, thus, serving as a useful reference literature to the academic and research community on the topic. More importantly, it discusses the implications of such major policy change from an objective perspective, unravelling the real reason behind the State’s decision to legalise the cultivation of cannabis in Ghana.

This paper will bring to the fore the other consequences of Ghana’s cannabis cultivation legalisation policy change, which little attention has been devoted to so far.

This paper, apart from reference to other published texts on the topic, which have been duly acknowledged, represents the sole work of the author. It has not been produced anywhere or by anyone else either in Ghana or elsewhere.

Promoting positive mental health is increasingly being encouraged as the focus of research and policies on the mental health of construction personnel. Most measures of mental health, however, typically use negative indicators such as depression and anxiety and are not specifically developed for the construction workforce, especially those with a Global South background. These limitations have made it challenging to measure construction personnel’s positive mental health. The purpose of this study was, therefore, to develop a scale for measuring the positive mental health of construction personnel with a Global South background.

Guided by Keyes’ two-continua model of mental health, the study objectives were addressed through a mixed-methods study using the case of Ghana. Qualitative data collected from eight key stakeholder groups using 16 interviews and two rounds of focus group discussions were analysed thematically. Quantitative data were obtained through a survey of 425 construction personnel and analysed using confirmatory factor analysis and correlation analysis.

Thematic analysis revealed a four-dimensional structure of positive mental health, namely, emotional, psychological, social and spiritual. Confirmatory factor analysis and correlation analysis of the results indicated good instrument validity and reliability.

Existing measures of positive mental health are based on a three-dimensional model, i.e. emotional, social and psychological well-being. By including spiritual well-being, this study proposes a four-dimensional measurement model as a more comprehensive and promising measure to use in surveys of positive mental health among the construction workforce, especially those with a Global South background, and to develop suitable interventions for them.

The prison population is seldom studied and often overlooked in many countries despite their vulnerability to long-term illness. This study aims to explore the factors associated with the non-treatment for long-term illnesses among incarcerated individuals.

This study is a cross-sectional analysis. The authors conducted a secondary data analysis using information collected in the Peruvian census of incarcerated individuals. The study population consisted of incarcerated individuals diagnosed with a long-term illness. To evaluate the factors associated with non-treatment, the authors used a Poisson regression model.

The authors included 12,512 incarcerated individuals (age: 40.9 ± 13.1 years), and 39% of them did not receive treatment for their long-term illness. The authors observed that non-treatment was statistically associated with gender, age, having children, use of the Spanish language, sexual identity, judicial situation, penitentiary location, discrimination inside the penitentiary and health insurance before incarceration. However, only having children (prevalence ratio [PR]: 1.11, confidence interval [CI]95% 1.03–1.19), using the Spanish language (PR: 1.15, CI95%: 1.01–1.31), being in a penitentiary not in Lima (PR: 1.11, CI95%: 1.06–1.17) and perceiving discrimination inside the penitentiary (PR: 1.12, CI95% 1.06–1.18) increased the prevalence of non-treatment.

Identifying the factors associated with non-treatment will allow us to implement measures for prioritizing groups and developing strategies for the evaluation, close follow-up of their health and management of comorbidities.