Annabel Boys, John Marsden and John Strang
A range of personal and social factors influence psychoactive substance use in young people. One of these influences is the perceived “functions” (or purposes) that using a drug…
Abstract
A range of personal and social factors influence psychoactive substance use in young people. One of these influences is the perceived “functions” (or purposes) that using a drug is intended to fulfil (e.g. “helping to relax” or “to stay awake”). Using a sample of 100 young people aged 16‐22 years recruited in the community, this study explores the relationship between patterns of alcohol, cannabis, amphetamines and ecstasy use and perceived functions and other social influences. Multiple regression analyses indicated that the frequency of substance use was more influenced by functions than by the extent of peer use and that the experience of negative effects from using had very little influence. These findings suggest that consideration of the functions associated with substance use could be valuable in the development of educational and prevention programmes
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John M Majer, Hannah M Chapman and Leonard A Jason
– The purpose of this paper is to compare the effects of two types of community-based, residential treatment programs among justice involved persons with dual diagnoses.
Abstract
Purpose
The purpose of this paper is to compare the effects of two types of community-based, residential treatment programs among justice involved persons with dual diagnoses.
Design/methodology/approach
A randomized clinical trial examined treatment conditions among justice involved persons with substance use disorders who reported high baseline levels of psychiatric severity indicative of diagnosable psychiatric comorbidity. Participants (n=39) were randomly assigned to one of three treatment conditions upon discharge from inpatient treatment for substance use disorders: a professionally staffed, integrated residential treatment setting (therapeutic community), a self-run residential setting (Oxford House), or a treatment-specific aftercare referral (usual care). Levels of psychiatric severity, a global estimate of current psychopathological problem severity, were measured at two years as the outcome.
Findings
Participants randomly assigned to residential conditions reported significant reductions in psychiatric severity whereas those assigned to the usual care condition reported significant increases. There were no significant differences in psychiatric severity levels between residential conditions.
Research limitations/implications
Findings suggest that cost-effective, self-run residential settings such as Oxford Houses provide benefits comparable to professionally run residential integrated treatments for justice involved persons who have dual diagnoses.
Social implications
Results support the utilization of low-cost, community-based treatments for a highly marginalized population.
Originality/value
Little is known about residential treatments that reduce psychiatric severity for this population. Results extend the body of knowledge regarding the effects of community-based, residential integrated treatment and the Oxford House model.
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John Gabriel, FCA, and Gerald Soane, BSc, have been appointed joint managing directors of Chemitrade Ltd, in succession to John Sinclair, who is returning to Australia to assume…
Abstract
John Gabriel, FCA, and Gerald Soane, BSc, have been appointed joint managing directors of Chemitrade Ltd, in succession to John Sinclair, who is returning to Australia to assume responsibility for all operations in the Pacific area of the Steuber group, Chemitrade's parent company.
Interest in developing institutional explanations of political and economic behavior has blossomed among social scientists since the early 1980s. Three intellectual perspectives…
Abstract
Interest in developing institutional explanations of political and economic behavior has blossomed among social scientists since the early 1980s. Three intellectual perspectives are now prevalent: rational choice theory, historical institutionalism and a new school of organizational analysis. This paper summarizes, compares and contrasts these views and suggests ways in which cross‐fertilization may be achieved. Particular attention is paid to how the insights of organizational analysis and historical institutionalism can be blended to provide fruitful avenues of research and theorizing, especially with regard to the production, adoption, and mobilization of ideas by decision makers.
Jane Fountain, Samantha Howes, Colin Taylor and Strang
A survey of the substance use of 389 homeless people included questions on current income and expenditure. The two sources of income most often reported were state benefits and…
Abstract
A survey of the substance use of 389 homeless people included questions on current income and expenditure. The two sources of income most often reported were state benefits and begging. Those whose main substance was heroin or crack cocaine were more likely to have a larger financial expenditure, and to obtain this income from criminal activities, than those whose main substance was another drug or alcohol. By far the most commonly‐cited main items of expenditure were drugs and alcohol. The findings are discussed in terms of current interventions and service development.
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Natasha Newbery, Jim McCambridge and John Strang
The feasibility of a community‐level drug prevention intervention based upon the principles of motivational interviewing within a further education college was investigated in a…
Abstract
Purpose
The feasibility of a community‐level drug prevention intervention based upon the principles of motivational interviewing within a further education college was investigated in a pilot study.
Design/methodology/approach
The implementation over the course of a single term of “Let's Talk about Drugs” was studied with both action research methods and a quasi‐experimental design.
Findings
Modest qualitative evidence of attitudinal and environmental benefit provides some optimism that intervention of greater duration may have the capacity to produce more substantial impact.
Research limitations/implications
The sustainability of the achieved institutional changes following the delivery of this intervention, most notably centring upon a revised drug policy, is questionable. No quantitative data on reduced drug use behaviour or associated problems directly attributable to intervention was obtained.
Originality/value
Further education colleges offer relatively unexplored opportunities for drug prevention and harm reduction, at both individual and community levels. Three major lessons were learned: for the motivational interviewing approach to be applied with meaningful potential to effectively shaping behaviour at the college level, greater input is required; quasi‐experimental methods for evaluation are feasible and appropriate; and intervention must be coherent with, and shaped by, the specific college context.
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Peter Miller, Stephen McKenzie, Jane Walker, Nicholas Lintzeris and John Strang
The behaviour of patients of alcohol and other drug treatment services in the communities where the services are based has often been a major problem for the services. This study…
Abstract
Purpose
The behaviour of patients of alcohol and other drug treatment services in the communities where the services are based has often been a major problem for the services. This study seeks to investigate the street behaviour of patients enrolled in a Medically Supervised Injectable Maintenance Clinic (MSIMC) implemented as part of the Randomised Injectable Opioid Treatment Trial (RIOTT), into the effectiveness and efficacy of providing injectable opioids versus conventional oral methadone.
Design/methodology/approach
Patient behaviour on the streets of Camberwell was recorded via data from records of the fortnightly Camberwell Street Population Forum (CSPF), between 12/11/2004 and 08/09/2006.
Findings
In total, 81 individuals were identified as engaging in anti‐social behaviour or being part of the street population, including seven (8.6 per cent) who had also taken part in the RIOTT. There was a clear treatment effect for RIOTT participants.
Originality/value
The use of CSPF records suggests a substantial treatment effect for the individuals who appeared on its register.
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Eric Blaauw, Gytha Strijker, Yentl Boerema, Eric Veersma, Margreet van der Meer-Jansma and Gabriel Anthonio
– The purpose of this paper is to examine the prevalence of psychopathology including substance use disorders in a sample of detained female systematic offenders.
Abstract
Purpose
The purpose of this paper is to examine the prevalence of psychopathology including substance use disorders in a sample of detained female systematic offenders.
Design/methodology/approach
All case files of female systematic offenders who had been subjected to a special court order for systematic offenders in the period 2004-2014 were studied. A total of 81 fairly complete case files were selected for the study. These were all systematic offenders as they had been sentenced for at least 25 offences with an average of 102 offences over a period of 17.5 years.
Findings
All except one woman were addicted to substances in the past year, with an average duration of addiction of 21 years. In addition, 53 per cent were diagnosed with another DSM Axis I disorder and 73 per cent were diagnosed with a personality disorder. Furthermore, 32-59 per cent were found to have intellectual dysfunctions. In total, 12 per cent had one type of the above disorders, 43 per cent two types, 31 per cent three types and 14 per cent all four types. The prevalence rates of these disorders were higher than those reported in other prison studies.
Research limitations/implications
It is concluded that female systematic offenders can be characterised as problematic in many respects. Even in such a problematic group treatment can be provided.
Originality/value
The present study is the only study that provides prevalence data of mental disorders among female systematic offenders.
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Bagga Bjerge, Karen Duke and Vibeke Asmussen Frank
The purpose of this paper is to examine the shifting roles of medical professionals as stakeholders in opioid substitution treatment (OST) policies and practices in Denmark and…
Abstract
Purpose
The purpose of this paper is to examine the shifting roles of medical professionals as stakeholders in opioid substitution treatment (OST) policies and practices in Denmark and the UK within the past 15 years.
Design/methodology/approach
The paper is based on literature reviews, documentary analyses and key informant interviews with a range of stakeholders involved in OST and policy in Denmark and UK. The study is part of the EU-funded project: Addictions and Lifestyles in Contemporary Europe: Reframing Addictions Project.
Findings
Denmark and the UK are amongst those few European countries that have long traditions and elaborate systems for providing OST to heroin users. The UK has a history of dominance of medical professionals in drugs treatment, although this has been recently challenged by the recovery movement. In Denmark, a social problem approach has historically dominated the field, but a recent trend towards medicalisation can be traced. As in all kinds of policy changes, multiple factors are at play when shifts occur. We examine how both countries’ developments around drugs treatment policy and practice relate to broader societal, economic and political changes, how such divergent developments emerge and how medical professionals as stakeholders enhanced their roles as experts in the field through a variety of tactics, including the production and use of “evidence”, which became a key tool to promote specific stakeholder’s perspectives in these processes.
Originality/value
The paper contributes to current policy and practice debates by providing comparative analyses of drug policies and examination of stakeholder influences on policy processes.