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The US is experiencing an unprecedented opioid crisis, with a record 81,000 opioid-involved overdose deaths in the past year. Addressing the opioid crisis will require a substantial scale-up of access to effective treatment for opioid use disorder. Currently, only 18% of individuals with opioid use disorder receive evidence-based treatment in a given year. While health systems and public health departments are working to implement innovative strategies for engaging people with opioid use disorder into treatment, these efforts are hindered by widespread shortages of addiction treatment providers. Using a case study from the largest municipal hospital system in the US, the authors describe the effects of a workforce shortage on health system responses to the opioid crisis. Solving this national problem will require a multi-pronged approach, including federal programs focused on growing and diversifying the pipeline of addiction providers, medical education initiatives spanning pre-medical through residency training, and enhanced training and mentorship to increase the capacity of allied clinicians to treat opioid use disorder. Workforce development should be combined with structural reforms for integrating addiction treatment into mainstream medical care, and with new treatment models, including telehealth, that can lower patient barriers to accessing treatment.

Objective Addiction treatment via telehealth expanded to unprecedented levels during the COVID-19 pandemic. This study aimed to clarify whether the research evidence on the efficacy of telehealth-delivered substance use disorder treatment and the experience of providers using telehealth during the pandemic support continued use of telehealth after the pandemic and, if so, under what circumstances. Methods Data sources included a literature review on the efficacy of telehealth for substance use disorder treatment, responses to a 2020 online survey from 100 California addiction treatment providers, and interviews with 30 California treatment providers and other stakeholders. Results Eight published studies were identified that compared addiction treatment via telehealth with in-person treatment. Seven found telehealth treatment as effective but not more effective than in-person treatment in terms of retention, therapeutic alliance, and substance use. One Canadian study found that telehealth facilitated methadone prescribing and improved retention. In the survey results reported here, California addiction treatment providers said that more than 50% of their patients were being treated via telehealth for intensive outpatient treatment, individual counseling, group counseling, and intake assessment. They were most confident that individual counseling via telehealth was as effective as in-person individual counseling and less sure about the relative effectiveness of telehealth-delivered medication management, group counseling, and intake assessments. Conclusions Telehealth may help engage patients in addiction treatment by improving access and convenience. Additional research is needed to confirm that benefit and to determine how best to tailor telehealth to each patient's circumstances and with what mix of in-person and telehealth services.

Addiction research suggests that recovery narratives share common structural elements. For further investigation of this topic, the current study invoked Propp's folktale theory and method to identify narratemes within retrospectives to depict the stages of recovery. Semi-structured interviews were recorded about the experiences of six recovering helpers who had been sober for a minimum of five years and worked as a professional for at least one year. A deductive narrative analysis was carried out. From the 31 Proppian narratemes, 28 were identified and different recovery stories were threaded into a commonly shared narrative strand, where the hero's relationship and struggle with the villain (drug) are depicted in process. Applying Propp's narratemes to analyze recovery stories is a new development that seems applicable according to our results, as it is consistent with fairytale therapy within addiction treatment, which helps the lost wanderer to create structure in their life.

As per the Magnitude of Substance Use in India 2019 survey report, over 57 million of the Indian population is in need of professional help for alcohol use disorders and around 7.7 million for opioid use disorders. The increasing demand for addiction treatment services in India calls for professionalising every aspect of the field. Frequent human rights violations and various unethical practices in Indian addiction treatment facilities have been reported in the mass media. This study is a content analysis of newspaper reports from January 1, 2016 to December 31, 2019 looking into legal, ethical and professional concerns regarding the treatment of substance use disorders in India. The content analysis revealed various human rights violations, the use of improper treatment modalities, the lack of basic facilities at treatment settings, and the presence of unqualified professionals in practice.

As adjunctive therapy, yoga is commonly integrated into addiction treatment. However, conventional yoga practice does not intentionally address the underlying trauma that many with addictive use di...

The Seven Challenges® (7C) is a program for adults and adolescents with substance use disorders and co-occurring problems. The aim of this systematic review was to examine the methodological charac...

Objective: In this study, it was aimed to evaluate the level of smart phone and internet addiction among the staff working in the substance dependence treatment center serving children and adolescents under the age of 18. Method: The study included 30 people from different professions working in the child adolescent substance dependence treatment center. Participants were given a sociodemographic data form, Smartphone Addiction Scale-Short Version (SAS-SV) and Short Form of Young’s Internet Addiction Test (YIAT-SF). Results: The mean score of the SAS-SV is 25.3 ± 11.4 and YIAT-SF is 19.2 ± 8.3. These values are accepted as low-moderate. A negative significant correlation was found between age and YIAT-SF. Also, a positive significant correlation was found between both scale scores. Conclusions: Internet and smartphone addictions of staff working in the adolescent addiction service were found to be similar to the results of studies conducted with other healthcare professionals. The data obtained from the study were discussed with the current literature. In this regard, there is a need for studies involving staff working in different dependence treatment centers and units.

Since the mid-1970s, neoliberal policies have relied on privatization and other tactics to down-size the state, transforming human service organizations in the process. The impact of this approach, also known as managerialism, has not been examined in addiction treatment, where the opioid epidemic has intensified the need for services. Using qualitative semi-structured interviews, we explore how managerialism has affected the workforce, service delivery, and the quality of care in New York City addiction treatment programs. Front-line and managerial staff identified threats to working conditions, including high caseloads and productivity demands; threats to service quality including standardization of practice, loss of professional discretion and serving only those most likely to succeed; and threats to worker well-being marked by stress, burn-out, and low morale. The contradictions between the goals of managerialism and addiction treatment threaten the ability to meet the needs of people struggling with addiction.

This study aimed to identify the context-specific barriers of addiction treatment.This study followed an inductive qualitative content analysis approach to explore the barriers to drug addiction tr...

Addiction is a severe social and mental health problem that requires concerted interdisciplinary efforts to address. Social workers routinely encounter addiction in their practice and can play an i...

Addiction is a multidimensional issue affecting North American, Indigenous peoples. Most federal and provincial-funded treatment programs follow a Western model. We argue for more comprehensive culturally responsive training for workers, and the concept of neurodecolonization be covered. We also call for developing policy within education, licensing bodies, and front-line organizations for a working knowledge of the historical and racial contexts affecting Indigenous peoples. These policies must engage with the Kehte-ayak (Old Ones), while harmonizing Indigenous and Western knowledge systems that incorporate contemplative practices such as Indigenous ceremonies and neurodecolonzation approaches to healing.

This article explores how professionals within Swedish addiction treatment (n = 18) describe and make sense of relapse prevention (RP). RP is known as a self-control programme for maintaining behav...

An autobiographical, narrative art therapy approach to treat drug addiction was co-developed at the Methadone Clinic of Muhimbili National Hospital, Dar-es-Salaam, Tanzania. The 10-session art ther...

BACKGROUND: People who use drugs (PWUD) have high rates of hepatitis C virus (HCV) infection. Hospitalization can be a time for PWUD to engage in addiction treatment, but little is known about how hospitalization shapes HCV treatment readiness. We aimed to describe how hospitalization and addiction medicine consult service (AMCS) can alter HCV prioritization of inpatient PWUD with HCV. METHODS: We conducted a qualitative study consisting of semi-structured interviews (n = 27) of hospitalized adults with addiction and HCV infection seen by an AMCS at a single, urban, academic center. Interviews were audio-recorded, transcribed, and coded iteratively at the semantic level, and analyzed for themes. RESULTS: Of the 27 participants, most identified as Caucasian (85%), male gender (67%), and they primarily used opioids (78%); approximately half (48%) reported HCV diagnosis over 5 years ago. We identified three main themes around hospitalization altering the prioritizations and HCV treatment preferences for PWUD: (1) HCV treatment non-engaged (2) HCV treatment urgency, and (3) HCV treatment in the future. Those wanting to treat HCV—whether urgently or in the future—shared the overlapping theme of hospitalization as a reachable moment for their addiction and HCV. These participants recognized the long-term benefits of addressing HCV and connected their hospitalization to substance use. CONCLUSION: In our study, PWUD with HCV expressed varying and competing priorities and life circumstances contributing to three main HCV treatment trajectories. Our results suggest ways hospitalization can serve as an HCV touchpoint for PWUD, especially in the context of addressing substance use, and could be used when designing and implementing targeted interventions to improve the HCV care continuum for PWUD.

Opioid use disorder (OUD) is increasingly recognized as a chronic, relapsing brain disease whose treatment should be integrated into primary care settings alongside other chronic conditions. However, abstinence from all non-prescribed substance use continues to be prioritized as the only desired goal in many outpatient, primary care–based treatment programs. This presents a barrier to engagement for patients who continue to use substances and who may be at high risk for complications of ongoing substance use such as human immunodeficiency virus (HIV), hepatitis C virus (HCV), superficial and deep tissue infections, and overdose. Harm reduction aims to reduce the negative consequences of substance use and offers an alternative to abstinence as a singular goal. Incorporating harm reduction principles into primary care treatment settings can support programs in engaging patients with ongoing substance use and facilitate the delivery of evidence-based screening and prevention services. The objective of this narrative review is to describe strategies for the integration of evidence-based harm reduction principles and interventions into outpatient, primary care–based OUD treatment settings. We will offer specific tools for providers and programs including strategies to support safer injection practices, assess the risks and benefits of continuing medications for opioid use disorder in the setting of ongoing substance use, promote a non-stigmatizing program culture, and address the needs of special populations with ongoing substance use including adolescents, parents, and families. Supplementary Information The online version contains supplementary material available at 10.1007/s11606-021-06904-4.

The Islamic spirituality permeating the practice of Muslim religious beliefs, values, and norms, is positioned to play a pivotal role in addiction prevention, treatment, rehabilitation therapy and recovery of Muslim addicts. This study seeks to explore potential interconnections between spirituality, addiction treatments, recovery , and the ways and means with which Islamic spirituality may assist addicts in coping with inner urges, relapse, and recovery. This study seeks to lay the groundwork for future theoretical and empirical research on spirituality and addiction, development of spirituality-based addiction programs, and the assessment of related current spiritual philosophies, methods, and strategies. This inquiry discusses spirituality as a source of meaning-making and purpose cultivation, self-discipline, motivation, support, reintegration, and related issues arising in these regards, and highlights the need for utilizing spirituality as a critical instrument in addiction treatment programs. Islamic spirituality however is neither – and should not be considered - a sole treatment scheme, nor does it appreciate absolute reliance on non-spiritual means of recovery in favor of positivistic empirical methods. [ Spiritualitas Islam meresap ke pelbagai praktik ke beragama an , nilai dan norma , yang mana hal ini juga berperan penting pada pencegahan , pengobatan, terapi rehabilitasi dan pemulihan kecanduan pada umat muslim . Artikel ini mengeksplorasi potensi keterkaitan antara spiritualitas, penyembuhan kecanduan, pemulihan dan cara serta sarana spiritualitas Islam dalam membantu pecandu mengelola kondisi batin, ketika kambuh dan pemulihan. Studi ini berusaha meletakkan dasar bagi pen elitian teoretis dan empiris dimasa depan tentang spiritualitas dan kecanduan, pengembangan program kecanduan berbasis spiritualitas, dan penilaian filosofi, metode, dan strategi spiritual terkait. Artikel ini membahas spiritualitas sebagai sumber pemb entukan makna dan pen ggalian tujuan, disiplin diri, motivasi, dukungan, reintegrasi, dan isu-isu terkait yang timbul dalam hal ini, dan menyoroti kebutuhan untuk memanfaatkan spiritualitas sebagai instrumen penting dalam program perawatan kecanduan. Spiritualita s Islam bagaimanapun juga bukan–dan tidak boleh dianggap– satu-satunya skema pengobatan, tapi juga tidak tergantung mutlak pada sarana pemulihan non-spiritual yang mendukung metode empiris positivistik. ]

Research shows that cannabis is understood differently across cannabis cultures. In Sweden, young cannabis users are seen as vulnerable, problem-burdened and increasingly embracing drug-liberal att...

Alcohol addiction is a chronic relapsing brain disease characterized by an impaired ability to stop or control alcohol use despite adverse consequences. A main challenge of addiction treatment is to prevent relapse, which occurs in more than >50% of newly abstinent patients with alcohol disorder within 3 months. In people suffering from alcohol addiction, stressful events, drug-associated cues and contexts, or re-exposure to a small amount of alcohol trigger a chain of behaviors that frequently culminates in relapse. In this review, we first present the preclinical models that were developed for the study of alcohol seeking behavior, namely the reinstatement model of alcohol relapse and compulsive alcohol seeking under a chained schedule of reinforcement. We then provide an overview of the neurobiological findings obtained using these animal models, focusing on the role of opioids systems, corticotropin-release hormone and neurokinins, followed by dopaminergic, glutamatergic, and GABAergic neurotransmissions in alcohol seeking behavior. Funding Agencies|Swedish Research Council, VR projectSwedish Research Council [2018-02320]

In March 2019, our health system launched a project called Linking MATTERS (Medication for Addiction Treatment linkage Through Emergency depaRtmentS) to initiate evidence-based treatment for opioid...

PurposeThis paper aims to explore the effective factors that influence the treatment of drug addiction in therapeutic communities (TCs) and to determine its essential elements in the Peruvian, Nicaraguan and Czech context.Design/methodology/approachThe qualitative data were collected during semi-structured interviews with inpatients/clients of seven TCs based in Peru (Takiwasi), Nicaragua (Centro de Especialiades en Adicciones, Centro de Rehabilitación del Alcohólico y Adicto a Otras Drogas and Albergue de Miembros Adictos en Recuperación) and the Czech Republic (Renarkon, Sejrek and Kladno-Dubi). All 90 interviews were manually transcribed, and content analysis was performed. Codes were created using the grounded theory method.FindingsThe effective factors of TC, treatment in Peru, Nicaragua and Czechia are identical in conditions such as the presence of a personal therapist, the use of psychotherapy and the importance of group cohesion. In Peru, the administration of medicinal plants and diet was perceived as a principal part of the treatment. Nicaraguan TCs were specific for practicing 12 steps. In Czechia, an emphasis is put on the therapeutic program, workshops and leisure activities. Spirituality and religion play a main role in the Peruvian and Nicaraguan TCs only.Originality/valueThe current study presents a unique insight into the factors considered effective by inpatients/clients of TCs in different socio-cultural contexts.

Objective To estimate treatment and postpartum health care utilization among pregnant persons with opioid use disorder (OUD) in Vermont and Maine. Methods Vermont's and Maine's All Payer Claims Databases were used to identify deliveries 2010 to 2018 that were paid for, in part, by Medicaid. OUD was identified among pregnant persons if they had any claim with an OUD-diagnosis code (ICD-9/10) or medication for addiction treatment (MAT) code during the 5 months before delivery event. Consistent and inconsistent MAT were compared to no MAT on the rate of hospitalizations and emergency department (ED) visits in the first 12 months' postpartum using negative binomial regression. Results From 2010 through 2018, 27,652 deliveries in Vermont and 43,480 deliveries in Maine were among persons insured by Medicaid. The prevalence of OUD among pregnant persons increased from 6.7% to 11.6% in Vermont and from 7.4% to 11.0% in Maine. Among pregnant persons with OUD in 2018, 57% had consistent MAT in Vermont and 50% had consistent MAT in Maine; approximately 32% and 27% were not in treatment in Vermont and Maine, respectively. In Maine, consistent MAT was associated with a 47% lower rate of hospitalization and 37% to 46% lower rates of ED visits when compared to those without MAT; in Vermont, those with consistent buprenorphine treatment had a 30% lower rate of ED visits. Conclusions Medicaid data from Vermont and Maine suggests that medication for addiction treatment for opioid use disorder during pregnancy reduces emergency health care utilization in the first year postpartum.

يهدف البحث إلى التعرف على أسباب الانتکاسة للإدمان لدى المدمن المتعافى من وجهة نظر القائمين على علاج الإدمان ؛ و التعرف على ترتيب أسباب الانتکاسة للإدمان لدى المدمن المتعافى من وجهة نظر القائمين على علاج الإدمان ، و التعرف على مدى اختلاف أسباب الانتکاسة للإدمان لدى المدمن المتعافى بناء على عدد سنوت الخبرة و نوع العمل (طبيب – إخصائى نفسى – تمريض – إخصائى اجتماعى – موجه ) الذى يقوم به القائمين على علاج الإدمان .، وقد تم تطبيق الاستبيان على عينة عددها ( 48) شخصا من القائمين على علاج الإدمان (طبيب – إخصائى نفسى – تمريض – إخصائى اجتماعى – موجه ) . وقد أظهرت النتائج أن السبب الأول للعودة للإدمان من وجهة نظر القائمين على علاج الإدمان هى العوامل التى تتعلق بالعلاج بنسبة 28.7%. ثم يأتى فى المرتبة الثانية العوامل الشخصية بنسبة 26.8% ، ثم جاءت العوامل الأسرية فى المرتبة الثالثة بنسبة 13.4% ، أما العوامل التى تتعلق بالأصدقاء فقد احتلت المرتبة الرابعة بنسبة 12.6% ، وجاءت العوامل الاجتماعية فى المرتبة الخامسة بنسبة 6.7% ، ثم العوامل التى تتعلق بالبيئة المحيطة فى المرتبة السادسة بنسبة 5.9% ، ثم العوامل الاقتصادية فى المرتبة السابعة بنسبة 3.1% ، ثم العوامل التى تتعلق بوسائل الإعلام والانترنت فى المرتبة الثامنة بنسبة 2.0% ، ثم العوامل الجنسية فى المرتبة التاسعة والأخيرة بنسبة 0.8 % . للانتکاسة للإدمان فى حدود عينة البحث . The research aims to identify the causes of addiction relapse in the recovering addict from the point of view of the Addictive therapists . And to identify the order of the causes of addiction relapse of the recovering addict from the point of view of those in charge of treating addiction, and to identify the extent of the different causes of addiction relapse of the recovering addict based on the number of years of experience and the type of work (Psychatres - psychologist - nursing - social worker - mentor) The questionnaire was applied to a sample of (48) persons who of the Addictive therapists The results showed that the first cause of re-addiction from the point of view of addiction treatment agents is the treatment-related factors, by 28.7%. Personal factors came in second place with a rate of 26.8%, then family factors came in third place with a rate of 13.4%, and factors related to friends ranked fourth with a rate of 12.6%, and social factors came in fifth place with a rate of 6.7%, then factors related to the environment The surrounding ranked sixth with 5.9%, then economic factors ranked seventh by 3.1%, then factors related to media and the Internet ranked eighth with 2.0%, then sexual factors ranked ninth and last by 0.8%. Relapse of addiction within the limits of the research sample.

Scoping Review

During the COVID-19 pandemic, access to addiction treatment has plummeted. At the same time, patients with opioid use disorder are at higher risk of COVID-19 infection and experience worse outcomes. The Baltimore Convention Center Field Hospital (BCCFH), a state-run COVID-19 disaster hospital operated by Johns Hopkins Medicine and the University of Maryland Medical System, continues to operate 14 months into the pandemic to serve as an overflow unit for the state’s hospitals. BCCFH staff observed the demand for opioid use disorder care and developed admission criteria, a pharmacy formulary, and case management procedures to meet this need. This article describes generalized lessons from the BCCFH experience treating substance use disorder during a pandemic.

Zusammenfassung. Hintergrund: Die Zahl der gerichtlich in der Entziehungsanstalt nach § 64 StGB Untergebrachten steigt seit Jahren. Gerichte werden dabei regelmäßig durch forensisch-psychiatrische Sachverständige beraten, für die die Auseinandersetzung mit den Voraussetzungen entsprechender Unterbringungsanordnungen mittlerweile ebenfalls zum Tagesgeschäft gehört. Zugleich stellt die Vielzahl und Komplexität dieser Eingangsvoraussetzungen eine besondere Herausforderung dar, während zur Erstellung entsprechender Eingangsgutachten bislang kein Leitfaden vorliegt. Zielsetzung: Der Beitrag kombiniert die juristische mit der praktischen Perspektive und leitet daraus konkrete Hinweise für gutachterliche Sachverständige ab, wie bei der Erstellung eines Gutachtens vorgegangen werden könnte, damit das Gericht alle nötigen Anknüpfungspunkte erhält, um über die Unterbringung in einer Entziehungsanstalt zu entscheiden. Methodik: Narrative Übersicht über empirische Literatur, Gesetzgebung und Rechtsprechung. Ergebnisse: Neben der Besonderheit einer qualifiziert negativen Risikoprognose, die auf die Begehung von Straftaten im Kontext eines Hanges zum Suchtmittelkonsum im Übermaß zu beziehen ist, stellt insbesondere die Einschätzung zum Vorliegen einer „hinreichend konkreten“ Erfolgsaussicht der Behandlung Sachverständige vor eine Herausforderung. Auch darüber können jedoch unter Einbezug der Faktoren Dissozialität und/oder kriminelle Vorbelastung, motivationaler Aspekte und der Analyse personaler und sozialer Ressourcen Aussagen getroffen werden. Schlussfolgerungen: Forensisch-psychiatrische Sachverständige haben bezüglich des § 64 StGB einen sehr großen Einfluss auf die gerichtliche Entscheidung. Die Beachtung der hier formulierten Hinweise dürfte die Gutachtenerstellung erleichtern und Missverständnissen zwischen Gericht und Sachverständigen vorbeugen.

The use of acute, short-term residential care for opioid use disorder has grown rapidly, with policy makers advocating to increase the availability of “treatment beds.” However, there are concerns ...

This preliminary study aimed to examine how engaging the family in addiction treatment affects sub-stance use and treatment compliance in patients who applied to the Green Crescent Consultancy Cen-ter (YEDAM). Using causal comparison model, 148 family members (mother, father, siblings, and/or spouse) of 214 patients with drug/alcohol addiction who applied to YEDAM between January 2016 and June 2017 participated in the study. Self-reports of the individuals were taken into account in the evaluation of alcohol/substance use or non-use for people with addiction. Compliance with the treat-ment was measured in the form of the rates of retention and drop-out for each individual. Individuals whose families attended 2 or lesser sessions abstained from substance use at a rate of 24.8%, whereas this rate was found to be 41% when they attended 3 or more sessions. When the families attended 2 or fewer sessions, it did not have an effect on treatment drop-out. When families attended 3 or more sessions, the rate of continuing treatment was 2.3 times higher. As the number of sessions attended by the family members increased, the duration of not using substance increased. This also enhanced treatment compliance and decreased the rate of dropping out of treatment. Even with some limitations as a preliminary study, this research underlines the importance of family engagement in the course of the addiction treatment.

الملخص العربي للخدمة الاجتماعية دور مهم وبارز في مؤسسات الرعاية الاجتماعية سواء کانت مؤسسات أهلية أو مؤسسات حکومية کأقسام الرعاية اللاحقة کسبيل للحد من الانتکاسة مرة اخرى ولاشک أن ماتنفقه اجهزة الرعاية اللاحقة بصفة خاصة في هذا السبيل أهون بکثير مما يتکبده المجتمع نتيجة ضراوة المجرم الحاقد على المجتمع والراغب في الانتقام منه ، أضف الى ذلک اذا کانت هذه المؤسسات تعطي الفرصة للمدمنين المنتکسين بعد خروجهم من المرکز العلاجي لبدء حياة کريمة بعيدة عن طريق الادمان والانحراف ، وتضمنت عدة مفاهيم (مفهوم المتطلبات – مفهوم الادمان – مفهوم الانتکاسة) وتسعى إلى تحقيق الهدف وهو متطلبات تحسين الخدمات الاجتماعية المقدمة للمدمن للمنتکس والوصول لمقترحات للخدمة الاجتماعية لتحسين خدمات الرعاية الاجتماعية للمدمن المنتکس ، وتنتمي هذه الدراسة الى نوع الدراسات الوصفية التحليلية ، واعتمدت على منهج المسح الاجتماعي الشامل للمدمنين المنتکسين داخل مرکز الهادي بسنورس وداخل قسم الصحة النفسية بالمستشفى العام بالفيوم وبلغ عددهم(73) ، اعتمدت الباحثة في جمع البيانات من الميدان على: استمارة استبار مطبقة على المدمن المنتکس وذلک لتحديد متطلبات تحسين خدمات الرعاية اللاحقة المقدمة لهم داخل قسم الصحة النفسية بالمستشفى العام بالفيوم ومرکز الهادي لعلاج الادمان بسنورس ، تم تطبيق هذه الدراسة في قسم الصحة النفسية بالمستشفى العام بالفيوم ، ومرکز الهادي لعلاج الإدمان بسنورس ، من خلال اسلوب الحصر الشامل للمستفيدين من خدمات الرعاية اللاحقة المقدمة من المرکز العلاجي للادمان (قسم الصحة النفسية بالمستشفى العام بالفيوم ، ومرکز الهادي لعلاج الادمان بسنورس) وعددهم73 مفردة ، وأوضحت نتائج الدراسة من وجهة نظر المدمنين المنتکسين أن متطلبات تحسين الخدمات الاجتماعية هي مساعدة المدمن المنتکس على مواجهة مشکلاته التى قد تواجهه أثناء فترة التعافي ، مساعدة الأخصائي الإجتماعي المدمن المنتکس على تفهم دوره الإجتماعي في اسرته. Summary in English Prepared by: Fatma Abdul Hadi Mahdi Social service has an important and prominent role in social care institutions, whether they are civil institutions or government institutions such as aftercare departments as a way to reduce relapse again, and there is no doubt that what aftercare services in particular spend in this way is much lesser than what society incurs as a result of the ferocity of the criminal who hates society and wants revenge In addition, if these institutions give the opportunity for relapsing addicts after leaving the treatment center to start a decent life away from addiction and delinquency. Study Concepts (The concept of requirements - The concept of addiction - The concept of relapse) The current study stems from a main objective that it fulfills (requirements to improve the social services provided to the relapsing addict and to reach proposals for social service to improve social care services for the relapsing addict. This study belongs to the type of descriptive and analytical studies. The researcher relied on the use of a comprehensive social survey methodology for relapsing addicts inside Al-Hadi Center in Senouras and inside the mental health department of Fayoum General Hospital, and their number reached (73) In collecting data from the field, the researcher relied onA questionnaire form applied to the relapsing addict in order to determine the requirements for improving the aftercare services provided to them within the mental health department of the General Hospital in Fayoum and the Al-Hadi Center for Addiction Treatment in Senouras. This study was applied in the mental health department of the General Hospital in Fayoum, and the Al-Hadi Center for the Treatment of Addiction in Senouras. The researcher used a comprehensive method of counting the beneficiaries of the aftercare services provided by the Addiction Treatment Center (Mental Health Department at Fayoum General Hospital, and Al-Hadi Center for Addiction Treatment in Senouras), totaling 73 individuals. The study showed from the point of view of relapsing addicts that the requirements for improving social services, according to their order from highest to lowest, are as follows Helping the relapsing addict to cope with his problems that he may face during the recovery period. Helping the relapsing addict social worker understand his social role in his family.

يهدف البحث إلى دراسة الخصائص السيکومترية لمقياس الانتکاسة للإدمان وذلک من خلال استخدام طرق متنوعة فى دراسة صدق المقياس وثباته ، وقد تم تطبيق المقياس على عينة عددها ( 40) من الطلاب المتعافين من الإدمان والذين تراوحت أعمارهم بين ( 15 – 21 سنة ) والذين تلقوا العلاج لدى قسم الطب النفسى وعلاج الإدمان بمستشفيات جامعة عين شمس (الدمرداش) ومستشفيات جامعة القاهرة (قصر العينى) ؛ نظرا لضرورة مراعاة مدة التعاطى ونوع المخدرات وليس السن فقط .. وقد أظهرت النتائج وجود دلائل جيدة لصدق المقياس من خلال حساب صدق المحکمين والصدق البنائى لأبعاد ومفردات المقياس ، وکذلک أظهرت النتائج وجود مؤشرات جيدة لثبات درجات المقياس من خلال التحقق من ثبات التجزئة النصفية والاتساق الداخلى للمقياس . وبالتالى توصل الباحث إلى تمتع المقياس بخصائص سيکومترية جيدة فى بيئة الدراسة وبالتالى صلاحيته للاستخدام فى حدود عينة البحث . The research aims to study the psychometric properties of the addiction relapse scale through the use of various methods in studying the validity and reliability of the scale. The scale was applied to a sample of (40) students recovering from addiction, whose ages ranged between (15-21 years) and who received treatment at the Department of Psychiatry and Addiction Treatment at Ain Shams University Hospital (Demerdash). Given the need to take into account the duration of abuse and the type of drug, not just age .. The results showed good evidence of validity of the scale through calculating the validity of the arbitrators and the structural validity of the dimensions and vocabulary of the scale. The results also showed the presence of good indicators of the stability of the scale scores by verifying the stability of the split half and the internal consistency of the scale. Consequently, the researcher concluded that the scale has good psychometric properties in the study environment and thus its suitability for use within the limits of the research sample.

The current model of nursing within international addiction services has been described as task oriented and reactive. Yet, it is known that nursing models should be led by client need and operate within the domain of the client and their wider environment. The aim of this study was to address this gap within addiction nursing and to develop an evidence-based addiction nursing model. To objectively assess the needs of clients, a cross-sectional survey was implemented within a representative selection of six drug treatment clinics and a sample of clients in receipt of opiate agonist treatment in Dublin, Ireland. The Opiate Treatment Index with the General Health Questionnaire embedded was used to measure heroin use, polydrug use, infectious disease risk, physical health, psychological adjustment, criminality and social well-being. To develop the addiction model, a mapping of relevant features of potential nursing models was conducted by nurses working in addiction services. The key finding from the client assessments was a lack of psychological adjustment; a cutoff score of 4 was recommended. The mean score among women was 11 (95% CI [8, 14]), and that among men was 8 (95% CI [6, 10]). Findings from the mapping of models highlighted the benefits of the BRENDA, FRAMES, and Tidal models. A focus on practical implementation and measurable outcomes was stressed. Results informed the development of the Healthy Addiction Treatment Recovery Model. The model refocused services on clients' objective needs and eradicated entrenched practices.

Background:Substance use disorders (SUDs) impact everything about an individual's life-health, family, employment, education, housing, transportation, and finances. By the time individuals with SUDs begin treatment-especially in publicly funded programs-most have few financial resources. Many have resorted to property crimes, resulting in fines, fees, and restitution costs that compound their financial difficulties. Reestablishing financial functioning is key to recovering from the consequences of addiction. Yet access to cash may also trigger relapses-especially in early recovery. Objective: This paper reports initial results from studies exploring how clients in treatment for SUDs manage their financial responsibilities, assessing their financial capability both in terms of access to financial services and personal financial literacy. Method: Using data collected between June 2017 and October 2019 from almost 5,000 SUD clients as they entered treatment as well as a financial needs assessment study of 70 clients during treatment, we conducted Chi-square testing and logistic regressions to analyze the relationships between client characteristics and financial capability. Results: Our results indicated that over 50% of individuals in addiction treatment did not have access to accounts at insured financial institutions, and that clients' ages and education levels were significantly related to their financial capability. We also found that 78% of clients feel that money management skills are important to their recovery. Conclusions: Many SUD clients in recovery have limited financial capability, and they are interested in developing financial skills. Increasing client financial capability may be an underemphasized, yet important part of recovery capital.

Prescription medicine misuse is a significant problem in many areas of the world. Understanding the acute and chronic harms related to misuse of prescription medicines allows healthcare professionals, drug addiction treatment services and legislative authorities to determine what interventions may be beneficial to reduce these harms and protect individuals and society. However, it is difficult to obtain systematic data on the harms associated with prescription medicine misuse because of how patient visits to clinics and hospitals are recorded and coded in regional or national databases. In this review, we discuss how regional, national and international sources of information can help develop a greater understanding of the prevalence and pattern of acute harms related to prescription medicine misuse using data from ambulance attendances, emergency department presentations and poisons information services.

INTRODUCTION: Implementing a hospital medication for addiction treatment (MAT) and a linkage program can improve care for patients with substance use disorder (SUD); however, lack of hospital funding and brick and mortar SUD resources are potential barriers to feasibility. METHODS: This study assesses the feasibility of implementation of a SUD linkage program. Components of the program include a county-funded hospital opioid support team (HOST), a hospital-employed addiction recovery specialist (ARS), and a medical toxicology MAT induction service and maintenance program. Data for linkage by HOST, ARS, and MAT program were tracked from July 2018 to December 2019. RESULTS: From July 2018 through December 2019, 1834 patients were linked to treatment: 1536 by HOST and 298 by the ARS. The most common disposition categories for patients linked by HOST were 16.73% to medically monitored detoxification, 9.38% to intensive outpatient, and 8.59% to short-term residential treatment. Among patients linked by the ARS, 65.66% were linked to outpatient treatment and 9.43% were linked directly to inpatient treatment. A total of 223 patients managed by the ARS were started on MAT by medical toxicology and linked to outpatient MAT clinic: 72.68% on buprenorphine/naloxone, 24.59% on naltrexone, 1.09% buprenorphine, and 0.55% acamprosate. CONCLUSION: Implementing a MAT and linkage program in the ED and hospital setting was feasible. Leveraging medical toxicology expertise as well as community and funding partnerships was crucial to successful implementation.

Substance dependent people are more likely to develop different disorders. This study aimed to compare the quality of life and general health between opium and non-opium users referred to addiction...

The Medicaid expansions made addiction treatment more accessible but they also made it less costly to obtain the prescription opioids that can trigger an addiction. We investigated the association between the Medicaid expansions and drug-related deaths. We add to the literature by explicitly accounting for the properties of illicit drug markets and by conducting a simulation-based power analysis to assess whether a plausible change in drug-related mortality could be detected with our data. We identify three main challenges in isolating the effect of the Medicaid expansions on drug-related mortality that cannot be sufficiently addressed with current data: (a) nonparallel preexpansion trends in drug-related mortality, (b) the contemporaneous surge in the supply of illicitly manufactured fentanyl, and (c) lack of statistical power. We argue that more comprehensive data are needed to answer this question.

Aim Given that co-occurring pain is prevalent among people who use drugs (PWUD), we sought to explore the effect of pain severity on accessing addiction treatment. Methods Data were derived from two prospective cohort studies of PWUD in Vancouver, Canada from June 2014 to May 2016. Multivariable generalized linear mixed-effects multiple regression (GLMM) analyses were used to investigate the association between average pain severity and self-reported inability to access addiction treatment. Results Among 1348 PWUD, 136 (10.1%) reported being unable to access addiction treatment at least once over the study period. Individuals who reported being unable to access addiction treatment had a significantly higher median average pain severity score (median=5, IQR=0-7) compared to individuals reporting no inability to access addiction treatment (median=3, IQR=0-6, p=0.038). Greater pain severity was independently associated with higher odds of reporting inability to access addiction treatment (AOR: 1.75, 95%CI: 1.08-2.82 for mild-moderate vs no pain; AOR: 1.98, 95%CI: 1.27-3.09 for moderate-severe vs no pain). Conclusion PWUD with greater pain severity may be at higher risk of being unable to access addiction treatment, or vice versa. While further research is needed to confirm causal associations, these data suggest that there may be underlying pathways or mechanisms through which pain may be associated with access to addiction treatment for PWUD.

Pathways to resolve the opioid epidemic focus on enhancing addiction treatment. Dropout rates from outpatient buprenorphine-naloxone (BN) treatment remain as high as 35% to 59%, contributing to poo...

James Balmer is the President of Dawn, Inc., which operates the Dawn Farm treatment and support facilities for individuals with drug and alcohol problems. Mr. Balmer has been in the human services ...

The need and the importance of telemedicine has been brought to the forefront during the ongoing pandemic of COVID-19. It has created another viable option for treatment delivery while reducing risks. However, there are major concerns regarding the delivery of services for treatment of substance use disorders using telepsychiatry. We discuss the various concerns and opportunities, the different international practices, and the Indian guidelines. We believe that there needs to be a balance between access to treatment and medication with reasonable checks and call for more patient and provider friendly practices. We also propose certain modifications in the Indian Telepsychiatry Guidelines.

Addiction is a chronic recurrent disorder characterized by substance abuse and withdrawal syndrome with "hunger." Cannabidiol (CBD), a non-psychoactive cannabinoid, is used to treat neurological conditions, including substance or behavioral addiction (behavioral addiction). This analysis focuses on evaluating the results of available clinical trials, assessing the potential of CBD pharmacotherapy for drug addiction, smoking, cannabis and alcohol use disorders. Clinical trials registered in the clinicaltrials.gov database and the resources of the Pubmed database were analyzed in search of those published in 2010–2020. The review was conducted in July and August 2020. The search terms were for CBD and addiction. The studies sought include randomized controlled and crossover (RCT) studies, open label clinical trials and case studies. 9 articles were identified for review: 6 small RCTs, 2 case studies and 1 open-label clinical study including: 5 studies on CBD in cannabis use disorders (including 63 patients in total; 25 women and 38 men), 2 studies on CBD use for treatment of addiction to smoking (54 patients; 26 women and 28 men), 1 study of CBD in the treatment of heroin dependence (9 patients; 9 men) and 1 study of CBD in drug addiction treatment (38 patients; 19 women and 19 men). Cannabidiol may be a therapeutic option for treating addiction. It is active not only as a substitute, but also supports the treatment of other addictions. Good tolerance and neuroprotective effect determine its high therapeutic potential. aaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaa