Substance Abuse and Rehabilitation最新文献

Background: Probable alcohol use disorder is rarely on the minds of people who use alcohol, probably due to technicality related to making that diagnosis. Men who have sex with men are more vulnerable to alcohol use, usually as a coping strategy to manage minority distress, stigma, violence and validation. This study determined the prevalence and factors associated with probable alcohol use disorder among men who have sex with men enrolled in the HIV pre-exposure prophylaxis program in Tanga, Tanzania.

Methodology: This study included 364 men who have sex with men recruited through respondent driven sampling. Structured questionnaire was used for socio-demographic and sexual characteristics data collection. Probable alcohol use disorder was assessed using the Alcohol Use Disorder Identification Test (AUDIT). A modified Poisson regression model was used to determine the factors associated with probable alcohol use disorder among men who have sex with men.

Results: Our study found that about 45% of participants had probable alcohol use disorder. The prevalence was high among participants with a history of having group sex (aPR=1.29; 95% CI: 1.00-1.65, P=0.051), who had ever paid for oral or anal sex (aPR=1.65; 95% CI: 1.21-2.25, p=0.002), who reported facing financial difficulties (aPR=1.40; 95% CI: 1.10-1.79, p=0.007), those who experienced moderate stigma (aPR=1.44;95% CI: 1.13-1.84, p=0.003) and higher stigma (aPR=1.39;95% CI: 1.02-1.91, p=0.040).

Conclusion: The prevalence of probable alcohol use disorder was found to be relatively high among men who have sex with men, especially those with a history of group sex, paying for sex, facing financial difficulties and those who reported experiencing a moderate-to-high level of stigma. This highlights the need to intensify health, reproductive and safe sex practices programs while escalating anti-stigma campaigns. We recommend the integration of substance screening and harm reduction services in HIV treatments and prevention programming.

The concomitant use of benzodiazepines (BZDs) among individuals with opioid use disorder (OUD) is highly prevalent, with a rapid annual increase in overdose-related deaths. The co-use of BZDs is a significant predictor of opioid overdose. In the absence of other drugs, BZDs are rarely the sole cause of death. Prolonged BZD use frequently results in the rapid development of tolerance and dependence. A strong association has also been established between BZD misuse and depression. Moreover, chronic BZD exposure is linked to cognitive impairments, psychomotor disturbance, delirium, and an increased risk of falls, fractures, injuries, and traffic accidents. Outpatient clinicians should routinely screen for concurrent BZD use and exercise caution in prescribing. Timely interventions-including patient education, gradual discontinuation, psychological therapies, and skills-based training-are critical to mitigating harm and improving prognosis. In addition, Traditional Chinese Medicine(TCM), including herbal prescriptions and acupuncture, may serve as promising non-addictive alternatives for the management of anxiety, insomnia, and withdrawal-related symptoms. Strengthening multifaceted efforts will be crucial for reducing the burden of BZD use and improving treatment outcomes in OUD.

Purpose: About 3 million children have lived in recent years with at least one parent who is addicted to legal and/or illegal substances in Germany. Parental substance use disorder represents a considerable social and economic burden for society. It also has severe health consequences for the parents themselves as well as for their children.The topic of parenthood and the needs of parents with substance use disorders have so far received little attention in inpatient rehabilitative treatment in Germany. Therefore, the study aims to explore the parenting-related needs of parents with substance use disorders in inpatient rehabilitation treatment from an expert perspective. We also aim to uncover structural and general challenges in relation to the topic of "parenting and substance use disorder".

Patients and methods: Semi-structured expert interviews were conducted at different intervention and non-intervention clinics. The data analysis was based on structured content analysis.

Results: The results reveal a strong need for rehabilitation measures that take the topic of parenthood into account. This would include, for example, different parenting-related offers such as organizing daily life, shaping the relationship with the children, programs about the general development of children, expressing and regulating emotions, and assistance with official/administrative matters. Further, there are various structural issues that need to be addressed.

Conclusion: Our results emphasize the concrete need for an evidence-based intervention for family-focused addiction treatment. In this way, care and the resulting health, quality of life, and functionality of the affected families can be improved in the future.

Purpose: An intersectionally-informed approach considers how personal factors such as sex, race, and ethnicity may compound to impact individuals and their health outcomes. We examined how these factors interact to influence treatment attrition in an outpatient, treatment-seeking substance use disorder population.

Patients and methods: The Treatment Episode Dataset-Discharges (2017-2021) provided de-identified data, with each outpatient treatment encounter assessed at admission and discharge, yielding a repeated cross-sectional design. The repeated admission bias was defined as the odds of total admissions relative to the odds of the first admission for each group. Discharge reasons of dropped out or terminated were coded as treatment attrition. Logistic regression assessed treatment attrition, with the interaction term assessing nonadditivity. The unadjusted model included sex, race and ethnicity, and their interaction term, and the adjusted model incorporated the state, primary substance, and age group.

Results: Of 3,934,962 admissions, 1,668,338 (42.4%) were first admissions. White males were over-represented in repeat admissions, and Latina females were 22% less likely to be readmitted. For first episode encounters, females had significantly greater treatment attrition across all groups. Sex, race, and ethnicity, and their interaction were significant in both unadjusted and adjusted models. In adjusted models, the sex difference in attrition was 1.3 percentage points for White individuals (95% CI: 1.2-1.5), but more than twice as large for Black (2.8; 95% CI: 2.5-3.2) and Latino individuals (2.8; 95% CI: 2.4-3.2).

Conclusion: Our findings show that intersecting identities of sex, race, and ethnicity shape disparities in treatment engagement. Black and Latina females face compounded barriers to retention and re-engagement. Incorporating an intersectional perspective into addiction treatment planning and policy may help reduce attrition and improve equity in care.

Purpose:  In inpatient addiction rehabilitation, the context factors of parenthood and family have long been neglected, and evidence-based inpatient, standardized programs to strengthen rehabilitants in their role as parents are not routinely implemented in Germany. Social workers are highly involved in the field of addiction and youth welfare support. Therefore, this study aimed to capture their perspectives on how to strengthen parents in the context of an inpatient addiction rehabilitation intervention.

Methods:  Semi-structured expert interviews were conducted with social workers working with parents with substance use disorder (SUD) in ambulatory settings. The interviews were transcribed verbatim and analyzed using Reflexive Thematic Analysis.

Results:  The analysis identified four main themes that are crucial for strengthening rehabilitants in their parental role. Theme one deals with the exploration of different spheres of parenthood as intervention content: the subjective perception as a parent, the parental role as a child carer, and as family manager. Theme two concerns the methods through which (theoretical knowledge transfer, reflexive and practical exercise) and social settings in which (single, one-to-one, and group settings) this intervention content shall be provided. In theme three, the importance of a sensitive and cooperative professional attitude of rehabilitation associated professional health and social care workers - towards rehabilitants and professionals alike - is included. Theme four stresses the need for a family-centered rehabilitation organization by working as a professional interinstitutional network and arranging adequate childcare.

Conclusion:  Results show that social workers see substantial potential in inpatient addiction rehabilitation for strengthening parents with SUD in their parenting role. The multifaceted parental role should be examined in depth during rehabilitation in a trusting atmosphere. After discharge, especially (social pedagogical) follow-up care is considered crucial for perpetuating insights and progressions and sustainably strengthening rehabilitants, thus, the family system as a whole.

Purpose: The rising use of electronic cigarettes alongside traditional tobacco presents a global health concern. Despite this, little is known about smokers' knowledge and attitudes toward electronic cigarettes in Qatar. This study addresses this gap by exploring the knowledge, attitude, and practice (KAP) of electronic cigarette use among smokers attending cessation clinics in Qatar.

Patients and methods: This analytical cross-sectional study involved 453 adult smokers, recruited through systematic random sampling at the Tobacco Control Center (TCC) in Qatar in 2020. Participants were interviewed via phone using a structured 42-item questionnaire after providing verbal consent. A cut-off score of 3 or higher indicated good knowledge, while a score of 1 or higher reflected a positive attitude. Bivariate analyses followed by logistic regression identified predictors of good knowledge and electronic cigarette use.

Results: Of the 453 participants, the average age was 38.9 ± 8.9 years, with most being male (95.1%, n=429), married (77.9%, n=353), and university-educated (64.7%, n=293). Participants had smoked for an average of 18.5± 9.1 years, consuming 15.3 cigarettes per day. Low nicotine dependence was found in 36% (n=163), while 5.5% (n=25) were highly dependent. About 60.2% (n=259) demonstrated good knowledge of electronic cigarettes, but 69% held negative attitudes ((n=289). Nearly half (48.3%, n=219) had tried electronic cigarettes, with 55.2% using them for cessation attempts (n=121). Age, marital status, education, and income levels were significantly associated with knowledge and practice, with high income (≥ 30,000 QR/month) predicting both good knowledge and use.

Conclusion: Although smokers are generally aware of electronic cigarettes, gaps persist in understanding their contents and health effects. Negative attitudes persist, yet half of current smokers have experimented with them. Tailored education and regulations are needed to dispel misconceptions and minimize risks for smokers in Qatar.

Introduction: Associations between substance use and unemployment are well established but complex. People dependent on opioids often want to work but encounter barriers, including requirements to attend services and/or pharmacies frequently. Long-acting injectable buprenorphine (LAIB) is a new pharmacological treatment for opioid use disorder, which reduces such attendance requirements. Studies indicate positive associations between LAIB treatment and employment, but there has been no detailed analysis of this topic.

Methods: Longitudinal qualitative interviews were conducted with 26 people (18 males; 8 females) initiating LAIB in English and Welsh drug treatment services. Participants were interviewed by telephone up to six times over a year (125 interviews in total). Interview data were used to produce narrative accounts of each participant's work-related experiences. These accounts were then combined and analysed via Iterative Categorization.

Results: Participants reported mixed education and employment histories. At first interview, three had full-time jobs, three were students, one worked occasionally, and nineteen were not working. Participants who remained on, or completed, their LAIB treatment reported ongoing work and education or new work-seeking activities, temporary/part-time work, or volunteering. Participants who discontinued LAIB did not start any new education, training or work during their time in the study. Most participants wanted to work but identified barriers to employment and little help with job-seeking. Participants confirmed that LAIB facilitated employment because they did not have to attend pharmacies so often and felt physically and psychologically more able to work. Nonetheless, they sometimes felt unwell after initiating LAIB, which interrupted work and study and made them reluctant to reduce their LAIB treatment later.

Conclusion: LAIB may help drug treatment patients who are interested in securing employment or achieving broader employment-related outcomes, such as education, training and volunteering. However, patients receiving LAIB may also need personalized employment support to assist them with wider barriers to working.

Purpose: Inclusion in sports fosters social integration and well-being for individuals with disabilities. However, sports environments also present risks related to alcohol consumption, particularly through social interactions and established drinking norms. While general prevention programs exist in Swiss sports, limited research exists and no specific strategies are tailored to the needs of disability sports settings. This study explores alcohol consumption and prevention measures in Swiss disability sports, focusing on the perspectives of sports coaches.

Methods: A qualitative research design was employed using semi-structured interviews with 27 coaches from disability sports programs in Switzerland. The thematic analysis by means of NVivo examined four key dimensions: perceptions of alcohol consumption, knowledge of alcohol-related risks, intervention approaches, and prevention strategies. The sample included coaches from diverse sports, disability groups, linguistic regions, and educational backgrounds.

Results: Coaches exhibited varying perspectives on alcohol consumption, with some considering it irrelevant in disability sports and others recognizing its role in social settings surrounding sports activities. While alcohol use was largely rejected during training, it was often normalized in post-sports socialization. Knowledge of alcohol-related risks, particularly concerning its interaction with medication, was inconsistent among coaches, and few had received formal guidance on managing alcohol-related issues. Additionally, prevention measures were seldom implemented, and coaches' awareness of the (national) prevention programs was unexpectedly low.

Conclusion: The findings highlight a need for targeted prevention strategies in disability sports, particularly concerning alcohol consumption and its health implications for athletes with disabilities. Strengthening educational initiatives for coaches, integrating substance use prevention into training curricula, and fostering structured intervention strategies could improve awareness and promote safer sports environments. Future research should explore the perspectives of athletes with disabilities and examine broader policy implications to enhance prevention efforts in inclusive sports.

Background and aims: Behavioral addictions, such as problematic use of social media, gaming disorder, gambling disorder, and compulsive buying-shopping disorder, are increasingly common among young adults worldwide. The aim of the present study was to identify distinctive factors of these behavioral addictions, focusing on gratification and compensation, reward deficiency syndrome, and compulsivity among young adults.

Methods: The sample comprised 1459 Jewish Israeli young adults from the general community (36% male, 64% female; aged 19-27 years). Participants were surveyed regarding general and compulsive/problematic engagement in shopping, online gaming, gambling, and social media use. The study also assessed gratification and compensation specific to each behavior, as well as reward deficiency syndrome and compulsivity.

Results: Network analysis of behavioral addiction measures identified three key factors related to buying-shopping, online gaming, and combined gambling and use of social media, with problematic engagement implicated. Gambling disorder acted as an important bridge, connecting different sub-networks and facilitating communication and information flow between them. Subsequently, using structural equation modeling, a higher need for gratification and compensation and more severe reward deficiencies were associated with greater severity across all four addictive behaviors. In contrast, compulsivity was inversely associated with the factor combining gambling and use of social media.

Conclusion: The present study highlights the complex relationship between gratification, reward deficiency, and compulsivity in young adults' addictive behaviors. It suggests a need for interventions that specifically address gratification and compensation, raising the possibility that a targeted approach could potentially mitigate the severity of multiple addictive behaviors.

Background: Adolescents and young adults in sub-Saharan Africa face a growing burden of alcohol use and related disorders, driven by a convergence of biological vulnerability, socio-environmental pressures, and weak regulatory systems. Rising digital media exposure and socio-economic disparities further exacerbate risky drinking behaviors.

Objective: This review synthesizes current evidence on the prevalence, risk factors, health and social impacts, and intervention strategies related to alcohol use among adolescents and young people in sub-Saharan Africa.

Methods: A narrative review approach was employed, drawing on peer-reviewed articles and global reports published between 2000 and 2024. Studies were identified through searches in databases including PubMed, Scopus, Google Scholar, and Web of Science, using defined inclusion criteria focused on youth aged 10-24 years.

Findings: Alcohol use and alcohol use disorders (AUD) among youth are influenced by a complex interplay of genetic, psychological, familial, social, and digital factors. Consequences include increased risks of mental illness, HIV infection, gender-based violence, poor educational outcomes, and long-term health complications. Despite these harms, interventions remain fragmented and under-resourced across much of the region. Promising interventions include school-based programs, community engagement, digital media regulation, and integration of alcohol services into mental and sexual health platforms.

Conclusion: Tackling adolescent alcohol misuse in sub-Saharan Africa requires urgent, multisectoral action. Policies must be evidence-based, culturally responsive, and supported by robust surveillance, regulation, and youth-centered programming to prevent long-term public health and socio-economic consequences.