Pub Date : 2019-03-04DOI: 10.1108/DAT-10-2018-0058
David Stuart
Purpose The purpose of this paper is to clarify the origins, use and meaning of the term “chemsex”. Design/methodology/approach The approach used here is one born of personal experiences and reflection. Findings The term chemsex has a definition and a purpose that promotes culturally competent care for a marginalized group of vulnerable people. Research limitations/implications This is a qualitative, personal, point-of-view piece which may be of value in broadening understandings and responses amongst public health and academic activities. Practical implications The findings can be used to develop a sense of community and support amongst men who have sex with men in a chemsex setting, and to provide some background and context for professionals working in this field. Originality/value This paper is amongst the first, if not the first, of its nature to be published in an academic journal.
{"title":"Chemsex: origins of the word, a history of the phenomenon and a respect to the culture","authors":"David Stuart","doi":"10.1108/DAT-10-2018-0058","DOIUrl":"https://doi.org/10.1108/DAT-10-2018-0058","url":null,"abstract":"\u0000Purpose\u0000The purpose of this paper is to clarify the origins, use and meaning of the term “chemsex”.\u0000\u0000\u0000Design/methodology/approach\u0000The approach used here is one born of personal experiences and reflection.\u0000\u0000\u0000Findings\u0000The term chemsex has a definition and a purpose that promotes culturally competent care for a marginalized group of vulnerable people.\u0000\u0000\u0000Research limitations/implications\u0000This is a qualitative, personal, point-of-view piece which may be of value in broadening understandings and responses amongst public health and academic activities.\u0000\u0000\u0000Practical implications\u0000The findings can be used to develop a sense of community and support amongst men who have sex with men in a chemsex setting, and to provide some background and context for professionals working in this field.\u0000\u0000\u0000Originality/value\u0000This paper is amongst the first, if not the first, of its nature to be published in an academic journal.\u0000","PeriodicalId":44780,"journal":{"name":"Drugs and Alcohol Today","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2019-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/DAT-10-2018-0058","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41950549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A message from the guest editor of this special “Chemsex” edition of Drugs and Alcohol Today","authors":"M. Day","doi":"10.1108/DAT-03-2019-068","DOIUrl":"https://doi.org/10.1108/DAT-03-2019-068","url":null,"abstract":"","PeriodicalId":44780,"journal":{"name":"Drugs and Alcohol Today","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2019-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/DAT-03-2019-068","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41487730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-01-25DOI: 10.1108/DAT-11-2018-0066
T. Platteau, R. Pebody, Nia Dunbar, T. Lebacq, Ben Collins
Purpose Chemsex is a phenomenon that has gained increasing attention in recent years. The purpose of this paper is to differentiate chemsex from other sexualized substance use, and clarify differences between recreational and problematic chemsex use. Despite plentiful publications, little has been published on underlying determinants that predispose individuals to chemsex, and their process toward problematic chemsex use. Design/methodology/approach During the second European Chemsex Forum, people who engage in chemsex, community organizers, researchers, clinicians, therapists, social workers and (peer) counselors discussed potential pathways to problematic chemsex. In this manuscript, we translate findings from these discussions into a framework to understand the initiation and process toward problematic chemsex. Findings Six stages (loneliness and emptiness, search for connection, sexual connection, chemsex connection, problematic chemsex and severe health impact) and a set of factors facilitating the transition from one stage to the next have been identified. Originality/value It is hoped that this “Journey towards problematic chemsex use” will stimulate reflection and debate, with the ultimate goal of improving prevention and care for people engaging in chemsex.
{"title":"The problematic chemsex journey: a resource for prevention and harm reduction","authors":"T. Platteau, R. Pebody, Nia Dunbar, T. Lebacq, Ben Collins","doi":"10.1108/DAT-11-2018-0066","DOIUrl":"https://doi.org/10.1108/DAT-11-2018-0066","url":null,"abstract":"\u0000Purpose\u0000Chemsex is a phenomenon that has gained increasing attention in recent years. The purpose of this paper is to differentiate chemsex from other sexualized substance use, and clarify differences between recreational and problematic chemsex use. Despite plentiful publications, little has been published on underlying determinants that predispose individuals to chemsex, and their process toward problematic chemsex use.\u0000\u0000\u0000Design/methodology/approach\u0000During the second European Chemsex Forum, people who engage in chemsex, community organizers, researchers, clinicians, therapists, social workers and (peer) counselors discussed potential pathways to problematic chemsex. In this manuscript, we translate findings from these discussions into a framework to understand the initiation and process toward problematic chemsex.\u0000\u0000\u0000Findings\u0000Six stages (loneliness and emptiness, search for connection, sexual connection, chemsex connection, problematic chemsex and severe health impact) and a set of factors facilitating the transition from one stage to the next have been identified.\u0000\u0000\u0000Originality/value\u0000It is hoped that this “Journey towards problematic chemsex use” will stimulate reflection and debate, with the ultimate goal of improving prevention and care for people engaging in chemsex.\u0000","PeriodicalId":44780,"journal":{"name":"Drugs and Alcohol Today","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2019-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/DAT-11-2018-0066","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48400638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-01-07DOI: 10.1108/DAT-11-2018-0064
R. Kunelaki
Purpose The purpose of this paper is to provide the first definition of sober sex and recommendations for health care professionals who work therapeutically with patients who struggle with intimacy after experiencing chemsex. Design/methodology/approach The recommendations are based on the clinical experience of a psychosexual therapist working with men having sex with men (MSM) in a Sexual Health clinic in central London. Findings The paper concludes that having a clear definition of sober sex and specific tools, such as healthy masturbation exercise, could prove helpful for health professionals who work with this cohort of patients. Originality/value This paper provides the first definition of sober sex and a clear set of guidelines for health professionals based on the clinical experience of the author.
{"title":"What is sober sex and how to achieve it?","authors":"R. Kunelaki","doi":"10.1108/DAT-11-2018-0064","DOIUrl":"https://doi.org/10.1108/DAT-11-2018-0064","url":null,"abstract":"\u0000Purpose\u0000The purpose of this paper is to provide the first definition of sober sex and recommendations for health care professionals who work therapeutically with patients who struggle with intimacy after experiencing chemsex.\u0000\u0000\u0000Design/methodology/approach\u0000The recommendations are based on the clinical experience of a psychosexual therapist working with men having sex with men (MSM) in a Sexual Health clinic in central London.\u0000\u0000\u0000Findings\u0000The paper concludes that having a clear definition of sober sex and specific tools, such as healthy masturbation exercise, could prove helpful for health professionals who work with this cohort of patients.\u0000\u0000\u0000Originality/value\u0000This paper provides the first definition of sober sex and a clear set of guidelines for health professionals based on the clinical experience of the author.\u0000","PeriodicalId":44780,"journal":{"name":"Drugs and Alcohol Today","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2019-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/DAT-11-2018-0064","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46871942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-01-07DOI: 10.1108/DAT-08-2018-0039
V. Leigh, S. Maclean
Purpose The purpose of this paper is to provide a commentary on new information from the Office for National Statistics (ONS) on deaths caused by volatile substance abuse (VSA) in Great Britain which occurred between 2001 and 2016. Design/methodology/approach Comparing the new study with previous mortality data, the authors consider the strengths and some limitations of the analysis provided by ONS. Findings By utilising a broader range of codes and collating additional information from death certificates, the new report provides a more comprehensive measure of VSA mortality than was previously available, showing increasing prevalence of deaths. The age profile of people dying is older than in previous studies. Most deaths were associated with inhalation of gases and almost three-quarters of deaths involved volatile substances alone. Practical implications Understanding VSA mortality is essential for service planning. It is important that we identify why so many people whose deaths are associated with VSA are not accessing treatment, with particular concern about treatment access for those who only use volatiles. Training to support drug and alcohol and other health service staff to respond to VSA is essential. In future reports, data to identify socioeconomic correlations of VSA deaths would enable targeted responses. Additionally, information on whether deaths occur in long term rather than episodic or one-off users could enable risk reduction education. Originality/value This paper shows how data on VSA deaths may inform for policy and service planning.
{"title":"Silent deaths: a commentary on new mortality data relating to volatile substance abuse in Great Britain","authors":"V. Leigh, S. Maclean","doi":"10.1108/DAT-08-2018-0039","DOIUrl":"https://doi.org/10.1108/DAT-08-2018-0039","url":null,"abstract":"\u0000Purpose\u0000The purpose of this paper is to provide a commentary on new information from the Office for National Statistics (ONS) on deaths caused by volatile substance abuse (VSA) in Great Britain which occurred between 2001 and 2016.\u0000\u0000\u0000Design/methodology/approach\u0000Comparing the new study with previous mortality data, the authors consider the strengths and some limitations of the analysis provided by ONS.\u0000\u0000\u0000Findings\u0000By utilising a broader range of codes and collating additional information from death certificates, the new report provides a more comprehensive measure of VSA mortality than was previously available, showing increasing prevalence of deaths. The age profile of people dying is older than in previous studies. Most deaths were associated with inhalation of gases and almost three-quarters of deaths involved volatile substances alone.\u0000\u0000\u0000Practical implications\u0000Understanding VSA mortality is essential for service planning. It is important that we identify why so many people whose deaths are associated with VSA are not accessing treatment, with particular concern about treatment access for those who only use volatiles. Training to support drug and alcohol and other health service staff to respond to VSA is essential. In future reports, data to identify socioeconomic correlations of VSA deaths would enable targeted responses. Additionally, information on whether deaths occur in long term rather than episodic or one-off users could enable risk reduction education.\u0000\u0000\u0000Originality/value\u0000This paper shows how data on VSA deaths may inform for policy and service planning.\u0000","PeriodicalId":44780,"journal":{"name":"Drugs and Alcohol Today","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2019-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/DAT-08-2018-0039","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44748133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-01-07DOI: 10.1108/DAT-11-2018-0067
S. Morris
Purpose Whilst chemsex is a relatively new phenomenon, trauma is not. Freud borrowed the word from physical medicine, where it was used to describe tissue damage, and applied it, for the first time, as a metaphor to a psychological process by which the protective functioning of the mind can too be pierced and wounded by events. The chemsex environment hosts a myriad of potentially traumatising scenarios and experiences, though perhaps disguised as exhilaration or excitement. The paper aims to discuss these issues. Design/methodology/approach The paper is a practitioner’s experience. Findings These experiences piled on top of childhood experiences of being “less than” for being gay, can be responsible for widespread undiagnosed post-traumatic stress disorder (PTSD) among those who engage in chemsex. This paper explores this possibility and offers solutions. Originality/value Compounded trauma and PTSD symptoms amongst MSM who engage in chemsex has to date, not been researched.
{"title":"Too painful to think about: chemsex and trauma","authors":"S. Morris","doi":"10.1108/DAT-11-2018-0067","DOIUrl":"https://doi.org/10.1108/DAT-11-2018-0067","url":null,"abstract":"\u0000Purpose\u0000Whilst chemsex is a relatively new phenomenon, trauma is not. Freud borrowed the word from physical medicine, where it was used to describe tissue damage, and applied it, for the first time, as a metaphor to a psychological process by which the protective functioning of the mind can too be pierced and wounded by events. The chemsex environment hosts a myriad of potentially traumatising scenarios and experiences, though perhaps disguised as exhilaration or excitement. The paper aims to discuss these issues.\u0000\u0000\u0000Design/methodology/approach\u0000The paper is a practitioner’s experience.\u0000\u0000\u0000Findings\u0000These experiences piled on top of childhood experiences of being “less than” for being gay, can be responsible for widespread undiagnosed post-traumatic stress disorder (PTSD) among those who engage in chemsex. This paper explores this possibility and offers solutions.\u0000\u0000\u0000Originality/value\u0000Compounded trauma and PTSD symptoms amongst MSM who engage in chemsex has to date, not been researched.\u0000","PeriodicalId":44780,"journal":{"name":"Drugs and Alcohol Today","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2019-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/DAT-11-2018-0067","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45223956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-01-07DOI: 10.1108/DAT-07-2018-0035
Iain McPhee, C. Holligan, Robert McLean, R. Deuchar
Purpose The purpose of this paper is to explore the hidden social worlds of competent clandestine users of drugs controlled within the confines of the UK Misuse of Drugs Act 1971, which now includes NPS substances. The authors explore how and in what way socially competent drug users differ from others who are visible to the authorities as criminals by criminal justice bureaucracies and known to treatment agencies as defined problem drug users. Design/methodology/approach This qualitative research utilises a bricoleur ethnographic methodology considered as a critical, multi-perspectival, multi-theoretical and multi-methodological approach to inquiry. Findings This paper challenges addiction discourses and, drawing upon empirical evidence, argues the user of controlled drugs should not be homogenised. Using several key strategies of identity management, drug takers employ a range of risk awareness and risk neutralisation techniques to protect self-esteem, avoid social affronts and in maintaining untainted identities. The authors present illicit drug use as one activity amongst other social activities that (some) people, conventionally, pursue. The findings from this study suggest that punitive drug policy, which links drug use with addiction, crime and antisocial behaviour, is inconsistent with the experience of the participants. Research limitations/implications Due to the small sample size (n=24) employed, the possibility that findings can be generalised is rendered difficult. However, generalisation was never an objective of the research; the experiences of this hidden population are deeply subjective and generalising findings and applying them to other populations would be an unproductive endeavour. While the research attempted to recruit an equal number of males and females to this research, gendered analysis was not a primary objective of this research. However, it is acknowledged that future research would greatly benefit from such a gendered focus. Practical implications The insights from the study may be useful in helping to inform future policy discourse on issues of drug use. In particular, the insights suggest that a more nuanced perspective should be adopted. This perspective should recognise the non-deviant identities of many drug users in the contemporary era, and challenge the use of a universally stigmatising discourse and dominance of prohibition narratives. Social implications It is envisaged that this paper will contribute to knowledge on how socially competent users of controlled drugs identify and manage the risks of moral, medical and legal censure. Originality/value The evidence in this paper indicates that drug use is an activity often associated with non-deviant, productive members of the population. However, the continuing dominance of stigmatising policy discourses often leads to drug users engaging in identity concealment within the context of a deeply capitalist Western landscape.
{"title":"Dr Jekyll and Mr Hyde: the strange case of the two selves of clandestine drug users in Scotland","authors":"Iain McPhee, C. Holligan, Robert McLean, R. Deuchar","doi":"10.1108/DAT-07-2018-0035","DOIUrl":"https://doi.org/10.1108/DAT-07-2018-0035","url":null,"abstract":"\u0000Purpose\u0000The purpose of this paper is to explore the hidden social worlds of competent clandestine users of drugs controlled within the confines of the UK Misuse of Drugs Act 1971, which now includes NPS substances. The authors explore how and in what way socially competent drug users differ from others who are visible to the authorities as criminals by criminal justice bureaucracies and known to treatment agencies as defined problem drug users.\u0000\u0000\u0000Design/methodology/approach\u0000This qualitative research utilises a bricoleur ethnographic methodology considered as a critical, multi-perspectival, multi-theoretical and multi-methodological approach to inquiry.\u0000\u0000\u0000Findings\u0000This paper challenges addiction discourses and, drawing upon empirical evidence, argues the user of controlled drugs should not be homogenised. Using several key strategies of identity management, drug takers employ a range of risk awareness and risk neutralisation techniques to protect self-esteem, avoid social affronts and in maintaining untainted identities. The authors present illicit drug use as one activity amongst other social activities that (some) people, conventionally, pursue. The findings from this study suggest that punitive drug policy, which links drug use with addiction, crime and antisocial behaviour, is inconsistent with the experience of the participants.\u0000\u0000\u0000Research limitations/implications\u0000Due to the small sample size (n=24) employed, the possibility that findings can be generalised is rendered difficult. However, generalisation was never an objective of the research; the experiences of this hidden population are deeply subjective and generalising findings and applying them to other populations would be an unproductive endeavour. While the research attempted to recruit an equal number of males and females to this research, gendered analysis was not a primary objective of this research. However, it is acknowledged that future research would greatly benefit from such a gendered focus.\u0000\u0000\u0000Practical implications\u0000The insights from the study may be useful in helping to inform future policy discourse on issues of drug use. In particular, the insights suggest that a more nuanced perspective should be adopted. This perspective should recognise the non-deviant identities of many drug users in the contemporary era, and challenge the use of a universally stigmatising discourse and dominance of prohibition narratives.\u0000\u0000\u0000Social implications\u0000It is envisaged that this paper will contribute to knowledge on how socially competent users of controlled drugs identify and manage the risks of moral, medical and legal censure.\u0000\u0000\u0000Originality/value\u0000The evidence in this paper indicates that drug use is an activity often associated with non-deviant, productive members of the population. However, the continuing dominance of stigmatising policy discourses often leads to drug users engaging in identity concealment within the context of a deeply capitalist Western landscape.\u0000","PeriodicalId":44780,"journal":{"name":"Drugs and Alcohol Today","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2019-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/DAT-07-2018-0035","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48602714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-12-17DOI: 10.1108/DAT-04-2018-0019
Jenni Savonen, P. Hakkarainen, Kati Kataja, Inari Sakki, C. Tigerstedt
Purpose The purpose of this paper is to study the social representations of polydrug use in the Finnish mainstream media. Social representations are shared ways of talking about socially relevant issues and have ramifications on both individual and socio-political levels. Design/methodology/approach The social representations theory and the “What’s the problem represented to be?” analysis provided the theoretical framework. In total, 405 newspaper articles were used as data and analysed by content analysis and thematic analysis. The key tenets of the social representations theory, anchoring, objectifying and naturalisation, were used in data analysis. Findings The study found that polydrug use was written about differently in articles over the study period from 1990 to 2016. Three social representations were introduced: first, polydrug use as a concept was used to refer to the co-use of alcohol and medical drugs. This was seen as a problem for young people, which could easily lead to illicit drug use. Second, illicit drugs were included in the definitions of polydrug use, which made the social representation more serious than before. The typical polydrug user was portrayed as a person who was addicted to substances, could not quite control his/her use and was a threat to others in society. Third, the concepts were naturalised as parts of common language and even used as prototypes and metaphors. Originality/value The study provides a look at how the phenomenon of polydrug use is conceptualised in everyday language as previous research has concentrated on its scientific definitions. It also adds to the research of media representations of different substances.
{"title":"Social representations of polydrug use in a Finnish newspaper 1990–2016","authors":"Jenni Savonen, P. Hakkarainen, Kati Kataja, Inari Sakki, C. Tigerstedt","doi":"10.1108/DAT-04-2018-0019","DOIUrl":"https://doi.org/10.1108/DAT-04-2018-0019","url":null,"abstract":"\u0000Purpose\u0000The purpose of this paper is to study the social representations of polydrug use in the Finnish mainstream media. Social representations are shared ways of talking about socially relevant issues and have ramifications on both individual and socio-political levels.\u0000\u0000\u0000Design/methodology/approach\u0000The social representations theory and the “What’s the problem represented to be?” analysis provided the theoretical framework. In total, 405 newspaper articles were used as data and analysed by content analysis and thematic analysis. The key tenets of the social representations theory, anchoring, objectifying and naturalisation, were used in data analysis.\u0000\u0000\u0000Findings\u0000The study found that polydrug use was written about differently in articles over the study period from 1990 to 2016. Three social representations were introduced: first, polydrug use as a concept was used to refer to the co-use of alcohol and medical drugs. This was seen as a problem for young people, which could easily lead to illicit drug use. Second, illicit drugs were included in the definitions of polydrug use, which made the social representation more serious than before. The typical polydrug user was portrayed as a person who was addicted to substances, could not quite control his/her use and was a threat to others in society. Third, the concepts were naturalised as parts of common language and even used as prototypes and metaphors.\u0000\u0000\u0000Originality/value\u0000The study provides a look at how the phenomenon of polydrug use is conceptualised in everyday language as previous research has concentrated on its scientific definitions. It also adds to the research of media representations of different substances.\u0000","PeriodicalId":44780,"journal":{"name":"Drugs and Alcohol Today","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2018-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/DAT-04-2018-0019","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46454775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-12-03DOI: 10.1108/DAT-12-2017-0062
E. Lowe, S. Akhtar, O. Emmerson, T. Parkman, E. Day
Less than 15 per cent of people starting opiate substitution treatment (OST) in England are employed, but few gain employment during treatment. Increasingly punitive approaches have been tried to encourage individuals with substance dependence into employment in the hope of facilitating recovery. It is not clear which factors are associated with the successful maintenance of employment whilst receiving OST, and whether this group can be said to be “in recovery”. The paper aims to discuss these issues.,A cross-sectional study of the OST population in one English region was conducted between January and April 2017. Measures of physical health, employment patterns, drug use, mental health, recovery capital, and dependence severity were administered to 55 employed and 55 unemployed clients.,Those in employment had higher levels of “recovery capital”, better physical and mental health, fewer drug problems, and less severe dependence, despite reporting heroin use at a similar level. Three variables were significantly associated with employment: longest period of employment (OR=1.01, p=0.003); number of chronic medical conditions (OR=0.44, p=0.011); and number of days of psychological problems in the last month (OR=0.95, p=0.031).,These results suggest that abstinence may not be required in order to maintain stable employment when OST is in place. Different treatment strategies are required for clients receiving OST already in employment compared with those who are unemployed.,This is the first UK study to the author’s knowledge to focus on people receiving OST who are also in employment.
{"title":"The impact of employment on perceived recovery from opiate dependence","authors":"E. Lowe, S. Akhtar, O. Emmerson, T. Parkman, E. Day","doi":"10.1108/DAT-12-2017-0062","DOIUrl":"https://doi.org/10.1108/DAT-12-2017-0062","url":null,"abstract":"Less than 15 per cent of people starting opiate substitution treatment (OST) in England are employed, but few gain employment during treatment. Increasingly punitive approaches have been tried to encourage individuals with substance dependence into employment in the hope of facilitating recovery. It is not clear which factors are associated with the successful maintenance of employment whilst receiving OST, and whether this group can be said to be “in recovery”. The paper aims to discuss these issues.,A cross-sectional study of the OST population in one English region was conducted between January and April 2017. Measures of physical health, employment patterns, drug use, mental health, recovery capital, and dependence severity were administered to 55 employed and 55 unemployed clients.,Those in employment had higher levels of “recovery capital”, better physical and mental health, fewer drug problems, and less severe dependence, despite reporting heroin use at a similar level. Three variables were significantly associated with employment: longest period of employment (OR=1.01, p=0.003); number of chronic medical conditions (OR=0.44, p=0.011); and number of days of psychological problems in the last month (OR=0.95, p=0.031).,These results suggest that abstinence may not be required in order to maintain stable employment when OST is in place. Different treatment strategies are required for clients receiving OST already in employment compared with those who are unemployed.,This is the first UK study to the author’s knowledge to focus on people receiving OST who are also in employment.","PeriodicalId":44780,"journal":{"name":"Drugs and Alcohol Today","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2018-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/DAT-12-2017-0062","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43152045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-12-03DOI: 10.1108/DAT-11-2017-0059
Andrew Collins, A. McCamley
Purpose The purpose of this paper is to compare quality of life scores in a long-term recovery population group (post five years) with a general population group and to explore how any differences might be explained by recovering individuals themselves in a small number of follow up qualitative interviews. Design/methodology/approach A sequential explanatory mixed method design combining quantitative quality of life measure (WHOQOL-BREF, 1996) and six subsequent semi-structured individual interviews. The quality of life measure compared long-term recovery scores (post five years) with the general population group. The subsequent qualitative semi-structured interviews explored what the participants themselves said about their recovery. Findings The quantitative data provide evidence of a significant difference in quality of life (WHOQoL-BREF) in two domains. The long-term recovery group (five or more years into recovery) scored higher in both the environment and psychological domains than the general population group. Of the long-term recovery group, 17 people who still accessed mutual aid scored higher in all four domains than those 23 people who did not. The interviews provide evidence of the this difference as result of growth in psychological elements of recovery, such as developing perspective, improvement in self-esteem, spirituality, as well as contributing as part of wider social involvement. Research limitations/implications This study provides support for the quality of life measure as useful in recovery research. The empirical data support the concept of recovery involving improvements in many areas of life and potentially beyond the norm, termed “better than well” (Best and Lubman, 2012; Valentine, 2011; Hibbert and Best, 2011). Limitations: snowballing method of recruitment, and undertaken by public health practitioner. Some suggestions of women and those who attend mutual aid having higher quality of life but sample too small. Practical implications Use QoL measure more in recovery research. Public health practitioners and policy makers need to work with partners and agencies to ensure that there is much more work, not just treatment focused, addressing the wider social and environmental context to support individuals recovering from alcohol and drugs over the longer term. Originality/value One of small number of studies using with participants who have experienced long-term (post five years) recovery, also use of quality of life measure (WHOQOL-BREF, 1996) with this population.
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