scholarly journals Service and Policy implication of substance use disorders among adolescents in juvenile correctional facilities in Lagos, Nigeria

2016 ◽  
Vol 3 ◽  
Author(s):  
O. Atilola ◽  
B. Ola ◽  
G. Abiri

Background.Lack of relevant data has continued to militate against the development of policy and practice toward identification and treatment of alcohol/substance abuse among adolescents coming in contact with the juvenile justice system in Nigeria. This study aims to provide such data, including its policy/practice implications.Methods.One hundred and seventy eight (178) adolescents, who are representative of adolescents within the youth correctional services of Lagos jurisdiction, were interviewed using the alcohol and substance abuse section of the Kiddies’ Schedule for Affective Disorders and Schizophrenia.Results.The lifetime prevalence rate of abuse of/dependence on any of alcohol or other substances was 22.5% (alcohol, 12.3%; illicit substance, 17.9%). Males were overrepresented among those with any substance use disorder, with gendered prevalence rate as high as 35%. Having had a lived-experience of being a street-child was the single most significant independent factor (Odds ratio (OR), 8.4;p= 0.007) associated with lifetime alcohol substance use disorder.Conclusions.Substance use disorder is highly prevalent among adolescents within the juvenile justice systems in Lagos Nigeria. There is need for deliberate incorporation of alcohol and substance abuse screening and intervention as part of individual care plan in youth correctional facilities in Nigeria. Practical steps toward achieving this were drawn from local reality and international best practices.

2021 ◽  
pp. 084456212110374
Author(s):  
Oona St-Amant ◽  
Jasna K. Schwind

Background Most persons with substance use disorder (SUD) live in family settings. In the absence of adequate mental health services, mothers are often called upon to provide care for their adult children with SUD. Despite positive outcomes such as decreased rates of hospitalization associated with family involvement, mothers are often stigmatized within the health care systems as contributors to trauma and/or family dysfunction. Purpose The purpose of this study is to explore mothers’ lived experience of caring for adult children with SUD. Method Guided by critical feminist theory, this study used interpretive descriptive qualitative research design to identify patterns within mothers’ experiences for practical relevance and application to service provision. Results The findings yielded in this study identified mothers’ experiences as: longing for wellness, identity as loving mother, loss, anticipatory grief, shame and blame and feeling excluded from services. Ultimately, the findings from this study extend the limited research to date on mothers’ experiences of stigma, especially when they are blamed for their child’s illness. Conclusions Findings from this study advocate for family-centered approaches that attend to mothers’ unique experience, from their standpoint, and offer recommendations for change to service provision.


2020 ◽  
Vol 50 (8) ◽  
pp. 880-897
Author(s):  
Sunggeun (Ethan) Park

This study extends the representative bureaucracy literature by theorizing and empirically testing how staff sharing lived experience with service users can serve as user representatives in service provision processes (i.e., the peer coproduction mechanism). Using survey data from a representative sample of substance use disorder treatment clinics in the United States, we explore factors associated with descriptive representation (the presence of staff with firsthand experience of a substance use disorder in both frontline treatment and senior positions) and directors’ perceptions of recovering staff’s potential to serve as user representatives in individual care and organizational decision-making processes. Recovering staff accounted for a third of the field’s workforce, but the majority of the clinics did not employ them in senior staff positions. Regression results suggest that organizational leaders’ recognition of recovering staff’s unique representation capacities may facilitate greater descriptive representation and grant meaningful organizational decision-making authority to recovering staff. Multiple research and practice implications are discussed.


Open Biology ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. 180115 ◽  
Author(s):  
Yasminah Elsaadany Dobs ◽  
Mohamed Medhat Ali

Studies have reported the significant economic impact of smoking cannabis and drinking alcohol In the USA. It was estimated that the costs of cannabis-related treatment, hospitalization and loss of work-related pay have amounted to $200 billion. (Andersen AM, Dogan MV, Beach SRH, Philibert RA. 2015 Genes 6 , 991–1022. ( doi:10.3390/genes6040991 )). Data from the National Epidemiologic Survey on Alcohol and Related Conditions showed that individuals with general anxiety disorder and substance use disorder (GAD-SUD) have higher psychiatric comorbidity rates than those without substance use disorder (Alegría AA, Hasin DS, Nunes EV, Liu SM, Davies C, Grant BF, Blanco C. 2010 J. Clin. Psychiatry 71, 1187–1195. ( doi:10.4088/JCP.09m05328gry )). Moreover, the criminal justice system is significantly impacted by this cost (Andersen AM, Dogan MV, Beach SRH, Philibert RA. 2015 Genes 6 , 991–1022. ( doi:10.3390/genes6040991 )). Despite the increasing use of cannabis, there are still too many obscure facts. One of the new areas that scientific evidence shows is impacted negatively by cannabis use is the epigenome, which is an understudied area that we are still learning about. In addition, over the past few decades, we have seen various social and healthcare changes that have raised critical questions about their ongoing roles in regulating marijuana and alcohol use. This is important because of the increasing popularity and usage across various ages especially young adults and teenagers. More than 97.5 million Americans over 12 years old have used cannabis for non-medical use despite the significant side effects, with 1 in 10 users developing cannabis dependence (Crean RD, Crane NA, Mason BJ. 2011 J. Addict. Med. 5, 1–8. ( doi:10.1097/ADM.0b013e31820c23fa ), Office of Applied Studies. 2006 Substance Abuse and Mental Health Services Administration, USA.). It was reported that 16% of substance abuse admissions in the USA were for cannabis-related symptoms, which is second only to alcohol-related disorders (Agalioti T, Lomvardas S, Parekh B, Yie J, Maniatis T, Thanos D. 2000 Cell 103, 667–678. ( doi:10.1016/S0092-8674(00)00169-0 ), Soutoglou E, Talianidis I. 2002 Science 295, 1901–1904. ( doi:10.1126/science.1068356 )). Today there are thirty-one states and the District of Columbia that currently have legalized marijuana for either medical or recreational use. Data about marijuana use from NIAAA's National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) indicates that ‘in total, 79 000 people were interviewed on alcohol and drug use. When examined by age young adults (ages 18–21) were found to be at highest risk for marijuana use and marijuana use disorder, with use increasing from 10.5 to 21.2% and disorder increasing from 4.4 to 7.5%’. ‘Given these facts, George Koob, PhD, director of NIAAA stated the importance for the scientific community to convey this information to the public about the potential hazards of marijuana and it's use’. On the other hand, according to the National Institute on Alcohol Abuse and Alcoholism, 16 million adults suffer from alcohol use disorders. To the best of our knowledge, epigenetic mechanisms have been previously studied in alcohol and cannabis abuse separately. Recent studies highlighted the molecular mechanisms that are linked with drug-induced transcriptional regulation, behavioural abnormalities and neurodegeneration, which has emphasized the role of chromatin modification/remodelling in the generation of drug activation of certain genes and the disabling of others, and the effect of that on addiction (Maze I, Nestler EJ. 2011 Ann. N. Y. Acad. Sci. 1216, 99–113. ( doi:10.1111/j.1749-6632.2010.05893.x ); Renthal W, Nestler EJ. 2008 Trends Mol. Med . 14, 341–350. ( doi:10.1016/j.molmed.2008.06.004 )). In this review, we will give an overview of epigenome science relevant to cannabis/the endocannabinoid system and the potential of epigenetic overlap between alcohol and cannabinergic activity at different stages, to aid further investigations that could bring more treatment options to our horizon.


Author(s):  
Riaan G. Prinsloo ◽  
Andre Swanepoel ◽  
Gian Lippi

Background: Designated psychiatric facilities are responsible for the care, treatment and reintegration of State patients. The necessary long-term care places a considerable strain on health-care resources. Resource use should be optimised while managing the risks that patients pose to themselves and the community. Identifying unique factors associated with earlier discharge may decrease the length of stay. Factors associated with protracted inpatient care without discharge could identify patients who require early and urgent intervention.Aim: We identify socio-economic, demographic, psychiatric and charge-related factors associated with the discharge of male State patients.Methods: We reviewed the files of discharged and admitted forensic State patients at Weskoppies Psychiatric Hospital. Data were captured in an electronic recording sheet. The association between factors and the outcome measure (discharged vs. admitted) was determined using chi-squared tests and Fischer’s exact tests.Results: Discharged State patients were associated with being a primary caregiver (p = 0.031) having good insight into illness (p = 0.025) or offence (p = 0.005) and having had multiple successful leaves of absences. A lack of substance abuse during admission (p = 0.027), an absence of a diagnosis of substance use disorder (p = 0.013) and the absence of verbal and physical aggression (p = 0.002 and p = 0.016) were associated with being discharged. Prolonged total length of stay (9–12 years, p = 0.031) and prolonged length of stay in open wards (6–9 years, p = 0.000) were associated with being discharged. A history of previous offences (p = 0.022), a diagnosis of substance use disorder (p = 0.023), recent substance abuse (p = 0.018) and a history of physical aggression since admission (p = 0.017) were associated with continued admission.Conclusion: Discharge of State patients is associated with an absence of substance abuse, lack of aggression, multiple successful leave of absences and length of stay in hospital.


2018 ◽  
Vol 28 (1) ◽  
pp. 29-35
Author(s):  
Rahissa D. Winningham ◽  
Devin E. Banks ◽  
Marcy R. Buetlich ◽  
Matthew C. Aalsma ◽  
Tamika C.B. Zapolski

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