Critical Care Medicine

2016 ◽  
pp. 719-728
Author(s):  
Cassie C. Kennedy
Keyword(s):  
Substance Use ◽  
Critical Care ◽  
Substance Use Disorders ◽  
Age Groups ◽  
Psychosocial Treatment ◽  
Racial Groups ◽  
Self Help ◽  
Self Help Groups ◽  
Alcohol And Other Drugs ◽  
Pharmacologic Agents

Alcohol and other substance use disorders are a major concern in all age groups and across all ethnic, socioeconomic, and racial groups. Despite high lifetime prevalence (up to 20%), less than 10% of persons with substance use disorders are involved in treatment (either self-help groups or professional care). Several pharmacologic agents are available to help diminish the craving for alcohol and other drugs or to deter relapse. Although several medications, including disulfiram, acamprosate, and naltrexone, may help prevent relapse, they are adjunctive and not a substitute for comprehensive psychosocial treatment.

scholarly journals Effectiveness of Self-Help Groups and Psychotherapy: Self-Assessment of Patients With Substance Use Disorders

Medicina ◽  
2012 ◽  
Vol 48 (10) ◽  
pp. 79
Author(s):  
Velga Sudraba ◽  
Inga Millere ◽  
Elmars Rancans
Keyword(s):  
Substance Use ◽  
Group Psychotherapy ◽  
Substance Use Disorders ◽  
Duration Of Treatment ◽  
Self Assessment ◽  
Self Help ◽  
Study Results ◽  
Psychosocial Model ◽  
Self Help Groups ◽  
Drug And Alcohol

Background and Objective. The basis of substance use disorders (SUD) is formed with regard to biopsychosocial aspects. By following the SUD biological model exclusively, the effectiveness of treatment is limited since all the formation aspects of SUD are not taken into account. By using the psychosocial model, however, the understanding and treatment of a substance use illness becomes enhanced and is more effective. A key role in this model is played by self-help groups and psychotherapy. The aim of this study was to determine the viewpoint of patients with substance use disorders in terms of the number of visits, duration of treatment, efficacy of self-help groups, and individual and group psychotherapy in different treatment methods. Material and Methods. The participants were approached by researchers at two drug and alcohol services in Latvia. In total, 587 patients received questionnaires developed by the authors of the study. Results. All the 587 questionnaires of both outpatient respondents (n=200, 34.1%) and inpatient respondents (n=387, 65.9%) were analyzed. Of all the outpatient department respondents, 41.5% (n=83) attended self-help groups, 28.5% (n=57) individual psychotherapy, and 14.5% (n=29) group psychotherapy; the inpatient department respondents were 2 to 4 times less often involved in the measures. Conclusions. The outpatient respondents were more frequently employed. They attended selfhelp groups and psychotherapy and obtained longer remission comparing with inpatient respondents. This study has shown that patients had a greater success rate in staying in remission, maintaining outpatient care and shedding the need of inpatient care.

Self-Help Organizations for Substance Use Disorders

2014 ◽  
Author(s):  
Anna Lembke ◽  
Keith Humphreys
Keyword(s):  
Substance Use ◽  
Substance Use Disorders ◽  
Stages Of Change ◽  
Personal Autonomy ◽  
Scientific Evidence ◽  
Psychological Mechanisms ◽  
Self Help ◽  
Self Help Groups ◽  
Moderation Management ◽  
Alcohol Dependent

Self-help groups for substance use disorders have been active for decades, and notions of self-help have been prevalent for centuries. After presenting universal features of self-help organizations, the authors focus on Alcoholics Anonymous (AA) and Moderation Management (MM), discussing the origins, membership, and philosophy of AA and MM and highlighting important differences between these organizations. AA’s emphasis on spirituality, interpersonal conduct, and abstinence as the only goal contrasts sharply with MM’s emphasis on personal autonomy, rational cognitions, and setting drinking limits. The chapter discusses scientific evidence of the effectiveness of AA and MM on substance use outcomes and potential social and psychological mechanisms of change. More research is needed in the area of self-help organizations. In the meantime, AA is proven effective for alcohol-dependent individuals who embrace its philosophy, and MM may fill an important niche for nondependent drinkers or those in the precontemplation stages of change.

Estimating the Prevalence of Mental and Substance Use Disorders: A Systematic Approach to Triangulating Available Data to Inform Health Systems Planning:: Estimer la prévalence des troubles mentaux et des troubles liés à une substance: une approche systématique de la triangulation des données disponibles pour éclairer la planification du système de santé

2021 ◽  
pp. 070674372110068
Author(s):  
Daniel Vigo ◽  
Wayne Jones ◽  
Naomi Dove ◽  
Daniel E. Maidana ◽  
Corinne Tallon ◽  
...  
Keyword(s):  
British Columbia ◽  
Substance Use ◽  
Health Systems ◽  
Substance Use Disorders ◽  
Age Groups ◽  
Data Sources ◽  
Distribution Model ◽  
Systems Planning ◽  
Prevalence Estimates ◽  
Age And Sex

Objective: To estimate the prevalence of specific mental and substance use disorders (MSUDs), by age and sex, as a first step toward informing needs-based health systems planning by decision-makers. Methods: We developed a conceptual framework and a systematic methodology for combining available data sources to yield prevalence estimates for specific MSUDs. Data sources used included published, peer-reviewed literature from Canada and comparable countries, Canadian population survey data, and health administrative data from British Columbia. Several well-established methodologies including systematic review and meta-analyses of published prevalence estimates, modelling of age- and sex-specific distributions, and the Global Burden of Disease severity distribution model were incorporated in a novel mode of triangulation. Results: Using this novel approach, we obtained prevalence estimates for 10 MSUDs for British Columbia, Canada, as well as prevalence distributions across age groups, by sex. Conclusion: Obtaining reliable assessments of disorder prevalence and severity is a useful first step toward rationally estimating service need and plan health services. We propose a methodology to leverage existing information to obtain robust estimates in a timely manner and with sufficient granularity to, after adjusting for comorbidity and matching with severity-specific service bundles, inform need-based planning efforts for adult (15 years and older) mental health and substance use services.

Abstract 228: National Prevalence of Substance Use Disorders Among Hospitalized Heart Failure Patients

2018 ◽  
Vol 11 (suppl_1) ◽  
Author(s):  
Sarah C Snow ◽  
Gregg C Fonarow ◽  
Joseph A Ladapo ◽  
Donna L Washington ◽  
Katherine Hoggatt ◽  
...  
Keyword(s):  
Heart Failure ◽  
Substance Use ◽  
Native American ◽  
Drug Use ◽  
Substance Use Disorders ◽  
Age Groups ◽  
Opioid Use ◽  
Drug Use Disorders ◽  
Increased Risk ◽  
Drug Use Disorder

Background: Several cardiotoxic substances contribute to the development of heart failure (HF). The burden of comorbid substance use disorders (SUD) among patients with HF is under-characterized. Objectives: To describe the national burden of comorbid SUD (tobacco, alcohol, or drug use disorders) among hospitalized HF patients in the U.S. Methods: We used data from the 2014 National Inpatient Sample to calculate the proportion of hospitalizations for a primary HF admission with tobacco, alcohol, or drug use disorder diagnoses, accounting for demographic factors. Drug use disorder analysis was further sub-divided into specific illicit substance categories. Results: There were a total of 989,080 HF hospitalizations of which 35.3% (n=348,995) had a documented SUD. Tobacco use disorder (TUD) was most common (n= 327,220, 33.1%) followed by drug use disorder (DUD) (n=34,600, 3.5%) and alcohol use disorder (AUD) (n=34,285, 3.5%). Female sex was associated with less TUD (OR 0.59; 95% CI, 0.58-0.60), AUD (OR 0.23; 95% CI, 0.22-0.25) or DUD (OR 0.58; 95% CI 0.55-0.62). Tobacco, alcohol, cocaine, and opioid use disorders were highest among HF patients age 45 to 55, while cannabis and amphetamine use was highest in those <45 years. Native American race (versus White) was associated with increased risk of AUD (OR 1.67; 95% CI 1.27-2.20). Black race was associated with increased risk of AUD (OR 1.09; 95% CI 1.02-1.16) or DUD (OR 1.63; 95% CI 1.53-1.74). Medicaid insurance (versus Medicare) was associated with greater TUD (OR 1.27; 95% CI 1.23-1.32), AUD (OR 1.74; 95% CI 1.62-1.87), and DUD (OR 2.15; 95% CI 2.01-2.30). Decreasing quartiles of median household income were associated with increasing SUD. Conclusions: Comorbid SUD disproportionately affects certain HF populations, including men, younger age groups, lower SES patients, and race/ethnic minorities. Further research on interventions to improve prevention and treatment of SUD among hospitalized HF patients are needed given the high rates of SUD in this population. Systematically screening hospitalized HF patients for SUD may reveal opportunities for treatment and secondary prevention.

Why Should We Focus on Emerging Adults with Substance Use Disorders?

2017 ◽  
pp. 1-15
Keyword(s):  
Substance Use ◽  
Emerging Adulthood ◽  
Emerging Adults ◽  
Substance Use Disorders ◽  
First Language ◽  
Developmentally Appropriate ◽  
Age Groups ◽  
Treatment Access ◽  
Problematic Substance Use ◽  
Problematic Substance

Emerging adulthood (roughly ages 18–29) is the lifespan period when the peak prevalence of substance use disorders (SUD) and substance use occurs. Opportunities for prevention and intervention abound during these years. This chapter provides a brief introduction to the concept of emerging adulthood, as well as a laundry list of terms used to describe problematic substance use. The chapter argues that we must be mindful of using person-first language and, based on available stigma research, advocates for use of the term substance use disorder. The chapter then presents a strong rationale for creating more developmentally appropriate treatments for emerging adults. This rationale is based on three pillars: (1) emerging adults’ current underrepresentation in large outcome studies, (2) existing disparities in treatment outcomes between emerging adults and individuals in other age groups, and (3) the possibility of expanded substance use treatment access under healthcare reform.

Psychosocial Treatment Approaches for Substance Use

2018 ◽  
Author(s):  
Lynn McFarr ◽  
Julie Snyder ◽  
Lisa Benson ◽  
Rachel Higier
Keyword(s):  
Substance Use ◽  
Substance Use Disorders ◽  
Meta Analysis ◽  
Contingency Management ◽  
Psychosocial Interventions ◽  
Psychosocial Treatment ◽  
Community Based ◽  
Theoretical Orientations ◽  
Psychosocial Treatments ◽  
Community Based Programs

Multiple psychosocial treatments for substance-use disorders have been studied for efficacy. A recent meta-analysis indicates that psychosocial interventions are effective across multiple types of substances used. In the case of opiates, psychosocial interventions combined with medication appear to be the most effective. Many studies further agree that psychosocial interventions are an integral and necessary part of treating substance-use disorders. Although theoretical orientations may differ across psychosocial treatments, they have several principles and practices in common. All involve talk therapy or talk in communities as a way to clarify triggers, build commitment, and improve accountability. Many also target addiction behaviors and work to develop alternative contingencies to reduce or eliminate use. Finally, targeting repeated performance (or building “chains of committed behavior”) decreases the likelihood of relapse. This chapter discusses the most frequently studied and employed psychosocial treatments for substance use including CBT, motivational interviewing, contingency management, mindfulness, and community-based programs.

Intensive referral to 12-Step self-help groups and 6-month substance use disorder outcomes

Addiction ◽  
2006 ◽  
Vol 101 (5) ◽  
pp. 678-688 ◽  
Author(s):  
Christine Timko ◽  
Anna DeBenedetti ◽  
Rachel Billow
Keyword(s):  
Substance Use ◽  
Substance Use Disorder ◽  
Self Help ◽  
Self Help Groups

scholarly journals Do psychological features distinguish those who sexually offend against different age groups from those who are stable in victim age?

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Isaac M. Cormier ◽  
Skye Stephens ◽  
Sonja Svensson ◽  
Angela Connors
Keyword(s):  
Substance Use ◽  
Substance Use Disorders ◽  
Age Groups ◽  
Drug Misuse ◽  
Assessment Data ◽  
Comprehensive Information ◽  
Significant Difference ◽  
Assessment Measures ◽  
Archival Database ◽  
Psychological Features

Aim/Background Victim age polymorphism occurs when someone offends against victims that span multiple age groups (e.g., child and adult victims). There is a need to better understand the correlates of age polymorphism, as clinicians are often asked about risk of offending against victims who may differ from the index offence victim as part of their risk formulation. The present study examines several potential correlates of age polymorphism: psychopathy, sexual preoccupation, multiple paraphilias, psychosis, and substance use disorders. Materials/Method Analyses were conducted using secondary clinical assessment data from a provincial forensic sexual behaviour program. The sample included 387 men with two or more contact sexual offence victims. The assessment data in the archival database included comprehensive information about victim age, as well as standardized assessment measures and diagnostic/clinical impressions. Results There were no significant associations between age polymorphism and psychopathy, multiple paraphilias, sexual preoccupation, psychosis, and substance use disorders. The only significant difference that emerged was that men who offended against victims 16 or older had a higher mean score on a measure of drug misuse than those who offended against victims 6 to 11. Most of the analyses produced small effects. Conclusion Our findings did not identify significant correlates of age polymorphism when restricting analyses to those men who offended against two or more victims. We consider key methodological differences that may have impacted our findings, as well as the need for rigorously designed research to develop a comprehensive model of age polymorphism.

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