Young people and substance misuse

2018 ◽  
Vol 11 (11) ◽  
pp. 601-607
Author(s):  
Irene Hernandez Sanchez
Keyword(s):  
Substance Misuse ◽  
Warning Signs ◽  
Assessment Tools ◽  
Drug Misuse ◽  
Mental Performance ◽  
Illegal Drug Use ◽  
And Performance ◽  
The Uk ◽  
Drunk Alcohol

In the UK in 2017, 9% of pupils aged 11–15 reported having drunk alcohol in the previous week, which is the lowest rate since the 1980s. Illegal drug use in the previous year reported by 15-year olds halved between 2001 and 2014. Despite these promising figures, adolescence is deemed to be decisive for future biopsychosocial development and performance. Initiation during adolescence may therefore have long-term implications, affecting mental performance and educational outcomes. This article focuses on patterns of drug misuse in teenagers. The warning signs of drug misuse and useful assessment tools are also introduced. For the purposes of this article, alcohol will be defined as a drug.

scholarly journals Opiate dependence and pregnancy: 20-year follow-up study

2007 ◽  
Vol 31 (12) ◽  
pp. 450-453 ◽  
Author(s):  
Marie Whitty ◽  
John O'Connor
Keyword(s):  
Psychosocial Functioning ◽  
Substance Misuse ◽  
Opiate Dependence ◽  
Drug Misuse ◽  
Clinical Implications ◽  
Follow Up Study ◽  
Treatment Centre ◽  
Long Term Follow Up

AIMS AND METHODThis study examined the 20-year outcome of 55 women who were pregnant and using opiates in 1985 and were attending the Drug Treatment Centre and Advisory Board, Dublin. We established outcome across a number of variables, including mortality, psychiatric and physical morbidity, psychosocial functioning, ongoing drug misuse and outcome of offspring.RESULTSAt 20-year follow-up 29 women (53%) were deceased. HIV was the commonest cause of death, accounting for 17 deaths (59%). Those who were alive at follow-up displayed high rates of unemployment (84%), illicit substance misuse (74%) and most were dependent on state-subsidised accommodation (78%).CLINICAL IMPLICATIONSMortality was higher in our group compared with other long-term follow-up samples. These findings suggest that such participants and their offspring require intensive long-term support and treatment.

Metrics, Targets and Performance

2006 ◽  
Vol 197 ◽  
pp. 80-92 ◽  
Author(s):  
Philip Andrew Stevens ◽  
Lucy Stokes ◽  
Mary O'Mahony
Keyword(s):  
Public Sector ◽  
Performance Management ◽  
Performance Indicators ◽  
Acute Hospital ◽  
Performance Management System ◽  
The Public ◽  
Productivity Measure ◽  
And Performance ◽  
The Uk

The setting and use of targets in the public sector has generated a growing amount of interest in the UK. This has occurred at a time when more analysts and policymakers are grasping the nettle of measuring performance in and of the public sector. We outline a typology of performance indicators and a set of desiderata. We compare the outcome of a performance management system — star ratings for acute hospital trusts in England — with a productivity measure analogous to those used in the analysis of the private sector. We find that the two are almost entirely unrelated. Although this may be the case for entirely proper reasons, it does raise questions as to the appropriateness of such indicators of performance, particularly over the long term.

scholarly journals Commentary

2000 ◽  
Vol 6 (1) ◽  
pp. 39-40
Author(s):  
Roch Cantwell
Keyword(s):  
Illicit Drugs ◽  
Substance Misuse ◽  
Illicit Drug ◽  
Information Gathering ◽  
Drug Misuse ◽  
High Prevalence ◽  
The Rich ◽  
The Uk ◽  
Tabloid Journalism ◽  
Timely Reminder

In the sometimes sensational world of illicit drug reportage, there is one unsung villain. While heroin misuse remains the bête noir of tabloid journalism, ecstasy the demon of the dance floors and cocaine caricatured as the choice of the rich and famous, amphetamine misuse has lurked the shadows. Its use defies such simple categorisation and spans several groups in society. Bruce has provided a timely reminder of this neglected area in substance misuse literature and, in the process, has highlighted the relevance of basic information gathering as the most important tool in the armamentorium of drug misuse workers. The lack of prominence given to what they describe as a “hidden epidemic” is striking. Could this be because amphetamine misuse is a less prevalent problem than that of other illicit drugs? Evidence suggests otherwise. Amphetamine is the second most common illicit drug seized in the UK (after cannabis). It is easily produced and used in a variety of modes, and recent research confirms a high prevalence of misuse in this country reflecting that found in North American and Australian literature.

Problems due to use of alcohol and other psychoactive substances

Psychiatry ◽  
2019 ◽  
Author(s):  
Rebecca McKnight ◽  
Jonathan Price ◽  
John Geddes
Keyword(s):  
Illicit Drugs ◽  
Substance Misuse ◽  
Classification Systems ◽  
Drug Misuse ◽  
Psychoactive Substances ◽  
Victorian England ◽  
True Incidence ◽  
Medicinal Use ◽  
The Individual ◽  
The Uk

Archaeological evidence has demonstrated that for at least the past 10,000 years humans have been using psychoactive substances. From the chewing of coca leaves in Ancient Peru (c.4000– 3000 bce) to the popular use of laudanum in Victorian England, the recreational, cultural, and medicinal use of ‘mind- altering’ substances has been widespread. As of 2016, alcohol and other psychoactive substances remain a leading cause of medical and social problems world­wide: humans are clearly vulnerable to their attrac­tion. Although a myriad of substances are available, only a few are commonly used, and all tend to produce similar harms upon the individual and society. This chapter will provide a general approach to managing a patient presenting with a problem stemming from substance misuse. It is extremely difficult to gather accurate data on the use of substances in the general population, especially if they are illegal. It is therefore likely that most figures are underestimations of the true incidence. The WHO estimates that tobacco, alcohol, and illicit drugs are a factor in 12.4 per cent of all deaths worldwide. This is a stark reminder of the severity that problems associated with substance usage can reach, but the morbidity sur­rounding them affects a much wider section of society. In the UK, 80 per cent of adults drink alcohol, 19 per cent smoke tobacco, and 30 per cent admit to having used an illegal drug at least once in their lifetime. Worldwide, the highest prevalence of drug misuse is found in the 16- to 30- year age group, with males outnumbering females at a ratio of 4 to 1. Table 29.1 shows a selection of epidemiological figures associ­ated with commonly used substances. Substance misuse is associated with an array of con­fusing terminology, the majority describing different disorders that may occur due to use of any substance. The following terms are internationally agreed and ap­pear in major classification systems:… ● Intoxication is the direct psychological and physical effects of the substance that are dose dependent and time limited. They are individual to the substance and typically include both pleasurable and unpleasant symptoms.

Primary care

2016 ◽  
pp. 466-533
Author(s):  
Andrew Baldwin ◽  
Nina Hjelde ◽  
Charlotte Goumalatsou ◽  
Gil Myers
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Social Class ◽  
Sleep Problems ◽  
Care Home ◽  
Medically Unexplained Symptoms ◽  
Drug Misuse ◽  
Independent Practice ◽  
And Performance ◽  
The Uk

This chapter explores primary care and general practice. It outlines primary care (general practice in the UK and worldwide, primary care, intermediate care and self-care, primary health care teams, and pressures of primary care), consulting and certifying (the consultation and patient centred care, consultation models, complex decision making, managing uncertainty, what to do for the best, continuity of care, home visits, telephone consulting, chronic disease, approaching minor illness, medically unexplained symptoms, time off work and fit notes, fitness to drive, fitness to fly, UK benefits, certification of death) health and healthy living (health and social class, social class and health inequalities, prevention, screening, health education, smoking cessation, managing alcohol and drug misuse, managing obesity, managing sleep problems, exercise, healthy eating and alternative medicine, domestic violence), and practice management and performance (GPs as business managers and commissioners, independent practice vs commercial companies, clinical governance, significant events, audit and complaints, appraisal, revalidation and performance, prescribing and referring, patient groups).

Substance misuse and dependence: older people deserve better services

1999 ◽  
Vol 9 (4) ◽  
pp. 327-342 ◽  
Author(s):  
Ilana B Crome ◽  
Ed Day
Keyword(s):  
Older People ◽  
Large Scale ◽  
Substance Misuse ◽  
Drug Misuse ◽  
Definition Of ◽  
The Uk ◽  
Available Information

It is not easy to establish with any confidence the prevalence of drug misuse in older people. The issue is confounded by variations in definition of what constitutes ‘elderly’ and ‘drug misuse’, and by the types of sample used (Tables 1 and 2). There are few large-scale studies in the UK, and much of the information has been extrapolated from the American findings. The available information can be organized into four main areas:

Nurturing and Pampering Paradigm for Office Ergonomics

1997 ◽  
Vol 41 (1) ◽  
pp. 519-523 ◽  
Author(s):  
Rajendra D Paul
Keyword(s):  
Blood Circulation ◽  
Occupational Injuries ◽  
Mood States ◽  
The Body ◽  
The Other ◽  
Mental Performance ◽  
Training And Education ◽  
Work Settings ◽  
And Performance

This paper proposes that current ergonomic practices for design of sedentary jobs, focusing on comfort and support, are inadequate to create healthy and productive workplaces. In fact, they may be counter-productive over the long term. The key results from several research investigations supporting this proposition are: 1) Comfortable workstations adjusted to the user, along with training and education, were inadequate to relieve potentially harmful spinal stress and circulatory impedance caused by sedentary jobs (Paul, 1995; Paul and Helander, 1995). 2) Sedentary jobs induced cognitive mood states like drowsiness and lack of alertness that degrade cognitive function and performance (Paul, 1995b). 3) Activity and movement, for example, between sitting and standing, significantly reduced spinal stress and improved blood circulation (Paul, 1995a; Paul and Helander, 1996a). They also improved mood states linked with superior mental performance (Paul, 1995b; Paul, Morrow and Helander, 1996) 4) Excessively comfortable sedentary work settings induce mood states that could be detrimental to cognitive performance (Paul, Morrow and Helander, 1996). 5) Comfort and discomfort are not two ends of an evaluative spectrum, but rather two orthogonal constructs with two sets of casual factors (Zhang and Helander, 1992). These results collectively provided foundation for the nurturing and pampering paradigm. In this paradigm, nurturing is the strategy to reduce discomfort and pampering is the strategy to apply comfort. Nurturing promotes active, dynamic use of the body during workday to maintain health and prevent injuries. It is discussed using phrases like ‘the best posture is the next posture’ or ‘use it or lose it.’ Pampering with aesthetic and plush environments that induce comfortable perceptions, on the other hand, is a motivational tool with an inverted-U relationship to performance. Utility of this paradigm to create healthy and productive work settings and reduce occupational injuries is supported with several studies from diverse fields. Finally, its implications for workplace design and limitations are discussed.

Standards and Specifications for Packaging Waste in the UK

2001 ◽  
Author(s):  
S. V. Barlow ◽  
J. D. Palmer
Keyword(s):  
Waste Management ◽  
Waste Product ◽  
Assessment Process ◽  
Design Quality ◽  
Safe Management ◽  
Performance Specifications ◽  
And Performance ◽  
Environmentally Sound ◽  
The Uk

Abstract The role of Nirex is to provide the United Kingdom with safe and environmentally sound options for the long-term management of radioactive waste generated by the UK’s commercial, medical, research and defence activities. This includes all intermediate level waste and some low level waste (ILW and LLW). One of the key objectives of Nirex over the past 10 years or so, has been to ensure that when waste is packaged, it is in a form suitable for its future safe management including storage, transport, handling and potential disposal. Being responsible for development of future long-term waste management facilities, Nirex is uniquely placed to define standards and performance specifications for waste packages that include wasteform and container design, quality assurance and data recording requirements. In addition to the specifications, Nirex also provides detailed advice on the suitability of specific packaging proposals and plant designs against the foreseen requirements for future transport, handling, storage and potential disposal, as defined by the Nirex phased disposal concept. Where packaging proposals meet these requirements, Nirex is prepared to endorse the proposed approach through the issue of a ‘Letter of Comfort’. This approach has enabled the commencement of waste packaging operations with a high degree of confidence that the waste product will meet future waste management requirements, including potential disposal requirements. This paper provides a summary of the standards and specifications developed by Nirex for waste packages, and of the assessment process applied by Nirex in providing advice and endorsement of specific packaging proposals.

scholarly journals The Destructive Capacity of Drug Abuse: An Overview Exploring the Harmful Potential of Drug Abuse Both to the Individual and to Society

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Thomas Peter Fox ◽  
Govind Oliver ◽  
Sophie Marie Ellis
Keyword(s):  
Drug Abuse ◽  
Substance Misuse ◽  
Crack Cocaine ◽  
Illegal Drug ◽  
Drug Misuse ◽  
Western World ◽  
Public Health Perspective ◽  
Published Evidence ◽  
The Individual ◽  
The Uk

From a public health perspective, substance abuse has long been a source of major concern, both for the individual’s health and for wider society as a whole. The UK has the highest rates of recorded illegal drug misuse in the western world. In particular, it has comparatively high rates of heroin and crack cocaine use. Substances that are considered harmful are strictly regulated according to a classification system that takes into account the harms and risks of taking each drug (see the tables) (Nutt et al. (2007)). The adverse effects of drug abuse can be thought of in three parts that together determine the overall harm in taking it: (1) the direct physical harm of the substance to the individual user, (2) the tendency of the drug to induce dependence, and (3) the effect of abuse of the drug on families, communities, and society (Gable (2004, 1993)). In this report, we discuss published evidence relating to the harm of substance misuse and consider the neuropsychopharmacological mechanisms behind addiction in an attempt to gain an improved picture of the potential devastation that abuse of these substances may evoke.

Multiple Exclusion Homelessness in the UK: Key Patterns and Intersections

2011 ◽  
Vol 10 (4) ◽  
pp. 501-512 ◽  
Author(s):  
Suzanne Fitzpatrick ◽  
Sarah Johnsen ◽  
Michael White
Keyword(s):  
Substance Misuse ◽  
Institutional Care ◽  
Drug Misuse ◽  
Multi Stage ◽  
Low Threshold ◽  
The Uk ◽  
High Degree ◽  
Personal Trauma ◽  
Very High ◽  
Prevalent Form

This article presents preliminary results from a multi-stage quantitative study of ‘multiple exclusion homelessness’ (MEH) in seven urban locations across the UK. It demonstrates a very high degree of overlap between a range of experiences associated with ‘deep social exclusion’ – namely, homelessness, substance misuse, institutional care and ‘street culture’ activities (such as begging and street drinking). It also provides evidence to support the contention that homelessness is a particularly prevalent form of exclusion, with its experience reported as widespread by those accessing low threshold support services targeted at other dimensions of deep exclusion, such as drug misuse. Further, the analysis presented indicates that the nature of MEH varies geographically, with the profile of the population affected looking quite different in Westminster (London) than in the other urban locations. The main explanation for this appears to be the exceptionally high proportion of migrants in the MEH population in Westminster, who tend to report lower overall levels of personal trauma and vulnerability than the indigenous MEH population.

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