scholarly journals Perceived role of psychiatrists in the management of substance misuse a questionnaire survey

1999 ◽  
Vol 23 (11) ◽  
pp. 667-670 ◽  
Author(s):  
Edward Day ◽  
Jon Arcelus ◽  
Ashraf Kahn
Keyword(s):  
Substance Misuse ◽  
Alcohol Misuse ◽  
Postgraduate Training ◽  
Evidence Base ◽  
Postal Questionnaire ◽  
Drug Misuse ◽  
Attitudes And Beliefs ◽  
Four Levels ◽  
Drug And Alcohol

Aims and methodsA postal questionnaire sent to all psychiatrists working in four NHS trusts in and around Birmingham was used to survey the number of new cases of drug and alcohol misuse identified in the previous month and the degree of postgraduate training in the management of such cases. Attitudes and beliefs about substance misuse problems were also elicited.ResultsA response rate of 70% was achieved across six sub-specialities in psychiatry and four levels of training. Of the 143 respondents, over half had identified at least one new case of alcohol (61%) or drug misuse (55%) in the previous month. Approximately half of the sample admitted to having received no training in management of substance misuse cases in the previous five years (45% alcohol 50% drugs). There was general agreement about the potential management role of the doctor in the field, but less consensus on whether the clinician had a responsibility to intervene in such cases. A clear discrepancy was demonstrated between psychiatrists' perceptions of the evidence supporting various treatments and the actual evidence base.Clinical implicationsThe study highlights the pressing need for training psychiatrists at all levels and in all sub-specialities in the management of substance misuse.

Young Males Attending a Family-Planning Clinic: Some Ideas about Consequences of Child Abuse

1999 ◽  
Vol 85 (2) ◽  
pp. 529-532
Author(s):  
PEggy B. Smith ◽  
Maxine L. Weinman ◽  
Ruth S. Buzi
Keyword(s):  
Smoking Cessation ◽  
Child Abuse ◽  
Family Planning ◽  
Behavioral Problems ◽  
Substance Misuse ◽  
Alcohol Misuse ◽  
Family Planning Clinic ◽  
Young Males ◽  
Medical Needs ◽  
Drug And Alcohol

33 young males attending a family-planning clinic were asked about the consequences of child abuse as it affects behavioral problems of teens and their interest in programs that deal specifically with these problems. Nine reported they had been victims of abuse. Most believed that drug and alcohol misuse and suicide were the major consequences of child abuse. Fifteen were interested in programs for prevention of child abuse but not for specific problems such as substance misuse and smoking cessation. This study's findings suggest that family-planning clinics with services for males must address their behavioral as well as medical needs.

scholarly journals Drug and alcohol misuse among in-patients with psychotic illnesses in three inner-London psychiatric units

2003 ◽  
Vol 27 (06) ◽  
pp. 217-220 ◽  
Author(s):  
Prashant Phillips ◽  
Sonia Johnson
Keyword(s):  
Dual Diagnosis ◽  
Illicit Drugs ◽  
Alcohol Misuse ◽  
Drug Misuse ◽  
Psychotic Illness ◽  
Psychiatric Units ◽  
History Of ◽  
The Mean ◽  
Drug And Alcohol ◽  
Current Alcohol

Aims and Method Ward staff were asked to rate whether in-patients with a diagnosis of functional psychotic illness also met criteria for a diagnosis of alcohol or drug misuse or dependence during the preceding 6 months. Those who demonstrated such evidence were then asked to report the nature and extent of their substance use and whether they continued to use as in-patients. Results 264 in-patients with psychotic illness were screened for evidence of recent or current alcohol or drug misuse. According to staff reports, 127 (48.9%) met the criteria for substance misuse or dependence. The mean age of those with ‘dual diagnosis' was 34.7 years and 72% were male. Eighty-three (83%) of those with a history of current or recent alcohol or drug misuse reported that they had continued to use alcohol and/or illicit drugs in the in-patient wards during their current admission. Clinical Implications It appears difficult to prevent in-patients with drug or alcohol misuse problems from continuing to use substances in hospital. Further consideration and investigation of how best to manage this group is therefore required.

scholarly journals Comorbid non-alcohol substance misuse among people with schizophrenia

2001 ◽  
Vol 179 (6) ◽  
pp. 509-513 ◽  
Author(s):  
Peter J. Duke ◽  
Christos Pantelis ◽  
Michael A. McPhillips ◽  
Thomas R. E. Barnes
Keyword(s):  
Substance Misuse ◽  
Alcohol Misuse ◽  
Demographic Data ◽  
Epidemiological Studies ◽  
Lifetime History ◽  
The Usa ◽  
History Of ◽  
And Gender ◽  
The Uk ◽  
Drug And Alcohol

BackgroundFew epidemiological studies have assessed the extent and nature of comorbid non-alcohol substance misuse in people with schizophrenia in the community in the UK.AimsTo study the extent and nature of comorbid non-alcohol substance misuse in people with schizophrenia in central London.MethodSubjects were identified in an epidemiological census survey of South Westminster. Standardised assessment of each subject included demographic data, ratings of mental state and movement disorder and questioning about drug and alcohol misuse.ResultsIndividuals with schizophrenia or related psychoses were identified (n=352) and 57 (16%) reported a lifetime history of non-alcohol substance misuse. Age and gender were the main variables relevant to the extent and pattern of misuse. Self-reported non-alcohol substance misuse showed no significant relationship with a range of outcome measures.ConclusionsThe high proportion of subjects reporting non-alcohol substance misuse is comparable with figures from the USA. The reports of lifetime misuse most commonly referred to cannabis, psychostimulants, LSD, opiates and anticholinergics. Misuse was concentrated in those younger than 36 years and was reported more often by males.

Substance misuse, mental health problems and recurrent child maltreatment

2014 ◽  
Vol 7 (1) ◽  
pp. 15-23 ◽  
Author(s):  
Anne-Marie Laslett ◽  
Robin Room ◽  
Paul Dietze
Keyword(s):  
Mental Health ◽  
Drug Use ◽  
Child Maltreatment ◽  
Child Protection ◽  
Substance Misuse ◽  
Alcohol Misuse ◽  
Mental Health Problems ◽  
Health Problems ◽  
Drug Misuse ◽  
Content Type

Purpose – The purpose of this paper is to determine whether the diagnosis of both carers’ mental health problems and substance misuse increase the likelihood of recurrent child maltreatment over and above the individual effects of these factors. Design/methodology/approach – Retrospective secondary data analysis of 29,455 children where child maltreatment was confirmed in the Victorian child protection system between 2001 and 2005. Recorded mental health, alcohol misuse and other drug misuse variables were entered into multivariate logistic regression models predicting repeated child maltreatment. Interactions and a range of other child, carer and socio-economic factors were included in these models. Findings – Carer alcohol misuse, other drug misuse and mental ill health all independently predicted recurrent child maltreatment. The presence of both other drug misuse and mental ill health increased the likelihood that recurrent child abuse was recorded over the likelihood that mental health alone predicted recurrent child maltreatment, and while alcohol misuse had an effect when there was no mental health condition recorded it did not have an additional effect when there was evidence of mental health problems. Research limitations/implications – Children in families where there is both mental health problems and other drug use problems are at greater risk of repeated maltreatment than where there is evidence of mental health problems or other drug use alone. Where there was evidence of carer mental health problems, alcohol misuse did not add to this likelihood. However, the effect of mental health and other drug use was similar in size to the effect of alcohol misuse alone. Originality/value – These findings add to understandings of the effects of co-occurring mental health problems and substance misuse on recurrent child maltreatment and differentiate between cases that involve alcohol and other drug misuse.

scholarly journals Substance misuse in life and death in a 2-year cohort of suicides

2016 ◽  
Vol 208 (3) ◽  
pp. 292-297 ◽  
Author(s):  
Karen Galway ◽  
Diana Gossrau-Breen ◽  
Sharon Mallon ◽  
Lynette Hughes ◽  
Michael Rosato ◽  
...  
Keyword(s):  
Substance Misuse ◽  
Alcohol Misuse ◽  
Alcohol Problems ◽  
Drug Misuse ◽  
Therapeutic Dosage ◽  
Life And Death ◽  
Other Substances ◽  
History Of ◽  
Toxicology Screening ◽  
The Relationship

BackgroundAlthough substance misuse is a key risk factor in suicide, relatively little is known about the relationship between lifetime misuse and misuse at the time of suicide.AimsTo examine the relationship between substance misuse and subsequent suicide.MethodLinkage of coroners' reports to primary care records for 403 suicides occurring over 2 years.ResultsWith alcohol misuse, 67% of the cohort had previously sought help for alcohol problems and 39% were intoxicated at the time of suicide. Regarding misuse of other substances, 54% of the cohort was tested. Almost one in four (38%) tested positive, defined as an excess of drugs over the prescribed therapeutic dosage and/or detection of illicit substances. Those tested were more likely to be young and have a history of drug misuse.ConclusionsA deeper understanding of the relationship between substance misuse and suicide could contribute to prevention initiatives. Furthermore, standardised toxicology screening processes would avoid diminishing the importance of psychosocial factors involved in suicide as a ‘cause of death’.

scholarly journals The future of specialised alcohol treatment services: a matter of policy?

2009 ◽  
Vol 15 (4) ◽  
pp. 253-259 ◽  
Author(s):  
Harish Rao ◽  
Jason Luty
Keyword(s):  
Alcohol Misuse ◽  
Alcohol Treatment ◽  
Evidence Base ◽  
Alcohol Problems ◽  
Stepped Care ◽  
Drug Misuse ◽  
Cost Of Treatment ◽  
High Profile ◽  
Treatment Services ◽  
Alcohol Harm Reduction

SummaryAround 7.1 million people in England drink hazardously or harmfully and a further 1.1 million are dependent on alcohol. Motivational interviewing is widely used to treat people with alcohol problems and is probably the best described example of a brief intervention. However, some recent trials have been disappointing. Specialised alcohol treatment services have also suffered from weakness in the evidence base. Investment in treating alcohol misuse has fallen far behind that for drug misuse. The Department of Health's Alcohol Harm Reduction Strategy for England embraces policies that are high-profile and cheap but are ineffective and ignore many effective measures. It recommends stepped care for alcohol treatment, but unlike the equivalent for drugs treatment, it sets no targets and leaves the small (7%) increase in funding to the discretion of local purchasers. UK spending on specialised treatment for drug misuse is estimated to be around £600 million for 2007 – around three times the estimated cost of treatment for alcohol misuse.

The Role of Acculturation in the Relation Between Intimate Partner Violence and Substance Misuse Among IPV-victimized Hispanic Women in the Community

2020 ◽  
pp. 088626052096713
Author(s):  
Miranda E. Reyes ◽  
Nicole H. Weiss ◽  
Suzanne C. Swan ◽  
Tami P. Sullivan
Keyword(s):  
Intimate Partner Violence ◽  
Partner Violence ◽  
Substance Misuse ◽  
Hispanic Women ◽  
The United States ◽  
Intimate Partner ◽  
Drug Misuse ◽  
Moderating Role ◽  
Relevant Factors

Hispanic women in the United States are disproportionately affected by intimate partner violence (IPV). One correlate of IPV among Hispanic women with important public health implications is substance misuse. However, limited research has identified culturally relevant factors that may impact the strength of the IPV-substance misuse association in this population. The present study examined the moderating role of acculturation in the relation between IPV types (i.e., physical, psychological, and sexual) and substance (i.e., alcohol and drug) misuse. Participants were 150 IPV-exposed Hispanic women in the community ( M age = 35.13). IPV types, substance misuse outcomes, and acculturation were significantly and positively correlated with each other at zero-order. Moderation analyses indicated that the relations between IPV and substance misuse were stronger among Hispanic women with higher (vs. lower) levels of acculturation. These findings suggest the potential utility of considering acculturation when assessing and treating substance misuse among IPV-exposed Hispanic women.

scholarly journals Drug and alcohol misuse among in-patients with psychotic illnesses in three inner-London psychiatric units

2003 ◽  
Vol 27 (6) ◽  
pp. 217-220 ◽  
Author(s):  
Prashant Phillips ◽  
Sonia Johnson
Keyword(s):  
Dual Diagnosis ◽  
Illicit Drugs ◽  
Alcohol Misuse ◽  
Drug Misuse ◽  
Psychotic Illness ◽  
Psychiatric Units ◽  
History Of ◽  
The Mean ◽  
Drug And Alcohol ◽  
Current Alcohol

Aims and MethodWard staff were asked to rate whether in-patients with a diagnosis of functional psychotic illness also met criteria for a diagnosis of alcohol or drug misuse or dependence during the preceding 6 months. Those who demonstrated such evidence were then asked to report the nature and extent of their substance use and whether they continued to use as in-patients.Results264 in-patients with psychotic illness were screened for evidence of recent or current alcohol or drug misuse. According to staff reports, 127 (48.9%) met the criteria for substance misuse or dependence. The mean age of those with ‘dual diagnosis' was 34.7 years and 72% were male. Eighty-three (83%) of those with a history of current or recent alcohol or drug misuse reported that they had continued to use alcohol and/or illicit drugs in the in-patient wards during their current admission.Clinical ImplicationsIt appears difficult to prevent in-patients with drug or alcohol misuse problems from continuing to use substances in hospital. Further consideration and investigation of how best to manage this group is therefore required.

Alcohol and substance misuse

2020 ◽  
pp. 713-734
Author(s):  
Tony Rao ◽  
Katy A. Jones
Keyword(s):  
Older People ◽  
Workforce Development ◽  
Prescription Drugs ◽  
Substance Misuse ◽  
Treatment Options ◽  
Evidence Base ◽  
Drug Misuse ◽  
Prescription Drug Misuse ◽  
Physical Disorders ◽  
To Come

Older people now represent a group at highest risk of rising substance misuse. This applies to alcohol as well as both illicit and prescription drugs. It is a trend that is likely to continue for decades to come, during which time we expect to see further increases in rates of illicit and prescription drug misuse. These problems are likely to pose a considerable burden on public health and clinical services, the problems being compounded by comorbid mental and physical disorders, polypharmacy and psychosocial problems such as retirement, loneliness, and bereavement. There is considerable scope for education and workforce development to improve screening and assessment, as well as exploring barriers to entering treatment, treatment options, and factors to promote recovery. Given the limited evidence base for treatment of substance misuse in older people, there is a pressing need for further research through both observational and analytical studies.

Prevalence of substance misuse in first-episode psychosis

1999 ◽  
Vol 174 (2) ◽  
pp. 150-153 ◽  
Author(s):  
Roch Cantwell ◽  
John Brewin ◽  
Cristine Glazebrook ◽  
Tim Dalkin ◽  
Richard Fox ◽  
...  
Keyword(s):  
Substance Use ◽  
Substance Misuse ◽  
Psychotic Disorders ◽  
Alcohol Misuse ◽  
Age Of Onset ◽  
First Episode Psychosis ◽  
Drug Misuse ◽  
First Episode ◽  
Multiple Sources ◽  
Episode Psychosis

BackgroundReports suggest a high prevalence of substance misuse in psychotic disorders but few studies examine comorbidity at onset of psychosis.AimsTo identify the prevalence and pattern of substance use and misuse in first-episode psychosis, and relationships with diagnosis, mode of presentation and demographic variables.MethodConsensus diagnoses for 168 subjects presenting with first-episode psychosis were made using ICD–10 diagnostic criteria. Information on substance use and misuse was obtained from multiple sources. We examined associations between substance misuse, diagnosis and demographic factors.ResultsCriteria for drug use, drug misuse or alcohol misuse were met by 37% of the sample. One-year prevalence rates were 19.5% (drug misuse) and 11.7% (alcohol misuse). Thirteen subjects (8.4%) received a primary diagnosis of substance-related psychotic disorder; a significant increase compared with an earlier cohort from the same catchment area. Drug misuse was associated with younger age of onset of psychosis, male gender and non–African–Caribbean ethnicity.ConclusionsThis study confirms high rates of substance misuse at onset of psychosis. There is evidence for an increase in diagnosis of substance-related psychotic disorders over time. Those most at risk of substance misuse are young males.

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