scholarly journals Community Based Interventions for Problematic Substance Use in Later Life: A Systematic Review of Evaluated Studies and Their Outcomes

2020 ◽  
Vol 17 (21) ◽  
pp. 7994
Author(s):  
Trish Hafford-Letchfield ◽  
Tricia McQuarrie ◽  
Carmel Clancy ◽  
Betsy Thom ◽  
Briony Jain
Keyword(s):  
Systematic Review ◽  
Substance Use ◽  
Older People ◽  
Age Groups ◽  
Later Life ◽  
Well Being ◽  
Community Based Interventions ◽  
Complex Needs ◽  
Problematic Substance Use ◽  
Problematic Substance

Problematic substance use (PSU) in later life is a growing global problem of significant concern in tandem with a rapidly ageing global population. Prevention and interventions specifically designed for older people are not common, and those designed for mixed-age groups may fail to address the unique and sometimes complex needs of ageing communities. We report findings from a systematic review of the empirical evidence from studies which formally evaluated interventions used with older people and reported their outcomes. Nineteen studies were included, of which thirteen focused solely on alcohol-related problems. Eight interventions utilised different types of screening, brief advice and education. The remaining drew on behavioural, narrative and integrated or multi-disciplinary approaches, which aimed to meet older people’s needs holistically. Quality assessment of study design helped to review evaluation practice. Findings point to recommendations for sustainable and well-designed intervention strategies for PSU in later life, which purposefully align with other areas of health and well-being and are delivered in locations where older people normally seek, or receive, help. There is further scope for engagement with older people’s own perspectives on their needs and help-seeking behaviours. Economic evaluation of the outcome of interventions would also be useful to establish the value of investing in targeted services to this underserved population.

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.

scholarly journals P008: Addressing chronic pain and problematic substance use of opioids in the emergency department: can a comprehensive framework for care work?

CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S81-S81
Author(s):  
M.A. Allen
Keyword(s):  
Emergency Department ◽  
Chronic Pain ◽  
Substance Use ◽  
Best Practice ◽  
Electronic Record ◽  
Emergency Department Visits ◽  
Direct Result ◽  
Complex Needs ◽  
Problematic Substance Use ◽  
Problematic Substance

Introduction: Chronic pain and substance misuse are complex chronic illness that are subject to prejudice, misinterpretation and cultural biases. They require a broad, multi-disciplined approach if they are to be effectively managed. Barrier’s to effective care in the emergency department include our reliance on pain scales alone to effectively triage and manage chronic pain, differing philosophy’s and attitudes regarding the appropriate use of high risk pain pharmacology including opioids and confusing classifications systems used to describe pain and problematic substance use which can often lead to further stigmatization and over medicating. Methods: The charts of thirteen patients with complex pain and problematic substance use who had more than 360 visits to a regional emergency department in one year were reviewed retrospectively and data collected regarding frequency of visits and disposition after the implementation of a comprehensive pain and addiction strategy from April 2011 to August 2015. Results: In the first year of implementation there was a 70% drop in the frequency of emergency department visits. Five patients (38%) required a comprehensive pain plan. Six agreed (46%) to a direct referral to our mental health, addiction and chronic pain services. Two patients (15%) were lost to follow-up. Review of the electronic record to track patient visits to provincial emergency departments did not show an increase in visits to other facilities within the province. Review of visits in 2015 show a 97% drop in the frequency of visits. Family Physicians in the community did not report an increase in the frequency of patient visits as a direct result of the implementation of this strategy nor was there an increase in complaints to administration regarding ineffective pain management. Conclusion: Although survey numbers are low it suggests that a framework for the management of complex pain and substance use disorders can be successfully implemented in the emergency department improving timely access to appropriate management and resources for patients based on best practice to address their complex needs.

scholarly journals Former inpatients’ narratives of substance use four years after substance use disorder treatment: A qualitative follow-up study

2021 ◽  
pp. 145507252110507
Author(s):  
Jacob Hystad ◽  
Turid Wangensteen
Keyword(s):  
Substance Use ◽  
Treatment Outcome ◽  
Substance Use Disorder ◽  
Healthcare Providers ◽  
Well Being ◽  
Analysis Model ◽  
Successful Treatment Outcome ◽  
Problematic Substance Use ◽  
Problematic Substance ◽  
Pre Treatment

Aim: The aim of this study was to explore the narratives of former substance use disorder (SUD) inpatients about substance use after their discharge from long-term SUD treatment in 2017. Method: We conducted semi-structured in-depth interviews with 11 former inpatients of SUD treatment. The data were analysed using a qualitative, thematic analysis model. Findings: During the analysis, two main themes emerged pertaining to participant reflections on substance use – their experience of non-problematic substance use (that is, substance use without declining into pre-treatment levels of misuse behaviours) and problematic substance use (that is, substance use associated with destructive patterns). All participants except one had engaged in substance use after their discharge three to four years ago. The commonly used substance was alcohol, which also appeared to be the most common substance for which there was consensus among the informants regarding non-problematic use. Conclusions: Most of the participants continued to use substances in some way, and some reported that such use did not affect them negatively. Healthcare providers and therapists in SUD treatment should avoid defining a relapse or failed treatment outcome in concrete terms. What is perceived as an actual relapse or a failed treatment outcome is highly subjective. Furthermore, complete sobriety might not necessarily be the best or the only way to measure the SUD treatment stay. An improvement in the quality of life and well-being, even when core symptoms are still present, may be considered a successful treatment outcome.

scholarly journals Changes in Social, Romantic, and General Life Satisfaction Over the Course of a Substance Use Disorder

2021 ◽  
Vol 12 ◽  
Author(s):  
Nina C. Christie ◽  
Vanya Vojvodic ◽  
Pranav Meda ◽  
John R. Monterosso
Keyword(s):  
Substance Use ◽  
Social Life ◽  
Well Being ◽  
Prescription Opioids ◽  
Drug Of Choice ◽  
Problematic Substance Use ◽  
Problematic Substance ◽  
Domains Of Life ◽  
History Of ◽  
The Relationship

Background: The pandemic has highlighted the importance of social connection for health and well-being. Satisfaction across domains of life is associated with substance use outcomes, such as risk of relapse and mortality. Previous work has delineated the relationship between substance use and social connections, yet there is a lack of research exploring the relationship between substance use and satisfaction with domains of life over time.Methods: We retrospectively assessed satisfaction with social life, romantic life, and general life across five phases of substance use among 339 adults, of whom 289 identify as formerly having a problem with substance use, and a comparison group of 50 who report no history of problematic drug use. We compared those whose primary drug of choice was alcohol, marijuana, methamphetamine, non-prescription opioids, and prescription opioids.Results: Those who used prescription opioids reported a larger drop in satisfaction in social life, romantic life, and general life during the course of substance use than those who used other drugs. However, we report no significant differences in current satisfaction, social well-being, or quality of life between people in recovery and people with no history of problematic substance use.Conclusions: These findings—alongside neuropsychological work on the opioid system and sociality—paint a picture that those who formerly used prescription opioids may experience lower satisfaction across life domains during the course of their substance use than those who used other substances. However, people in prolonged recovery—regardless of their drug of choice—all show similar levels of satisfaction compared to people with no history of problematic substance use.

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