Theory of Filipino Substance Use Recovery (SUR): A Grounded Theory Approach

Treatment for Substance Use Disorder (SUD) is often theory-based however, recovery has not been guided by a theory. This grounded theory study intended to identify how an individual maintains recovery from SUD. Twenty (20) recovering persons as the participants in a one-on-one in-depth interview employing Charmaz’s grounded theory methodology of analyzing data, a theory was developed. The theory of Filipino Substance Use Recovery (SUR) generated five theoretical phases: Exhaustion, Recognition, Acceptance, Involvement, and Maintenance. Under the Maintenance phase, components in maintaining a lifelong recovery were also identified such as autonomy, maturity, support system, positive feelings, and restitution. Furthermore, it recognized two recovery barriers (internal and external barriers) thus explained the phenomena of substance use relapse. In conclusion, the theoretical foundation of Filipino SUR could help improve the current treatment and management of SUD in the Philippines. Findings could be utilized in developing programs grounded and contextualized in the Philippine setting to address issues in substance use prevention, harm reduction, intervention, and recovery. Keywords: Substance Use Disorder (SUD), recovery, relapse, grounded theory

Factors That Influence the Effectiveness of Primary Prevention of Substance Use: A Review of Reviews

Context: The fact that substance use may result in dependence and severe harm to the user and the community has led to serious and extensive endeavors to design and implement preventive interventions. Prevention programs, however, have been shown to have different effects, and that should not be taken for granted. Systematic reviews and meta-analyses in the field have tried to reveal the effects of different types of substance use prevention programs and to identify the influencing factors. Objectives: The purpose of the current review was to more accurately identify factors associated with the effectiveness of interventions or reversal of desired effects. Evidence Acquisition: We systematically reviewed systematic review and meta-analyses studies within the period of 2009 - 2019 that reported the effectiveness of substance use prevention programs. After the systematic screening of 1586 articles, 43 articles were finally reviewed. Results: In preparation for extracting our data, we designed a structural model for analyzing the results of research on the effectiveness of substance use prevention programs. In general, universal types of prevention programs were reported as more effective than the two other types of selective and indicated programs. Regarding the context of programs, the school setting was more effective than others. In the case of interventions performed in the family setting, selective programs were more effective. Interventions provided by specialists are more effective than those provided by laypeople and / or peers. Interventions provided by more than one person and from more than one discipline showed higher effectiveness. Conclusions: Based on our structural design, we feel that further studies are needed to extend our knowledge regarding the effectiveness of substance use prevention programs.

How to prevent alcohol and illicit drug use among students in affluent areas: a qualitative study on motivation and attitudes towards prevention

Background The use of alcohol and illicit drugs during adolescence can lead to serious short- and long-term health related consequences. Despite a global trend of decreased substance use, in particular alcohol, among adolescents, evidence suggests excessive use of substances by young people in socioeconomically affluent areas. To prevent substance use-related harm, we need in-depth knowledge about the reasons for substance use in this group and how they perceive various prevention interventions. The aim of the current study was to explore motives for using or abstaining from using substances among students in affluent areas as well as their attitudes to, and suggestions for, substance use prevention. Methods Twenty high school students (age 15–19 years) in a Swedish affluent municipality were recruited through purposive sampling to take part in semi-structured interviews. Qualitative content analysis of transcribed interviews was performed. Results The most prominent motive for substance use appears to be a desire to feel a part of the social milieu and to have high social status within the peer group. Motives for abstaining included academic ambitions, activities requiring sobriety and parental influence. Students reported universal information-based prevention to be irrelevant and hesitation to use selective prevention interventions due to fear of being reported to authorities. Suggested universal prevention concerned reliable information from credible sources, stricter substance control measures for those providing substances, parental involvement, and social leisure activities without substance use. Suggested selective prevention included guaranteed confidentiality and non-judging encounters when seeking help. Conclusions Future research on substance use prevention targeting students in affluent areas should take into account the social milieu and with advantage pay attention to students’ suggestions on credible prevention information, stricter control measures for substance providers, parental involvement, substance-free leisure, and confidential ways to seek help with a non-judging approach from adults.

A vibrant reflection of the revised integrated school health policy with a lens on substance use

Substance use is rife amongst adolescents, including learners. Learners are easily exposed to substances with onset as early as 10 years and average age of drug experimentation is 12 years in South Africa. This results in many negative health and social outcomes, a challenge as far as the achievement of global, regional and national goals such as quality education. The revised Integrated School Health Policy (ISHP) is a policy operating within the school environment aiming to address health and social barriers of learners and improve optimal health, comprising a vague action component on substance use prevention. This article is an opinion piece, which uses the Walt and Gilson model as an operational framework to analyse the revised ISHP within the lens of substance use. It assesses the four interrelated aspects: policy context, policy content, policy actors, and the policy process. The ISHP is placed within schools where adolescents are found and has the potential to reduce many health challenges such as substance use amongst learners. However, some issues are left to chance, such as health education on substance use prevention stated to only begin at Grade 4 (10 years), little mention of parental involvement, limited interplay amongst actors, limited investment in upskilling educators on dealing with substance use, scarce resources for implementation in all developmental phases and provinces to address substance use. Intervention can be more comprehensive with an intersectoral political approach needed to ensure that implementation addresses all multiple levels of influence of substance use amongst learners and the numerous health and social barriers.

Impulsivity and family conflict as predictors of illegal psychoactive substance use in adolescents

This research studies impulsiveness and family conflict as predictors of illegal psychoactive substance use. The objective of this research was to analyze the differences in impulsiveness and family conflict between high school student users and non-users of illegal psychoactive substances. A quantitative methodology through a cross-sectional, correlational study was carried out. A questionnaire composed by the Plutchik scale of impulsiveness, some items of the Climent, Aragón and Plutchik Scale of Impulsivity and indicators to explore consumption of psychoactive substances. The sample was composed by 344 high school students of the municipality of Emiliano Zapata in Veracruz, México. The results show that 9.0% have consumed illegal drugs. A correlation was found between family conflict, impulsivity and use of psychoactive substances. We found that impulsivity and risk taking are predictors of illegal drug use. The results show that impulsivity is a factor related to drug use and it is necessary to design interventions that favor management of emotions and decision making in adolescents, as well as the participation of the family in substance use prevention programs.

Community-Based Substance Use Prevention

Community-based substance use prevention involves changing the community context to reduce the prevalence of substance use among community members. The specific actions taken to prevent substance use will vary depending on the initiative but should include activities that target community-level factors that influence substance use, as well as the implementation of specific, evidence-based policies and programs that reach as many individuals as possible in the community. Many community-based prevention efforts are led by coalitions of community members. Ideally, these coalitions will include representation from diverse groups and organizations and comprise all stakeholders concerned about substance use. The use of broad-based coalitions helps ensure that prevention efforts are community-specific, responsive to community needs, and culturally relevant. Participation by community stakeholders and organizations also increases the likelihood that prevention programs are implemented in multiple contexts, reach large numbers of individuals in order to achieve community-level reductions in substance use, and can be sustained over time. Coalitions can also work to change local policies, regulations, and/or ordinances to reduce all community members’ access to substances and opportunities to use them. Community-based prevention can be very challenging, especially in under-resourced communities. In any community, it can be difficult to recruit community members to volunteer to participate in such initiatives and to sustain their interest over time. In addition, maintaining active coalitions, enacting policy changes, and implementing prevention programs requires significant human and financial resources. Communities are also likely to need technical support and ongoing consultation from researchers to help them plan, implement, and evaluate the success of their efforts. Despite these difficulties, some community-based prevention efforts have been demonstrated as effective in reducing substance use/abuse. Although these interventions vary in their complexity and mechanisms for achieving change, common features of successful community-based approaches include the following: (1) clear definition of the specific problem(s) to be prevented; (2) involvement of community members, often through broad-based coalitions; (3) assessment of community-specific needs and resources; (4) implementation of prevention programs, practices, and policies to address these needs; and (5) monitoring of these activities over time to ensure their effectiveness and sustainability. By following these steps and using interventions that have prior evidence of effectiveness from well-conducted research studies, communities should be able to achieve significant reduction in community rates of substance use.