Role of Early Brief Psychological Interventions in Substance Use Disorders

Objective: To assess the effects of early brief psychological interventions in patients of substance use disorders. Study Design and Setting: This descriptive prospective study was conducted at main reception centre filter clinic/ Emergency Department of PNS Shifa hospital from 1st July 2020 to 31st March 2021. Methodology: Total n=78 patients were identified after a simple screening question regarding substance abuse which was how many times the patient had used an illegal drug in the last one year. An answer of more than 1 was considered as a positive response and further screening was done with Drug and Alcohol screening test (DAST). Patients who showed low scores on DAST were recommended for brief interventions which were given as weekly sessions for 6 weeks and reassessment was done at 3rd month. The SPSS 20 package program was used for statistical analysis. The descriptive statistics were analyzed for all the variables evaluated in the study. Results: This study revealed that that after 3 months of brief psychological interventions, 43(55.1%) patients remained abstinent from drugs. 18(23%) patients did not report for follow up. 9(11.5%) had reduced their use while 8(10.2%) were still using drugs regularly. Conclusion: This study showed that brief psychological interventions at the level of filter clinics/Emergency departments can help patients of substance use seek early care who fear going to a psychiatric clinic.

A gendered difference? Female experience of drug and alcohol treatment in New Zealand

<p>This study examined women’s experiences of drug and alcohol treatment in New Zealand, with a focus on Methadone Maintenance Treatment (MMT). The qualitative literature on the treatment experiences of substance-using women is scarce, especially in a New Zealand context, with the majority of literature being quantitative, male-focused, and lacking the female voice. Available literature suggests that substance-using women have unique needs and experiences which must be addressed and acknowledged in treatment for a long-lasting positive change. This thesis aims to explore the experiences of women who have or are attending substance use treatment in New Zealand and their recommendations for improving substance use treatment for women. Areas examined include the experience of stigma, connections and relationships in treatment, and the importance of knowledge. These factors culminate in an exploration of participants’ suggestions for improvement. The current study is qualitative, feminist-informed and employed the use of semi-structured interviews with 11 women who have been or are currently in treatment as well as two service providers. The data from these interviews was analysed using Thematic Analysis, finding that women in this study overall had positive experiences. However, there were several areas for improvement suggested by participants including a need for greater access to treatment options, particularly gender-sensitive, holistic approaches. A need for greater knowledge amongst service providers, especially General Practitioners (GPs), on how to treat problematic substance use and the available treatment options was also expressed. Women on MMT had similar, yet varied, experiences compared to those attending other treatments.</p>

A gendered difference? Female experience of drug and alcohol treatment in New Zealand

<p>This study examined women’s experiences of drug and alcohol treatment in New Zealand, with a focus on Methadone Maintenance Treatment (MMT). The qualitative literature on the treatment experiences of substance-using women is scarce, especially in a New Zealand context, with the majority of literature being quantitative, male-focused, and lacking the female voice. Available literature suggests that substance-using women have unique needs and experiences which must be addressed and acknowledged in treatment for a long-lasting positive change. This thesis aims to explore the experiences of women who have or are attending substance use treatment in New Zealand and their recommendations for improving substance use treatment for women. Areas examined include the experience of stigma, connections and relationships in treatment, and the importance of knowledge. These factors culminate in an exploration of participants’ suggestions for improvement. The current study is qualitative, feminist-informed and employed the use of semi-structured interviews with 11 women who have been or are currently in treatment as well as two service providers. The data from these interviews was analysed using Thematic Analysis, finding that women in this study overall had positive experiences. However, there were several areas for improvement suggested by participants including a need for greater access to treatment options, particularly gender-sensitive, holistic approaches. A need for greater knowledge amongst service providers, especially General Practitioners (GPs), on how to treat problematic substance use and the available treatment options was also expressed. Women on MMT had similar, yet varied, experiences compared to those attending other treatments.</p>

Relationship Between Clinician-Level Attributes and Implementation Outcomes From The Pathways To Comorbidity Care Training Program

Background A more nuanced understanding of the interrelationships between clinician-level factors and implementation outcomes may enhance the utility of evidence-based practice implementation strategies. The Pathways to Comorbidity Care (PCC) training program [1] aimed to facilitate integrated management of comorbid drug and alcohol and mental disorders amongst drug and alcohol clinicians. We hypothesised that implementation outcomes would be associated with clinician-level: (i) demographics (gender, education, experience), (ii) attitudes (evidence-based practice, therapist manuals, counselling self-efficacy), and (iii) organisational readiness to change. Methods Twenty clinicians participated in the 9-month PCC training program. Attitudes towards evidence-based practices and psychotherapist manuals, self-efficacy, and organisational readiness to change, along with demographics, were measured at baseline. At follow-up, change in Comorbidity Practice (CoP) scores related to integrated comorbidity management were obtained using a file audit checklist and categorised into high (at least 60% increase in CoP), medium or low (a decrease of -20% or less in CoP). Clinician-level characteristics were examined across the implementation categories. Results There were no significant differences found between implementation groups on sociodemographic variables (p’s > 0.30), attitudes to evidence-based practices, attitudes to therapist manuals, and self-efficacy (p’s > 0.52). The high implementation group demonstrated significantly higher scores on leadership practices aspect of organisational readiness to change relative to the low and medium implementation group ((F(2, 16) = 3.63, p = 0.05; Cohen’s d = .31) but not on the other subscales (p’s > 0.07). Conclusions Confidence that leadership will play a positive role in the implementation process may improve effectiveness of comorbidity training programs for drug and alcohol clinicians. On the other hand, contrary to our hypothesis, counselling self-efficacy, evidence-based practice attitudes, attitudes towards therapist manuals, gender, education and experience were not distinguishing factors.

Role of Nociceptin/Orphanin FQ-NOP Receptor System in the Regulation of Stress-Related Disorders

Nociceptin/orphanin FQ (N/OFQ) is a 17-residue neuropeptide that binds the nociceptin opioid-like receptor (NOP). N/OFQ exhibits nucleotidic and aminoacidics sequence homology with the precursors of other opioid neuropeptides but it does not activate either MOP, KOP or DOP receptors. Furthermore, opioid neuropeptides do not activate the NOP receptor. Generally, activation of N/OFQ system exerts anti-opioids effects, for instance toward opioid-induced reward and analgesia. The NOP receptor is widely expressed throughout the brain, whereas N/OFQ localization is confined to brain nuclei that are involved in stress response such as amygdala, BNST and hypothalamus. Decades of studies have delineated the biological role of this system demonstrating its involvement in significant physiological processes such as pain, learning and memory, anxiety, depression, feeding, drug and alcohol dependence. This review discusses the role of this peptidergic system in the modulation of stress and stress-associated psychiatric disorders in particular drug addiction, mood, anxiety and food-related associated-disorders. Emerging preclinical evidence suggests that both NOP agonists and antagonists may represent a effective therapeutic approaches for substances use disorder. Moreover, the current literature suggests that NOP antagonists can be useful to treat depression and feeding-related diseases, such as obesity and binge eating behavior, whereas the activation of NOP receptor by agonists could be a promising tool for anxiety.