Social Construction of Target Populations: A Theoretical Framework for Understanding Policy Approaches to Perinatal Illicit Substance Screening

Perinatal illicit substance use is a nursing and public health issue. Current screening policies have significant consequences for birthing individuals and their families. Racial disparities exist in spite of targeted and universal screening policies and practices. Thus, new theoretical approaches are needed to investigate perinatal illicit substance use screening in hospital settings. The purpose of this analysis is to evaluate the social construction of target populations theory in the context of perinatal illicit substance use screening. Using the theoretical insights of this theory to interrogate the approaches taken by policy makers to address perinatal illicit substance use and screening provides the contextual framework needed to understand why specific policy tools were selected when designing public policy to address these issues. The analysis and evaluation of this theory was conducted using the theory description and critical reflection model.

Emotional reactivity and difficulties in emotional regulation in drug users: a study in adolescents undergoing treatment in a therapeutic community

Purpose The purpose of this study is to investigate which emotions and difficulties in the emotional regulation of adolescents with illicit substance consumption. Design/methodology/approach In total, 41 adolescents undergoing treatment for the use of alcohol and drugs were recruited. The instruments used were the emotional rating scale and the difficulties in the regulation of emotions scale. Findings Emotional reactivity showed significant differences in the sadness dimension in relation to the number of cannabis cigarettes smoked daily and length of stay, and in the surprise dimension in relation to the number of cannabis cigarettes smoked daily. There was a significant correlation between happiness and age, surprise and number of siblings, sadness and school absenteeism and fear, school absenteeism and number of substances consumed. In regard to difficulties in emotional regulation, there were significant differences between the groups, in strategies regarding the gender of the participants and the number of substances consumed, in non-acceptance and impulses and in the number of substances consumed and in the awareness of the type and number of substances consumed. There was a significant correlation between strategies, non-acceptance, awareness and impulses and the number of substances consumed. Originality/value This study demonstrated that the emotional problems of adolescents admitted to a therapeutic community are predictors of illicit substance use.

Recreational Drug Using Behaviour and Legal Benzylpiperazine Party Pills

<p>Benzylpiperazine (BZP) is a stimulant drug that produces effects similar to amphetamines (Campbell, Cline, Evans, Lloyd, & Peck, 1973). It has been sold legally in New Zealand in the form of 'party pills' since 2000. The legal status of BZP party pills has been debated in New Zealand as the media reported cases of apparent overdoses and adverse reactions leading to hospitalization (Brogden, 2005; Crewdson, 2007; Reiber, 2005; Rankin, 2006). Representatives of the BZP party pill industry publicly defended their product claiming that BZP party pills were reducing substance related harm by reducing illicit substance use (Bowden, 2007b, p.1). They also claimed that banning BZP would result in an increase in use of illicit substances, especially methamphetamine or 'P' (Barnett, 2007). The overall aim of this thesis is to test the claims that BZP party pills reduce substance related harm by reducing illicit substance use, and to identify potential outcomes of a BZP party pill ban. In addition, the perceived risks of party pill and other drug use will be examined. In chapter one I review key concepts relating to BZP party pill use: recreational drug use, harm reduction, and risk perception. In chapter two the history and New Zealand context of BZP party pills are reviewed. In chapter three, study one qualitatively analyzes BZP party pill marketing material in an attempt to describe the culture and discourse promoted by the BZP party pill industry. This analysis demonstrated that BZP party pills were primarily marketed as part of a recreational drug using culture. In chapter four, study two quantitatively investigated whether BZP party pill use was associated with reduced levels of illicit substance use in a sample (N=796) of first year university students. This study also examined the relationship between risk perception and frequency of substance use. Study two demonstrated that BZP party pill users are generally recreational poly-drug users who used illicit substances equally as often as illicit users who did not use BZP party pills. BZP party pills did not appear to reduce illicit substance use, and therefore harm. For the majority of substances there was no significant relationship between risk and use behaviour. The legal status of substances appeared to be important when participants rated the risks of use. Legal substances (including BZP) tended to be rated as safer than illegal substances. In chapter five, study three qualitatively analyzed 60 interviews with regular BZP party pill users to identify potential outcomes of a BZP party pill ban. A combination of alternatives were likely to be used by BZP party pill users, primarily illicit substances, especially ecstasy, as well as alcohol, and black market BZP. However methamphetamine (P) was an unpopular alternative. Study three also analyzed how BZP party pill users assess the costs and benefits of BZP party pill use. Decisions to use BZP party pills relied heavily on the benefits of use, rather than the costs. In chapter six, the general discussion describes the implications, ethical considerations, limitations, and outcomes of the research.</p>

Recreational Drug Using Behaviour and Legal Benzylpiperazine Party Pills

<p>Benzylpiperazine (BZP) is a stimulant drug that produces effects similar to amphetamines (Campbell, Cline, Evans, Lloyd, & Peck, 1973). It has been sold legally in New Zealand in the form of 'party pills' since 2000. The legal status of BZP party pills has been debated in New Zealand as the media reported cases of apparent overdoses and adverse reactions leading to hospitalization (Brogden, 2005; Crewdson, 2007; Reiber, 2005; Rankin, 2006). Representatives of the BZP party pill industry publicly defended their product claiming that BZP party pills were reducing substance related harm by reducing illicit substance use (Bowden, 2007b, p.1). They also claimed that banning BZP would result in an increase in use of illicit substances, especially methamphetamine or 'P' (Barnett, 2007). The overall aim of this thesis is to test the claims that BZP party pills reduce substance related harm by reducing illicit substance use, and to identify potential outcomes of a BZP party pill ban. In addition, the perceived risks of party pill and other drug use will be examined. In chapter one I review key concepts relating to BZP party pill use: recreational drug use, harm reduction, and risk perception. In chapter two the history and New Zealand context of BZP party pills are reviewed. In chapter three, study one qualitatively analyzes BZP party pill marketing material in an attempt to describe the culture and discourse promoted by the BZP party pill industry. This analysis demonstrated that BZP party pills were primarily marketed as part of a recreational drug using culture. In chapter four, study two quantitatively investigated whether BZP party pill use was associated with reduced levels of illicit substance use in a sample (N=796) of first year university students. This study also examined the relationship between risk perception and frequency of substance use. Study two demonstrated that BZP party pill users are generally recreational poly-drug users who used illicit substances equally as often as illicit users who did not use BZP party pills. BZP party pills did not appear to reduce illicit substance use, and therefore harm. For the majority of substances there was no significant relationship between risk and use behaviour. The legal status of substances appeared to be important when participants rated the risks of use. Legal substances (including BZP) tended to be rated as safer than illegal substances. In chapter five, study three qualitatively analyzed 60 interviews with regular BZP party pill users to identify potential outcomes of a BZP party pill ban. A combination of alternatives were likely to be used by BZP party pill users, primarily illicit substances, especially ecstasy, as well as alcohol, and black market BZP. However methamphetamine (P) was an unpopular alternative. Study three also analyzed how BZP party pill users assess the costs and benefits of BZP party pill use. Decisions to use BZP party pills relied heavily on the benefits of use, rather than the costs. In chapter six, the general discussion describes the implications, ethical considerations, limitations, and outcomes of the research.</p>

Intervenciones de cambio de comportamiento para la reducción del consumo de alcohol durante el embarazo.

INTRODUCCIÓN: A nivel mundial, se estima que más del 20% de las mujeres embarazadas consumen alcohol. La investigación actual sugiere que la ingesta de alcohol durante el embarazo pone en riesgo al recién nacido de sufrir discapacidades cognitivas y del desarrollo graves de por vida. Las intervenciones de cambio de comportamiento pueden ayudar a las mujeres a reducir su consumo de alcohol durante el embarazo. OBJETIVO: El objetivo de este análisis crítico es comprobar la validez y aplicabilidad de los resultados con respecto a la efectividad de intervenciones de cambio de comportamiento para reducir el consumo de alcohol en mujeres embarazadas, y responder a la interrogante: ¿Son efectivas las intervenciones de cambio de comportamiento en la reducción del consumo de alcohol en mujeres embarazadas?. MÉTODOS: Se realizó una búsqueda de evidencia proveniente de revisiones sistemáticas, sobre Intervenciones de cambio de comportamiento para la reducción del consumo de alcohol durante el embarazo. Se especificó para cada revisión los componentes PICO de la pregunta y, del listado de revisiones relevantes, se seleccionó la que pudiese responder mejor a la pregunta. RESULTADOS: Identificamos seis revisiones sistemáticas y dos revisiones panorámicas. Se analizó críticamente el artículo “Identifying effective behavior change techniques for alcohol and illicit substance use during pregnancy: a systematic review.” CONCLUSIÓN: Existe evidencia para decir que algunas técnicas de cambio de comportamiento podrían ser útiles para lograr la reducción del consumo de alcohol durante el embarazo. Sin embargo, estos resultados se deben tomar con precaución dado algunas limitaciones metodológicas en la evidencia disponible.

Instructor Training on Opioids and the Workplace, Prevention and Response in the Plumbing and Pipe-Fitting Industry: An Interview With Cheryl Ambrose

Workers in the plumbing and pipe-fitting industry experience a wide variety of physical and emotional pain related to job hazards and lifestyle issues. Pain treatment and stress can lead to prescription or illicit substance use. The United Association of Journeymen and Apprentices of the Plumbing and Pipe-Fitting Industry of the United States and Canada has taken on these issues by adapting training developed by the National Institute of Environmental Health Sciences, Opioids and the Workplace, Prevention and Response Training. Under the leadership of Cheryl Ambrose, Health, Safety, and Environmental Administrator, the United Association of Journeymen and Apprentices of the Plumbing and Pipe-Fitting Industry of the United States and Canada has added an instructor training course and is tailoring the National Institute of Environmental Health Sciences curriculum to industry and union needs.

Substance use determinants in Jamaican under-25s: family, peers, spirituality and maltreatment (literature review)

AimsJamaica is undergoing rapid change in its attitudes and laws regarding substance use; understanding the reasons why under-25s use substances will help inform future interventions and policy decisions. This review will investigate the determinants of substance use in under-25s in Jamaica, aiming to identify key sub-groups to target with interventions, and propose topics for further research.MethodA literature search was performed with Ovid on three databases, using wildcards and synonyms to increase the number of hits. This search produced 379 results, of which 41 remained after inclusion/exclusion criteria were applied. Additional sources were utilised as the review was written.ResultStrong family relationships are protective against illicit substance use for under-25s, with conflicting results for licit substance use. Healthy peer relationships protect against substance use, particularly in the academically-stressful university environment. All Jamaican under-25s appear to be susceptible to peer pressure, which increases the likelihood of substance use. Spirituality is protective against substance use, although male Rastafarians are more likely to use cannabis. Certain forms of childhood maltreatment make use of particular substances more likely. University students and under-18s brought up in single-parent families are key sub-groups to target with interventions. Further research on mechanisms by which these determinants work, particular religions and which determinant has the greatest effect is recommended.ConclusionVarious factors can protect against or predispose substance use in Jamaican under-25s. This review, and future research, can help inform policy decisions and intervention design for the key sub-groups found.