Social Stability and Unmet Health Care Needs in a Community-Based Sample of Women Who Use Drugs

Objective To examine the relationship between social stability and access to healthcare services among a community-based sample of adult female drug users. Methods We developed a measure of social stability and examined its relationship to health care access. Data came from a cross-sectional sample of female drug users (N = 538) in Oakland, CA who were interviewed between September 2014 and August 2015. We categorized women as having low (1-5), medium (6-10), or high (11-16) social stability based on the tertile of the index sample distribution. We then used ordered logistic regression to examine the relationship between social stability and self-reported access to mental health services and medical care. Results Compared with women in the low stability group, those with high stability experienced a 58% decline in the odds of needed but unmet mental health services [AOR: 0.42; 95% C.I.: 0.26, 0.69] and a 68% decline in the odds of unmet medical care [AOR: 0.32; 95% C.I.: 0.19, 0.54] after adjusting for confounders. The coefficients we observed reduced in size at higher levels of the stability index suggesting a positive association between social experiences and access to healthcare services. Conclusion Women who use drugs are at increased risk of adverse health outcomes and often experience high levels of unmet healthcare needs. Our study highlights the importance of addressing social determinants of health and suggests that improving social factors such as housing stability and personal safety may support access to healthcare among female drug users.

Examining the Link between Drug Use Disorders and Crime among Chinese Drug Users Receiving Mandatory Detoxification and Treatment

Prior research has generated inconsistent results about the relationship between drug use and crime. To improve on previous research, this study focuses on drug use disorders as a predictor of crime and offending behavior specifically related to drug use to measure the potential impact of drug abuse and dependence. Through the analysis of data collected from 930 male and female drug users receiving mandatory treatment in two drug detoxification centers in China, the current study finds that drug use disorders significantly predict drug-related crime. The results provide an empirical validation of the findings from the West that drug use disorders and crime are positively related.

SIMPTOM KEMURUNGAN DALAM KALANGAN PENAGIH DADAH WANITA DI PUSAT RAWATAN DAN PEMULIHAN DADAH

Kajian ini bertujuan untuk mengenal pasti simptom kemurungan dalam kalangan penagih dadah wanita yang sedang menjalani rawatan dan pemulihan penagihan dadah. Pengenal pastian simptom kemurungan dalam kalangan penagih dadah wanita penting bagi mengelakkan masalah dual diagnosis yang boleh memberi risiko penagih dadah wanita pada tingkah-laku relaps, tingkah-laku penagihan impulsif dan penularan penyakit berjangkit khususnya penyakit bawaan darah. Kajian rintis ini dilaksanakan menerusi kaedah penyelidikan kuantitatif dan dapatan dikumpul melalui kaedah tinjauan dengan menggunakan borang soal selidik. Instrumen M.I.N.I. Neuropsychiatry telah digunakan bagi mengukur kemurungan, manakala jenis penyalahgunaan bahan khususnya dadah diteliti berdasarkan instrumen ASSIST (Alcohol, Smoking and Substance Involvement Screening Test). Seramai 31 dari 180 orang penagih dadah wanita telah dipilih secara rawak mudah dan data dianalisis secara deskriptif. Dapatan kajian mendapati, seramai 12 orang daripada 31 orang responden kajian menyatakan mereka mengalami simptom gangguan kemurungan yang digariskan oleh ‘Diagnostic Statistical Manual Mental Disorders’ (DSM-IV) seperti rasa sedih, murung atau pilu secara berpanjangan atau hampir setiap hari sekurang-kurangnya dalam tempoh dua minggu sehingga menyebabkan individu kurang berminat menikmati perkara terdahulu sehingga mengganggu aktiviti sosial. Manakala selebihnya lagi responden tidak menunjukkan simptom kemurungan dan ia mungkin dipengaruhi oleh proses rawatan dan pemulihan. Penyalahgunaan dadah jenis methamphetamine seperti syabu dan ‘ecstasy’ boleh memberi implikasi negatif terhadap kesihatan mental penagih. Perhatian yang serius perlu diberikan kepada penagih dadah wanita yang menderita dengan masalah ‘dual diagnosis’. Hasil kajian penting sebagai informasi kepada pihak yang bertanggungjawab mengenai kepentingan saringan kesihatan mental secara klinikal kepada penagih dadah khususnya wanita dan keperluan integrasi rawatan kesihatan mental dalam program rawatan dan pemulihan penagihan dadah yang mempunyai masalah ‘dual diagnosis’. Kata Kunci: Dadah, kemurungan, penagih dadah wanita, pusat rawatan pemulihan, simptom ABSTRACT This study aims to identify symptoms of depression among female drug users that are treated at a Cure and Care Drug Rehabilitation Centre. The identification of depression symptoms among female drug user is crucial to prevent ‘dual diagnosis’ problem that can cause female drug users to be at risk of having relapse behavior, impulsive addiction behavior and transmission of infectious diseases especially blood related disease. This pilot study used quantitative method and data were collected via survey involving a set of close-ended questionnaire. M.I.N.I Neuropsychiatry Instrument was used to identify depression symptoms, while Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) instrument was used to determine types of specific substance abused among the female drug users. 31 of 180 female drug users were randomly selected using simple random sampling technique and data were descriptively analyzed. The findings indicated that 12 out of 31 respondents reported having depression symptom as outlined by Diagnostic and Statistical Manual of Mental Disorders (DSM-V) such as prolonged sadness, moody or melancholy continuously for at least two weeks and had caused loss of interest in enjoying things they preferred to in the past and distributed their daily social activities. However, the remaining respondents did not report any depression symptom and it could be due to the current treatment and recovery process they undergo. Methamphetamine drug abused such as syabu and ecstasy had negative effects to users’ mental health. Serious attention should be given to the female drug users who are suffering from dual diagnosis. The findings are crucial for the relevant and responsible authorities to providing clinical mental health screening for the addicts especially the female drug addicts. An integrated mental health treatment among the female drug users with ‘dual diagnosis’ is recommended in the treatment and rehabilitation program. Keywords: Depression, cure and care rehabilitation centre, drug, female drug users (FDU), symptom Cite as: Ismail, R. F., Rashid, R. A., Abd. Wahab, H., & Ishak, Z. (2019). Simptom kemurungan dalam kalangan penagih dadah wanita di pusat rawatan dan pemulihan dadah [Depression symptoms among female drug users at cure and care rehabilitation centre]. Journal of Nusantara Studies, 4(2), 168-192. http://dx.doi.org/10.24200/jonus.vol4iss2pp168 -192

An Exploration of Aftercare Services for Female Drug Users

The number of female drug users has been on the rise in South Africa, with statistics reflecting a rise in the number of women who attend treatment centres annually. This article presents empirical data from a broader qualitative study which aimed to explore perceptions concerning the effectiveness of aftercare programmes for female recovering drug users. The main data source was transcripts of in-depth interviews and focus groups with both service users and service providers from a designated rehabilitation centre in Gauteng, South Africa. Framed within a biopsychosocial-spiritual model, this article explores the perceptions and meanings which the female recovering drug users and the service providers attach to aftercare programmes. The findings of the research outlined the range of factors promoting recovery, alongside noteworthy suggestions for improvement in aftercare services. While acknowledging multiple influences on behaviour, this article highlights the significance of these findings in planning and implementing holistic aftercare programmes.

Chinese Female Drug Users’ Experiences and Attitudes With Institutional Drug Treatment

With its rapid economic growth and the increased influence of Western culture, China has become a drug-consuming country. Forty-six semistructured interviews were conducted in a compulsory drug treatment institution to document Chinese female drug users’ experiences with and attitudes toward two mandated treatment modalities: vocational training and educational activities. Detainees required to participate in first institutional treatment showed enthusiasm and had more positive attitudes; those who had entered the compulsory treatment facilities 2 or more times generally had a negative outlook on their pursuit of abstinence. Although female detainees achieved detoxification in the institution, many relapsed upon release to their community, indicating the institutional compulsory treatment model’s failure to ensure long-term abstinence. By revealing four main flaws of the current institutional compulsory treatment, this study indicates the need for a comprehensive treatment system that combines improvements to institutional treatment and development of community-based treatment to address different stages of abstinence.

Increased synthetic drug abuse and trends in HIV and syphilis prevalence among female drug users from 2010–2014 from Beijing, China

The objective of this study was to monitor the trend of addiction drug use and its relationship with sexually transmitted infections (STIs) among female drug users (FDUs). Serial cross-sectional surveys were conducted during 2010–2014 among FDUs in Beijing to collect information on addiction drug usage, sexual behaviors, and STI prevalence. Characteristics were analyzed and compared between traditional and synthetic drug users among FDUs by logistic regression method. A total of 3859 FDUs were surveyed during 2010–2014, with the median age being 32.7 years old. The proportion of synthetic drug users among FDUs increased from 43.7% in 2010 to 70.7% in 2014. Compared with traditional drug users, synthetic drug users were younger (P < 0.001), lacked education (P < 0.001), were unmarried (P < 0.001), and were non-local residents (P < 0.001). No significant difference was found with condom usage during sexual activity between traditional and synthetic drug FDUs. However, the engagement of commercial sexual activities (P < 0.001) and syphilis prevalence (P < 0.001) among synthetic drug users were significantly higher than traditional drug users. Synthetic drug abuse appears to be correlated with commercial sex behavior and higher syphilis prevalence among FDUs. Tailored strategies on health education to curb the prevalence of synthetic drug abuse are urgently needed in Beijing.