Showing papers in "Journal of Social Work Practice in The Addictions in 2012"
TL;DR: The military's dual role in enforcing troop readiness with its alcohol and drug policies and resiliency-building programs and in seeking to provide treatment to troops with combat-acquired problems, including substance abuse are discussed.
Abstract: Iraq and Afghanistan veterans experience extreme stressors and injuries during deployments, witnessing and participating in traumatic events. The military has organized prevention and treatment programs as a result of increasing suicides and posttraumatic stress disorder among troops; however, there is limited research on how to intervene with alcohol misuse and drug use that accompany these problems. This review presents statistics about post-deployment substance use problems and comorbidities, and discusses the military's dual role in 1) enforcing troop readiness with its alcohol and drug policies and resiliency-building programs, and 2) seeking to provide treatment to troops with combat-acquired problems including substance abuse.
80 citations
TL;DR: Mindfulness-based interventions can decrease addictive behaviors while promoting nonreactivity to stressors while helping clients to cope more effectively with emotional distress and addictive impulses.
Abstract: Mindfulness-based interventions can decrease addictive behaviors while promoting nonreactivity to stressors. This study employed qualitative methods to enhance understanding of mindfulness-related treatment effects. Study participants were 18 alcohol-dependent adults residing in a therapeutic community who had participated in a mindfulness-oriented recovery enhancement (MORE) intervention. Interviews were conducted to elicit participant narratives. Responses to open-ended questions were analyzed using a grounded theory approach and the method of constant comparison. Narrative accounts suggested that MORE enhanced self-awareness while helping clients to cope more effectively with emotional distress and addictive impulses. MORE appears to be acceptable to participants and feasible to implement within a residential treatment setting. Mindfulness training could assist marginalized persons in recovering from addiction.
45 citations
TL;DR: A grounded description of barriers to psychosocial services among homeless women veterans is provided and three focus groups were held in Los Angeles, California, with a total of 29 women veterans.
Abstract: Veterans comprise a disproportionate fraction of the nation's homeless population, with women veterans up to four times more likely to be homeless than non-veteran women. This paper provides a grounded description of barriers to psychosocial services among homeless women veterans. Three focus groups were held in Los Angeles, CA, with a total of 29 homeless women veterans. These women described three primary, proximal (current) barriers: lack of information about services, limited access to services, and lack of coordination across services. Compared to non-veteran homeless women, women veterans potentially face additional challenges of trauma exposure during military service, post-military readjustment issues, and few services specific to women veterans. Understanding their service needs and experiences is critical to the development of relevant and appropriate services that move homeless women veterans away from vulnerability, into safety.
41 citations
TL;DR: TBI and drinking in both civilian and military populations is examined and implications for clinical care and policy are discussed.
Abstract: Military personnel engage in unhealthy alcohol use at rates higher than their same age, civilian peers, resulting in negative consequences for the individual and jeopardized force readiness for the armed services. Among those returning from combat deployment, unhealthy drinking may be exacerbated by acute stress reactions and injury, including traumatic brain injury (TBI). Combat-acquired TBI is common among personnel in the current conflicts. Although research suggests that impairments due to TBI leads to an increased risk for unhealthy drinking and consequences among civilians, there has been little research to examine whether TBI influences drinking behaviors among military personnel. This article examines TBI and drinking in both civilian and military populations and discusses implications for clinical care and policy.
26 citations
TL;DR: For example, the authors found that early treatment attrition is associated with a history of youth partner violence, perceived need for psychological treatment, and abuse of alcohol, opioids, and stimulants.
Abstract: Participant retention is one of the more challenging issues in the treatment of substance use disorders. Using data from the National Institute on Drug Abuse Clinical Trials Network's Women and Trauma Study (recruitment in 2004–2005), we examine prominent factors associated with early attrition among women with cooccurring substance use disorders and posttraumatic stress disorder (N = 340). Early treatment attrition is associated with a history of youth partner violence, perceived need for psychological treatment, and abuse of alcohol, opioids, and stimulants. Logistical barriers (e.g., transportation, having children) were not significantly associated with early attrition. Findings provide insight into characteristics of women who might need additional supports to engage in treatment.
21 citations
TL;DR: It is argued that substance abuse interventions in distressed African American communities must be culturally tailored and must incorporate a framework targeting changes in both individual behavior and the community.
Abstract: This paper argues that substance abuse interventions in distressed African-American communities must be culturally-tailored and incorporate a framework targeting changes in both individual behavior and the community. The current study employed Concept Mapping in conjunction with Community-Based Participatory Research (CBPR) principles to involve 100 community members, substance users, and service providers to examine the role of alcohol and other drugs in distressed African-American communities. Findings reveal the way participants understand the role of drugs and alcohol in their community and their perceptions of substance abuse services. The paper describes a collaborative approach to engage the community in addressing substance abuse.
21 citations
TL;DR: Treatment receipt and engagement were positively related to being age 31 to 55, having a psychiatric comorbidity, and receiving treatment at facilities providing women's services and more licensed psychosocial treatment providers per patient.
Abstract: We examined patient- and facility-level correlates of specialty substance use disorder (SUD) outpatient treatment receipt (at least 1 visit) and engagement (visit count) for female Veterans Health Administration patients in 2008. Overall, 33% of 15,653 females with SUD received specialty SUD outpatient treatment. Treatment receipt and engagement were positively related to being age 31 to 55, having a psychiatric comorbidity, and receiving treatment at facilities providing women's services. Additional facility-level factors related to treatment receipt were treatment at a facility with comorbid psychiatric services and more licensed psychosocial treatment providers per patient. More prescribers per patient was associated with more treatment engagement.
14 citations
TL;DR: It is suggested that the Pima County FDC model might be effective for working with parents battling substance abuse.
Abstract: Family Drug Courts (FDC) support parents' reunification efforts by providing case management aimed at cross-agency collaborations. Innovatively, the Pima County FDC includes trauma-specific treatment provided concurrently with alcohol and other drug (AOD) treatment. This study examines outcomes including AOD use, mental health, education and employment involvement, housing stability, and reunification of 121 FDC participants who completed baseline and 6-month postbaseline self-report assessments. At follow-up, AOD use remained low and mental health problems had decreased. Engagement in employment and education increased, as did housing stability. This study suggests that the Pima County FDC model might be effective for working with parents battling substance abuse.
14 citations
TL;DR: An examination of alcohol use and sexual risk behaviors among 52 male substance-abusing young offenders found that over 50% were using alcohol, 37% reported current marijuana use, and one third of all sexual intercourse episodes were unprotected.
Abstract: Juvenile drug courts (JDCs) largely focus on marijuana and other drug use interventions. Yet, JDC offenders engage in other high-risk behaviors, such as alcohol use and sexual risk behaviors, which can compromise their health, safety, and drug court success. An examination of alcohol use and sexual risk behaviors among 52 male substance-abusing young offenders found that over 50% were using alcohol, 37% reported current marijuana use, and one third of all sexual intercourse episodes were unprotected. After accounting for recent marijuana use, the odds of a juvenile having vaginal or anal sex was 6 times greater if they had recently used alcohol. JDCs might benefit from delivering alcohol and sexual risk reduction interventions to fully address the needs of these young offenders.
14 citations
TL;DR: In this article, the prevalence of co-occurring posttraumatic stress disorder (PTSD) and substance use disorders (SUDs) in the veteran population is discussed.
Abstract: This article reviews the prevalence of co-occurring posttraumatic stress disorder (PTSD) and substance use disorders (SUDs) in the veteran population. Recommendations regarding how to better understand, engage, and retain veterans with PTSD/SUDs in treatment are presented through an ecological perspective that takes into account the multiple systems and worldviews, including culture, ethnicity, family, and military culture, that are transacting with the individual. A case example illustrates the multifaceted approach that the authors feel is necessary to increase treatment participation and retention with military clients. This article can be useful for both civilian social work clinicians and those working in military or veteran treatment settings.
13 citations
TL;DR: The judge asked each woman on the day's docket: “How long have you been clean today?” “238 days, Sir. “That's great! Everyone here is proud of you,” he responds.
Abstract: Judge Paul Herbert asks each woman on the day's docket: “How long have you been clean today?” “238 days, Sir.” Applause. “That's great! Everyone here is proud of you,” he responds. “186 days, Your ...
TL;DR: Investigation of the effect of meditation on warning signs of relapse among adults in residential treatment for chemical dependency found that meditation increased participants' mindfulness, decreased negative mood, and reduced warning Signs of relapse.
Abstract: This research investigated the effect of meditation on warning signs of relapse among adults in residential treatment for chemical dependency. Results were that meditation increased participants' mindfulness, decreased negative mood, and reduced warning signs of relapse. The effect of the intervention on risk of relapse was mediated by mindfulness, the effect of which was, in turn, partially mediated by decrease in negative mood states. The data provide evidence for the effectiveness of meditation to reduce risk for relapse in this population and also add to our knowledge of the relationship between negative mood states and risk for relapse among those in treatment for chemical dependency.
TL;DR: In this article, the authors examined adolescents' perspectives on the contribution of a strengths-based orientation to the development of group cohesion in a 5-week residential treatment program for substance abuse in Canada, where 36 adolescents agreed to participate in an open-ended interview about their perceptions of how a strengthsbased approach might have influenced group cohesion.
Abstract: It is common to conduct treatments for adolescent substance abuse within a group format. Because previous research has identified group cohesion as being an important factor in adolescent substance abuse group treatment outcomes, it is important to examine therapeutic strategies that could help facilitate the development of group cohesion within substance abuse treatment programs for adolescents. The purpose of this study was to examine adolescents' perspectives on the contribution of a strengths-based orientation to the development of group cohesion. Following a 5-week strengths-based residential treatment program for substance abuse in Canada, 36 adolescents agreed to participate in an open-ended interview about their perceptions of how a strengths-based approach might have influenced group cohesion. Thematic analysis was used to identify common themes across participant responses. Findings suggest that working from a strengths-based perspective could help facilitate the development of several aspects o...
TL;DR: In this paper, the authors focus on the narrative approach to the motivation and ambivalence inherent in recovery over the course of a residential treatment program and reveal common thoughts, skepticism, and difficulties patients face during recovery, with the linkage between each type of narrative.
Abstract: Various studies have employed quantitative and qualitative methods to explore the process of behavioral, emotional, and cognitive change that emerges during drug addiction treatment, including the factors both encouraging and discouraging such change. This article focuses on the narrative approach to the motivation and ambivalence inherent in recovery over the course of a residential treatment program. The study sample consisted of 46 clients undergoing substance abuse treatment in a residential facility in Greece. All conversations were taped and later elaborated on with the help of narrative analysis. Seven main types of narrative emerged from the overall analysis: optimistic, overly optimistic, pessimistic, overly pessimistic, “tough life,” troubled/confused, and balanced. Results based on these categorizations reveal common thoughts, skepticism, and difficulties patients face during recovery, with the linkage between each type of narrative.
TL;DR: The development of a prototype of a multimedia computer-tailored intervention that relies on an evidence-based model of behavior change, the transtheoretical model, and expert system technology to deliver assessments, feedback, printed reports, and counselor reports with intervention ideas is described.
Abstract: Studies assessing the efficacy of juvenile justice interventions show small effects on recidivism and other outcomes. This paper describes the development of a prototype of a multimedia computer-tailored intervention ("Rise Above Your Situation"or RAYS) that relies on an evidence-based model of behavior change, the Transtheoretical Model, and expert system technology to deliver assessments, feedback, printed reports, and counselor reports with intervention ideas. In a feasibility test involving 60 system-involved youths and their counselors, evaluations of the program were favorable: 91.7% of youths agreed that the program could help them make positive changes, and 86.7% agreed that the program could give their counselor helpful information about them.
TL;DR: In this paper, the authors explored the relationship between posttraumatic stress disorder (PTSD) and the use and abuse of psychoactive substances among Israeli veterans of different campaigns who were diagnosed with severe and chronic PTSD.
Abstract: This study explores the relationships between posttraumatic stress disorder (PTSD) and the use and abuse of psychoactive substances among Israeli veterans of different campaigns who were diagnosed with severe and chronic PTSD (N = 201). Main findings include: (a) Prevalence of substance use and abuse among these veterans was significantly higher than in the general Israeli adult male population; (b) Substance use and misuse among the respondents was related to the intensity of their posttraumatic symptoms, levels of anxiety and depression, and low levels of resilience. Significant relationships were found among substance use, PTSD, and participation in combat casualty evacuation; and (c) Misuse of medications was the most common form of substance abuse and was significantly related to the intensity of PTSD symptoms. The role of social workers working with PTSD patients is discussed.
TL;DR: Results largely supported the hypothesis that clients with a diagnosis of mood disorder would report greater substance use, indicate more problems associated with substances use, and would be more likely to use substances to cope with negative emotions than would clients with schizophrenia.
Abstract: Research has consistently shown that alcohol consumption motivated by a desire to alleviate negative emotional states predicts alcohol use and relapse among clients with cooccurring psychiatric disorders. However, studies examining the role of drinking motives in people with severe mental illness are few. This study of 283 community mental health clients (43.8% men, 55.1% women), assigned a primary Axis I diagnosis of schizophrenia (28.3%), schizoaffective (23.3%), major depression (31.1%), or bipolar I disorder (17.3%), tested the hypothesis that clients with a diagnosis of mood disorder would report greater substance use, would indicate more problems associated with substance use, and would be more likely to use substances to cope with negative emotions than would clients with schizophrenia. In addition, coping motives would account for more variance in substance use and related problems than would convivial drinking when controlling for age, gender, and Axis I diagnosis. Results largely supported these...
TL;DR: Social workers can make important contributions in key areas identified in the survey, including fostering improved communication and coordination with medical center programs, educating care staff regarding substance use in older persons, and providing discharge planning that takes into account residents' substance use history.
Abstract: Residents of Veterans Affairs nursing homes have high rates of substance use problems. To evaluate relevant treatment resources and practices available to them, we surveyed 48 nursing home units with high substance use disorder prevalence. We summarize survey findings and describe areas of strength and weakness in addressing the needs of residents with substance use disorders. Social workers can make important contributions in key areas identified in the survey, including fostering improved communication and coordination with medical center programs, educating care staff regarding substance use in older persons, and providing discharge planning that takes into account residents' substance use history.
TL;DR: Analysis of the relationship of lifetime membership and program growth using a series of agent-based models demonstrates that programs encouraging lifetime attendance produce more groups and recruit more members than programs encouraging graduation.
Abstract: Research on Alcoholics Anonymous and other self-help programs has shown mixed results regarding lifetime participation at the individual level. No one has systematically studied whether lifetime membership contributes to the success of the program as a whole. This project analyzes the relationship of lifetime membership and program growth using a series of agent-based models. Results demonstrate that programs encouraging lifetime attendance produce more groups and recruit more members than programs encouraging graduation. Rapid graduation disrupts the availability of senior members to help newcomers, limiting program growth. Self-help programs may improve program effectiveness by encouraging long-term attendance.
TL;DR: Examination of the association among religiosity, mental health, and drug use among a community-recruited sample of women who use methamphetamine found those with high scores had higher odds of self-reporting a mental health diagnosis and of being psychologically dependent on methamphetamine.
Abstract: Religiosity is not found to be consistently protective in mental health and substance use outcomes among illicit drug users. This study examines the association between religiosity, mental health and drug use among a community-recruited sample of women who use methamphetamine. The majority of the sample (74%) had high scores of religious faith. In multivariate analysis, those with high scores had higher odds of self-reporting a mental health diagnosis and of being psychologically dependent upon methamphetamine, and were less likely to report injection risk. Further examination of the role of religiosity in the lives of women who use methamphetamine is advised.
TL;DR: Holleran Steiker as mentioned in this paper established that the relationship between trauma and substance abuse has long been established in social work practice and related research, according to experts in the area of pos...
Abstract: Holleran Steiker: The relationship between trauma and substance abuse has long been established in social work practice and related research (Goeders, 2003). According to experts in the area of pos...
TL;DR: The New Jim Crow: Mass Incarceration in the Age of Colorblending as mentioned in this paper is a book about mass incarceration in the age of colorblending, where race is mentioned and eyes shift to the floor when race is brought up.
Abstract: In a time when Americans whisper when race is mentioned and eyes shift to the floor when race is brought up in an ethnically mixed crowd, The New Jim Crow: Mass Incarceration in the Age of Colorbli...
TL;DR: When she disclosed an aspiration that helped sustain her commitment to educating future social workers, I was initially disappointed. As a Bachelor of Social Work student I was a young idealist, p...
Abstract: When she disclosed an aspiration that helped sustain her commitment to educating future social workers, I was initially disappointed. As a Bachelor of Social Work student, I was a young idealist, p...
TL;DR: In this paper, the authors examined the impact of military work-related factors (increased work tempo, deployment, and permanent change of station) on treatment disruption for substance abuse and family violence among Army soldiers from the perspective of substance abuse treatment providers and clinical social workers.
Abstract: Military settings present a unique context that can affect the continuity of care for substance abuse and other issues. We examined the impact of military work-related factors (increased work tempo, deployment, and permanent change of station) on treatment disruption for substance abuse and family violence among Army soldiers from the perspective of substance abuse treatment providers and clinical social workers. Among the 264 respondents, nearly 90% of providers reported that work-related factors resulted in disruption or termination of soldiers' treatment. Given the potential implications of treatment disruption on treatment effectiveness, steps for ensuring treatment continuity for soldiers should be considered.
TL;DR: SurvSurvivors of Addiction: Narratives of Recovery as discussed by the authors is a thematically inspired text that draws on the voices brought forth in case studies conducted with persons who sought addiction treatment in a hosp...
Abstract: Survivors of Addiction: Narratives of Recovery is a thematically inspired text that draws on the voices brought forth in case studies conducted with persons who sought addiction treatment in a hosp...
TL;DR: One of the most disturbing findings is that prescription drug abuse is a major public health concern and the consequences continue to mount; the cost in human lives lost is tragic and the cost to society growing.
Abstract: Prescription drug abuse is a major public health concern and the consequences continue to mount; the cost in human lives lost is tragic and the cost to society growing. “One of the most disturbing ...
TL;DR: Steiker et al. as discussed by the authors discussed the role and experience of the military in the exploration of drug and alcohol issues with this population and found that the military has made notable progress in decreasing illicit drug use and cigarette smoking, but has made less progress in reducing heavy alcohol use.
Abstract: Holleran Steiker: Clearly, the job of the military demands that troops be at their best for the security and well-being of the nation. It is easy to imagine alcohol and drug abuse lowering the readiness of troops, undermining the authority that ensures efficiency in operations, and putting soldiers’ lives on the line, as well as increasing the risks of accidents. According to the literature (Bray & Hourani, 2007), the military has made notable progress in decreasing illicit drug use and cigarette smoking, but has made less progress in reducing heavy alcohol use. First, can you share what your roles and experience are in relation to the military that lend themselves to an exploration of drug and alcohol issues with this population?
TL;DR: The first drug court was launched in Dade County, Florida, in 1989, and there are now close to 2,500 such courts across the United States (Huddleston & Marlowe, 2011).
Abstract: The first drug court was launched in Dade County, Florida, in 1989, and there are now close to 2,500 such courts across the United States (Huddleston & Marlowe, 2011). A drug court is a specific co...
TL;DR: SBIRT models have utility in both substance abuse and nonsubstance-related settings and can be used by social workers in child welfare settings, family services, schools and colleges, and geriatric services.
Abstract: Holleran Steiker: More than 70% of drinkers aged 21 or older exceed the guidelines for what is referred to as “low-risk drinking” and therefore National Institutes of Health recommendations have included “rethinking drinking” among other alcohol interventions (Willenbring, 2012). Although those who are at risk might not pursue alcohol treatment, they often visit a primary care physician or other health care provider. Brief screenings and intervention techniques for alcohol were initially developed in Europe and have gradually become more widely used in the United States to address the growing problems of “risky drinkers.” SBIRT, which stands for Screening, Brief Intervention, and Referral to Treatment, has become a widely adopted interdisciplinary model for early identification of alcohol problems in primary health facilities, such as general medical practitioners, hospital emergency room, and, more recently, in Employee Assistance Programs (Straussner, 2012, p. 130). As noted in an article by social work researchers Bliss and Pecukonis (2009), SBIRT models have utility in both substance abuse and nonsubstance-related settings and can be used by social workers in child welfare settings, family services, schools and colleges, and geriatric services (Bliss &