Addiction Rehabilitation Centers Research Articles

Positive, challenging, or impossible self-managing organizations? Exploring radical decentralization at an addiction rehabilitation center

AbstractSelf-management has been explored in research for more than half a century and is said to be linked to several positive effects ranging from a more egalitarian and democratic structure to enhanced productivity, improved quality of work and greater adaptability. More recently, the self-managing organization (SMO) has emerged as a novel organizational structure that departs from managerial hierarchy through radical decentralization. However, only a few empirical scientific studies have explored how radically decentralized structures of SMOs create new dynamics for organizations and the people in them. In this paper, we present the case of a public sector addiction rehabilitation center that had developed into an SMO through radical decentralization of managerial authority to staff. We use narrative theory as an enriching theoretical perspective to examine critically staff and managers’ subjective experiences of working in the SMO, finding that work was experienced as not only positive and challenging but also impossible. While positive experiences included increased collective responsibility, well-being, and efficiency within teams, conflict and disidentification emerged between teams, challenging the decentralized structure and, in some instances, making work within that context impossible. By drawing on these findings, we extend our understanding of SMOs.

Situational factors affecting abstinence from drugs: Panel data analysis of patients with drug use disorders in residential drug use treatment.

To identify situational factors that can predict drug abstention in patients with drug use disorders undergoing residential drug use treatment. Patients with drug use disorders admitted to drug addiction rehabilitation centers (DARCs) in 2016 were involved in this study. Longitudinal panel data were used, with eight follow-up surveys over 6 years, approximately every 6 months. Of the 2752 samples from the eight follow-up surveys, 2293 were analyzed as the complete panel data set. The primary outcome was drug abstention for approximately 6 months. The influences of situational factors during this period on the primary outcome were also assessed using a generalized linear mixed model in which inter-individual differences were controlled as variable effects. The use of residential DARCs positively influenced the primary outcome (adjusted odds ratio [AOR] 3.33, 95% confidence interval [CI] 1.79-6.21) when compared to no DARC usage. The cessation of drinking also positively affected the primary outcome (AOR 3.10, 95% CI 1.79-4.62), while employment status (AOR 2.22, 95% CI 1.12-4.41) and the cessation of drinking (AOR 4.92, 95% CI 2.77-8.72) positively impacted the primary outcomes of patients not using DARCs. The use of residential DARCs and the cessation of drinking positively affected drug abstention rates. Employment and the cessation of drinking for patients who were not using the DARCs also had a positive effect. This information will aid in the development of social recovery strategies for people with drug use disorders.

한국의 마약중독 치료·재활체계 현황 및 개선방안

Drug-related problems have become very serious social problems in Korea which used to boast as drug-free society. Korean government proclaimed ‘War on Drugs’ and has fortified supply-prevention strategies. However, for ‘War on Drugs’ we should intervene not only on supply side but also on treatment·rehabilitation(TR) for drug abusers. Currently the infrastructure for TR for drug abuse is very poor in Korea. This study analyzed the TR system in Korea and made suggestions for improvement. Specific contents of this paper are as follows. First, the nature of the problems in Korea was analyzed. They are availability of diverse drugs, sharp increase of abusers and young users, and high relapse rate, etc. Second, the ineffective court-ordered treatment policy was analyzed. It was recommended that treatment facilities should be improved and the collaboration system between legal system and treatment system should be developed. Third, the TR systems in public sector such as hospitals, Addiction Rehabilitation Centers(ARCs), Addiction Management Integrative Support Centers(AMISC) were analyzed. Public support to hospital treatment expense, nation-wide expansion of ARCs, and the development of referral system using AMISC were suggested. Fourth, the private sector systems such as DARC, Sonasa, NA were analyzed. It was suggested that government should financially support DARC and Sonasa. Also, it was recommended that NA meetings should be set up across the country. Finally, it was suggested that government should strengthen NIMS, drug-testing kits, prevention education, and develop the control tower to effectively deal with drug addiction issues.

Effectiveness of Habeas Corpus in cases of non-consensual detentions in addiction rehabilitation centers in Ecuador

Habeas corpus, originally designed to safeguard the right to physical freedom of individuals, extends to situations of detention that may be unjust, arbitrary or illegal. This study investigated its effectiveness in cases of non-consensual detentions in addiction rehabilitation clinics in Ecuador. Through an exhaustive review of court records collected between 2018 and 2023, and interviews with legal experts, it was found that more than 60 % of habeas corpus requests resulted in the release of detainees, while the remainder were denied due to deficiencies. procedural or lack of sufficient evidence. The legal professionals interviewed agree that habeas corpus is effective in protecting individual freedom, but its application varies depending on rigorous compliance with legal procedures and institutional supervision in clinics. It is recommended to improve judicial training in human rights and strengthen the supervision and regulation mechanisms in these centers. This study provides a substantial foundation for future research and policy aimed at improving human rights protection and equitable access to justice in addiction contexts.

PATTERN OF SUBSTANCE USE DURING COVID-19

Objective: To assess the impacts of covid-19 on substance use behavior. Study Design: A descriptive cross-sectional study. Place and Duration: Department of Psychiatry, Dow Medical College, Dr. Ruth KM Pfau Civil Hospital, Karachi and Model Addiction Treatment and Rehabilitation Centre (MATRC) Anti Narcotic Force, Karachi from December 16th 2020 to 15th April 2021. Methodology: Male patients of substance use disorders visiting on out-patient bases were enrolled and their status of covid-19 was assessed and impact of covid-19 on their substance use behavior was recorded. Sample size was of 250 clients and non-probability consecutive type sampling was done. Ethical approval was sought before commencement of study. Results: The mean age of 250 participants was 28.2 +- 8.25 years. Out of total 24 (9.6%) were came out PCR positive as Covid-19 while 226 (90.4%) were negative for covid-19. When they were asked regarding the effect of covid-19 on their substance taking behavior, 138 (55.2%) were in the favor that this pandemic has increased their substance using habit while 112 (44.8%) replied that their substance using behavior has been remained as usual and covid-19 has not affected it. Statistically covid-19 status whether positive or negative was significantly related with type of substance use as well as mode of substance use having P value of less than 0.05. While the effect of covid-19 over the substance using behavior was also significantly associated having P value of less than 0.05. Conclusion: The impact of covid-19 on substance use behavior was quite high in terms of usage, amount and mode of taking substance.

Personality Traits, Psychological Distress, and Locus of Control among Drug Abusers and Non-Drug users

The problem of drug addiction is growing day by day in Pakistani youth. Previous studies on drug addictions highlighted that drug addicts have different personality traits and level of stress, anxiety and depression as compared to the non addicts. Objective: To get the deep understanding of the personality traits, psychological discomfort, and Locus of control among drug and non-drug users. Methods: For this purpose, a sample of 200 participants, drug abusers (n=100) and non-drug users(n=100) of the same age, were taken from the general population and various rehabilitation facilities in Islamabad and Rawalpindi by using three reliable scales: The TIPI Questionnaire, the DASS-21, and the Locus of Control Questionnaire were administered to the selected sample. The core findings of the study were interpreted in terms of descriptive, correlation and t–test analysis. Results: The study findings demonstrate a statistically significant difference between drug and non-drug users in extraversion, Openness to experience, agreeableness, conscientiousness, and emotional stability. Drug abusers reported significant levels of psychological discomfort and external Locus of control, in contrast to non-drug users who scored well on internal Locus of control. Conclusions: Drug users exhibits high level of psychological discomfort and negative personality trait than non-drug users. Therefore, health professionals and psychologists working in drug addiction rehabilitation centers should focused on the improvement of drug addicts’ psychological health.

Investigating the State of Sports Facilities and Therapists' Views on Sports in Addiction Treatment and Rehabilitation Centers

Investigating the State of Sports Facilities and Therapists' Views on Sports in Addiction Treatment and Rehabilitation Centers

The LSU AgCenter Healthy Communities Initiative: Community-Participatory Policy, Systems, and Environmental Change

The LSU AgCenter Healthy Communities Initiative: Community-Participatory Policy, Systems, and Environmental Change

A comprehensive overview of substance abuse amongst Syrian individuals in an addiction rehabilitation center

ObjectivesThis study aims to provide a comprehensive overview of substance abuse amongst Syrian individuals in an addiction rehabilitation center. MethodsThis is a descriptive cross-sectional survey-based study, from patients receiving treatment in an addiction rehabilitation center in Damascus. Syria. The study was conducted over a period of nine months. ResultsA total of 82 participants were recruited, the majority of them were males (n = 78.95.1%). More than half of those investigated reported multi-level failure (n = 46, 56.1%) during their education. Most of the participants (n = 44, 53.7%) started to use drugs at a friend’s home. The family was shown to play a positive role in stopping the initial drug taking trials at early stages (33/56, 58.9%). Again, friends' effect was the main reason for the return of abusing drugs (20/56, 35.7%). Sources of drugs were mainly from drug promoters for most of the participants (n = 58, 70.7%) followed by friends (n = 28, 34.1%). Participants revealed that taking drugs were mostly accompanied by additional habits such as cigarette smoking before using their drugs (n = 65, 79.3%), or drinking alcohol (57.3%). Surprisingly, participants believed that drug abuse does not lead to addiction (n = 52, 63.4%). The most common experienced feeling was depressed, desperate, or sad (n = 47, 57.3%), followed by anxiety and the desire to escape reality and resort to imaginations (n = 44, 53.7%). ConclusionsThe findings of this study indicate the need of policymakers to give more attention, in developing preventive strategies, to friends, as a main cause of addiction, in addition to the family influences on individual’s drug abuse, addiction behaviors, and mindsets. Understanding the influencing factors could spot the light on the key to solve the addiction problem. A realist rehabilitation programs must be well designed and implemented as the level of individuals, institutions and communities to face this problematic addiction disaster.

Evaluation of resilience components of the identity of recovered addicts in resocialization: a case study of clients in addiction rehabilitation centers in districts 4, 6 and 22 of Tehran)

Background and Aim: Drug addiction is one of the most important problems of the present era, which has gained a global scope, has gone beyond the boundaries of health and treatment, and has turned into a social and family problem. Addiction, in most cases, causes a person to be isolated from society. Therefore, the present study aimed to evaluate the resilience components of the identity of recovered addicts in resocialization: the case study of referrals in addiction recovery centers in districts 4, 6 and 22 of Tehran). Methods: The current research was a descriptive survey research in terms of its practical purpose and in terms of the method of data collection. The method of conducting this study (post-event) as well as this study was in the scope of quantitative research. In the present study, the population included all people who recovered from addiction in rehabilitation centers in Tehran's 4th, 6th, and 22nd districts. The method of selecting samples randomly was simple. Among the 2580 people who referred to these centers, 388 people were selected randomly and with a probability proportional to the volume of the center's clients. For this, a list of centers and the number of its clients was prepared, and 11 centers were systematically selected. This study was carried out in accordance with ethical considerations. The data collection tools were demographic characteristics, resilience scale, and a researcher-made questionnaire on the factors affecting addiction recovery. Data analysis was done by SPSS 24.0 statistical software. Results: The results showed a significant difference between the average scores of identity resilience of those who recovered from addiction in the post-test with resocialization (P<0.01) so the level of socialization had increased. Conclusion: According to the obtained results, it can be claimed that environmental protective factors, environmental risk factors, and exchange-environmental processes are effective in resiliency against abuse and prevention of re-addiction.

Comparing Defensive Mechanisms and Suicidal Thoughts in Addicted Men and Women

e present study aimed to compare the defensive mechanisms and suicidal thoughts among substance-dependent men and women. The research design was a retrospective (causal-comparative) study. The sample included 112 substance users (56 women and 56 men) from addiction rehabilitation centers in Gilan province, selected through convenience sampling based on entry criteria for this study. Two questionnaires were used in this study: the Defense Style Questionnaire (DSQ-40) and the Beck Scale for Suicide Ideation (BSSI). The collected data were analyzed using multivariate analysis of variance with SPSS software version 26. Data analysis showed no significant difference in the defensive mechanisms between men and women dependent on substances; however, there was a significant difference in suicidal thoughts between men and women dependent on substances. Considering the results of this study, therapists and counselors working with substance-dependent individuals are advised to pay attention to the defensive mechanisms and suicidal thoughts of these individuals, as awareness of these variables can assist in providing better and more appropriate services to these patients.

The Implementation of Contingency Management Intervention in an Institutionalized Drugs Treatment Facility in Malaysia

Despite Contingency Management Intervention (CM) having been proven to be a highly effective intervention in the context of substance use treatment and rehabilitation worldwide, it is still rarely studied in the context of institutionalized treatment settings. The purpose of the study was to determine the effectiveness of CM intervention conducted in an institutionalized drug treatment setting in Malaysia. The study’s main objective was to examine the effectiveness of CM intervention on clients’ treatment engagement within a usual psychosocial (PS) program. A total of 44 clients from the Narcotic Addiction Rehabilitation Centre or PUSPEN were randomly assigned into two groups, namely the experimental group and the control group. The experimental group followed a 12-week psychosocial intervention (PS) with CM intervention (CM) (PS+CM). Meanwhile, the controlled group inclusively went through 12 weeks of the usual psychosocial intervention program (PS). CM intervention was used to reinforce clients’ engagement within treatment sessions by giving tangible rewards for every treatment engagement behaviour recorded. Rewards collected have an associated monetary value which was used to redeem retail items such as food, toiletries, books and clothing items. Data collection was performed weekly for every psychosocial session conducted by the PUSPEN’s treatment officers. The findings demonstrated that CM intervention effectively improves clients’ treatment engagement and verified that CM interventions can also be conducted in an institutionalized drug treatment setting in Malaysia.

Childhood Trauma and Dissociation Correlates in Alcohol Use Disorder: A Cross-Sectional Study in a Sample of 587 French Subjects Hospitalized in a Rehabilitation Center.

This study aimed to determine whether dissociative symptoms and childhood trauma (CT) may help identify a specific subgroup of patients among those hospitalized for alcohol use disorder (AUD). We assessed 587 patients hospitalized for an AUD in a French addiction rehabilitation center (cross-sectional study) regarding dissociative symptoms (DES-taxon), childhood trauma (CTQ), depression (BDI), anxiety (STAI-state and STAI-trait), posttraumatic stress disorder (PTSD; PCL-5), and AUD symptoms (AUDIT). We ran a hierarchical cluster analysis and compared the clusters in terms of dissociation and CT, as well as AUD, depressive, anxiety, and PTSD symptoms. We identified three clusters of patients: (1) patients with low AUD severity and low dissociation (LALD); (2) patients with high AUD severity and low dissociation (HALD); (3) patients with high AUD severity and high dissociation (HAHD). Patients from the HAHD group had significantly higher dissociation and more severe depression, anxiety, and PTSD symptoms than those with LALD and HALD. They also reported more emotional and sexual abuse than those with LALD. Among patients with an AUD, those with high dissociation may constitute an independent subgroup that exhibits a higher prevalence for CT and higher AUD severity, as well as higher depression, anxiety, and PTSD symptoms. Patients with more severe AUD and associated psychiatric symptoms should be systematically screened for dissociation and provided with tailor-based treatments.

Comparison of the effect of two interventions of group dialectical behavior therapy and structured matrix treatment on pathological narcissism and craving for drugs among drug abusers

Background and aims: Pathological narcissism is one of the personality disorders in drug abusers, and its main characteristic is self-conceit and lack of empathy and solidarity with others. The present study aimed to compare the effects of group dialectical behavior therapy (DBT) and structured matrix treatment on pathological narcissism and craving for drugs among drug abusers in Ahvaz. Methods: This was a quasi-experimental study based on a pretest-posttest design with control and test groups. The study population consisted of all drug abusers visiting the addiction rehabilitation centers affiliated with the Department of Social Welfare, Ahvaz, Iran, in 2021. Of them, 75 individuals were selected as the sample through the cluster random sampling method and were randomly assigned to two experimental groups and a control group. Participants in all three groups completed the Pathological Narcissism Inventory (PNI) and the Desires for Drug Questionnaire (DDQ) as the pre-test. The first experimental group participated in eight 90-minute sessions of group DBT. Moreover, the second experimental group underwent fourteen 90-minute sessions of structured matrix treatment. Finally, all participants took a post-test, and data were statistically analyzed by multivariate analysis of covariance (MANCOVA). Results: The results showed that both group DBT and structured matrix treatment reduced pathological narcissism and craving for drugs in experimental groups (P<0.001). However, there was no significant difference between the two experimental groups in the mean scores of pathological narcissism and craving for drugs. Conclusion: As our findings demonstrated the effectiveness of group DBT and structured matrix treatment in reducing pathological narcissism and craving for drug among drug abusers, these two interventions, along with other therapies, are recommended to improve the mental state and reduce craving for drugs among drug abusers.

Cultural Safety as an Outcome of a Dynamic Relational Process: The Experience of Inuit in a Mainstream Residential Addiction Rehabilitation Centre in Southern Canada.

Few addiction treatment options are available in Arctic Canada, leading many Inuit to seek treatment programs in southern cities. We conducted a case study to understand what contributes to a culturally safe experience for Inuit in a mainstream addiction rehabilitation centre in Southern Canada. We carried out more than 700 hours of participant observation, in addition to semi-structured interviews and member-checking activities with 20 Inuit residents, 18 staff and four managers. Data were analysed using an inductive interpretative process. Throughout their journey in the program, Inuit navigated through contrasting situations and feelings that we grouped under six broad themes: having Inuit peers, having limitations imposed on one’s ways of being and doing, facing ignorance and misperceptions, having conversations and dialogue, facing language barriers and being in a supportive and caring environment. This study highlights how cultural safety varies according to people, context and time, and relates to developing trustful relationships.

A Comprehensive Overview of Substance Abuse Amongst Syrian Individuals in an Addiction Rehabilitation Center

A Comprehensive Overview of Substance Abuse Amongst Syrian Individuals in an Addiction Rehabilitation Center

Pharmaceutical Care in the Treatment of Substance Use Disorders in Jordan: A Randomized Controlled Trial

Background Substance Use Disorder is a chronic relapsing disease that is characterized by compulsive drug seeking and use, despite harmful consequences. The aim of this study was to evaluate the impact of clinical pharmacist intervention/recommendation on the treatment of patients admitted to addiction rehabilitation centers in Jordan. Methods A randomized controlled trial was conducted in two public addiction treatment centers in Amman. Patients (n = 93) were randomized into 2 groups (control and intervention). Medication review was conducted for both groups at baseline, during stay and at discharge. Treatment related problems (TRPs) were identified by the clinical pharmacist and recommendations provided to the therapeutic team in the intervention group. Additionally, quality of life and quality of sleep were assessed at baseline and 2 weeks later. Results A total of 392 TRPs were identified during the study period. The mean number of TRPs ± SD was 4.22 ± 2.58 per patient. The clinical pharmacist intervention led to a reduction in the mean number of TRPs at discharge by 2.2 ± 0.85 (p < 0.001) in comparison to the control group (by 0.23 ± 0.27, p = 0.066). After 2 weeks of admission, there was an improvement of physical health (p = 0.035) and of the overall sleep status (p = 0.048) in the intervention vs. control groups. Conclusion Clinical pharmacy services provided to patients with substance use disorder reduced the number of TRPs and improved other outcomes such as physical health and quality of sleep during detoxification. Long term studies with larger sample sizes are needed.

Symptomatic Trauma: Japan, Drug Addiction, and the Limits of Treatment

Abstract Possession and use of illegal drugs carry harsh penalties in Japan if an individual is apprehended by authorities. These severe legal restrictions stigmatize drug use while failing to eliminate narcotics from Japan. This makes individual efforts to take on recovery difficult, as admissions of past use are often met with fear and disdain. Drug Addiction Rehabilitation Center (DARC) is a Japanese organization that helps individuals work a program based on Narcotics Anonymous (NA), while providing members a place to spend their days free from temptation or judgment. Underestimated in this program is how DARC members drug use is often a symptomatic response to interpersonal trauma and struggles to meet societal expectations of success. I argue here that an NA influenced approach to recovery, typically the only option available to those seeking help in Japan, struggles to acknowledge contextual and societal factors that motivated members to begin using drugs. In doing so, I show the necessity for comprehensive change to the ways in which Japan understands, perceives, and treats those labeled as addicts.

Factors influencing the provision of care for Inuit in a mainstream residential addiction rehabilitation centre in Southern Canada, an instrumental case study into cultural safety

BackgroundProvision of culturally safe care has been proposed to address health inequity, including in the areas of mental health and addiction. The factors that influence the provision of culturally safe care remain understudied. This paper explores the factors influencing the efforts of a mainstream residential addiction rehabilitation centre to provide culturally appropriate and quality care for Inuit.MethodsAn instrumental case study was conducted, informed by ethnographic and creative research methods. Over 700 h of participant observation were carried out between March 2018 and January 2020, in addition to qualitative semi-structured interviews (34 participants) and/or member-checking activities (17 participants) conducted with a total of 42 individuals: 20 Inuit residents, 18 clinical/specialized staff, and 4 clinical/administrative managers. An interpretive thematic analysis was performed to examine the factors that may influence the provision of culturally safe care for Inuit residents.ResultsTen categories of interrelated factors were identified and classified according to whether they relate to individual, programmatic, organizational, or systemic levels. These categories covered: (1) residents’ and staff’s life experiences; (2) personal and relational qualities and skills; (3) the model of care; (4) model flexibility; (5) ways in which relational aspects were considered; (6) sensitivity of the organization towards the population served; (7) human resources and professional development issues; (8) social climate; (9) political, relational, and funding climate; and (10) legislative, regulatory, and professional environment. While system-level factors generally had a negative effect on experiences of cultural safety, most factors at other levels had both favourable and unfavourable effects, depending on the context and dimensions examined.ConclusionsThe results offer insight into the interplay between the challenges and barriers that mainstream organizations face when working with Inuit, and the opportunities and enablers that organizations can build on to improve their services. This paper contributes to a better understanding of the challenges and opportunities to providing culturally safe addiction programs to Inuit within a complex intervention setting. It concludes by highlighting some areas for improvement to advance cultural safety in this context.

Feeling at Home in the Clinic: Therapeutic Dwelling in an Addiction Rehabilitation Center in Tehran, Iran

AbstractThis article describes community life in a free residential rehabilitation center for women in Tehran, Iran. In a social context that stigmatizes drug use, especially by women, this rehabilitation center provides poor and homeless drug users a much‐needed opportunity to engage in recovery. I argue that the treatment team's emphasis on “therapeutic dwelling” had significant ramifications on the rehabilitation outcomes of their patients. I use the term “therapeutic dwelling” to refer to a patient's ability to form mutual relations of care and concern with others in therapeutic settings. A therapeutic culture that emphasizes dwelling can have multiple effects on the healing trajectories of patients. It can create a supportive community that extends the rehabilitation process while also further marginalizing patients who are unable to properly exhibit care toward others. Ultimately, this article highlights that dwelling should be approached as a malleable—rather than a purely positive—form of sociality that has the power to both exclude and welcome, to provide and withhold personal connection and intimacy