Alcohol Rehabilitation Research Articles

Change in the profile of the service utilizers of a community-based drug treatment clinic: a retrospective study from India

ABSTRACT Background Community-based drug treatment clinics (CB-DTC) aim to reduce the barriers to treatment-seeking among substance users. Literature is lacking in assessing the change in the profile of the clients seeking treatment from the CB-DTC over time. The current study aimed to assess the change in the profile of the service utilizers of a CB-DTC located in an urban slum in the northern part of India. Methods A retrospective chart review of the profile of the patients (n = 631) who were enrolled at a CB-DTC at two different periods (n = 330, 2003; n = 301, 2017). Results As compared to 2003, enrolees of 2017 had better socio-demographic profiles; earlier age of initiation of substance use and early treatment-seeking (p < .0001); relatively higher prevalence of alcohol (p < .0001) and volatile substance-dependence (p < .001); lower prevalence of opioid dependence (p < .0001); and lower prevalence of substance-related complications (injection drug use, illegal activities, and broken families) (p < .001). However, there was no difference in prevalence of high-risk sexual behaviors (HRSB) and polysubstance use. Conclusion Changing profile of the service utilizers of the CB-DTC reflect the changing dynamics of the substance use pattern and the putative role a CB-DTC can play. Interventions need to be tailored to address these changing requirements.

Impact of the COVID-19 pandemic on opioid agonist treatment in Ireland: Protocol for an interrupted time series analysis

While opioid agonist treatment (OAT) is the most effective treatment for opioid dependence, it is heavily dependent on regular face-to-face healthcare delivery placing both clients and treatment providers at risk of COVID-19. Following the emergence of COVID-19, policies were rapidly changed in Ireland, with the introduction of national contingency guidelines by the HSE National Social Inclusion Office, beginning in March 2020 to ensure rapid and uninterrupted access to OAT while balancing efforts to mitigate COVID-19 risk. This study aims to assess the impact of the national contingency guidelines, on the quality of OAT care delivered in Ireland. An interrupted time series analysis will be conducted using anonymised aggregated level data obtained from the Central Treatment List (CTL), the national register of people receiving OAT, administered by the National Drug Treatment Centre Board on behalf of the HSE. Separate segmented regressions will be conducted to estimate the impact of the national contingency guidelines on the following outcomes: (1) number of patients in treatment; (2) number of patients starting OAT; (3) average waiting time for treatment; (4) number of people on waiting list; (5) number of patients dropping out of treatment. The study period will be divided into pre-(March 2019 to February 2020) and post- intervention (April 2020 to March 2021) segments. Immediate (change in level) and longer-term impacts (change in slope) of changes to provision of OAT in each of the outcomes will be investigated. Regression coefficients (β) and 95% confidence intervals (CIs) will be reported.

Rapid situational assessment of people who inject drugs (PWID) in Nairobi and coastal regions of Kenya: a respondent driven sampling survey

BackgroundA Cross-sectional Rapid Situational Assessment of People Who Inject Drug (PWIDs) applying Respondent Driven sampling techniques (RDS) was used to recruit subjects/participants in a study aimed at assessing HIV prevalence and risk behaviors among injecting drug users in Nairobi and Coastal regions of Kenya. There is paucity of data and information on injecting drug use in sub-Saharan Africa and there is sufficient evidence of existence of the environment for development and growth of injecting drug use. Past studies on PWID and its association to HIV and AIDS that have been conducted in Kenya do not provide sufficient information to support effective planning and comprehensive national response to the HIV and AIDS epidemic.MethodsA cross-sectional study design was adopted in which a set of initial subjects referred to as ‘seeds’ were first identified from which an expanding chain of referrals were obtained, with subjects from each wave referring subjects of subsequent waves. The seeds were drawn randomly from the population and interviewed to pick the one with the largest network and other unique characteristics. A maximum of twelve seeds were recruited. The second stage involved conducting assessment visits to the sites to identify potential collaborators that included non-governmental organizations (NGOs), drug treatment centres, health facilities, community based organizations (CBO’s) among others. Three NGOs located in the coast region and one in Nairobi region were identified to assist in identifying drug injection locations and potential participants. Key informant interviews (KIIs) and Focus Group Discussions (FGDs) were also conducted using interview guides.ResultsA total of 646 individuals (344 in Nairobi and 302 at the coast) were recruited for the study between January and March 2010. Of these 590 (91%) were male and 56 (9%) were female. Findings showed that most PWIDs initiated injecting drug use between the ages of 20–29 years, with the youngest age of initiation being 11 years and oldest age being 53 years. Most commonly injected drug was heroin (98%), with a small (2%) percentage injecting cocaine. Other non-injecting methods such as smoking or combining these two drugs with other drugs such as cannabis or Rohypnol were also common. Most PWIDs used other substances (cigarettes, alcohol, and cannabis) before initiating injecting drug use. The adjusted national HIV prevalence of PWIDs was 18.3% (19.62% unadjusted) with PWIDs in Nairobi region registering 18.33% (20.58% unadjusted) compared PWIDs for Coastal region indicating 18.27% (18.59% - unadjusted). The gender based HIV prevalence showed that women were more at risk of acquiring HIV (44.51%-adjusted) compared to men (15.97%-adjusted). The age specific HIV prevalence showed that PWIDs who initiated injecting at 11–19 years (44.7% adjusted) were most at risk in Nairobi compared to those who initiated injecting at age 20–24 years (23.2% - adjusted) in the coastal region. While all PWIDs continue to be at risk in the two regions, those from the Western parts of Nairobi, Kenya were at a relatively higher risk given their increased propensity for sharing injecting equipment and solutions.ConclusionsCompared to the national HIV prevalence of (4.9%), the results show that People Who Inject Drugs (PWIDs) are at particularly high risk of infection in Kenya and there is urgent need for intervention (KenPHIA, 2018). This study also showed clear evidence that 70% of PWIDs are primary school educated, engage in high risk injecting and sexual behaviors comprising sharing of injecting equipment, unprotected heterosexual and homosexual sex. Given that initiation of injecting drug use begins early and peaks after formal school years (20–29 years), prevention programmes should be targeted at primary and secondary school students, college and out of school youth. Further, to protect People who inject drugs (PWIDs) from HIV infection, the country should introduce free Needle Syringe Programs (NSP) with provision of condoms and Methadone Assisted Therapy (MAT) as a substitute for drug use.

Effects of 12-week aerobic exercise on cue-induced drug craving in methamphetamine-dependent patients and the moderation effect of working memory

ObjectiveTo explore the effect of 12-week aerobic exercise of varying intensity on cue-induced drug craving in methamphetamine (MA)-dependent patients and how this effect may be moderated or mediated by changes in cognitive function. MethodFifty-seven MA-dependent patients were randomly divided into three groups. Two exercise groups were engaged in a 12-week exercise program that involved three 30-min sessions per week of moderate- or high-intensity aerobic exercise on a cycle ergometer. The control group maintained daily life in a drug rehabilitation center for 12 weeks. Inhibitory control, working memory, and cue-induced drug craving were assessed before and after the intervention via Stroop task, 2-back task and visual analogue scale, respectively. ResultsA 12-week program of high-, but not medium-, intensity aerobic exercise significantly reduced cue-induced drug craving and improved working memory performance, while did not improve inhibitory control. Multiple linear regressions revealed that the effects of aerobic exercise on cue-induced drug craving were moderated by working memory. ConclusionsHigh-intensity aerobic exercise could be used to reduce cue-induced drug cravings of MA-dependent patients while also providing benefits in working memory. For patients with improved working memory, 12-week aerobic exercise can significantly reduce cue-induced drug craving, and the higher the exercise intensity, the greater the decrease in craving. These results suggest that appropriate high-intensity exercise would be a positive tool to promote drug rehabilitation for patients without any physical or medical conditions, and the improvement of working memory is important for exercise-induced effects.

Intergenerational Transmission of Violence Among Substance-Abusing Chinese Parents: Roles of Detachment and Social Support.

Despite a large population of registered people with drug addiction, child protection in substance-abusing families is a neglected issue in China. The present study aims to investigate the association between parents' childhood abuse history and the risk of abusing their own children in substance-abusing Chinese families and also to examine the mediating role of detachment and moderating role of social support during the intergenerational transmission of abuse. A total of 173 men and 116 women were selected using cluster sampling from two compulsory drug rehabilitation centers in Jiangsu Province. Results indicated that one's childhood abuse history was positively associated with the current perpetration of child abuse for both fathers and mothers. Detachment mediated the linkage between a history of childhood maltreatment and perpetration of child abuse in all types of abuse for both men and women except for women's sexual abuse. Social support from family members buffered the intergenerational transmission of child abuse for fathers but not for mothers. Child maltreatment in substance-abusing families is an urgent issue that needs measures to prevent the intergenerational transmission of violence in China. Intervention programs could involve helping parents cope with their childhood abuse history through rebuilding secure attachment and facilitating social support for their parenting practices, especially for fathers.

Drug Addiction in Pakistan: A step towards alleviation of sufferings

Drug Addiction in Pakistan: A step towards alleviation of sufferings

Digital Capacity and Interest in mHealth Interventions Among Individuals on Opioid Agonist Maintenance Treatment: A Cross-Sectional Community-Based Study.

Background:Integrating mobile technologies in healthcare (mHealth) is helpful to manage various medical conditions. mHealth applications can bridge the gap in the management of patients with opioid use disorder (OUD). Research evaluating the feasibility of mHealth to address OUD is limited in developing countries. We aimed to assess the digital capacity and interest in mHealth interventions in patients maintained on opioid agonist treatment (OAT).Methods:150 patients on OAT from a community drug treatment clinic in New Delhi, India, were included. We assessed the participants on their pattern of mobile and Internet use and their willingness to use mHealth technology to access health information and services related to OUD.Results:88% of participants (n = 132) owned a mobile phone at assessment; 2.7% (n = 4) had never used a mobile phone in their lifetime. 70% (n = 105) participants had Internet access. 80% (n = 120) of participants showed interest in receiving text messages related to the management of OUD. 60% of participants showed a willingness to download and use applications for monitoring their substance use.Conclusions:In India, there is an interest among people on OAT to use mHealth interventions to manage their substance use. This population also has access to mobile phones and the necessary knowledge to install and run applications needed for various mHealth interventions.

The Factors affecting the Tedency of Drug Addiction among Malays in Malaysia

Drug addiction is a very serious issue in Malaysia that has been declared as the number one enemy and the main agenda of this country. Hence, the National Anti-Drugs Agency is committed to eradicate drugs through the campaign of total fight against drugs. It is a fact that drug addicts among Malay ethnic more than other ethnics. Various other factors may influence this tendency of drug addiction such as culture, economy, environment and religion. Therefore, this article aimed to measure the level, pattern and influence of the constructs of religion, socio-culture, socio-economic and environment, and identify factors that affect the tendency of drug addiction among Malays in Malaysia. This study used quantitative approach with research design of survey used questionnaires as research instrument. The location was divided by zones, namely northern, western, southern, east coast and Sabah. It involved 13 National narcotics addiction rehabilitation centres and three (3) private drug rehabilitation centres. A total of 674 respondents comprising 549 Malay clients were selected randomly as research sample. The obtained data had been analyzed using the IBM-SPSS-AMOSversion 21.0 to run Structural Equation Modeling (SEM) analysis which consists of two main models: measurement model and structural model. Prior to the SEM test, several adaptation tests were conducted to ensure that the tested indicators truly represented the measured construct. The findings of the study have shown that the factors of religion, socio-cultural, socio-economic and environment have positive and significant impact on Malay drug addicts. Socio-cultural factor is the most significant, followed by the environment, socio-economic and religion. This implies that the lack of religious teachings also affects the tendecy of drug addiction among Malays.

A cross-section observational study on the seroprevalence of antibodies to COVID-19 in patients receiving opiate agonist treatment.

IntroductionThe HSE National Drug Treatment Centre is an inner city drug treatment centre in Dublin which provides opiate agonist treatment (OAT) to approximately 565 patients, many of whom have complex care needs.ObjectiveThis study was conducted to determine seropositivity to the COVID-19 virus in patients attending NDTC, and to establish if patients tested had any clinical symptoms of this disease since March 2020.MethodAll patients attending for OAT were invited to participate and 103/565 patients agreed. The patients were tested for the presence of serum antibodies to COVID-19 in a single sample collected over a 4-month period (July–October 2020). A questionnaire was administered at the same time as sample taking.ResultsResults showed that the majority of patient samples (100; 97%) tested were negative for the presence of antibodies to COVID-19. There were only two confirmed positive results (1.9%) and one equivocal result (1%). None of the approximately 565 attendees at the HSE NDTC presented with serious illness indicative of COVID-19 throughout the three waves of the pandemic, nor were any deaths due to COVID-19 reported. ConclusionThese findings indicate (a) possible low level of exposure to COVID-19 among this patient cohort or (b) that those patients who have been exposed have not developed or maintained detectable antibody levels, nor developed symptoms of the disease. Public health measures could explain the low level of COVID-19 in this cohort. The findings are also consistent with the possibility of a protective effect of OAT medications on development of the disease.

Major and trace elements changes of female methamphetamine addicts during six months’ compulsory treatment: Biomarkers discovery

BackgroundThe concentration levels of major and trace elements are significantly correlated with human health. However, studies profiling major and trace elements among female using methamphetamine are rare. This study aims to investigate the major and trace elements changes and discover elemental biomarkers in plasma of female methamphetamine (METH) addicts in six months’ compulsory treatment. MethodsA total of 60 female METH addicts selected from drug rehabilitation center were randomly divided into three equal groups: (1) Detoxification for one month; (2) Detoxification for three months; (3) Detoxification for six months. Twenty healthy women, without drug abuse history were selected as control group. Four major elements including Na, Mg, K, Ca and twelve trace elements including V, Cr, Mn, Fe, Ni, Cu, Zn, As, Se, Mo, Sn, Pb were determined using inductively coupled plasma mass spectrometry (ICP-MS). The results were analyzed using One-way Analysis of Variance (ANOVA) and Student-Newman-Keuls (SNK test). Elemental biomarkers were discovered based on orthogonal partial least squares discriminant analysis (OPLS-DA). ResultsThe four groups used in the study were divided into four significant sections according to scatter plots. The total elemental concentrations of three METH withdrawal groups were increased compared to the control group. Over six months, element contents of the withdrawal groups gradually equaled element contents of the control group in compulsory treatment. The variable importance in the projection values (VIP > 1) of OPLS-DA model and SNK test (p < 0.05) revealed Fe, Cu, Cr and Se as elemental biomarkers. ConclusionMajor and trace elements demonstrated significant differences between control group and three METH withdrawal groups. Fe, Cu, Cr and Se are potential elemental biomarkers among METH-abused female groups. Metabolic disorders of major and trace elements exist in the female methamphetamine addicts.

Therapuetic Community (TC) as Drug Rehabiliation Center Design Principles

Drugs are something that has been fought for for a long time and rehabilitation is one way to save victims from drug dependence. Therapy and rehabilitation methods using the Therapeutic Community approach are inseparable from the therapeutic communication carried out by addiction counselors which functions to create a comfortable atmosphere for residents who are drug addicts. This study aims to determine the community therapeutic variables at the rehabilitation center that are often used by patients: bedroom, common room and dining room at the drug rehabilitation center. This research method uses a comparative method by identifying the application of the therapeutic community principles in case studies. The buildings being compared include The Chiang Mai Cabin, the Lido BNN Drug Rehabilitation and Therapy Unit, the FAN Campus, West Java, and the Regional Mental Hospital, Bangka Belitung. The results showed that each room has a quality standard that must be met in order to increase the level of patient comfort at the Drug Rehabilitation Center. These results can help architects in designing drug rehabilitation centers with a therapeutic community approach.

Using a pragmatically adapted, low-cost contingency management intervention to promote heroin abstinence in individuals undergoing treatment for heroin use disorder in UK drug services (PRAISE): a cluster randomised trial

IntroductionMost individuals treated for heroin use disorder receive opioid agonist treatment (OAT)(methadone or buprenorphine). However, OAT is associated with high attrition and persistent, occasional heroin use. There is some evidence...

Incidence and predictors of 30-day hospital readmissions for liver cirrhosis: insights from the United States National Readmissions Database.

BackgroundCirrhosis is associated with substantial inpatient morbidity and mortality. This study aimed to determine the trends in 30-day hospital readmission rates among patients with cirrhosis and identify factors associated with these readmissions.MethodsWe conducted a retrospective analysis of data retrieved from the Nationwide Readmissions Database to determine trends in 30-day readmission for patients discharged with a diagnosis of cirrhosis in 2010 through 2014. Multivariate logistic regression analysis was used to identify predictors of readmission.ResultsAmong 303,346 patients identified from the database, the 30-day readmission rate for patients with a discharge diagnosis of cirrhosis was 31.4% (n=95,298). The trends in the readmission rates remained steady during the study period. On multivariate analysis, female sex, age 45 years or older, esophagogastroduodenoscopy (EGD) during admission, and disposition to a short-term care facility or skilled nursing facility protected against readmissions. In contrast, coverage by Medicaid insurance, admission during a weekend, nonalcoholic cause of cirrhosis, and history of hepatic encephalopathy and ascites were associated with readmission.ConclusionsWe found an exceptionally high 30-day readmission rate in patients with cirrhosis, although it remained stable during the study period. This study identified some modifiable factors such as disposition to a short-term care facility or skilled nursing facility and patients’ attendance of alcohol rehabilitation facilities that could decrease the likelihood of readmission and could inform local and national healthcare policymakers.

Efficacy of Eye Movement Desensitization Reprocessing (EMDR) in Improving Self-Regulation of In-House Filipino Clients with Substance-Use-Disorder

Abstract: Drug addiction is considered as a global epidemic which drastically affects millions of people worldwide, damaging an individual’s physiological, social, and psychological facets. One of the constructs that has been determined as an essential factor in the development of a variety of addictive behaviors is self-regulation. It plays an important role in predicting, maintaining, and treating addiction. In this study, the efficacy of Desensitization of Triggers and Urge Reprocessing (DeTUR), an Eye Movement Desensitization Reprocessing (EMDR) addiction protocol, in improving self-regulation was tested among fourteen (14) in-house clients of two drug treatment and rehabilitation centers using sequential explanatory mixed method research design wherein Self-regulation Inventory-Short Version (SRI-S) and individual interviews were employed. Results explicitly proved that self-regulation scores obtained significantly differed before, after, and even the delivery of delayed posttest using the EMDR as an intervention. The study confirmed that EMDR enhances the clients’ self-regulations (Overall SRI) and the sub-areas: positive actions, controllability, expressions of feelings and needs, assertiveness, and well-being seeking. Themes generated using thematic analysis further established a basis for the efficacy of EMDR.Keywords: drug addiction, self-regulation, Eye-movement Desensitization Reprocessing (EMDR), Desensitization of Triggers and Urge Reprocessing (DeTUR)

Quality of Life, Behavioural Activation and Inhibition and Perceived Social Competence among Drug Addicts

The purpose of this article was to shower light on the quality of life that mostly we expect. Life quality is determined by two aspects i.e., physiological and psychological aspects. While if a person is addicted by the drugs, then the both aspects of his/ her life is deteriorated to the extreme. Due to drug addiction, the negative psychological effects which arises are anxiety, stress, depression, and familial relationships while the negative physiological effects that arise from the drug addiction are weakness, headache, dizziness, and pain in the body, etc. The main objective was to evaluate the quality of life of Diamorphine addicts, behavioral stimulation and inhibition, perceived social competence, and the relationship between these variables; and check differences between drug addicts on these variables based on their belongingness to joint and nuclear family systems. To achieve the objectives, 10 Diamorphine addicts were taken from Azm Drug Rehabilitation center, Sargodha, through purposive sampling. A total number of 10 participants responded to the 26-items quality of life survey (WHO-QOL-BREF), 24-items BAS/BIS (BIS/BAS scale) questionnaire, and 5-items perceived social competence questionnaire (Perceived Social Competence Scale II). Results were analyzed via SPSS version 20. The results showed that all three variables in the study were not associated with each other. Quality of life and social competence correlated -.25 (p = n.s); quality of life and BAS/BIS had .30 (p = n.s); while social competence and BAS/BIS had -.16 (p = n.s). It may be due to the cultural settings of Pakistan. In drug addicts, BAS has high activity, and BIS has low activity. And there is no significant difference in these variables among addicts of the nuclear and joint family system.

Factors associated with intimate partner violence and barriers to reporting it, among female who use drugs in Malaysia

Females who use drugs (FWUDs) are vulnerable to intimate partner violence (IPV). This study was initiated to identify factors that evoke IPV, and identify barriers that preclude FWUDs from seeking help. Two-hundred FWUDs were recruited from a mandatory drug rehabilitation centre (CCRC) for this cross-sectional study. The data were collected through face-to-face interviews using a semi-structured questionnaire. The majority in our sample was Malay (86%, n = 171/200), and their mean age was 32.3 years (SD = 8.61). The lifetime IPV prevalence rate in the sample was 53% (n = 105/200), far exceeding the reported rate for non-drug dependent married women in Malaysia. The prevalence rates for physical, psychological, and sexual violence in the sample were 41%, 29%, and 24%, respectively. Lifetime IPV incidence among FWUDs was associated with living away from parents/family, having a regular intimate male partner who uses drugs, and having been a victim of underage rape. The main reasons for not reporting IPV were the lack of knowledge of one’s rights, not knowing how to access legal counsel, and the fear of retaliation from one’s partner. Our findings may be useful in designing interventions to minimize the occurrence of IPV and promote the seeking of assistance and treatment by FWUDs.

Suicide attempts among people who use drugs: a comparative gender-based analysis using the ANRS-Coquelicot survey in France

Objective There exists no national French study on suicide attempts among people who use drugs (PWUD). Our objectives are to analyze lifetime suicide attempts in that population and to compare associated risks based on gender. Method The ANRS-Coquelicot study (2011–2013) conducted 1718 interviews with people over 18 who have injected or snorted a drug or medication (whether or not it was prescribed) at least once in their lifetime, who speak French or Russian, and who attend harm reduction facilities and drug treatment centers in France. Through stratified multivariate analyses based on gender using a Poisson regression, we determined risk factors. Results Among PWUD, 39.9% had attempted suicide (n = 655), with a distribution of 58.8% (n = 188) for women and 35.0% (n = 467) for men. Experiences of overdose, depression, receiving psychiatric care, setting during adolescence, daily alcohol use, and number of substances consumed during the last month were risk factors for men. Among women, experiences of overdose, self-reported HIV positive, and daily use of benzodiazepines and cocaine were risk factors. Conclusion we should develop psychiatric care into health services catering specifically to PWUD. As risk factors differed based on gender, we should strive to create distinct preventive health measures adapted to different populations. Keywords: people who use drugs; lifetime suicide attempts; gender; mental health, quantitative survey

Diagnosis and Treatment of Alcohol-Associated Liver Disease: A Patient-Friendly Summary of the 2019 AASLD Guidelines.

Diagnosis and Treatment of Alcohol-Associated Liver Disease: A Patient-Friendly Summary of the 2019 AASLD Guidelines.

Use of the Instagram Hashtags #winemom and #momjuice Among Mothers During the COVID-19 Pandemic: Descriptive, Cross-sectional Study.

BackgroundThe tendency of parents to consume alcohol during the COVID-19 pandemic is likely to be moderated by pandemic-related stress combined with the ongoing demands of childcare and home-based education, which are reported to be more burdensome for females than males.ObjectiveThe purpose of this study was to describe alcohol-related content posted by mothers on Instagram during the COVID-19 pandemic.MethodsUsing two popular hashtags, #momjuice and #winemom, 50 Instagram posts on each were collected from the “top posts” tab. The coding categories were created inductively and were as follows: displays alcohol (drinking/holding alcohol or alcohol itself), person is making alcoholic beverages, type of alcohol featured or discussed, highlights anxiety and/or depression/mental state, highlights struggling (in general), highlights parenting challenges, encourages alcohol consumption, discourages alcohol consumption, features a person wearing clothing or shows products promoting alcohol, promotes alcohol rehabilitation, highlights caffeine to alcohol daily transition throughout the day, and highlights other drugs besides caffeine and alcohol.ResultsOverall, the 100 selected posts had a total of 5108 comments and 94,671 likes. The respective averages were 51.08 (SD 77.94) and 946.71 (SD 1731.72). A majority (>50%) of the posts reviewed encouraged alcohol consumption (n=66) and/or displayed alcohol (n=56). Of the 66 that encouraged and/or displayed alcohol, the common type of alcohol discussed or featured was wine (n=55). Only 6 posts discouraged alcohol use and only 4 provided the audience with a disclaimer. None of the videos promoted or endorsed alcohol rehabilitation in any way. Only 37 posts highlighted struggle. However, these posts garnered more than a majority of the likes (n=50,034, 52.3%). Posts that showed struggle received an average of 1359.57 (SD 2108.02) likes. Those that did not show struggle had an average of 704.24 (SD 1447.46) likes. An independent one-tailed t test demonstrated this difference to be statistically significant (P=.0499).ConclusionsThe findings of this investigation suggest that though these hashtags ostensibly exist to valorize excess alcohol consumption, they may be serving as a support system for mothers who are experiencing increased burdens and role stress during the pandemic. Given the strains placed on mothers overall and especially during the COVID-19 pandemic, efforts must be taken to increase access to and affordability of telehealth-based mental health care.

Gender differences in patient outcomes following drug abuse treatment in Afghanistan: Results from a new evaluation

Drug use rates among adults in Afghanistan are over twice as high as the global average which complicates an already challenging situation in the country. Although progress has been made toward improving availability of treatment and the rights and status of women, cultural norms and historical precedents have delayed advances, including in drug treatment. Female Afghan patients access treatment via home-based systems without the option of group in-patient treatment centers available to male patients. Using data from a new evaluation of Afghanistan's drug treatment system we report on updated differences in treatment outcomes for male and female patients in drug treatment centers in Afghanistan. A probability sample was used, selecting 32 centers to evaluate, and including baseline and follow-up data from 865 individuals who were officially admitted to drug treatment. Data collection included: (a) baseline and follow-up interviews; (b) baseline and follow-up urine drug tests; and (c) intake and treatment participation records. Random intercept generalized linear models were used to analyze change by regressing outcomes on a contrast representing time and a correction for selectivity biases. Male and female patients had similar, overall pre-treatment characteristics including low levels of education, though education levels were lower for women. At follow-up, there were significant differences between male and female patients' self-reports of substance use and related consequences, including criminal behavior. These findings represent mixed results; while some progress has been made in offsetting gender disparities in Afghanistan, remaining significant gender differences in posttreatment results suggest more positive outcomes for female than for male patients.