Alcohol Rehabilitation Research Articles

Assessment of treatment retention rates and predictors of retention on opioid agonist treatment among adolescents.

Opioid agonist treatment (OAT) is an effective treatment for opioid dependence syndrome in adults. However, studies on effectiveness of OAT in adolescents are limited; existing studies show varying retention rates. The present study aimed to assess OAT retention rates in adolescent patients with opioid dependence syndrome registered in a community drug treatment clinic in Delhi, India, and to analyse factors associated with retention at 1 year. Retrospective cohort study. All adolescents (n = 130) aged 10-19 years, started on OAT from January 2020 to July 2022 were included. Baseline and follow-up data was extracted from online record system maintained at the clinic. OAT retention rates at different timepoints were assessed. Multivariable logistic regression was used to discern factors associated with one-year retention. The participants' mean age was 16.9 (SD 1.4) years. Mean age of starting opioids was 14.9 (SD 2.2) years; 29.5% (n = 38) injected opioids. The 6-, 12-, 18- and 24-month retention rate on OAT was 64.4%, 45.6%, 38.7% and 29% respectively. The retention rates with buprenorphine and methadone were comparable. Multivariate logistic regression showed retention for less than 12 months to be significantly associated with younger age of starting heroin, involvement in illegal activities, absenteeism from school and substance use in family. The 12-month retention rates on OAT in adolescents is comparable to retention rates in adults. Various factors associated with early age of onset of opioid use are also associated with lower retention rates on OAT.

Developing Characters of Rehabilitation Students through Islamic Religious Education

This research aims to address the issue of drug abuse by exploring the influence of adolescent peers. The study suggests that exposure to drug use among peers can lead to addiction in children. It is important to note that the language used in this study is objective and avoids any biased or emotional language. Effective solutions are proposed through spiritual rehabilitation or Islamic Religious Education. The research recognizes the significance of addressing psychiatric disorders arising from drug consumption and aims to contribute to character development through the incorporation of Islamic education within rehabilitation centers. This research uses a qualitative approach with descriptive methods, informant determination techniques using SnowBall sampling, data collection techniques through observation, interviews and documentation. Data analysis techniques through data reduction, data presentation and verification. The character-building process at the Drug Rehabilitation Center is flexible and involves tailored materials that are aligned with individual client needs. The study utilises lecture methods and question-and-answer sessions to facilitate comprehension. Additionally, project-based learning models are adapted to suit the taught material. Evaluation takes place after the explanation, requiring clients to promptly articulate or reapply the knowledge gained. The importance of ongoing assessment by coaches and administrators is underscored by the implications. This will ensure that clients not only grasp the material but also internalize and exhibit the desired moral values. It is recommended that teaching strategies be refined to align with the goal of instilling positive character traits in clients.

Purging to Cleanse: A Qualitative Study of Ayahuasca Healing at a Drug Treatment Center in Peru.

Ayahuasca, an entheogen from the Amazon rainforest, has garnered growing interest for treating substance dependence. To date, there is little research concerning the act of ayahuasca-related purging (mainly vomiting), which is considered to be central to healing during ayahuasca rituals. This study explored practitioner perspectives on purging during ayahuasca rituals at the Takiwasi Center in Peru. We conducted in-depth interviews with curanderos (healers), plant preparers, and psychotherapists (N = 11) at the Takiwasi Center between August and October 2021. Interviews were conducted and transcribed in Spanish. Interviews were analyzed using a thematic analysis approach. Participants described purging as a fluid concept that went beyond the act of vomiting. Participant narratives around purging were organized into three central themes or accounts: spiritual-oriented, which highlighted the relationship between purging and spiritual development; Amazonian-oriented, which emphasized purging as a cathartic expulsion of embodied cargas (loads) that are perceived to lead to sickness; and clinical-oriented, which stressed that purging generates a range of empirically observable therapeutic benefits. All of these explanatory models emphasized the pivotal interconnection between purging and healing during ayahuasca-assisted treatment for substance dependence at Takiwasi. This study highlights practitioner perspectives on purging at the Takiwasi Center, who offer three main explanatory models for this aspect of healing during ayahuasca-assisted therapy for substance dependence. This research contributes to the limited literature on the role of purging in ayahuasca-related healing, which may inform further investigation into differential understandings of the role of purging for therapeutic benefits.

Risk Factors and Preventive Measures for Cardiovascular Diseases.

Background: Cardiovascular diseases are the most frequent cause of death worldwide. The aim of this study was to identify and demonstrate correlations between mortality data and etiological factors in EU countries. The relationships presented could thus provide a better understanding of etiological factors and possible points for interventions to prevent cardiovascular diseases. The focus was on the following diseases: hypertensive heart disease, atrial flutter/atrial fibrillation, myocardial infarction, and ischemic heart disease, as well as heart failure. Methods: The data in this study come from WHO databases. Connections between the mortality rates and the possible influencing factors were analyzed. The significant factors from the correlation analysis were simultaneously evaluated using a stepwise multiple regression analysis. Results: Analysis of hypertensive heart disease in women reveals the following factors to be significant: drug expenses, health expenses on gross domestic product, and smoking. For men, population density, first admission to a drug treatment center, and drug expenses per person emerged as important factors. Admission to drug treatment centers and length of hospitalization were significant factors for atrial fibrillation and flutter. Fine dust pollution was the most important factor in heart failure. The most important influencing factor for myocardial infarction and ischemic heart disease is nitrogen dioxide concentration. For women, the second highest value is health expenses, followed by the number of outpatient contacts per year. For men, outpatient contacts are in second place. Conclusions: Prevention measures must be taken by the government. The extent to which population density has an influence on cardiovascular diseases should be examined in more detail. In order to reduce the number of initial admissions to drug treatment centers, behavioral prevention related to drug use could be improved.

Drugs and Juvenile Delinquency based on Educational Research: Case Study at the Drug Rehabilitation Center of YPAP Lhokseumawe City

Drugs and Juvenile Delinquency based on Educational Research: Case Study at the Drug Rehabilitation Center of YPAP Lhokseumawe City

Improving Health System Engagement in Patients With Substance Use Disorders: Audit of Care Plans in the National Drug Treatment Centre

Improving Health System Engagement in Patients With Substance Use Disorders: Audit of Care Plans in the National Drug Treatment Centre

The Application of Religion as a Method of Drug Rehabilitation for Victims of Drug Abuse at Baitusyifa Rehabilitation Center

Drugs are a complex problem that needs to be resolved, one of the efforts that can be made is to undergo rehabilitation for drug abusers. Drug rehabilitation centers have different methods to achieve their clients' goals in the healing period. Baitusyifa Rehabilitation Center is one of the rehabilitation centers located in Deli Serdang City, North Sumatra which applies religion as a method of drug rehabilitation. The purpose of this study is to describe the religious methods or efforts applied at Baitusyifa Rehabilitation Center. This research uses a qualitative approach. Data were obtained through interviews, observations, and documentation at the research location. Furthermore, the data was analyzed using descriptive qualitative to answer the effectiveness of the application of religion in handling drug abuse clients. The results showed that the application of religion was very influential on clients at Baitusyifa Rehabilitation Center. Clients feel a change for the better and make habits that are carried out in rehabilitation to life after completing the rehabilitation period. Baitusyifa Rehabilitation Center takes an approach by creating self-awareness through study/recitation, changing habits with worship activities such as prayer and murojaah, increasing motivation through reward and punishment models, implementing anonymous letters so that clients evaluate themselves, cupping healing therapy recommended in Islam, and morning exercises to keep clients fit.

“A little bit of hope goes a long way”: Exploring the role of peer workers in alcohol and other drug rehabilitation services

IntroductionPeer workers operating within health care settings can offer unique perspectives based on their own lived experience. Within alcohol and other drug (AOD) rehabilitation services, the potential value of peer work is becoming increasingly recognised. This qualitative study aimed to evaluate a newly implemented peer worker program located across three rehabilitation services in Tasmania, Australia. MethodsOnline interviews were conducted with eight clients, seven peer workers, and five non-peer worker employees with varied experience with peer worker programs. All interviews were audio-recorded and transcribed verbatim. ResultsGuided by an overarching exploratory-descriptive methodological framework, thematic analysis generated three overarching themes: 1) Enhancing and supporting client experiences (what peer workers did in their role to improve client experiences, 2) Changing experiences with AOD rehabilitation (the unique benefits and changes that peer work brings to AOD rehabilitation services) and 3) Finding organizational value (how defining peer work and the feasibility of the peer worker role was challenged by different organizational factors). Overall, peer work was viewed as a positive addition to all rehabilitation services that was able to enhance client experiences through various mechanisms, such as by sharing their own stories, assisting with understanding, and creating safety. Peer work was also able to create change in AOD services, by instilling hope and reducing stigma. However, ongoing challenges with defining the peer worker role in a way that offers organizational recognition and financial security remain. ConclusionPeer workers offer a unique and valuable perspective when working within rehabilitation services. Through their own lived experience peer workers were able to support clients and assist them in their recovery. These findings highlight the potential benefit of peer work programs within AOD rehabilitation services.

The Association Between Rumination and Craving in Chinese Methamphetamine-Dependent Patients: The Masking Effect of Depression

Background Craving is a core feature of addiction. Rumination and depression play a crucial role in the process of methamphetamine addiction. The aim of this study was to examine the relationship between rumination, depression and craving in methamphetamine patients, which has not been explored yet. Methods A total of 778 patients with methamphetamine user disorder (MUD) at the Xinhua Drug Rehabilitation Center, located in Mianyang City, Sichuan Province, China. We used a set of self-administered questionnaires that included socio-demographic, detailed drug use history, rumination, depression and craving information. The Rumination Response Scale (RRS) was used to measure rumination, the Beck Depression Inventory (BDI) to measure depression and the Visual Analogue Scale (VAS) to measure craving. Results There was a significant positive correlation between rumination and craving, or depression, and between depression and craving. Furthermore, depression mediated between rumination and craving, with a mediation effect of 160%. Conclusions Our findings suggest that there is a close interrelationship between rumination, craving and depression in MUD patients, and that depression may play a mediating role between rumination and craving.

Hepatitis C virus subtype diversity and transmission clusters characteristics among drug users in Zhuhai, South China

BackgroundHepatitis C virus (HCV) infection poses a major public health challenge globally, especially among injecting drug users. China has the world’s largest burden of HCV infections. However, little is known about the characteristics of transmission networks among drug user populations. This study aims to investigate the molecular epidemiology and transmission characteristics of HCV infections among drug users in Zhuhai, a bustling port city connecting Mainland China and its Special Administrative Regions.MethodsParticipants enrolled in this study were drug users incarcerated at Zhuhai’s drug rehabilitation center in 2015. Their sociodemographic and behavioral information, including gender, promiscuity, drug use method, and so forth, was collected using a standardized questionnaire. Plasmas separated from venous blood were analyzed for HCV infection through ELISA and RT-PCR methods to detect anti-HCV antibodies and HCV RNA. The 5’UTR fragment of the HCV genome was amplified and further sequenced for subtype identifications and phylogenetic analysis. The phylogenetic tree was inferred using the Maximum Likelihood method based on the Tamura-Nei model, and the transmission cluster network was constructed using Cytoscape3.8.0 software with a threshold of 0.015. Binary logistic regression models were employed to assess the factors associated with HCV infection.ResultsThe overall prevalence of HCV infection among drug users was 44.37%, with approximately 19.69% appearing to clear the HCV virus successfully. Binary logistic regression analysis revealed that those aged over 40, engaging in injecting drug use, and being native residents were at heightened risk for HCV infection among drug user cohorts. The predominant HCV subtypes circulating among those drug users were 6a (60.26%), followed by 3b (16.7%), 3a (12.8%), 1b (6.41%) and 1a (3.85%), respectively. Molecular transmission network analysis unveiled the presence of six transmission clusters, with the largest propagation cluster consisting of 41 individuals infected with HCV subtype 6a. Furthermore, distinct transmission clusters involved eight individuals infected with subtype 3b and seven with subtype 3a were also observed.ConclusionThe genetic transmission networks revealed a complex transmission pattern among drug users in Zhuhai, emphasizing the imperative for a targeted and effective intervention strategy to mitigate HCV dissemination. These insights are pivotal for shaping future national policies on HCV screening, treatment, and prevention in port cities.

Plant Medicine, Psychedelics and the Inner-Sciences of Mental Wellness: Implications for Healthy Longevity and Rejuvenation

Plant Medicine, Psychedelics and the Inner-Sciences of Mental Wellness: Implications for Healthy Longevity and Rejuvenation

Needle and syringe sharing among people who have recently injected drugs in Australia: The ETHOS Engage Study.

Understanding needle/syringe sharing is crucial for reducing hepatitis C virus (HCV) infection and reinfection. This study aimed to assess the prevalence and factors associated with needle/syringe sharing among people who inject drugs in Australia, including those previously receiving HCV treatment. The ETHOS Engage study was an observational cohort study which collected self-reported survey data on demographic and drug use information from people who inject drugs attending drug treatment clinics and needle and syringe programs over two waves between May 2018 and June 2021. Logistic regression was used to identify factors associated with needle/syringe sharing. Overall, 1555/2395 people enrolled in ETHOS Engage (65%) injected drugs in the past month. Among these, 432 (28%) reported needle/syringe sharing in the past month and 276 (18%) reported receptive sharing. Factors associated with receptive sharing included younger age (adjusted odds ratio [aOR] 1.72; 95% confidence interval [CI] 1.28-2.30), recent incarceration (aOR 2.04; 95% CI 1.40-2.94), more frequent injecting (≥daily vs. less than weekly; aOR 2.59; 95% CI 1.75-3.84) and unstable housing (aOR 1.78; 95% CI 1.26-2.52). Among 560 participants with prior HCV treatment, 87 (16%) reported receptive sharing with younger age (aOR 2.42; 95% CI 1.45-4.05) and daily or greater injection frequency (aOR 2.51; 95% CI 1.31-4.83) associated with receptive sharing. Needle/syringe sharing was common among this population accessing harm reduction services. This study identifies high-risk populations with needle/syringe sharing. Research is needed to optimise HCV treatment to ensure people with ongoing risk behaviours receive adequate harm reduction following treatment to prevent reinfection.

Factors associated with hepatitis C testing, treatment, and current hepatitis C infection among men and women who inject drugs: The ETHOS engage study

BackgroundEvaluating gender-specific trends in hepatitis C virus (HCV) treatment uptake among men and women who inject drugs is crucial for ensuring equitable progress towards HCV elimination. This study aimed to quantify differences in testing, treatment, and current HCV infection between men and women who inject drugs. MethodETHOS Engage is an observational cohort study of people who inject drugs attending drug treatment clinics and needle and syringe programs in Australia recruited from May 2018-September 2019 (wave 1) and November 2019-April 2021 (wave 2). Participants completed a questionnaire including self-reported HCV testing and treatment history and underwent point-of-care HCV RNA testing (Xpert® HCV Viral Load Fingerstick). Logistic regression was used to compare the factors associated with self-reported HCV testing and treatment and current HCV infection for men and women who inject drugs. ResultsAmong 2,395 participants enrolled in ETHOS Engage, 66% (n = 1,591) were men, 33% (n = 786) women, and <1% (n = 18) did not identify as a man or woman. HCV testing history and current infection were similar among men and women. Among men or women ever eligible for HCV treatment (ever chronic HCV) (n = 1,242), women were less likely to report a history of HCV treatment compared to men (227/352, 64% vs. 631/890, 71%; p = 0.03). Among women, those aged <45 were less likely to report HCV testing (aOR: 0.57, 95%CI: 0.36, 0.90), treatment (aOR: 0.47, 95%CI: 0.29, 0.77), and more likely to have HCV infection (aOR: 1.48, 95%CI: 1.00, 2.20) ConclusionAmong women, those of childbearing age (<45) were less likely to report testing and treatment and were more likely to have current HCV infection. Women <45 years old should be a priority population for HCV care. Services that interface with these women should be optimised to enhance HCV testing and treatment.

Understanding physical exercise among individuals with substance use disorders using an integrated theoretical perspective of the health action process approach and theory of planned behavior.

Physical exercise is considered a useful non-pharmacological adjunctive treatment for promoting recovery from substance use disorders (SUD). However, adherence to physical exercise treatments is low, and little is known about what factors are associated with the initiation and maintenance of physical exercise behaviors. The aim of this study was to explore the psychosocial factors underlying these behaviors in individuals with SUD using an integrated theoretical model based on the health action process approach (HAPA) and the theory of planned behavior (TPB). A total of 1,197 individuals with SUDs (aged 37.20 ± 8.62 years) were recruited from 10 compulsory isolation drug rehabilitation centers in Zhejiang Province via convenience sampling according to a set of inclusion criteria. Self-reported data were collected to assess task self-efficacy (TSE), maintenance self-efficacy (MSE), recovery self-efficacy (RSE), outcome expectations (OE), action planning (AP), coping planning (CP), social support (SS), subjective norms (SN), attitude behavior (AB), behavioral intention (BI), perceived behavioral control (PBC), risk perception (RP), exercise stage, and exercise behavior in this integrated model. ANOVA and structural equation modeling (SEM) were used to evaluate this model. One-way ANOVA revealed that the majority of the moderating variables were significantly different in the exercise phase. Further SEM showed that the model fit the data and revealed several important relationships. TSE, RP, SS, AB, and SN were indirectly associated with physical exercise behavior in individuals with SUD through the BI in the SUD initiation stage. In addition, PBC was directly related to physical exercise behavior in individuals with SUD. In the maintenance stage, MSE, AP, CP and exercise behavior were significantly related. Moreover, AP and CP were mediators of BI and MSE. This study is the first attempt to integrate patterns of physical exercise behavior in individuals with SUD. The HAPA-TPB integration model provides a useful framework for identifying determinants of physical exercise behavioral intentions and behaviors in individuals with SUD and for explaining and predicting the initiation and maintenance of physical exercise behaviors in these individuals. Moreover, the model provides scientific guidance for the enhancement of physical exercise adherence in individuals with SUD.

A casuistic case of ignoring an expert opinion by the court conclusions about the absence of drug use disorder diagnosis

The article cites the case of Dmitry A., who was detained by the police on the street on suspicion of using cannabinoids and sent for a medical examination for intoxication, which he refused. The judge found Dmitry guilty and ordered him to be examined at a drug treatment clinic. Based on the results of an inpatient examination, despite the absence of mental disorders, somatic consequences of episodic cannabinoid use and the absence of pathological changes according to laboratory tests, he was diagnosed with "harmful use of cannabinoids". Dmitry was placed under preventive observation. During the court-ordered forensic psychiatric examination at the Serbsky Center (Moscow), the drug diagnosis was not confirmed. However, the expert opinion was ignored at the court hearing. The author analyzes the frequency and validity of the diagnosis of "harmful use of psychoactive substances" and concludes that the case of Dmitry A. may become a precedent.

Effect of interactive exergame training on physical fitness and executive function among men with substance use disorder in rehabilitation center

BackgroundSubstance use disorder (SUD) is a chronic disease characterized by drug seeking and use that is compulsive or difficult to control despite harmful consequences. Researchers have found treatments to help people recover from SUD and lead productive lives. Exercise therapies have been approved to be effective on executive function, physical fitness, and cravings in men with SUD. Exergaming, which involves physical activity through interactive video games, has attracted considerable interest due to its ability to provide a fun and engaging aerobic workout while stimulating cognitive functions. However, despite its popularity in recreational settings and its potential to promote physical fitness and cognitive well-being, the use of exergaming as a therapeutic modality for SUD remains relatively underexplored. This study aimed to investigate the effects of exergame on physical fitness and executive function in men with SUD. MethodsThe 44 compulsory men in a rehabilitation center (mean age = 39.7 ± 9.2 years) were divided to either an exergame training (ET) or a control group. The ET group underwent a moderate-intensity (65%–75% of maximum heart rate) exergame training intervention (Fitness Boxing 2 & Super Mario Party) for 50 min thrice weekly during a 12-week period. The control group maintained their original lifestyle in the rehabilitation center. Before and after the intervention, participants were evaluated for drug craving, executive function (working memory and attention bias), and physical fitness (blood biochemical, choice reaction time, and BMI et al.). ResultsThe exergame training group showed a significantly positive effect in drug craving and attention bias score, relative to the control group (drug craving: F = 4.374, p = 0.043, d = − 0.51; attention bias score: F = 4.832, p = 0.034, d = − 0.357). No significant effect has been found in other variables (p > 0.05). ConclusionThe 12-week interactive exergame training can effectively reduce drug craving and improve executive function in men with SUD in drug rehabilitation centers. This training may offer a new and alternative exercise treatment against SUD. Exercise treatment approaches tailored to men with SUD may lead to continued recovery in health and lower the risk of returning to substance use.

Trauma-Informed Evangelism: Cultivating Communities of Wounded Healers

Trauma-Informed Evangelism: Cultivating Communities of Wounded Healers

Trauma-Informed Evangelism: Cultivating Communities of Wounded Healers

Trauma-Informed Evangelism: Cultivating Communities of Wounded Healers

Exploring Socioeconomic Disparities in Mandibular Trauma: A Retrospective Cohort Analysis of Patient Profiles and Treatment Outcomes

Study Design Retrospective Chart Review. Objective Mandible fracture is a life-altering event, and its complications can have devastating consequences for patients. Patients are therefore well-served if providers can identify their risk factors and engage strategies to reduce complication risk. The present study examines mandible trauma in an urban tertiary hospital serving an economically disadvantaged population. Methods This review identified all patients undergoing operative repair of traumatic mandible fractures from January 2015 to December 2020. Patient risk factors, operative technique, and surgical complications (including infection, hardware failure, malunion, and mandible nonunion) were analyzed. Results Two hundred and seventy-two patients were identified with mandible fractures; 78.3% of these injuries were related to interpersonal violence; 83.4% of patients were male, and 55.5% were African American. Based on multivariable logistic regression models, increased rates of postoperative complications were observed in patients with increasing Area Deprivation Index (Odds Ratio 1.02), mandible body fracture (OR 3.11), tobacco use disorder (OR 3.75), history of hepatitis C infection (OR 7.35), and discharge to drug and alcohol rehabilitation (OR 23.42). Conclusions For providers treating patients with mandible fractures, the effects of comorbid substance use—including tobacco use—and inadequate discharge disposition (a reflection of financial means and insurance status) should be identified early, and steps to mitigate their consequences should be taken. Providers must recognize that patients with these comorbidities require more patience, support, and attention than patients without these risk factors. Increased engagement with multidisciplinary services such as psychiatry, addiction medicine, primary care, and social work may improve outcomes for these vulnerable patients.

Peer Facilitator Training for Diabetes Prevention in a Nigerian Drug Treatment Center.

Individuals with substance use disorders (SUDs) are at an increased risk of developing comorbid medical conditions, including Type 2 diabetes. Although the diabetes prevention program (DPP) is efficacious and cost-effective, there is no published evidence to support its implementation in Nigeria or within SUD treatment settings. In this first known DPP within an SUD treatment program, we implemented a multiphased, nurse-led DPP at a small outpatient drug treatment center in Nigeria. The aim of this article was to describe only the processes utilized for the initial peer facilitator (PF) training (Phase 1). In Phase 1, a diabetes prevention master trainer delivered a virtual DPP training to the facility's lead nurse, who return-demonstrated the DPP workshop skills and competencies over four 4-hour sessions. The lead nurse then independently delivered four 8-hour training sessions to a small number of client volunteers (n = 4) who subsequently delivered the DPP lifestyle interventions to their peers in the outpatient treatment program. The client volunteers attended all PF workshop sessions and were observed to be proficient in all aspects of implementation. They indicated that the training objectives were easily achieved and expressed enthusiasm for delivering DPP content to their peers. The need to better contextualize the DPP curriculum specific to Nigerian food preferences was identified. The Phase 1 training process appears to be an appropriate and effective approach for preparing PFs to deliver health programs, like the DPP, in environments with limited resources for populations facing numerous challenges.