Problematic Drug Use Research Articles

Assessment and treatment of substance use in adults with ADHD: a psychological approach.

Over half of young people and adults diagnosed with Attention Deficit Hyperactivity Disorder [ADHD] also have substance use disorder [SUD]. Their use of substances may arise from an attempt to self-medicate and/or to cope with their difficulties. This manuscript reviews key research in the literature and identifies that traditional SUD psychological interventions are an effective treatment for those presenting with a dual diagnosis of ADHD and SUD. However, typically, this is only available to those presenting to specialist SUD services for treatment of harmful use and/or dependency. This misses an opportunity to intervene much earlier, before drug use escalates to these levels. The manuscript aims to provide practical guidance for healthcare practitioners, by detailing a psychological framework for earlier assessment and intervention of problematic drug use in young people and adults with ADHD. Specific techniques are outlined drawing on psychoeducation, motivational interviewing and cognitive behavioural therapy in a phased approach to address factors that motivate initial use of substances and those that maintain use.

Journal Digest: Tic Disorders; Infrared Therapy; SGA; Weight Stigma; TBT

Journal Digest: Tic Disorders; Infrared Therapy; SGA; Weight Stigma; TBT

Psychological Exhaustion and Problematic Use of Drugs in The Nursing Team in A Hospital Environment

Objective: The objective of this study was to verify the relationship between problematic drug use and the occurrence of Burnout Syndrome among nursing professionals in a hospital environment. Methods: This is a study with a quantitative and exploratory approach. 416 professionals participated in the research. The data collection instrument was Sociodemographic and professional information; Alcohol, Smoking and Substance Involvement Screening Test; Alcohol Use DisordersIdentification Test - Consumption; Maslach Burnout Inventory. The level of significance (p value) was set at 0.05. Results: The consumption of tobacco and alcohol among workers was evidenced, being common to the practice of using alcohol in binge. There was a positive correlation between the use of alcohol and the occurrence of depersonalization and between the use of sedatives and depersonalization. Conclusion: It is essential that there are actions to minimize the occurrence of mental disorders in nursing workers.

Harm Reduction and Moral Desert in the Context of Drug Policy

The target of my discussion is intuitions lay people have about justice in the context of drug policy—intuitions that take on a more or less moral-desert-based shape. I argue that even if we think desert is the right measure of how we ought to treat people, we ought still be in favour of Harm Reduction measures for people who use drugs. Harm Reduction measures are controversial with members of the public, and much of the opposition seems to come from something like an appeal to a desert conception of justice—the notion that a just state of affairs is one in which everybody gets what they deserve, no more, no less. A recent study, for example, found that ‘moral outrage’ predicts a preference for prevalence reduction (criminal sanction, etc.) over Harm Reduction. The thinking seems to be that, since drug use is wrong, letting people who use drugs suffer and/or die as a consequence of their use is just. Aiding their health and safety, while perhaps compassionate, is unjust. I argue that there is a bad desert fit between using drugs and suffering avoidable harm even if using drugs is morally wrong. Many of the possible harms of drug use are socially/policy driven, and much problematic drug use is context dependent, not cleanly attributable to the decisions of the person who uses drugs. This means that even if drug use is wrong, people who use drugs deserve Harm Reduction policies, at minimum.

Problematising ‘Recovery’ in Drug Policy within Great Britain: A Comparative Policy Analysis Between England, Wales and Scotland

Abstract Drug strategies in Great Britain emphasize the notion of recovery, with the concept being central in England, Wales and Scotland. There are however tensions, with recovery being defined differently across jurisdictions. In this study we address this dilemma by critically interrogating how the term recovery is represented, how these presentations are shaped and what effects are subsequently had. We applied an adapted version of Bacchi's What's the Problem Represented to Be? (WPR) policy analysis approach to the 2017 UK Drug Strategy, the 2008–2018 Welsh Drug Strategy and the 2008 Scottish Drug Strategy notions of service user responsibility; (b) recovery as ‘a problem of product quality’, shaped by the implicit notion of service provider responsibility and the disease model of addiction; (c) recovery as ‘a problem of service collaboration and teamwork’, underpinned by the bio-psycho-social model of addiction. We conclude that the problematisations found in GB’s current drug policies have the ability to shape the drug policy-making process which may limit mainstream knowledge of recovery, and thereby unintentionally contribute to a narrow understanding of how to effectively support the service user community in their recovery from problematic drug use.

International legal standards for ensuring the right of minors deprived of liberty to health

The article analyzes the general and special international legal acts in the field of regulation of the right to the highest standard of living (right to health) of minors deprived of liberty, in particular: Declaration of the Rights of the Child, 1924, United Nations Declaration of the Rights of the Child, 1959, International Covenant on Economic, Social and Cultural Rights, 1966, Convention on the Rights of the Child, 1989, United Nations Minimum Standard Rules on the Administration of Juvenile Justice (Beijing Rules), 1985, United Nations Guidelines for the Prevention of Juvenile Delinquency (The Riyadh Guidelines), 1990, UN General Assembly special resolutions on the protection of the rights of the child, including children deprived of their liberty, etc. The emphasis is placed on key problematic aspects of the protection of the right to health of minors deprived of their liberty, in particular: the use of torture and other cruel, inhuman or degrading treatment or punishment; harm to the mental and physical health of children in all situations of imprisonment; the spread of sexually transmitted infections. The article focuses on the special needs of children with disabilities. Given the existing problems of drug use, which contribute to the spread of infectious diseases among the categories of prisoners, cause significant harm to the health of minors, attention is focused on the characteristics of special rules in this area. Given the fact that the emergence and spread of the COVID-19 pandemic has become a modern threat and a challenge to health of population in general, including persons deprived of their liberty, attention is paid to international acts, which set out recommendations to protect this category of persons during the pandemic. Relevant conclusions and recommendations have been made to improve the status of minors deprived of their liberty.

Evidence That Cannabis Exposure, Abuse, and Dependence Are Related to Glutamate Metabolism and Glial Function in the Anterior Cingulate Cortex: A 1H-Magnetic Resonance Spectroscopy Study.

There is evidence that long-term cannabis use is associated with alterations to glutamate neurotransmission and glial function. In this study, 26 long-term cannabis users (males=65.4%) and 47 non-cannabis using healthy controls (males=44.6%) underwent proton magnetic resonance spectroscopy (1H-MRS) of the anterior cingulate cortex (ACC) in order to characterize neurometabolite alterations in cannabis users and to examine associations between neurometabolites, cannabis exposure, and cannabis use behaviors. Myo-inositol, a marker of glial function, and glutamate metabolites did not differ between healthy controls and cannabis users or cannabis users who met criteria for DSM5 cannabis use disorder (n=17). Lower myo-inositol, a putative marker of glial function, was related to greater problematic drug use (F1,22 = 11.95, p=.002; Cohen’s f=0.59, large effect; Drug Abuse Screening Test) and severity of cannabis dependence (F1,22 = 6.61, p=.17; Cohen’s f=0.44, large effect). Further, past-year cannabis exposure exerted different effects on glutamate and glutamate+glutamine in males and females (glutamate: F1,21 = 6.31, p=.02; glutamate+glutamine: F1,21 = 7.20, p=.014), such that greater past-year cannabis exposure was related to higher concentrations of glutamate metabolites in male cannabis users (glutamate: F1,14 = 25.94, p=.00016; Cohen’s f=1.32, large effect; glutamate+glutamine: F1,14 = 23.24, p=.00027, Cohen’s f=1.24, large effect) but not in female cannabis users (glutamate: F1,6 = 1.37, p=0.78; glutamate+glutamine: F1,6 = 0.001, p=.97). The present results extend existing evidence of altered glial function and glutamate metabolism with cannabis use by providing evidence linking problematic drug use behaviors with glial function as measured with myo-inositol and recent chronic cannabis exposure to alterations in glutamate metabolism. This provides novel directions for the interrogation of the impact of cannabis use on brain neurochemistry.

Social Media Text Mining Framework for Drug Abuse: Development and Validation Study With an Opioid Crisis Case Analysis.

BackgroundSocial media are considered promising and viable sources of data for gaining insights into various disease conditions and patients’ attitudes, behaviors, and medications. They can be used to recognize communication and behavioral themes of problematic use of prescription drugs. However, mining and analyzing social media data have challenges and limitations related to topic deduction and data quality. As a result, we need a structured approach to analyze social media content related to drug abuse in a manner that can mitigate the challenges and limitations surrounding the use of such data.ObjectiveThis study aimed to develop and evaluate a framework for mining and analyzing social media content related to drug abuse. The framework is designed to mitigate challenges and limitations related to topic deduction and data quality in social media data analytics for drug abuse.MethodsThe proposed framework started with defining different terms related to the keywords, categories, and characteristics of the topic of interest. We then used the Crimson Hexagon platform to collect data based on a search query informed by a drug abuse ontology developed using the identified terms. We subsequently preprocessed the data and examined the quality using an evaluation matrix. Finally, a suitable data analysis approach could be used to analyze the collected data.ResultsThe framework was evaluated using the opioid epidemic as a drug abuse case analysis. We demonstrated the applicability of the proposed framework to identify public concerns toward the opioid epidemic and the most discussed topics on social media related to opioids. The results from the case analysis showed that the framework could improve the discovery and identification of topics in social media domains characterized by a plethora of highly diverse terms and lack of a commonly available dictionary or language by the community, such as in the case of opioid and drug abuse.ConclusionsThe proposed framework addressed the challenges related to topic detection and data quality. We demonstrated the applicability of the proposed framework to identify the common concerns toward the opioid epidemic and the most discussed topics on social media related to opioids.

‘I could have went down a different path’: Talking to people who used drugs problematically and service providers about Irish drug policy alternatives

BackgroundPeople who use drugs problematically are consistently left out of consultations and deliberation on drug policy. This article explores how people who formerly used drugs problematically and service providers view Ireland's current drug policy and if alternative policies could be successful in an Irish context. MethodsSemi-structured interviews were conducted with eight people who used drugs problematically and six practitioners working with people who use drugs in Cork city, Ireland. All people who used drugs problematically had at least one year of abstinence and had been criminalised because of their drug use, all but one had served at least one custodial sentence. Participants were asked their opinions on safe injecting facilities, heroin assisted treatment, decriminalisation of drugs for personal use, depenalisation of cannabis and, the relationships between economic deprivation and problematic drug use. ResultsRespondents stressed that, in Cork city, problematic drug use is closely linked with economic deprivation and social exclusion. There was a near consensus that criminalisation and penalisation do not deter consumption and produce unintended consequences. All participants supported safe injecting facilities and the decriminalisation of drugs for personal use. Participants were less certain about the utility of heroin assisted treatment and depenalisation of cannabis. Many discussions drifted away from alternatives policies towards the need for improved treatment provision. ConclusionSeveral participants were clear that none of the alternative policies discussed are silver bullets. Participates felt that, while they could reduce the harms caused by drugs and drug policies, the government's longer-term objectives should be increased treatment provision and, reduced social exclusion and economic deprivation.

Alcohol and drug problems among Australian homicide offenders.

Most homicide studies focus upon 'acute' situational intoxication as opposed to 'chronic' substance misuse. The aims of the study were to: (1) determine the extent of homicide offenders' alcohol and drug use in the year preceding the homicide; (2) compare the individual characteristics of homicide offenders across levels of problematic substance use; and (3) compare homicide incident characteristics across levels of problematic substance use. Observational study using data collected through face-to-face interviews in custodial and community correctional settings across Australia. Participants were recruited through an opt-in process. The data consist of 302 individuals convicted of murder or manslaughter. We used the Alcohol Use Disorder Identification Test and Drug Abuse Screening Test to determine problematic alcohol or drug use. We also used a range of self-report measures to ascertain offender characteristics [socio-demographics, developmental experiences, criminal history, personality] and incident characteristics (who was killed, and situational intoxication). Of the sample, 38.8% displayed high levels of alcohol problems and 30.8% displayed high levels of drug problems. Those displaying high levels of alcohol and/or drug problems were more likely than those without high levels of alcohol and/or drug problems to report adverse developmental experiences, low education, financial difficulties, extensive criminal histories and high levels of trait anger, impulsivity and risk-seeking. In addition, offenders with problematic substance use were more likely to have killed non-family and to have used substances at the time of the homicide. High proportions of homicide offenders in Australia appear to have problematic substance use in the year preceding the homicide offence, and such use appears to be associated with a range of other challenging factors, including adverse childhoods, criminal involvement, low socio-economic factors and low self-regulation.

Factors influencing social work students’ motivation to work in drug treatment settings: the role of knowledge and attitudes

ABSTRACT Given the continuing problem of drug use in the United States and the high risk of burnout among substance use treatment staff, this study focuses on examining the relationship between social work students’ knowledge and attitudes toward individuals who use drugs and their motivation to work in drug treatment settings. A Multiple linear regression analysis was conducted, using a convenience sample of 229 social work students (age = 21 to 60, female = 82.5%, White = 79.9%, African American = 13.5%, Asian = 2.6%, Hispanic = 3.9%) at a large public university in an eastern state. Results revealed that knowledge and positive attitudes were key factors stimulating social work students’ motivation to work with individuals who use drugs, and knowledge was the most influential factor. Social work students are more likely to want to work with individuals who use drugs if they have positive attitudes toward their clients and increased knowledge of drugs and drug-related problems. Interestingly, there is no significant difference in motivation between those who have negative attitudes and other people. Implications for social work education on substance abuse are discussed.

The Relationship Between Housing Status and Substance Use and Sexual Risk Behaviors Among People Currently Seeking or Receiving Services in Substance Use Disorder Treatment Programs.

Although HIV risk behaviors such as substance use and condomless sex are prevalent among people currently seeking or receiving services at substance use disorder (SUD) treatment programs, associations with housing status in this population have not been well studied. We examined the associations between housing status, substance use and HIV-related sexualriskbehaviors among 1281 participants from 12 US community-based SUD programs. In addition, substance use was examined as a potential mediator of the relationship between housing status and sexual risk behaviors. We conducted Chi-square, univariate and multivariate logistic regression models on data from the National Drug Abuse Treatment Clinical Trials Network HIV Rapid Testing and Counseling study. Path analysis was used to test the mediation and indirect effects. Unstable housing was significantly associated with having multiple concurrent condomless sex partners, condomless sex with non-primary partners, and partners of unknown HIV serostatus. Homelessness was significantly associated with condomless vaginal sex and condomless sex with any substance use. The path between unstable housing and sexual risk behaviors was mediated by problematic drug use, particularly by cocaine, opioids, and marijuana use. Because housing status impacts HIV risk behaviors for individuals in SUD treatment programs, both housing status and substance use behaviors should be assessed upon program entry in order to identify and mitigate risk behaviors.

Bichas, ganchos y territorios de la droga en Bogotá: toporrepresentaciones de una forma de esclavitud

La reflexión expuesta en el documento aborda al habitante de calle (hombres y mujeres, niños, niñas y adolescentes, adultos mayores), en una perspectiva multidimensional y escalar, marcando como propósito la caracterización de las relaciones entre consumo de bazuco —bichas— (base sucia de coca, conocido como crack en otras latitudes), espacios de vida, imaginarios y representaciones-toporrepresentaciones en el contexto de Bogotá-Colombia. Esto como una propuesta analítica y metodológica para su estudio, con foco en la configuración de una forma de esclavitud vinculada con la adicción y la dependencia a psicoactivos.Desde un enfoque cualitativo, se recurre tanto a la implementación como al análisis de mapas mentales, en calidad de expresiones e imágenes de las experiencias espaciales y de las simbologías de la vida cotidiana de estos sujetos; estos mapas permiten comprender otros elementos no evidentes ni unificados en los perfiles individuales de sus historias de vida. Con ello, al unificar sus narraciones y grafías, se llega a evidenciar la instrumentalización de la que son objeto por su consumo de drogas, en una red muy estructurada, horizontal y verticalmente, de tráfico y microtráfico de sustancias psicoactivas (spa), que se nutre, entre otras, de las condiciones y saberes de la trashumancia por la ciudad propia del habitante de calle. Así, en una condición dual de consumidores y expendedores, son convertidos en un eslabón estratégico para el funcionamiento de los ganchos (marcas registradas para el bazuco) y los territorios de las drogas que se han configurado en el medio urbano de Bogotá con grandes macroexpendios (el antiguo Bronx, por ejemplo), otros subsidiarios y unos últimos micro a nivel barrial, para tener, de tal forma, un robusto mercado en cada sector, que garantiza una oferta efectiva en cualquier radio de demanda de la capital, como se visualiza en el mapa construido para estos fines.En suma, estos patrones pareciesen no ser aislados, pues, por el contrario, pareciesen estar replicados en otras ciudades, guardando las proporciones y particularidades, lo que impone la necesidad analítica de volver la mirada a la sociología del sujeto y su salto al enfoque colectivo en torno a una población con realidades distantes a los marcos de las políticas públicas y sociales.

Problem opioid use and HIV primary care engagement among hospitalized people who use drugs and/or alcohol

BackgroundThere is growing public health concern around the potential impact of the opioid crisis on efforts to eradicate HIV. This secondary analysis seeks to determine if those who report opioids as their primary problem drug compared to those who report other drugs and/or alcohol differ in engagement in HIV primary care among a sample of hospitalized people with HIV (PWH) who use drugs and/or alcohol, a traditionally marginalized and difficult to engage population key to ending the HIV epidemic.Setting and participantsA total of 801 participants (67% male; 75% Black, non-Hispanic; mean age 44.2) with uncontrolled HIV and reported drug and/or alcohol use were recruited from 11 hospitals around the U.S. in cities with high HIV prevalence from 2012 to 2014 for a multisite clinical trial to improve HIV viral suppression.MethodsA generalized linear model compared those who reported opioids as their primary problem drug to those who reported other problem drugs and/or alcohol on their previous engagement in HIV primary care, controlling for age, sex, race, education, income, any previous drug and/or alcohol treatment, length of time since diagnosis, and study site.ResultsA total of 95 (11.9%) participants reported opioids as their primary problem drug. In adjusted models, those who reported opioids were significantly less likely to have ever engaged in HIV primary care than those who reported no problem drug use (adjusted risk ratio, ARR = 0.84, 95% Confidence Interval, CI 0.73, 0.98), stimulants (ARR = 0.84, 95% CI 0.74, 0.95), and polydrug use but no alcohol (ARR = 0.79, 95% CI 0.68, 0.93). While not statistically significant, the trend in the estimates of the remaining drug and/or alcohol categories (alcohol, cannabis, polydrug use with alcohol, and [but excluding the estimate for] other), point to a similar phenomena—those who identify opioids as their primary problem drug are engaging in HIV primary care less.ConclusionsThese findings suggest that for hospitalized PWH who use drugs and/or alcohol, tailored and expanded efforts are especially needed to link those who report problem opioid use to HIV primary care.Trial registration This study was funded by National Institutes of Health (NIH) grant: U10-DA01372011 (Project HOPE—Hospital Visit as Opportunity for Prevention and Engagement for HIV-Infected Drug Users; Metsch); which is also a registered clinical trial under the Clinical Trials Network (CTN-0049). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

Assessment of prescription stimulant misuse among college students using the MMPI-2-RF

Prescription stimulant misuse (PSM) is a growing concern on college campuses and more research is needed to validate clinical measures commonly used for the assessment of risk for PSM among college students. The present study examined correlations between scores on the Minnesota Multiphasic Personality Inventory–Second Edition–Restructured Form (MMPI-2-RF) and self- and peer-reported misuse of prescription stimulants and other drugs in a sample of 96 pairs (included within a total N = 212) of undergraduate students. Nearly half of the participants (48%) reported that they had been offered prescription stimulants and one quarter (26%) reported trying someone else's prescription stimulant medications, often to perform better academically. Scores on the MMPI-2-RF scales designed to measure general substance misuse (Substance Abuse [SUB]) and related behavioral or externalizing constructs (e.g., Antisocial Behavior [RC4], Behavioral/Externalizing Dysfunction [BXD], and Disconstraint-Revised [DISC-r]), were correlated positively with both self- and peer-reported prescription stimulant misuse (rs = 0.45–0.66), as well as with problematic use of other drugs (rs = 0.44–0.63). MMPI-2-RF scales designed to measure constructs in the domains of Emotional/Internalizing, Somatic/Cognitive, and Thought Dysfunction, as well as Interpersonal Functioning, had weaker correlations with misuse of prescription stimulants (rs < 0.24) and other drugs (rs < 0.29). These results provide support for the convergent validity of the MMPI-2-RF with regard to the assessment of prescription stimulant misuse and general drug misuse among college students.

Estimating the prevalence of problem drug use from drug-related mortality data.

Indirect estimation methods are required for estimating the size of populations where only a proportion of individuals are observed directly, such as problem drug users (PDUs). Capture-recapture and multiplier methods are widely used, but have been criticized as subject to bias. We propose a new approach to estimating prevalence of PDU from numbers of fatal drug-related poisonings (fDRPs) using linked databases, addressing the key limitations of simplistic 'mortality multipliers'. Our approach requires linkage of data on a large cohort of known PDUs to mortality registers and summary information concerning additional fDRPs observed outside this cohort. We model fDRP rates among the cohort and assume that rates in unobserved PDUs are equal to rates in the cohort during periods out of treatment. Prevalence is estimated in a Bayesian statistical framework, in which we simultaneously fit regression models to fDRP rates and prevalence, allowing both to vary by demographic factors and the former also by treatment status. We report a case study analysis, estimating the prevalence of opioid dependence in England in 2008/09, by gender, age group and geographical region. Overall prevalence was estimated as 0.82% (95% credible interval=0.74-0.94%) of 15-64-year-olds, which is similar to a published estimate based on capture-recapture analysis. Our modelling approach estimates prevalence from drug-related mortality data, while addressing the main limitations of simplistic multipliers. This offers an alternative approach for the common situation where available data sources do not meet the strong assumptions required for valid capture-recapture estimation. In a case study analysis, prevalence estimates based on our approach were surprisingly similar to existing capture-recapture estimates but, we argue, are based on a much more objective and justifiable modelling approach.

The knife's edge: Masculinities and precarity in East Africa.

In our field sites and clinical practice in East Africa, we regularly encounter men who have become overwhelmed by "thinking too many thoughts" and "gone crazy from confusion," brought about by the problems of life created by deepening social, economic and political precarity. Across diverse settings, many African men continue to be enmeshed in social and material obligations and expectations that position them as economic consumers and providers for those they care for and love. When these gendered obligations, expectations and fantasies are left unfulfilled, this sense of failure can be embodied to produce particular kinds of health effects. Namely, men may become plagued by troublesome and confusing thoughts, leading them in some cases to "give up on" (as our research subjects put it) pursuing work and education, to become immersed in problematic drug and alcohol use, and even to take their own lives. While these afflictions can be glossed using the language of depression, anxiety, addiction and suicide, such medicalizing frames may obscure more nuanced social, structural and affective diagnoses of what is happening to men across Africa and globally. Anthropology provides us with alternative frames through which to understand how psychological wounds are made-and healed.

Dosage of booster phone calls following an SBIRT intervention in the emergency department for reducing substance use

Brief Interventions (BIs) for problematic drug use in general medical settings, including in Emergency Departments (EDs), have shown disappointing results compared to those that target problematic alcohol use. Telephone booster calls may augment the impact of a BI delivered in the ED. The current study uses data from the National Drug Abuse Treatment Clinical Trials Network (CTN) Protocol 0047, “Screening, Motivational Assessment, Referral, and Treatment in Emergency Departments (SMART-ED)”, a multisite randomized clinical trial conducted in six EDs in the U.S. We examine dose effects of telephone boosters (0, 1, or 2 calls completed) with non–treatment seeking patients who we randomized to the BI-Booster condition and who endorsed problematic drug use during their ED visit (N = 427). We assessed primary outcomes at 3-, 6-, and 12-month follow-ups, which included past month use of the primary drug of choice, use of any drug, and heavy drinking. There were no significant differences among those completing 0, 1, or 2 booster calls on any of the three main outcomes at 3-, 6-, and 12-months post-BI in the ED. Patients who were older were significantly more likely to complete booster calls. Taken together, these findings raise questions about the clinical utility of booster phone calls following screening and BIs targeting heterogeneous drug use in the ED.

A qualitative exploration of substance misuse among homeless women in Addis Ababa, Ethiopia

BackgroundSubstance use among homeless people is higher compared to the general population. In some studies, reported rates of problematic drug use among the homeless vary, with estimates ranging from 25 to 70%. There is a common perception that substance abuse and homelessness are linked, but there is considerable debate about the direction of the relationship. Despite observations of high levels of substance use among the homeless population in Addis Ababa, there are limited studies to date conducted on the topic. This study aims to explore the factors associated with onset of substance use and its continued use, patterns of substance use and its social and health consequences among female residents of a shelter in Addis Ababa, Ethiopia.MethodsA qualitative study was conducted in 2019. In-depth interviews were conducted on 14 study participants who were selected purposively. The qualitative data analysis software QDA Miner 5.0.30 was used for data processing and analysis.ResultsFour major thematic areas were identified and they comprised the categories under which sub-themes were identified and coded. The major segments or categories included the following: reasons for the onset of substance use after becoming homeless, experiences of substance use and reasons for continued use, the harms which resulted on them from substance use, and the means of obtaining supply of the substances.ConclusionFactors related to life on streets were strong reasons for onset of substance use, as well as for its continued use. Homeless women suffered untimely death, addiction, and ill health from use of substances; however, they gave priority to obtaining substances than any other thing, and used every means to grab a supply of the substances.

A transdiagnostic examination of affective motivations for drug use

IntroductionSubstance use often co-occurs with both internalizing and externalizing disorders, highlighting the importance of understanding reciprocal relations among problematic drug use and psychopathology. We examined affective (approach and avoidance) motivations for drug use as potential transdiagnostic constructs that relate to symptoms of common clinical disorders. Methods175 community adults with a lifetime history of drug use reported on their motivations for use, frequency of use, and DSM-5 lifetime psychopathology symptoms. Linear regression was used to examine associations between drug use motivations and psychopathology. ResultsAvoidance motivations for drug use (e.g., using to cope with distress) correlated positively with symptoms of both internalizing and externalizing disorders, borderline personality disorder, and psychiatric comorbidity. In contrast, approach motivations for drug use (e.g., using to get a thrill) correlated only with substance use disorder symptoms. Notably, motivations for drug use continued to show these transdiagnostic associations after accounting for general approach-avoidance motivational tendencies. ConclusionThese findings suggest that affective motivations for drug use provide a useful framework for conceptualizing substance problems that cuts across traditional dimensions of psychopathology.