Journal Cover Drugs and Alcohol Today
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   Hybrid Journal Hybrid journal (It can contain Open Access articles)
   ISSN (Print) 1745-9265 - ISSN (Online) 2042-8359
   Published by Emerald Homepage  [335 journals]
  • The UK drugs strategy 2017: contexts and analysis
    • Pages: 205 - 217
      Abstract: Drugs and Alcohol Today, Volume 17, Issue 4, Page 205-217, December 2017.
      Purpose The purpose of this paper is to examine the content of the strategy and assess its claims to be evidence based. Design/methodology/approach This study is a close-reading of the text with commentary on specific content and reference to wider contexts. Findings The strategy makes use of evidence in its sections on treatment. Much evidence, including that of the UK ACMD, is dismissed or ignored. The issue of funding in times of austerity is not considered in the strategy. The range and complexity of drug use and users are not fully considered. Research limitations/implications The strategy can be seen as an idealised ambition with little basis in reality without funding to support its aims. Social implications There is no consideration of the impact of macro-economic policy on the extent of drug misuse. Originality/value Other commentaries on the strategy are emerging. This paper is a more extensive consideration than has so far appeared.
      Citation: Drugs and Alcohol Today
      PubDate: 2017-11-29T03:14:50Z
      DOI: 10.1108/DAT-08-2017-0034
  • Why did cannabis treatment presentations rise in England from 2004-2005 to
    • Pages: 218 - 231
      Abstract: Drugs and Alcohol Today, Volume 17, Issue 4, Page 218-231, December 2017.
      Purpose Cannabis treatment entries rose significantly from 2004/2005 to 2013/2014, but there has been limited investigation into why this increase has occurred. The purpose of this paper is to evaluate the plausibility of different explanations within the English context and identifies gaps in the literature. Design/methodology/approach Explanations have been categorised under: misreporting, increased probability of entering treatment and increased incidence of cannabis use disorder (CUD). The explanations are evaluated through published literature, data in the public domain and interview data. Interview participants included four practitioners, one senior manager, one commissioner, one journalist, one academic and one clinician. Findings Plausible and influential explanations are that an expanding treatment offer occurred alongside an expanding cohort of people needing support for CUD. The evidence suggests increased prevalence in the 1990s to early 2000s, and an increase in high-potency cannabis, led to a significant rise in need for cannabis treatment. Minor explanations relating to funding formulas, criminal justice referrals and the emergence of synthetic cannabinoids could also cumulatively have a substantial effect on the data. Research limitations/implications Due to the dearth of research in use and attitudes towards cannabis, there are some explanations which cannot be ruled out. Practical implications More research is needed on user perceptions of cannabis harms and how intensively people are using cannabis. Social implications Wider implications are that a genuine and increasing need for support relating to cannabis within the English population requires an appropriate response from national bodies, commissioners and service providers. Originality/value A more comprehensive understanding of why this new cohort is emerging can inform better service provision and commissioning.
      Citation: Drugs and Alcohol Today
      PubDate: 2017-11-29T03:14:47Z
      DOI: 10.1108/DAT-08-2017-0033
  • What stops people on long-term opioid substitution from completing
    • Pages: 232 - 241
      Abstract: Drugs and Alcohol Today, Volume 17, Issue 4, Page 232-241, December 2017.
      Purpose Opioid substitution treatment is effective in reducing harm for the person and society. However, the introduction of the recovery agenda has changed treatment philosophy. Associated targets such as successful treatment completions have introduced new expectations from treatment providers and service users. The purpose of this paper is to provide a service user-centred evaluation of underlying reasons that might prevent them from considering completion of treatment. Design/methodology/approach Ten service users who were stable on opioid substitution treatment for more than five years were interviewed face-to-face using a semi-structured format. Detailed inductive coding and thematic analysis of all transcripts was conducted. Findings Most participants expressed fear of change to their treatment and in particular reduction of the prescribed medication, due to past traumatic withdrawal experience, fear of relapse, fear of negative impact on their mental and physical health. Nevertheless all were optimistic about their future lives and were hoping to be able to complete their treatment at some point. A three-month follow-up revealed little change, with most participants not considering changing their medication dose in the future. Practical implications It could be argued that treatment providers, instead of focussing their efforts on stable service users in promoting treatment exit, should focus on new service users, avoiding coercion to treatment aims and rushed detoxifications. Originality/value This small qualitative study confirms results of other recent studies on the same theme and argues for the importance of the quality of the treatment experience of new people accessing treatment.
      Citation: Drugs and Alcohol Today
      PubDate: 2017-11-29T03:14:40Z
      DOI: 10.1108/DAT-09-2017-0055
  • Prevalence of somatisation as a determinant of burnout amongst staff
           working in drug and alcohol services
    • Pages: 242 - 249
      Abstract: Drugs and Alcohol Today, Volume 17, Issue 4, Page 242-249, December 2017.
      Purpose The purpose of this paper is to explore the prevalence of somatisation as a determinant of burnout amongst drug and alcohol staff in the UK. Design/methodology/approach The study employed a cross-sectional design utilising a self-completion online questionnaire. Data were collected from substance misuse workers across England and Wales. In total, 165 responses were eligible for analysis, yielding a response rate of 5 per cent. Burnout and somatization were measured with Maslach’s Burnout Inventory and the Physical Symptoms Inventory. Findings The prevalence of somatic symptoms was relatively low in the sample studied. The reported levels of burnout were moderate. Personal accomplishment remained high in the sample. There was a strong association between burnout and incidence of stress-related somatic symptoms, with higher levels of burnout correlating with multiple symptoms. Research limitations/implications It was not possible to determine the extent of non-response bias, as at the time of the study there was no information available relating to the characteristics of drug and alcohol staff in the selected services. Therefore, as the response rate was very low (5 per cent) it was recognised that non-response bias might have affected the findings, in such way that non-respondents may have differed in their experiences of work stress, satisfaction, burnout and health outcomes. Practical implications Despite the limitations, the study provided practical information relating to burnout vulnerability and associated physical symptoms in this specific occupational group. These findings can support employers to address staff wellbeing with a view to prevent burnout and reduce existing levels of burnout and related somatic symptoms, and improve job performance, job satisfaction and staff retention through making appropriate adjustments, such as developing staff-wellbeing programmes. These adjustments could potentially contribute to improvement in substance misuse practice, through maintenance of healthy and satisfied workforce. Originality/value There are very few studies looking at burnout in drug and alcohol staff. This study is also novel in a way that it reveals correlations between a variety of specific stress-related physical symptoms and the three components of burnout.
      Citation: Drugs and Alcohol Today
      PubDate: 2017-11-29T03:14:42Z
      DOI: 10.1108/DAT-05-2017-0018
  • Thailand’s national alcohol survey as a policy monitoring tool
    • Pages: 250 - 257
      Abstract: Drugs and Alcohol Today, Volume 17, Issue 4, Page 250-257, December 2017.
      Purpose The purpose of this paper is to assess to what extent the Smoking and Alcohol Drinking Behavior Survey (SADBeS), the national alcohol survey, could be used in monitoring goals and cost-effective measures suggested by the National Alcohol Strategy (NAS) issued by public health authorities in 2010. Design/methodology/approach The NAS was reviewed. Strategies, measures, and corresponding indicators were extracted. Questionnaire items used in the 2014 SADBeS were assessed in comparison with those indicators. Findings Four primary indicators indicate overall success of the NAS. In all, 6 out of 15 measures were in accordance with best-buy or good-buy policies – cost-effective policies suggested by the World Health Organization. After excluding indicators unlikely to be obtained from population-based surveys, the SADBeS could be used in monitoring 5 out of 14 indicators corresponding to best-buy or good-buy measures. Of 103 questionnaire items, 26.2 percent of items could be used to monitor primary indicators of the NAS; 34.0 percent could be used to estimate indicators corresponding to best-buy or good-buy measures. Overall, only 35.0 percent of questionnaire items provided useful information for monitoring primary indicators and cost-effective measures suggested in the NAS. Practical implications The SADBeS questionnaire items should be added or replaced to cover feasibly obtained indicators corresponding to best-buy or good-buy policies in the next wave of the survey. Originality/value This is the first study addressing the compatibility between the national strategy and the national alcohol survey. It also includes the overview of Thailand’s alcohol strategy, which is, to the author’s knowledge, never presented in any English articles.
      Citation: Drugs and Alcohol Today
      PubDate: 2017-11-29T03:14:46Z
      DOI: 10.1108/DAT-06-2017-0027
  • Homelessness among clients of Sydney’s supervised injecting facility
    • Pages: 258 - 268
      Abstract: Drugs and Alcohol Today, Volume 17, Issue 4, Page 258-268, December 2017.
      Purpose The Uniting Medically Supervised Injecting Centre (MSIC) opened in Sydney, Australia, in May 2001. Homelessness among people who inject drugs (PWID) in Australia has been increasing, and establishing how supervised injecting facilities (SIFs) might best support clients into housing is an important goal. The purpose of this paper is to update knowledge regarding the accommodation status of MSIC clients, thereby supporting a better understanding of the complex needs of these clients. Design/methodology/approach Client accommodation status at MSIC registration (first visit) and in a brief survey (conducted in May 2016) were compared; unstable accommodation was defined as rough sleeping, couch surfing, hostel, boarding house or crisis accommodation. The bivariate logistic regression analysis was used to explore the association between socio-demographics and accommodation status at both time points; a paired t-test was used to compare the visit records for those who reported stable and unstable accommodation in May 2016. Findings Of 232 clients who were present at MSIC during the week the Brief Survey was conducted, 107 participated. Most were male (79 per cent) with a mean age of 41.4 years. A total of 64 (60 per cent) identified as living in unstable accommodation; having increased from 40 per cent at the time of registration (first visit). There were significant positive associations between unstable accommodation status and unemployment, imprisonment and history of overdose, all measured at registration. In May 2016, unstable accommodation status was significantly associated with age of first injection and with unemployment status (as measured at registration); those living in unstable accommodation in May 2016 had a lower number of visits, a lower number of referrals to health and social services and a lower number of overdoses at MSIC than those living in a stable accommodation. Originality/value The rates of unstable accommodation among MSIC clients have been increasing. These findings highlight the importance of SIFs and drug consumption rooms as venue to address the essential needs of PWID, such as housing. The window of opportunity to support PWID who experience housing instability seems to be narrower than for those who live in stable accommodation.
      Citation: Drugs and Alcohol Today
      PubDate: 2017-11-29T03:14:45Z
      DOI: 10.1108/DAT-06-2017-0026
  • Exploring problem use, discrimination, ethnic identity and social networks
    • Pages: 269 - 279
      Abstract: Drugs and Alcohol Today, Volume 17, Issue 4, Page 269-279, December 2017.
      Purpose Possessing a strong ethnic identity and ethnic network are described in some epidemiological literature as moderating factors in the relation between perceived discrimination and varying types of substance use in people with a migration background (PMB). The purpose of this paper is to qualitatively explore problem use, discrimination, ethnic identity and social networks in a small purposive sample of users with a Turkish and Eastern European migration background in Ghent, Belgium. Design/methodology/approach The authors present data retrieved within the framework of a qualitative community-based participatory research study that primarily aims to understand the nature of substance use in PMB. In the secondary analysis, the authors focus on a sub-study examining substance use by people with a Turkish (n=55) and Eastern European (n=62) migration background and explore how individuals perceive discrimination, ethnic identity and (ethnic) social networks in 117 qualitative interviews. Findings Almost all the respondents in this study reported perceived (inter-)ethnic discrimination. The authors establish that problem users in this study have a complex but albeit weak sense of ethnic identity nor do they have a strong ethnic network. This, in combination with perceived discrimination, is a risk factor for continued problem substance use and may hamper recovery related to problem use. Originality/value This article intends to lay the groundwork for future research that should focus more on longitudinally studying the intertwined relation between problem use, discrimination, ethnic identity and especially social instead of solely ethnic networks, their complex nature as well as their relation to recovery processes among persons with a migration background.
      Citation: Drugs and Alcohol Today
      PubDate: 2017-11-29T03:14:52Z
      DOI: 10.1108/DAT-07-2017-0030
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