A comparison of substance abuse patients' and counselors' perceptions of relapse risk
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Keywords:
Relapse prevention
Alcohol abuse
Polysubstance use in adolescence is a known precursor to chronic substance misuse. Identifying risk factors for polysubstance use is necessary to inform its prevention. The present study examined the association of elevated levels of multiple mental health symptoms with adolescents' engagement in polysubstance use (past month use of alcohol, cigarettes, and marijuana). In a US national sample of 8th, 10th, and 12th grade students from Monitoring the Future surveys, we estimated probability of polysubstance use associated with high levels of depressive symptoms, conduct problems, or both. Depressive symptoms and conduct problems, alone and particularly in combination, were associated with drastically elevated probability of polysubstance use. Adolescents with high levels of both depressive symptoms and conduct problems had the highest probability of polysubstance use. Among 8th and 10th graders, probability of polysubstance use associated with co-occurring mental health problems was significantly higher for girls than boys.
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Studies in medical, surgical, and gynecologic practices indicate that the prevalence of alcohol and other substance abuse among patients ranges from 20% to 50%. Although physicians are in a unique position to detect alcohol or drug abuse in their patients, they often fail to do so. Physicians are particularly unlikely to identify substance abuse in its earliest stages, and thus miss major opportunities for intervening. Several screening questionnaires for early detection of alcohol and other substance abuse have been developed. Alcohol abuse questionnaires have been the most extensively validated and have good sensitivity and specificity. Those developed for nonalcohol drug abuse are not well validated, but may be useful in clinical populations. Early biological laboratory markers of alcohol abuse are routinely available but are not as sensitive or specific as the screening questionnaires. Early biological markers of nonalcohol drug abuse are not yet well defined.
Alcohol abuse
Substance Abuse Detection
Drugs of abuse
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Abstract Introduction Substance use is increasingly prevalent among women. Little research examines subgroups of women with substance use issues to identify their characteristics and thus enable treatment recommendations. The present study used latent class analysis to identify subgroups of substance use among women in substance‐use treatment based on use in the 30 days prior to intake and examined changes in mental health and treatment outcomes following 60 days of treatment. Methods Participants were women ( N = 493) attending specialist non‐government substance use treatment services in New South Wales, Australia. Results Four distinct classes of substance users were identified: (i) Amphetamine Type Stimulants (ATS) Polysubstance (40.6%, n = 200); (ii) Alcohol Only (33.1%, n = 163); (iii) Cannabis and Alcohol (17.0%, n = 84) and (iv) Other Polysubstance (9.3%, n = 46). Women in the ATS Polysubstance class were the youngest and those in the Alcohol Only class were the oldest. Discussion and Conclusions Findings show that classes with high polysubstance use ( ATS Polysubstance ) differed from the single‐substance use class ( Alcohol Only ). The ATS Polysubstance class had significantly greater improvements in health outcomes after 60 days compared to the Alcohol Only class. These findings suggest that although women with polysubstance use can benefit from substance use treatment, younger women ( ATS Polysubstance ) may benefit even more than older women ( Alcohol Only ). Future research should utilise a longitudinal design and examine additional psychosocial characteristics to extend on current findings.
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Objective: Studies show that stimulant users have varied substance use patterns and that polysubstance use is associated with poorer past or concurrent medical, mental health, and substance use outcomes. This study examined outcomes of substance use patterns prospectively. Method: A latent class analysis was conducted to examine substance use patterns among adults using stimulants (n = 710; 38.6% women) at baseline, and the health and treatment utilization outcomes of different use patterns over the subsequent 3 years. To examine associations between latent class membership and outcomes, generalized estimating equation modeling was conducted. Results: Four classes of substance use patterns at baseline were identified, involving high use of (a) methamphetamine and marijuana (23%); (b) crack cocaine and alcohol (25%); (c) powder cocaine, alcohol, and marijuana (23%); and (d) nonprescribed opioids, alcohol, marijuana, crack cocaine, and powder cocaine (i.e., polysubstance [29%]). Polysubstance class members had poorer physical health and mental health status, and more severe substance use, over the subsequent 3-year period, than other class members. Regarding treatment utilization, polysubstance class members had more medical care utilization than crack cocaine class members, and more substance use treatment utilization than powder cocaine class members. The methamphetamine, crack cocaine, and powder cocaine classes did not differ from each other on any health or treatment utilization outcome. Conclusions: People using stimulants commonly use other substances, and those whose polysubstance use includes nonprescribed opioids have especially poor health outcomes.
Stimulant
Methamphetamine
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Rural areas have high rates of opioid and stimulant involved polysubstance use which are known to contribute to overdose. Justice-involved women are likely to have multiple substance use disorders and are particularly vulnerable in rural areas where treatment is limited.
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This study addressed the rate and predictors of substance abuse relapse among clients with severe mental illness who had attained full remission from substance abuse.In a ten-year prospective follow-up study of clients with co-occurring severe mental and substance use disorders, 169 clients who had attained full remission, defined according to DSM-III-R as at least six months without evidence of abuse or dependence, were identified. The Kaplan-Meier survival curve was developed to show the pattern of relapse, and a discrete-time survival analysis was used to identify predictors of relapse.Approximately one-third of clients who were in full remission relapsed in the first year, and two-thirds relapsed over the full follow-up period. Predictors of relapse included male sex, less than a high school education, living independently, and lack of continued substance abuse treatment.After attaining full remission, clients with severe mental disorders continue to be at risk of substance abuse relapse for many years. Relapse prevention efforts should concentrate on helping clients to continue with substance abuse treatment as well as on developing housing programs that promote recovery.
Relapse prevention
Substance abuse treatment
Substance abuse prevention
Special section
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The aim of the present study was to compare the patterns of substance abuse in the Kingdom of Saudi Arabia (KSA) and the United Arab Emirates (UAE). One hundred and twenty substance abusers from the KSA and 79 substance abusers from the UAE participated. All participants were males. Age, education, age at onset of abuse, substances abused, duration of abuse, mode of abuse, and employment were investigated. Analysis of the data revealed some similarities including age, employment, and substances prevalent among poly-substance abusers. Differences in patterns of substance abuse included age at onset, prevalence of polysubstance abuse, and substances prevalent among single-substances abusers. The findings are discussed and compared with previous reports. Recommendations for future studies are made.
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Drug overdose
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Cost and Usage Impacts of Treatment Initiation: A Comparison of Alcoholism and Drug Abuse Treatments
An extensive literature on substance abuse and mental health treatments suggests that they often lead to decreased usage and/or spending on other medical treatments. We compare alcohol and drug abuse treatment costs with a model that decomposes total treatment costs into amount of treatment (outpatient visits or inpatient days) and costs per treatment. The analysis compares alcohol and drug abuse treatment costs regarding: (1) the incremental costs attributable to changed short-term substance abuse and nonsubstance abuse treatments; (2) the impacts of current substance abuse treatments on short-term nonsubstance abuse, long-term substance abuse, and long-term nonsubstance abuse treatments; and (3) the difference in inpatient and outpatient impacts. Our findings indicate that alcoholism and drug abuse treatment initiation have similar impacts on coincident and subsequent utilization and costs. For both treatments, the largest portions of the cost impacts occur for inpatient treatments, and for treatments that occur within 6 months of the initiation. The similarity of results suggests that it may often be reasonable to infer utilization and cost impacts for one type of care from studies that examine the other.
Alcohol abuse
Substance abuse treatment
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The Diagnostic Interview Schedule was employed to ascertain the prevalence of major depressive disorder (MDD), alcohol and substance abuse in a sample of 424 college students aged 16 to 19 years. Applying DSM III criteria, the prevalence of MDD was 6.8 per cent; of alcohol abuse, 8.2 per cent; and of substance abuse 9.4 per cent. Alcohol abuse was associated with MDD, but not with other psychiatric diagnoses. Substance abuse was associated both with MDD and with other psychiatric diagnoses as well. The onset of MDD almost always preceded alcohol or substance abuse suggesting the possibility of self-medication as a factor in the development of alcohol or substance abuse.
Alcohol abuse
Depression
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