Advances in Dual Diagnosis最新文献

{"title":"Older adults’ knowledge, beliefs and attitudes about prescription opioids","authors":"Susan Glose, Tamatha E. Arms, Noell L. Rowan","doi":"10.1108/ADD-12-2020-0030","DOIUrl":"https://doi.org/10.1108/ADD-12-2020-0030","url":null,"abstract":"\u0000Purpose\u0000The purpose of this study is to explore the knowledge, beliefs and attitudes surrounding prescription opioid medications of community living older adults in southeast North Carolina.\u0000\u0000\u0000Design/methodology/approach\u0000A cross-sectional, descriptive, anonymous survey design of participants aged 55 or over was used.\u0000\u0000\u0000Findings\u0000Study participants (N = 119) reported bias in their attitudes and beliefs about the use and misuse of prescription opioid medications. Multiple regression analyses revealed that gender, age, work, marital status and education level all had significant results in explaining variance in the statistical models. Even though study participants demonstrated high levels of education and understanding of the potential of addiction to opiates, there were a number of misconceptions about prescription pain medications revealed.\u0000\u0000\u0000Originality/value\u0000There is a dearth of studies looking at older adults’ knowledge, beliefs and attitudes about prescription pain medications. This urges the necessity of increased awareness via further research, presentations and creative discourse to assist in the understanding of precursors of addiction and ways to deal with pain that do not automatically depend on prescription opioid medicines. Implications include outreach to a larger and more diverse sample to address knowledge, beliefs and attitudes surrounding prescription opioid medications of community living older adults in southeast North Carolina and beyond.\u0000","PeriodicalId":51922,"journal":{"name":"Advances in Dual Diagnosis","volume":"13 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2021-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87376870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The health of older Western Australians: the role of age, gender, geographic location, psychological distress, perceived health, tobacco and alcohol","authors":"C. Wilkinson, Kim Clarke, R. Sambell, J. Dare, S. Bright","doi":"10.1108/ADD-12-2020-0026","DOIUrl":"https://doi.org/10.1108/ADD-12-2020-0026","url":null,"abstract":"\u0000Purpose\u0000Rates of drinking- and alcohol-related harms among older adults are increasing in most developed nations. The purpose of this paper was to explore the relationship among at-risk alcohol use, smoking, gender, geographical location, self-reported health and psychological well-being among Western Australians aged 65 years and older.\u0000\u0000\u0000Design/methodology/approach\u0000A secondary analysis was conducted of a cross-sectional survey that collected data from 7,804 West Australians aged 65 years and older between 2013 and 2015. Participants were categorised according to the following age groups: young-old (aged 65–74 years), older-old (aged 75–84 years) and oldest-old (aged 85+ years).\u0000\u0000\u0000Findings\u0000Results from a multinomial logistic regression analysis indicated that at-risk drinking decreased with increasing age. Current smokers, males and those males and females who perceived their health to be “excellent” were more likely to report at-risk drinking, as were the oldest-old males who lived in remote communities. Psychological well-being was not a predictor of at-risk drinking\u0000\u0000\u0000Originality/value\u0000This paper examines drinking behaviour among a diverse population of older Western Australians. The way in which the age groups were segmented is unique, as most studies of older Australian drinking patterns aggregate the older adult population. Some of the authors’ findings support existing literature, whereas the remainder provides unique data about the relationship among at-risk drinking, geographic location and psychological well-being.\u0000","PeriodicalId":51922,"journal":{"name":"Advances in Dual Diagnosis","volume":"19 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2021-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83497205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pathway to care in co-occurring disorder and substance use disorder: an exploratory, cross-sectional study from India","authors":"R. Tripathi, Shalini Singh, S. Sarkar, R. Lal, Y. Balhara","doi":"10.1108/ADD-10-2020-0023","DOIUrl":"https://doi.org/10.1108/ADD-10-2020-0023","url":null,"abstract":"There is a paucity of comparative literature on pathway to care among patients with co-occurring disorders and those with only substance use disorders. This paper aims to compare the pathways to care among patients with co-occurring disorder and those with only substance use disorders.,A cross-sectional observational study was carried out on male treatment seekers at a tertiary care substance use disorder treatment center in India. Participants were recruited in two groups, those with co-occurring psychiatric and substance use disorders and those with only substance use disorders. The two groups were matched for age and socio-economic status.,A total of 189 subjects with co-occurring psychiatric and substance use disorders and 197 subjects with substance use disorders only were recruited. Psychiatric services were the most common first point of care. However, a larger proportion of the subjects in the co-occurring disorder group received the first care from faith healers, while a greater proportion received first care from the therapeutic communities in substance use disorder only group. Initial care was sought mostly following suggestion from the family members in both the groups. The time to treatment for substance use disorders did not differ between the two groups, though the treatment seeking for substance use disorder was more delayed than that of psychiatric disorder in the co-occurring disorder group.,The findings shed light on the pathway of care followed in India and is a matter of further research.,Expansion of services and dissemination of information about psychiatric disorders and substance use disorders can provide timely care to patients with substance use disorders and co-occurring disorders.,The findings have a social implication as well. More awareness is needed currently in India for timely treatment of dual disorders.,The paper is an original research by the authors. The data were collected from the participants who reported to the dual diagnosis clinic. The findings are important as they tell us about the current understanding of dual diagnosis by the general public.","PeriodicalId":51922,"journal":{"name":"Advances in Dual Diagnosis","volume":"19 1","pages":"20-32"},"PeriodicalIF":0.9,"publicationDate":"2021-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76488533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A co-occurring disorders intervention for drug treatment court: 12-month pilot study outcomes","authors":"D. Smelson, Paige M. Shaffer, C. Rodriguez, Ayorkor Gaba, Jennifer Harter, D. Pinals, Sheila C. Casey","doi":"10.1108/add-08-2020-0016","DOIUrl":"https://doi.org/10.1108/add-08-2020-0016","url":null,"abstract":"PurposeMany individuals in drug treatment courts (DTCs) have co-occurring mental health and substance use disorders (COD), which can negatively impact treatment engagement, behavioral health and criminal justice outcomes. This paper aims to report results of DTC participants with a COD, who received a 12-month wraparound treatment intervention called MISSION-Criminal Justice (MISSION-CJ) alongside DTC to improve treatment engagement and behavioral health outcomes and reduce reincarcerations.Design/methodology/approachIn this pre-post, single-group pilot, 48 clients enrolled and 81% completed 12-month follow-up assessments (N = 39) and weekly MISSION-CJ fidelity for type and intensity of services delivered. Generalized linear mixed models (GLMMs) were computed with a fixed term for fidelity (e.g. high or low MISSION-CJ), time and a fidelity x time interaction term.FindingsAmong participants, at 12 months, 81% of the participants remained engaged in treatment at study completion, and 89% had high MISSON-CJ fidelity. Clients demonstrated significant reductions from baseline to 12 months in average nights in jail (B = −0.1849511, p < 0.0344), mental health symptoms via the Behavior and Symptom Identification Scale (BASIS) total and subscale scores (B = −0.121613,p< 0.0186) and trauma symptoms on the PTSD Checklist-5 (PCL-5) (B = −0.928791, p < 0.0138). High MISSION-CJ fidelity further improved criminal justice, and behavioral health outcomes.Originality/valueThis was the first reported 12-month MISSION-CJ trial. While feasible to implement, given the design limitations, future research should include a large randomized controlled trial.","PeriodicalId":51922,"journal":{"name":"Advances in Dual Diagnosis","volume":"25 1","pages":"169-182"},"PeriodicalIF":0.9,"publicationDate":"2020-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82781775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An invisible problem: stigma and FASD diagnosis in the health and justice professions","authors":"Katharine Dunbar Winsor","doi":"10.1108/add-07-2020-0014","DOIUrl":"https://doi.org/10.1108/add-07-2020-0014","url":null,"abstract":"\u0000Purpose\u0000Fetal alcohol spectrum disorder (FASD) is a complex lifelong disorder impacting the brain and body. Individuals with FASD may require lifelong supports and are at a higher risk of experiencing adverse outcomes, including incarceration. Individuals with FASD face stigma related to FASD that impacts disclosure of the diagnosis and access to supports. The prevalence of FASD exceeds that of other developmental disabilities, yet it remains less visible and stigmatized.\u0000\u0000\u0000Design/methodology/approach\u0000Interviews conducted with health-care and justice professionals in a Canadian province explore their experiences attending to FASD and challenges of stigma.\u0000\u0000\u0000Findings\u0000While difficult to access, diagnosis provides a pathway to supports and is crucial in the criminal justice process. Visibility and invisibility in health and justice systems highlight the lack of understanding of FASD and surrounding stigma. When unaddressed, individuals with FASD face additional challenges stemming from a lack of information and strategies by professionals involved in their lives.\u0000\u0000\u0000Originality/value\u0000Stigma represents a significant and complex issue intertwined in understandings of FASD. This research explores this relationship and the mechanisms through which FASD stigma has impacts in health-care and justice settings.\u0000","PeriodicalId":51922,"journal":{"name":"Advances in Dual Diagnosis","volume":"51 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2020-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80955327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A qualitative longitudinal study of the first UK Dual Diagnosis Anonymous (DDA), an integrated peer-support programme for concurrent disorders","authors":"R. Milani, K. Nahar, D. Ware, Alana Butler, S. Roush, D. Smith, Luisa Perrino, J. O’Donnell","doi":"10.1108/add-01-2020-0001","DOIUrl":"https://doi.org/10.1108/add-01-2020-0001","url":null,"abstract":"Dual Diagnosis Anonymous (DDA) is a peer-led programme developed in the USA, which aims to address mental and addictive disorders in an integrated manner. This study is part of a mixed-methods evaluation of the first DDA pilot in the UK, and the purpose of this study is to explore the impact and mechanism of change of the programme through the perspective of DDA attendees, facilitators and the funding commissioners.,Six DDA members were interviewed three times over a period of 12 months, the facilitators were interviewed twice and the commissioner was interviewed once. The qualitative longitudinal data were analysed using a trajectory thematic analysis.,DDA attendance was perceived to have had a positive impact on five main areas: acceptance of self, of others and from others; social functioning; self-development; recovery progression; and feeling of hope. The possibility of addressing both mental health and addiction at the same time was a key factor in the recovery process. The facilitators observed that DDA had contributed to integrate members into employment and education, while the commissioner stressed the importance of joint commissioning and sustainability.,The longitudinal approach provided a unique insight into the recovery process of DDA members. Being able to address the mental health as well as the substance use problems was considered to be a fundamental strength of DDA in comparison to the single purpose peer-support fellowships.","PeriodicalId":51922,"journal":{"name":"Advances in Dual Diagnosis","volume":"22 1","pages":"151-167"},"PeriodicalIF":0.9,"publicationDate":"2020-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85260586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"“The dual diagnosis attitudes survey”: understanding the attitudinal impact of training across mental health and alcohol and drug service systems","authors":"Gavin Foster","doi":"10.1108/add-05-2020-0004","DOIUrl":"https://doi.org/10.1108/add-05-2020-0004","url":null,"abstract":"Anecdotal feedback obtained from alcohol and drug and mental health staff across the eastern metropolitan region of Melbourne, Australia suggests that attitudes towards working with people experiencing a dual diagnosis are becoming more positive. The purpose of this paper is to understand if dual diagnosis-specific training delivered to staff within mental health and alcohol and other drug services was a factor positively influencing attitudes.,No formal evaluation assessing the impact of dual diagnosis-specific training on staff attitudes had previously occurred within this region of Australia. Access to staff on two occasions from three distinct sectors provided an opportunity to examine if and, to what degree, attitudes can be influenced by dual diagnosis-specific training. Using a co-designed attitudes survey, information was gathered from mental health and alcohol and drug staff on their attitudes to working with people with co-occurring mental health and substance use problems.,Two surveys were conducted involving 186 staff in 2012 and 110 staff in 2016. The dual diagnosis attitudes survey showed that positive attitudes to working with people experiencing a dual diagnosis were associated with recency of training. While attitudes may be improved by dual diagnosis training, these findings cannot exclude the impact of other dual diagnosis capacity building activities.,This study highlights the benefits of a regional partnership between mental health and alcohol and drug services and people with lived experience of dual diagnosis and the benefit of recent co-designed dual diagnosis training on longitudinally assessed worker attitudes.","PeriodicalId":51922,"journal":{"name":"Advances in Dual Diagnosis","volume":"85 1","pages":"137-149"},"PeriodicalIF":0.9,"publicationDate":"2020-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73614222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"“Come together”: a thematic analysis of experiences with belonging","authors":"E. Ogundipe, Knut Tore Sælør, K. Dybdahl, L. Davidson, S. Biong","doi":"10.1108/add-03-2020-0002","DOIUrl":"https://doi.org/10.1108/add-03-2020-0002","url":null,"abstract":"The purpose of this paper is to explore, describe and interpret two research questions: How do persons with co-occurring mental health and substance abuse problems, living in supportive housing, experience belonging? How do residential support staff experience promoting a sense of belonging for persons with co-occurring mental health and substance abuse problems, living in a supportive housing?,Individual semi-structured interviews were conducted with five persons with co-occurring mental health and substance abuse problems living in supportive housing in a Norwegian district. In addition, one semi-structured focus group was conducted with nine residential support staff. All interviews were transcribed verbatim and analyzed using thematic analysis.,Analysis resulted in three main themes: “I do not go to sleep in my pajamas”, “Do I have a choice?” and “Be kind to each other”.,More research on how inclusive practices that are commonly described in guidelines actually affect the experience of residents and residential support staff is needed.,Practices that incorporate a communal and contextual understanding when assigning supportive housing are warranted.,By paying attention to the components of social recovery, this paper provides a nuanced understanding of how persons with co-occurring mental health and substance abuse problems, living in supportive housing, experience belonging. In addition, residential support staffs’ experiences with promoting a sense of belonging for this group are explored.","PeriodicalId":51922,"journal":{"name":"Advances in Dual Diagnosis","volume":"7 1","pages":"123-134"},"PeriodicalIF":0.9,"publicationDate":"2020-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87789578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Addressing treatment capacity of uninsured adults with co-occurring disorders","authors":"K. Gruber, K. J. Poole, Kelly N. Graves, Antonia Monk Richburg","doi":"10.1108/add-04-2020-0003","DOIUrl":"https://doi.org/10.1108/add-04-2020-0003","url":null,"abstract":"The purpose of this paper is to report on the success of an initiative involving the transformation of a group of small substance use treatment only or mental health treatment only provider agencies serving uninsured adults into providers of co-occurring disorder treatment.,The paper uses a case study narrative to describe the initiative and the transformation of the participant agencies from being providers of mental health or substance use treatment to providers of co-occurring disorders.,Six agencies serving uninsured adults expanded their scope of patient treatment services to include the capacity to treat adults with co-occurring disorders. This was achieved with modest support funding from a local foundation. The initiative has been ongoing for five years.,The outcome of this initiative demonstrates the financial and practical feasibility of improving and expanding treatment services to low-resourced patient populations. The participating agencies were able to improve their capacity to treat patients with substance use or mental health issues that previously they were not prepared to treat and thus increased their ability to provide integrated care.,The initiative described here shows that the treatment of concomitant substance use and mental health disorders is within the range of many small-scale treatment providers, if provided the leadership and support. Delivery of effective treatments to populations experiencing co-occurring disorders that are underserved and undertreated are achievable in community-based clinical practices. This has implications for developing treatment capacity outside of hospital settings to enable treatment of co-occurring disorders to become more accessible.","PeriodicalId":51922,"journal":{"name":"Advances in Dual Diagnosis","volume":"48 1","pages":"111-121"},"PeriodicalIF":0.9,"publicationDate":"2020-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75983582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recovery from mental illness versus substance use disorder","authors":"P. Corrigan, Sang Qin, L. Davidson, G. Schomerus, V. Shuman, D. Smelson","doi":"10.1108/add-10-2019-0012","DOIUrl":"https://doi.org/10.1108/add-10-2019-0012","url":null,"abstract":"\u0000Purpose\u0000While serious mental illness (SMI) and substance use disorders (SUD) are common, less research has focused on causal beliefs across conditions. This is an important question when trying to understand the experience of dual diagnosis. The purpose of this paper is to examine how three factors representing causal beliefs (biogenetic, psychosocial or childhood adversity) differ by SMI and SUD. This study also examined how causal beliefs were associated with overall, process and outcome beliefs about recovery.\u0000\u0000\u0000Design/methodology/approach\u0000Using Mechanical Turks online panel, 195 research participants from the general public completed measures of recovery – overall, outcome and process – for SMI and SUD. Participants also completed the Causal Beliefs Scale yielding three causal factors for SMI and separately for SUD: biogenetic, psychosocial and childhood adversity.\u0000\u0000\u0000Findings\u0000Results indicated participants endorsed biogenetic cause more for SMI and SUD. Moreover, research participants endorsed biogenetic causes more than the other two for SMI. Results also showed the psychosocial cause was positively associated with recovery for SMI. Biogenetic causes were not. Almost none of the causal indicators was significantly associated with recovery for SUD.\u0000\u0000\u0000Originality/value\u0000Implications of these findings for future research and public efforts to enhance attitudes about recovery are discussed.\u0000","PeriodicalId":51922,"journal":{"name":"Advances in Dual Diagnosis","volume":"1 1","pages":"101-110"},"PeriodicalIF":0.9,"publicationDate":"2020-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91307873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}