Whose Responsibility is it? A Call for the Integration of the Knowledge of Substance Misuse in Social Work Education,Practice and Research

This commentary is based on the review of two articles written by Hutchinson and Allnock (2014a; 2014b) presented in this journal issue. The commentary reviews the two articles and other research on the integration of substance misuse in social work education, practice and research. Four lessons are presented in terms of how to enhance the knowledge and skills around substance misuse by creating stronger links between social work education, practice and research.     

Assessing state substance abuse prevention infrastructure through the lens of CSAP's Strategic Prevention Framework

Although the organizational structures and operating procedures of state substance abuse prevention systems vary substantially across states, there is scant empirical research regarding approaches for rigorous assessment of system attributes and which attributes are most conducive to overall effectiveness. As one component of the national cross-site evaluation of the SPF State Incentive Grant Program (SPF SIG), an instrument was developed to assess state substance abuse prevention system infrastructure in order to measure infrastructure change and examine the role of state infrastructure in achieving prevention-related outcomes. In this paper we describe the development of this instrument and summarize findings from its baseline administration. As expected, states and territories were found to vary substantially with respect seven key characteristics, or domains, of state prevention infrastructure. Across the six domains that were assessed using numeric ratings, states scored highest on data systems and lowest on strategic planning. Positive intercorrelations were observed among these domains, indicating that states with high capacity on one domain generally have relatively high capacity on other domains as well. The findings also suggest that state prevention infrastructure development is linked to both funding from state government and the presence of a state interagency coordinating body with decision-making authority. The methodology and baseline findings presented will be used to inform the ongoing national cross-site evaluation of the SPF SIG and may provide useful information to guide further research on state substance abuse prevention infrastructure.     

Adolescents’ perceptions of the ‘substance use-violence nexus’: a South African perspective

The aim of the study was to explore adolescents’ perceptions of substance use as a contributing factor to community violence by employing a conceptual framework proposed by Goldstein. Data were collected from a sample of adolescents between the ages of 15 and 16 years by means of focus group interviews. Theoretical thematic analysis was used to analyse and interpret the findings. The participants’ perceptions indicated that substance use and withdrawal symptoms induce physiological and behavioural modifications resulting in aggression and violence. The findings also suggest that participants believed that substance users frequently commit property and violent interpersonal crimes such as theft, robbery, assault and murder to procure their substances. Further, the adolescents’ perceived violence to be rooted within gang culture as well as the involvement in shared markets for illicit substance trading.     

The Extent and Nature of Practitioners,Encounters with Alcohol and Other Drug Use in Social Work and Social Care Practice

This article considers the extent and nature of social work and social care practitioners' experience of working with service users whose lives are affected by the problematic use of alcohol or other drugs (AOD). It draws on the findings of a national study of ‘working with alcohol and drug use’ which was conducted in England in 2010–2011. The study reported here comprised an online survey of front-line practitioners (n = 597), complemented by 12 practitioner focus groups and interviews with 21 key informants from participating local authorities and substance use treatment services. This paper focuses primarily on data from one element of the survey. Findings indicate that the great majority of staff encountered service users who are affected by AOD problems at some level, although there were differences between groups of practitioners in the extent and nature of AOD problems for different groups of service users. The differential experiences of staff according to their client groups underlines the need for education and professional development not only to provide training on working with AOD but to ensure that training is contextualised and relevant to practitioners across the range of social work and social care services.     

School context and American Indian substance use

The present study extends prior research exploring the role of school contextual factors in predicting individual adolescent substance use by examining how a school’s racial composition is associated with American Indian adolescent tobacco and marijuana use. Using a subsample of 523 American Indian students from the restricted use Add Health data, we consider both individual and school contextual factors across 99 schools. Our results suggest that a school’s racial composition is associated with individual tobacco and marijuana use among American Indian youth, but in different ways depending upon the substance. Our findings illustrate the importance of extending research on the correlates of substance use for racial and ethnic minorities beyond studies examining African-Americans and/or Hispanics.     

Exploratory Study on Drug Users’ Perspectives on Quality of Life: More than Health-Related Quality of Life?

In drug treatment outcome literature, a focus on objective and socially desirable indicators of change (e.g. no drug use) has predominated, while outcome indicators that are important for drug users themselves (e.g. quality of life, satisfaction with treatment) have largely been neglected. Nonetheless, Quality of Life (QoL) has become an important concept to evaluate effectiveness of treatment in mental health care research and disability studies. Given the almost exclusive focus on Health-related Quality of Life (HRQOL) in substance abuse research and the neglect of clients’ perspectives in this field, we explore in this study the concept of QoL as perceived by drug users. Focus group discussions (n = 9) were organised in various treatment settings and community services for drug users in the region of Ghent, Belgium to identify important dimensions of QoL and their interpretation by drug users. Data were clustered and analysed based on the theoretical framework of Robert Schalock (Quality of life. Volume 1: Conceptualization and measurement, 1996). The domains ‘personal relationships’, ‘social inclusion’ and ‘self-determination’ were discussed most frequently by the participants. They stressed the importance of a supportive social network in particular. It can be concluded that QoL is not primarily associated by drug users with health and it involves much more than the aspects typically represented in measures of HRQOL.     

作为后现代情感的网络爱情：一个过程论的视角

由于网络爱情所具有的既隔离又连结的特性，使得人们获得较高的安全感的同时，又保有与他人的亲密感。所以，在网络中形成和发展的网络爱情所反映出的需要别人的许可和接受，需要别人的支持和合作，人们既想发泄内心深处的不安全感，渴望社会生活，同时又不想被伤害等精神旨趣，与“后现代情感”存在着逻辑的耦合与同构性。     

Lifestyle habits,substance use and predictors of job burnout in professional working women

Abstract

This study explores differences in self-reported lifestyle habits, substance use (alcohol, drugs and smoking) and predictors of job burnout in a sample of 879 professional working women employed in dental health ofices in a cross-sectional design. Job burnout was measured using the Maslach Burnout Inventory (MBI) and self-reported substance use and lifestyle habits were assessed using the Stress Assessment Profile. Self-reported drinking, smolung and drug use were only modestly correlated with each other in this sample. Employed women with higher levels of drinking reported significantly lower quality overall lifestyle practices, eating/nunition habits, and more frequent use of avoidant coping strategies in the face of work and life hassles compared to non-drinkers. Women who smoked also reported significantly lower overall lifestyle practices and eating/nutrition habits. Those who reported using drugs for recreational purposes reported significantly greater hassles, poorer lifestyle habits, a less hardy outlook on life, and more frequent use of dysfunctional coping strategies. Although women who reported using drugs experienced significantly higher interpersonal burnout (depersonalization) compared to non-drug users, in general, self-reported substance use was not significantly related to job burnout. After controlling for age and psychological distress, perceived stress, type A behaviour, cognitive hardiness and lifestyle habits significantly contributed to predictions of job burnout in multiple regression analyses. Despite methodological limitations, the prevalence of substance use found in this study supports previous research findings. Professional working women who practise poor lifestyle and health habits appear to be at risk of experiencing job burnout.     

The Role of Hawaiian Elders in Substance Abuse Treatment Among Asian/Pacific Islander Women

SUMMARY

The elders of a culture are often the designated transmitters of long-standing values and ways that define the unique essence of a people. Küpuna (elders) teachings are especially important to Native Hawaiians who have experienced the cumulative effects of cultural imperialism, which has taken their lands, discouraged use of their language and cultural ways, damaged their identity as a people and destroyed their sovereignty.

Modern day cultural imperialism, which universalizes the dominant group's experience and culture, renders minority groups as invisible while marginalizing them (Young, 1990). The chronic stress of this insidious form of oppression can translate into physical, mental health problems which lead to decreased life expectancy (McEwen, 1998; Schulkin, Gold & McEwen, 1998). Statistics on Hawaiians and other Asian/Pacific Islanders in Hawaiì indicate these groups have high rates of health problems and increasing rates of substance abuse (Office of Hawaiian Affairs, 1998).

This article describes the roles and Hawaiian practices of küpuna who acted as facilitators in the healing of Asian/Pacific Islander pregnant and postpartum women who participated in a culturally based substance abuse treatment program (CBSATP). The findings of a qualitative study, which examined the effectiveness of küpuna in these roles and their implications for practice are discussed.     

Retrospective Reasons for the Initiation of Substance Use

ABSTRACT

Evidence for comorbidity in psychiatric disorders and chemical depend ency suggests that peopie with ad dietion problems use drugs and alcohoito cope with painful affeetive states and symptoms. At the same time, sus tained chem i cal use may also lead to fur ther dam age and mimic symp toms of dis or ders. This study was de signed to build knowledge about the rea sons in-patient and out-patient sub stance abus ers in treatment initially use, and to test if there were dif fer ences be tween gender and eth nie (White non-His panic and Af ri can-Amer i can) groups. Findings in di cated that peo pie not only started using drugs and al co hoi to en hance af feetive states, they also were likely to use chem i cals as a way to cope with pain ful, af feetive symp toms. Gender seemed to play a salient role than ethnieity in that fe males of either ethnieity were more likely than males to end or se items relating to the management of negative af feetive states, for enhancement of skills and prob-lem-solving abilities, and for per ceived lack of alternatives. Implications of this study are provided.