Koob: Understanding negative reinforcers of opioids could uncover new treatments

The National Survey on Drug Use and Health (NSDUH) showed that treatment for illicit drug use declined in 2018, from 2.2 million in 2017 to 1.8 million in 2018. In 2018, treatment for heroin was not even on the chart. There was no data.     

Elderly Prisoners: A Growing and Forgotten Group Within Correctional Systems Vulnerable to Elder Abuse

ABSTRACT

There are over 2.1 million people incarcerated in the nation's jails and prisons. Additionally, close to 600,000 prisoners are released annually into communities across the country. Many prisoners and those released from prisons are elderly. The purpose of this article is to examine the systemic abuse and neglect experienced by elderly prisoners while they are incarcerated and when they are released from prison. Most correctional systems have inadequate resources, processes, and personnel to manage the elderly population inside and outside of prisons. In addition to providing a definition of “elderly prisoner,” two specific problems–prison health care and prisoner re-entry–are examined in the article. The article concludes with recommendations for both policy and research on how best we can further understand and address the multiple needs and concerns faced by elderly prisoners.     

Employment and Support Allowance,the ‘summer budget’ and less eligible disabled people

In the first UK budget by a Conservative Government for 18 years, £13 billion per annum savings in social security spending by 2020/21 were announced. Of these, 4.9% (£640 million per annum, and up to £900 million in the years after 2020) is to come from the withdrawal from April 2017 of the work-related component of the Employment and Support Allowance. This means that new claimants will be worse off by £29.05 per week (2015/16 figures) than would have been the case had the measure not been introduced. This brief commentary critically analyses this development as the extension of an ideological assault upon the out-of-work benefits for disabled people which has been gathering momentum for about a decade in the hope of forcing such people into competing for wage work in the open market.     

The use of mental health care,psychotropic drugs and social services by divorced people: does informal support matter?

This study compares the mental health care, psychotropic drugs and social service use of divorced people (re-partnered or single) with that of married people. This paper questions whether the availability of informal support facilitates or substitutes for formal care seeking. Data from the Divorce in Flanders survey of 2009–2010 are used. Logistic regression analyses are performed separately for women (N = 3450) and men (N = 3020). Greater use of mental health care, psychotropic drugs and social services by single divorced men is explained by their higher need for care, while divorced women (especially single divorced) more frequently contact a general practitioner (GP), a psychiatrist, or a psychologist, regardless of their mental health, socio-economic background and informal support. Women who have support from non-family members are more inclined to use social services and to contact a GP, while support from family members is only positively related to GP consultations. With regard to men, informal support from non-family members positively influences each type of formal care seeking. Our results suggest that non-family members (and only among women, family members as well) can provide help and advice about seeking professional mental health care and social services, but they do not have an influence on psychotropic drug use.     

Talking about The Shape of Water: three women dip their toes in

Abstract

This article is about a film called The Shape of Water by Guillermo del Toro, which was released in 2017 and won the Best Picture award at the 2018 Oscars. The three authors of this article, all friends, had each enjoyed The Shape of Water, so went for a second viewing together. Our enjoyment had been somewhat at odds with criticisms of the film, mostly made by other members of the disabled people’s community/disabled academics. After seeing the film again, we found it to be a ground-breaking portrayal of a disabled woman. This article is a summary of the discussion which ensued. Our discussion of The Shape of Water is a current issue because we found ourselves disagreeing with, and questioning, a number of complaints about the representation of disability and impairment within the film. At a time when the film industry is making noises about inclusion, it is important that we know what we are asking for, and avoid demands which may be counterproductive to the cultural recognition of disabled people. This film is still being shown in cinemas in the UK and elsewhere.     

Mental health and the media: From illness to wellbeing

The media are a main source of information about mental health for many people, and an ever‐growing body of literature is evaluating their coverage of the topic. To help keep track of such research, several comprehensive but now dated literature reviews have been published. We assess more recent studies (2007–2017) and suggest future directions by integrating (a) the “circuit of mass communication” model from media and communication studies which posits that production, content, and reception need to be analysed for an in‐depth understanding of the media, (b) the holistic view of mental health as comprising both illness and wellbeing, and (3) the critical psychiatry literature questioning the assumptions underlying psychiatric knowledge and practice. We find that recent studies have focused on content and “the illness side” of mental health by examining the representation of particular mental disorders and events involving individuals with specific diagnoses. We identify as a promising development the growing interest in “the wellbeing side” of mental health whereby authors have started to analyse recovery messages. We invite more production and reception research and more critical content studies which use diagnostic labels cautiously and analyse the representation of people with mental health problems as the victims of violence.     

Aging,Disability, and Disabled Older People in India

Summary

India is witnessing a demographic revolution, leading to a considerable increase in the proportion of older people in the population. Similarly, life expectancy of both the mentally and physically disabled has improved considerably. About 5% of Indian older people have problems with physical mobility. Aging has become a gender issue in India not only because more women are surviving into old age; they are also vulnerable and disadvantaged in many ways. In most cases they are the only caregivers available for the old and disabled. Older Indians are considered a high-risk group for multiple morbidity. It is estimated that nearly four million Indians suffer from mental problems. India has around 12 million people designated as “handicapped.” However, little information is available about disabled people who grow older. The National Policy on Older Persons, which has been recently formulated, aims at providing an improved quality of life for millions of older Indians. However, the concerns of older disabled and of the disabled who grow old are still treated separately in both policy and practice.     

Stress,Coping, and Mental Health Differences among Homeless People

People who are chronically homeless are assumed to have higher rates of mental health problems than episodically or new‐entry homeless individuals. It is unclear to what extent early‐life and current stressors account for this disadvantage. Guided by cumulative disadvantage theory and stress research, we analyze data from a national study of the US homeless population to examine how stressors and coping resources throughout the life course are implicated in differences among homeless people in psychiatric disorders and alcohol or other drug abuse disorders. Logistic regression analysis reveals that new‐entry homeless persons are less likely than their chronically and episodically homeless counterparts to have current psychiatric disorders. This is explained by stressors and coping resources experienced in childhood and during adult homeless spells. Alcohol and other drug abuse is common but comparable across the three homeless types and shares an association with selected stress and coping measures. Findings lend credibility to an accumulation of risks perspective, highlighting how past as well as contemporaneous stressors are related to the mental health of homeless people.     

Sublocade: Why a placebo arm?

In a time when people are dying from illicit fentanyl overdoses, why would a trial for a new medication to treat opioid use disorder — a formulation of buprenorphine, already proven to be safe and effective in oral form — include a placebo arm? This was the question asked by many when the results of Indivior's trial for Sublocade, a buprenorphine injection that lasts a month, were published last month in The Lancet (see ADAW, Feb. 25). The trial results were what led to Sublocade's approval by the Food and Drug Administration (FDA) for the treatment of opioid use disorder more than a year ago (see ADAW, Dec. 11, 2017).     

Departies: conceptualizing extended youth parties

Every year, millions of young people travel away from home to party for days or weeks on end in permissive environments, such as music festivals, dance parties, and nightlife resorts. The studies that have been conducted on these extended youth parties have focused primarily on specific risk-taking behaviors, such as drug use and violence. Here, we scrutinize the research on extended youth parties to identify general changes that young people undergo at these events. We call these celebrations departies, because they center on the organization and facilitation of momentary departures from the participants’ everyday life. Participants depart (1) spatially, by traveling to locations that are constructed as sites of opportunity and excess; (2) temporally, by partying for several days in a row and focusing on immediate gratifications; (3) morally, by engaging in activities that are widely deemed immoral; (4) stylistically, by altering their stylistic expressions through dress, demeanor, and consumption; and (5) experientially, because the parties generate mood and mind alterations. These are overlapping and intertwined elements, the combination of which amounts to a distinct type of youth party. Departies constitute exceptional events in the lives of many young people, and ought to be studied from a comparative perspective.     

Provider Preparedness for Treatment of Co-occurring Disorders: Comparison of Social Workers and Alcohol and Drug Counselors

Substance use and mental health disorders remain significant behavioral health concerns in the United States and other Western nations. Nearly half of the 20.3 million adults with substance use disorders in the US have a co-occurring mental illness . Despite growing research support, integrated treatment by providers with expertise in both mental health and substance use is critically lacking. As part of a co-occurring disorders (COD) training initiative in the USA, this study investigated providers' (n = 438) past training, current COD service provision, and future training needs. Specifically, we examined the extent to which social workers were prepared to treat individuals with COD compared to alcohol and drug counselors. Unsurprisingly, social workers reported receiving significantly more mental health related training, while alcohol and drug counselors reported more substance use related training. Alcohol and drug counselors reported significantly more COD-specific training including general COD, psychopharmacology, COD treatment, and relapse prevention. Social workers were significantly more likely than alcohol and drug counselors to report wanting more training in substance use disorders and culturally-specific intervention techniques. These findings suggest that tailored training and licensure changes are needed to enhance social workers' capacity for competent COD treatment.     

Briefly Noted

The biennial International Drug Policy Reform Conference, sponsored by the Drug Policy Alliance and held Nov. 7–9 in St. Louis, Missouri, was full of varying sessions on harm reduction and reform — 45 of them in all. An article by Filter editor Will Godfrey summed up his perspective — he was the only print reporter so far to have covered the entire conference. We asked him what his feeling was about the prospects for treatment and harm reduction working together, as they have in the past. “There's plenty of friction, but there can and should be rapprochement between the harm‐reduction and traditional treatment communities,” he told ADAW. “Many people in the harm‐reduction movement pursue traditional recovery, and there are treatment folks who support harm reduction. All should be trying to save lives and empower people. Harm reductionists' legitimate concerns about mainstream treatment include its coercive or controlling deployment, its frequent eschewal of evidence‐based practices and its promotion of abstinence at the expense of stigmatizing people who use drugs. Treatment advocates often overlook that most people who use drugs are fine. And in any case, everyone must be free to choose their own path.” But the fact that two approaches — one more radical than the other — coexist still is bound to make some treatment providers uncomfortable. After all, some of the speakers said that even supervised consumption sites are unfair to drug users, who have no need to be “supervised,” and instead should be free to use drugs. All viewpoints were there. “There's constant debate in the harm‐reduction movement about working to change systems that inflict harm from the inside, versus calling for radical reforms from the outside,” said Godfrey. “I think both approaches are simultaneously necessary.” Not everyone saw the conflict. “I have to say that I didn't see an anti‐public health movement there at all,” Maia Szalavitz, who is writing a history of harm reduction and is respected in both harm reduction and some, at least, treatment camps, told ADAW. “There has always, of course, been tension between activists and researchers and between people who want to fight within the system and those who want to tear it all down.” For the Filter article, go to https://filtermag.org/drug‐policy‐reform‐movement/ .     

Blurring Boundaries? Linking Technology Use,Spillover, Individual Distress,and Family Satisfaction

Information technology is entrenched in everyday life; yet, scholars have not firmly established whether this use blesses or vexes individuals and their families. This study analyzes longitudinal data (N =1,367) from the Cornell Couples and Careers Study to assess whether increases in spillover explain changes in distress and family satisfaction associated with technology use. Structural equation models indicate that cell phone use over time (but not computer use) is associated with increases in negative forms of spillover (positive spillover is not significant) and is linked to increased distress and lower family satisfaction. Overall, the evidence suggests that technology use may be blurring work/family boundaries with negative consequences for working people.     

‘It’s so scary how common this is now:’ frames in media coverage of the opioid epidemic by Ohio newspapers and themes in Facebook user reactions

ABSTRACT

Deaths from opioid overdose in the US have increased five-fold since 1999. Ohio ranks second among states in drug overdose deaths, with more than 39 deaths for every 100,000 people. In light of this, opioid addiction and related issues have garnered substantial media attention. However, few studies have examined the content and framing of opioid-related media coverage or explored ways that audiences react to coverage of the crisis within their communities. This study attempts to fill this gap through an analysis of opioid-related posts and comments on the public-facing Facebook pages of 42 Ohio newspapers between 2013 and 2017 (N?=?397). Content analysis was used to identify frames in posted newspaper content and themes in comments. Four frames were identified in posted stories: (1) Awareness of the Opioid Epidemic and Affected Populations (34.0% of all posted content; n?=?135); (2) Programs, Policies, and Interventions (29.5%; n?=?117); (3) Crime, Punishment, Legal Cases, and Law Enforcement (28.2%; n?=?112); and (4) Narratives of Addiction and the Long Road to Recovery (8.3%; n?=?33). Analyses of Facebook user comments on posted newspaper content revealed five themes: Emotion and Support, Choice and Responsibility, Disease and Treatment, Worthiness, and Attention and Action. Findings indicate both the intensive and diverse efforts of newspapers to cover the epidemic as well as the varied reactions of community members to opioid use and addiction.     

Aspects of the ecology and behaviour of a potential urban exploiter,the southern tree agama,Acanthocercus atricollis

Urbanisation has caused significant alterations to ecosystems, generally resulting in decreased biodiversity. However, certain animal species persist and thrive in urban environments by making use of available opportunities, anthropogenic resources, infrastructure and increased ambient and surface temperatures. These species are known as urban exploiters. We investigated the southern tree agama, Acanthocercus atricollis population trends, habitat use and basking and shading behaviour in a high-density urban human-populated housing metropolitan area in Pietermaritzburg, KwaZulu-Natal, South Africa. We marked individual southern tree agamas to determine habitat use and territories (n?=?37). The southern tree agama population density was high, and they had established set territories here. We conducted monthly observations (February 2017–July 2017 and March 2018–February 2019) to determine the degree of basking and shading behaviour with season and time of day and location. Southern tree agamas invested more than half of their time (57%) in basking behaviour during the overall observational study period. Basking and shading patterns changed with season and time of day. The number of basking southern tree agamas decreased during winter and basking commenced later. We found that increased anthropogenic infrastructure and supplementary food availability, decreased predators, and basking opportunities could have had an influence on their population increase and that the southern tree agama is a potential urban exploiter.

     

Childhood Family,Ethnicity, and Drug Use Over the Life Course

Using multiply imputed data from 5 waves of the National Longitudinal Survey of Youth (N = 8,294), we investigated whether childhood family characteristics and childhood religious affiliation explain ethnic differences in marijuana and cocaine use in the last year. None of the childhood factors explained ethnic differences in drug use, though ethnicity and several childhood factors had age‐specific effects. Over the life course from young adulthood to middle age, ethnic differences in drug use changed and the effect of childhood religious affiliation declined. Having a more intellectually rich family in childhood increased the risk of drug use at younger ages but reduced it at older ages. The study demonstrates the significance of childhood family experiences for understanding adult drug use.     

SPORTS‐LED TOURISM,SPATIAL DISPLACEMENT,AND HOTEL DEMAND

We analyze the relationship between professional sports events and concerts held in LA's Staples Center and nearby hotel performance. Government‐led economic redevelopment projects often envision sports facilities as tourist magnets. Little evidence exists supporting links between sporting events and hotel demand. An empirical analysis exploiting exogenous daily variation in the timing of games and concerts from 2002 to 2017 shows a small positive impact on room revenue at hotels within one mile and larger room revenue decrease at hotels located one to 4 miles away. The overall impact on hotel room revenue and rooms rented was not positive. Nearby hotel room rates increased during NBA and NHL work stoppages. The city granted four new hotels built very near the arena exemptions from occupancy taxes for 20–25 years; these exemptions reduced hotel tax revenues by a minimum of $4.5 million annually and may not have been needed to spur new hotel development. (JEL H26, H71, Z28)     

The Pune Slum Census: creating a socio-economic and spatial information base on a GIS for integrated and inclusive city development

Urban planning systems rarely include the poor. Cities are growing and so is the urban population. Pune is a large city in Western Maharashtra. According to the National Census, 2001, the population of the Pune urban agglomeration is 3.5 million and it is (in some estimates) to reach nearly 6 million by 2021.¹ Out of this, the city of Pune has a 2.5 million people living in it. Forty percent and above of the population live in slums. One of the biggest shortfalls of Pune's urban planning is that it still fails to include the poor in mainstream policies. The reason is that the poor are hardly known about, in fact, even government authorities are unaware about how many poor people there are in Pune. This attitude, and the fact that Shelter Associates (SA) work is closely connected with the poor regarding basic services and housing, started the development of a slum database by SA. Finally, the Pune Municipal Corporation asked us to make a complete census of the slum dwellers in the year 2000. That gave rise to a detailed survey of Pune's slum dwellers, to become, amongst other things, the first ever spatial and socio-economic census processed and analysed on a geographical information system (GIS). The Pune Slum Census has built upon this experience and expanded the communities’ information base, and has created a methodology which the city can use to work on detailed urban planning using a GIS and with the slum database as the base. This article focuses on the Pune Slum Census in progress.     

Heaviest drinkers still drinking during lockdown: UK research

Lockdown due to the COVID‐19 pandemic doesn't necessarily result in an across‐the‐board increase in alcohol consumption, according to research commissioned by Alcohol Change UK and released last month. The study found that 21% of adults who drink alcohol are drinking more often since the March 23 lockdown began in England, but that 35% reduced their frequency of consumption or stopped drinking altogether. Of those surveyed, 6% of previous drinkers chose to stop drinking altogether during lockdown. The study, a representative survey of more than 2,000 people, extrapolates to 8.6 million adults in the United Kingdom drinking more frequently since lockdown, while 14 million are drinking less often or have stopped drinking entirely. In addition, many people are seeking help based on visits to the “Get help now” section of Alcohol Change UK's website increasing 355% between March 23 and April 13, compared to the same period last year.