The Emerging Problems of Alcohol and Substance Abuse in Late Life

Treatment of substance abuse among older adults will become increasingly important as the number of aged Americans increases. The abuse of psychoactive substances is a major contributor to excess morbidity, mortality, and homelessness among persons of all ages and socioeconomic strata regardless of race or ethnicity. Alcohol and tobacco account for the majority of substance abuse-related death and disability in the United States; the former through cerebrovascular and hepatic disease, accidents and violence, the latter through chronic pulmonary disease and malignancy. Patterns of substance abuse in late life are substantially different from those observed among younger adults. However, treatment may be less challenging. Effective diagnosis and treatment requires a nonpunitive, supportive, but persistent approach. This means the capacity to collect a substance intake history and the ability to formulate a treatment plan or referral strategy to an addiction specialist or residential treatment setting. It is also important for the practitioner to manage negative feelings toward patients who decline treatment or who are chronic abusers.     

Substance Use Patterns and Consequences Among Lesbians,Gays, and Bisexuals

Substance abuse among gays and lesbians may be considered a “neglected area” of drug use research in criminology and criminal justice. In the current study, we seek to address the lack of scientific inquiry on substance use among lesbians, gays, and bisexuals by drawing from an availability sample of 179 lesbian, gay, and bisexual (LGB) adults to examine substance use patterns as well as the relationship of self-esteem with problems associated with using alcohol and drugs. Results showed consistency in the frequency of tobacco, alcohol, marijuana, and cocaine use in the past year; however, more gay and bisexual men than gay and bisexual women reported problems stemming from substance use.     

Consumption and Saving Behavior of Older and Younger Baby Boomers in Korea

The 1998 Korean Survey of Family Income and Expenditures was used to examine the overall consumption and saving behavior of Korean baby boomers and compared the differences in consumption and saving behavior between older and younger boomers. The t -test results indicated that the younger boomers allocated a significantly higher percentage of their expenditures on food away from home, household appliances, transportation and communication than did the older boomers, whereas the older boomers spent higher amounts and allocated larger budget shares on their children's education than did the younger boomers. The results of Ordinary Least-Squares (OLS) regression analysis showed that, holding other factors constant, older boomers not only spent significantly more in the total consumption expenditures and education expenditures, but older boomers also saved significantly less than did younger boomers.     

Enhancing Health-Conscious Behaviors Among Clients in Substance Abuse Treatment Programs

The physical health of substance abuse clients significantly deteriorates because of the client’s prolonged abuse of alcohol and other drugs and accompanying behaviors. The purposes of this study are (a) to understand how substance abuse clinicians think about the health needs of their clients, (b) to identify the mechanisms through which clinicians seek to enhance health-conscious behaviors among their clients, and (c) to identify how substance abuse clinicians view their role in enhancing health-conscious behaviors among their clients. A qualitative study was conducted using in-depth, semistructured interviews with substance abuse clinicians (N = 16) from 4 substance abuse treatment centers. Using the theory of planned behavior as a framework for understanding the promotion of health-conscious behaviors in substance abuse treatment, the findings suggest that substance abuse clinicians are capable of enhancing health-conscious behaviors among clients in substance abuse programs.     

Barriers to Integrated Treatment of Substance Abuse and Trauma Among Women

Despite increasing empirical support for an integrated approach to treating trauma and substance abuse, many substance abuse treatment programs have been slow to embrace integrated models of practice. Using an embedded case study design, the purpose of this study was to understand barriers that prevented a substance abuse treatment provider and 20 professionals and staff from adopting an integrated approach to treating substance abuse and trauma. Data analysis revealed 2 kinds of barriers that prevented substance abuse treatment professionals from fully integrating substance abuse and trauma: systemic and professional barriers. These barriers have to be taken into account when trying to move providers and professionals toward integrated approaches to treating substance abuse and trauma.     

Physical Activity as a Helpful Adjunct to Substance Abuse Treatment

ABSTRACT

While limited research exists on the topic of physical activity as an adjunct to substance abuse treatment, a review of relevant multidisciplinary literature indicates a logical rationale for its potential benefits to recovery from addiction. This article provides an overview of common variables that contribute to addictive disease and summarizes the relationship of regular physical activity to improvements on many of these variables. The stages of change from the Transtheoretical Model (TTM, Prochaska & DiClemente, 1982; Prochaska & Velicer, 1997) are described in the context of effectively matching clients in substance abuse therapy to interventions that may include physical activity. Finally, important practical suggestions for implementing physical activity as a useful adjunct to substance abuse treatment are provided.     

Assessing Social Work's Contribution to Controlled Studies of Adolescent Substance Abuse Treatment

ABSTRACT

Findings from a review of social work's contribution to the adolescent substance abuse treatment outcome literature between 1990 and 2001 are presented. Social work involvement in adolescent substance abuse treatment was evaluated through a computerized bibliographic search of medical and social science databases and by a manual search of 13 core social work journals. Results indicate that social work has contributed little to knowledge development in adolescent chemical dependency treatment. Investigators affiliated with a department or school of social work accounted for three of 15 controlled treatment outcome studies. Only one report was published in a core social work journal. Efforts to develop clinical guidelines in this important practice domain will founder until a sufficiently directive body of practice-relevant research accumulates to guide evidence-based substance abuse treatment for adolescents.     

Adolescents in Treatment: Effects of Parental Substance Abuse on Treatment Entry Characteristics and Outcomes

SUMMARY

Research strongly supports an increased risk of substance use disorders among the adolescent children of addicted parents. However, little documentation exists of how these adolescents fare when they present for treatment. This article uses data taken from a two-state study on the effects of adolescent substance abuse treatment to examine the characteristics of adolescents with substance-abusing parents and their outcomes following an episode of outpatient treatment. Although such adolescents enter treatment with greater problem severity in a range of areas, outcomes appear similar to adolescents with no substance-abusing parents. The impact of family and individual counseling on outcomes was also examined, demonstrating mixed results for adolescents with substance-abusing parents.     

The Seven Challenges: An Effective Treatment for Adolescents with Co-Occurring Substance Abuse and Mental Health Problems

ABSTRACT

Recent developments in the provision of the substance abuse treatment for adolescents has included a focus on age appropriate treatment with consideration for adolescents' relatively low level of motivation for treatment and high incidence of co-occurring substance use and mental health problems. This study examines 3- and 6-month substance use and mental health outcomes for youth (n = 36) participating in The Seven Challenges Program. Results indicate significant reductions in both substance use and mental-health-related measures at 3 months with all measures except substance abuse frequency continuing to improve at the most distal 6-month assessment. The Seven Challenges treatment model is presented along with a discussion of the findings.     

Exploring the Nature of the Relationship Between Poverty and Substance Abuse

Abstract

Poverty and substance abuse are two serious social problems that are often assumed to be interrelated. This article explores what is currently known about the relationship between these two problems. Four possible models for describing the interrelationship are identified: causal, risk factor, exacerbation, and spurious. The theoretical explanations from both the substance and poverty literature are discussed in light of their implications for these types of models. The public health perspective is selected from the substance abuse theoretical literature as the model that best subsumes and directs thinking about the relationship between poverty and substance abuse, because its focus on agent, host, and environment draws attention to the range of factors that can influence both problems, as well as the ways in which they come together. Findings from the research literature are then discussed within the framework of the public health model. The article concludes by outlining the gaps in knowledge and an agenda for future research.     

Alcohol Use and Prior Substance Abuse Treatment in Relation to Gambling Problem Severity and Gambling Treatment Outcome

Recent research has made it clear that problematic gambling is often accompanied by problematic alcohol use. Unfortunately, little is known about the nature of this association, especially as it relates to gambling treatment outcome. The purpose of this study is to explore the effect of current alcohol use level and previous substance abuse treatment on the symptoms of a large cohort of pathological gamblers as well as on their response to treatment for pathological gambling. The sample included 464 men and 301 women recruited at six gambling treatment programs in Minnesota. Gambling treatment patients were assessed on a number of gambling problem severity and related clinical variables using the Gambling Treatment Outcome Monitoring System (GAMTOMS). Patients with frequent alcohol use had greater gambling involvement at baseline than infrequent alcohol users. Patients with a previous history of substance abuse treatment had more severe psychosocial problems, ostensibly resulting from their gambling behavior, than patients without past substance abuse treatment. A MANOVA with repeated measures showed that neither pretreatment alcohol use, nor past substance abuse treatment exerted significant effects on gambling treatment outcome. While the level of pretreatment alcohol use and a history of substance abuse treatment are markers for greater gambling problem severity, treatment outcome for pathological gambling was not adversely impacted by these variables.     

The Impact of Elder Abuse Education on Young Adults

The present study examined the effectiveness of educational interventions in altering tolerance for and behavioral intentions of elder abuse among college student young adults. Participants were 225 undergraduates who were assigned to one of four educational groups: Elder Abuse Education, Aging Education, Family Education, and a Pre- and Posttest only condition. While the Elder Abuse Education group reported less tolerance and intentions for elder abuse compared to the other groups at the immediate posttest, a decrement in such positive changes at 1-month follow-up was observed in such persons. These mixed findings suggest that while specific interventions may reduce elder abuse tolerance, supplemental educational efforts over time may be necessary to maintain intervention-specific gains in intentions and behaviors particular to elder abuse.     

Conceptual Model and Map of Psychological Abuse of Older Adults

Psychological abuse of older adults is a hidden and pervasive problem that is not well conceptualized nor well measured. Goals. The goals were to (a) conceptualize psychological abuse using three-dimensional concept maps, and (b) develop theoretical models. Methods. Statements describing the construct were generated by local and national panels. These were sorted and rated using Concept Systems software whereby the concepts were depicted as a map. Results. The concept maps guided development of theoretical hierarchies. Significance. Theoretical models may help to develop measures to estimate prevalence better and may enable more precise screening for triage into appropriate interventions.     

Powerlessness and Abuse and Neglect of Older Adults

ABSTRACT

This article is a qualitative study which addresses the interacting relationship between the environmental context of care giving and abuse and neglect of older adults. These are examined through a thematic content analysis of risk factors identified in sixteen ‘in depth’ interviews of abused and neglected victims including two of their abusers. The interviews provide a portrait of their past and present situations, their roles and relationships and the process through which the interviewees move into their described process of powerlessness.

The interviewees are analysed through a critical, systemic, ecological analysis of the historical, gender and cultural perspectives of the interviewees. Through the relationships of the victims and their abusers in the macro, meso, exo and micro systems, questions are raised about the growing debate regarding changes in family patterns and demographics that affect how societies define the provision of care to their dependent adults. They demonstrate that violence is produced by complex interacting systems and significant events, that impact on the life courses of some older adults and some care givers leading them into powerless positions and resulting in abuse and neglect.     

Infant Trafficking and Baby Factories: A New Tale of Child Abuse in Nigeria

Baby factories are new systematic abuse structures that are promoting infant trafficking, neo‐slavery and the exploitation of young women with unwanted pregnancies in Nigeria. Since this practice was first described in 2006, it has been growing rather than abating. This paper reviews the scientific literature, along with media reports, and critiques this phenomenon from a children's rights' perspective. Children born into baby factories are denied various civil rights. They also suffer abuse in the baby factories and as a consequence of being born in such places. This abuse can be classified into immediate and long term. Immediate abuse includes inadequate care and its repercussions, denial of birth registration, illegal adoption and murder. Long‐term or delayed abuse that they may be exposed to includes health‐related consequences, neglect, death, child labour, prostitution and other sexual abuse, organ trafficking and recruitment as child soldiers. Various factors are thought to drive the baby factory phenomenon which include poverty, high infertility rates and the profitability of local and inter‐country adoptions. Programmes directed at addressing the root cause of the problem are needed in order to eliminate infant trafficking. Also, clear laws that delineate inter‐country adoption and infant trafficking need to be enacted. Most importantly, baby factories need to be recognised as child trafficking routes. Copyright © 2015 John Wiley & Sons, Ltd.

‘New systematic abuse structures that are promoting infant trafficking, neo‐slavery and the exploitation of young women’

Key Practitioner Messages:

• A new type of child abuse and human trafficking that targets infants has emerged in Nigeria in what are described as ‘baby factories’.
• Baby factories are criminal entities that exploit young girls with unwanted pregnancies and the practice is growing.
• Children born in baby factories suffer a range of immediate abuses and are exposed to long-term abuses.
• Baby factories violate several articles in the Convention on the Rights of a Child.

‘Criminal entities that exploit young girls with unwanted pregnancies’

Citing Literature

Number of times cited: 5

• Olga B. A. van den Akker , Cross-Border Surrogacy , Surrogate Motherhood Families , 10.1007/978-3-319-60453-4_8 , (199-230) , (2017) . Crossref
• Olusesan Ayodeji Makinde, Clifford Obby Odimegwu and Stella O. Babalola , Reasons for Infertile Couples Not to Patronize Baby Factories , Health & Social Work , 42 , 1 , (57) , (2017) . Crossref
• Peter Sidebotham , Kneeling on Mung Beans , Child Abuse Review , 25 , 6 , (405-409) , (2017) . Wiley Online Library
• Olusesan Ayodeji Makinde, Olufunmbi Olukemi Makinde, Olalekan Olaleye, Brandon Brown and Clifford O. Odimegwu , Baby factories taint surrogacy in Nigeria , Reproductive BioMedicine Online , 32 , 1 , (6) , (2016) . Crossref
• Olusesan Makinde, Bolanle Olapeju, Osondu Ogbuoji and Stella Babalola , Trends in the completeness of birth registration in Nigeria: 2002-2010 , Demographic Research , 35 , (315) , (2016) . Crossref

Volume 25 , Issue 6 November/December 2016

Pages 433-443     

The Effects of Loneliness on Telemarketing Fraud Vulnerability Among Older Adults

ABSTRACT

Older adults are disproportionately affected by telemarketing fraud, especially those who are socially isolated. Twenty-eight older adult telemarketing fraud victims completed a questionnaire assessing loneliness and other variables related to telemarketing fraud vulnerability. Victims tended to be male, divorced/separated, and college-educated, between ages of 60 and 70. Age and marital status were significantly associated with loneliness. This study is an important first step for additional research in this area and may enhance the prevention and intervention efforts of social service providers who work with older adults who may be most vulnerable.     

A Family Perspective for Substance Abuse: Implications from the Literature

SUMMARY

This paper calls for researchers and treatment providers to increase their recognition of the role that family and family functioning has for understanding the incidence and impact of substance abuse. Substance abuse is identified as a family problem by exploring its occurrence within families as well as its impact on marital relationship, family violence, and child abuse and neglect. The impact of substance abuse on the roles of spouses and parents are examined, as is the impact of substance abuse on children at various developmental stages. The role of the family as participant in active substance abuse as well as a valuable treatment resource is also explored. Finally, the authors present recommendations for increasing the focus on family in substance abuse research.     

Substance Use and Mental Health Severity Among LGBTQ Individuals Attending Minnesota Model-Based Residential Treatment

This administrative data analysis examined substance use and mental health severity among a sample of lesbian, gay, bisexual, transgender, and questioning (LGBTQ) individuals receiving residential treatment for an alcohol or drug use disorder. LGBTQ were statistically compared to heterosexual patients on a number of variables, including frequency and amount of pretreatment alcohol use, frequency of pretreatment illicit drug use, co-occurring Axis I mental health diagnoses, and past history of physical or sexual abuse. LGBTQ patients exhibited significantly greater severity on nearly all variables, suggesting a strong relationship between clinical severity and being a sexual minority. This study also found a relationship between patient gender and the pattern of differences between LGBTQ and heterosexual patients. These results replicate and extend those of studies examining LGBTQ in the general population and suggest opportunities for development of alcohol/drug treatment approaches that address the unique needs of LGBTQ.