The role of research in drug policy in Hong Kong: highlighting life satisfaction from two longitudinal studies of drug abusers

ABSTRACT

This paper examines the role of research in the development of drug policy in Hong Kong. The upsurge of the prevalence of psychoactive drug abuse in young people since the mid-1990s had brought about a great demand for medical and social science research on psychoactive drugs and users. Among a large number of Beat Drugs Fund-funded projects, two longitudinal studies, conducted between 2000 and 2002 and between 2009 and 2011, respectively, were used to illustrate the possible contributions of research findings to treatment and rehabilitation services. The most salient finding present in both studies was the significant and negative relationship between life satisfaction and continuation of drug use. The finding suggested that subjective well-being should be incorporated into treatment programmes, and there is a need to provide post-treatment services to young rehabilitated psychoactive drug abusers in the form of life planning programmes and organisation of sustainable social activities in the community.     

‘I make use of my precious experience,and help others. It's a kind of blessing.’ Does public sharing of past experiences help in the rehabilitation of former offenders or drug abusers?

The Community Education Service (CES) of The Society of Rehabilitation and Crime Prevention (SRACP) has pioneered the adoption of life education in crime prevention education in Hong Kong since 1977. Under this programme, former offenders and drug abusers are recruited to share their experiences with community audiences. Through such sharing, it is hoped that the former offenders and drug abusers will gain a deeper insight into the consequences of committing crime or abusing drugs, have the courage to admit their failings and find the way to lead a more fulfilling and law-abiding life.

In the past, different organizations have employed former offenders and drug abusers in educational programmes, particularly in relation to the prevention of juvenile delinquency. A number of studies demonstrate the educational effectiveness of sharing past deviant behaviours with audiences. Moreover, the mission of SRACP is to help the reintegration into society of former offenders and drug abusers. Consequently, employing former offenders and drug abusers to share their experiences serves another important function; to facilitate the transformation of their past histories into valuable assets and help with their own rehabilitation during the process of serving others, as suggested by ‘helper therapy’ and ‘professional ex-s’ (Brown 1991). A successful rehabilitation means success in reducing recidivism.

This paper examines whether sharing one's real-life experiences with others can influence the rehabilitation process, and provides recommendations for improving service delivery to benefit both audience and the speakers themselves. Fifteen individuals who were formerly either offenders or drug abusers, aged between 18 and 45 years, and who had led a ‘clean’ life for the previous six months, took part in in-depth interviews in order to investigate their perceptions of the function of real-life experience sharing in their own rehabilitation. Concepts of labelling theory (Becker 1963) and self-fulfilling prophecy (Wilkins 1976) provided the framework for these interviews.

The study concludes that respondents are normally able to help themselves to resist crime and drugs, given that the internal and external factors affecting sharing are well addressed. The results identify practical implications and directions for future involvement of former offenders and drug abusers in community-based crime prevention education programmes.     

Childhood maltreatment among Norwegian drug abusers in treatment

This article reports on the investigation of the correlation between the European Addiction Severity Index (EuropASI) and the Childhood Trauma Questionnaire (CTQ) among 102 Norwegian drug abusers admitted to treatment. The aim of the study is to explore how different types and levels of childhood trauma and social and psychiatric factors, medical situation and experienced family history are interrelated. The study addresses three main questions: 1) What is the prevalence of different kinds of childhood trauma among drug abusers in treatment? 2) Does type or level of maltreatment in childhood predict specific substance abuse problems as adults and/or specific social, psychiatric and medical problems as adults? 3) Do substance abuse problems and mental health problems in the primary family predict different types and levels of childhood maltreatment? Twenty‐five per cent of the total sample was included in the high‐level trauma group and 54% in the intermediate‐level group. Females had significantly higher scores than males in all types of childhood trauma. The strongest correlations were found between childhood trauma and lifetime psychiatric problems and psychiatric status during the last 30 days before admission for treatment. More research, and especially prospective studies, is needed to clarify the importance of parents' substance abuse and psychiatric problems in childhood/adolescent compared with trauma in the client's childhood and the client's current psychiatric status.     

Easy target and moral panic: the Law on Drug Addiction No. 162 of 1990

In industrialized societies the war against drugs tends to develop into a war that concretely strengthens control by the state over potentially dangerous classes. This is also true for Italy. In 1988, Bettino Craxi, now under investigation for a series of serious crimes, but at the time the powerful leader of the Socialist Party, launched a crusade against drugs. After about 18 months of moral panic campaigns, Law No. 162 was passed. Its ideological keystone is the section forbidding the personal use of narcotic or psychotropic drugs. Its officially declared objectives are to reduce the drug trade, to increase access by drug addicts to the services and, of course, to reduce the number of deaths by overdose. The available evidence, however, does not prove that these objectives have been reached. Rather, the true motivations must be sought elsewhere: in the attempt by the political class to regain legitimacy and thus consensus.     

The role of social support when giving up drug abuse: a female perspective

This article contains a presentation and analysis of the results from two qualitative studies, which examined female drug abusers' everyday lives and the social support available to them within their close relationships. Both studies concerned women who were participating in work-training or treatment programmes and who were in the process of giving up drug abuse. The two main questions concerned the supply of social support from the women's social networks and whether the amount of support available or lack of support had any impact on the exit process. Social support within different relationships of the women's social networks is presented, as well as different types of professional social support and treatment. The results in relation to previous research about female drug abusers and social support from gender and class perspectives are discussed. Conclusions about three important factors when creating a new life after drug abuse are drawn.     

Poverty drug use in Hungary

There is little substantive information on the present trends on drug use in the countries of central and eastern Europe, including Hungary. There has been a substantial change in recent years in the illegal and legal use of psychoactive substances: the western type of drug trade and drug use has begun, with the influx of the classical drugs (heroin, cocaine, amphetamines, LSD and hashish). In addition, a study based on data obtained from all district physicians shows that the rate of regular use of psychoactive substances is very high in the parts of Hungary with poor infrastructure. This "poverty" drug use, together with the poppy cult and the traditions of grape cultivation and wine drinking could be a serious obstacle to the wider spread of western type drug use in Hungary.     

Redefining Success: A Qualitative Investigation of Therapeutic Outcomes for Noncompleting Drug Court Clients

ABSTRACT

Utilizing a convenience sample from a drug court program, the authors investigated the benefits of treatment for noncompleting drug court clients (n = 30). Using an as-treated design, the qualitative investigation assessed whether noncompleters received any benefit from their drug court experience. In-depth interviews were conducted to determine both benefits gained and reductions in harm that occurred as a result of drug court participation. Data analysis was guided by the grounded theory method. Outcomes of coding indicated that participants' motivation and self-efficacy were enhanced through the intervention. Further, participants reported that their relationships with family, therapists, or peers were improved as a result of their involvement with drug court. Individuals in the study sample reported abstinence or decreased substance use, as well as improvements in employment and/or educational attainment. Participants’ perceptions of barriers to program completion were also noted. Study outcomes suggest that expansion of a harm reduction approach in social service practice may have utility for drug-abusing populations. Limitations of the research, including lack of generalizability, are discussed. Further research of harm reduction effects with a larger, heterogeneous sample size is recommended.     

Research in the concept‐based therapeutic community – its importance to European treatment research in the drug field1

The concept‐based therapeutic community (TC) has been more scrutinised than almost every treatment model in the drug field except for methadone maintenance treatment. Important reasons for emphasising research right from the beginning were financial and/or ideological. Because of strong, ideological reasons and because of extensive research, the American TC movement has had a great impact on the treatment field of drug abusers in Europe. However, independent of the TC movement, at the same time the European treatment field also initiated several important research projects. In particular the Scandinavian countries were active in process studies with a qualitative approach. For different reasons this research tradition in Scandinavia was never considered important in the international research society. In recent years this has changed, and there is now a consensus about the need for more process evaluation and phenomenological research to complement the large body of quantitative studies in the treatment field. Probably both American and European treatment research has contributed to the preservation of the best from the original TC models and a renunciation of the more destructive elements.     

吸毒人群社会支持网研究对重庆市南岸区戒毒所的调查

本文通过对重庆市南岸区戒毒所的调查,采用社会支持网分析方法,发现吸毒人员的社会支持网规模很小,吸毒网络具有秘密性和牢固性。其相识关系提供毒品支持,朋友关系和亲戚关系提供情感和经济支持。吸毒人员的吸毒年限、有抢劫和偷盗行为对注射吸毒行为和共用针头注射吸毒行为有明显的影响等一系列特征。     

Effects of a Therapeutic Community on Korean Substance Abusers in Prison

ABSTRACT. This study tested the effectiveness of a therapeutic community (TC) intervention on imprisoned Korean substance abusers. Volunteer participants from 2 Korean prisons were randomly assigned to either the experimental group (n = 24) with the TC intervention or a control group (n = 24) with optional supportive sessions. Pretest and posttest data were collected on measures of abstinence self-efficacy and problem-solving skills. Participants in the TC intervention showed significant increases in abstinence self-efficacy and problem-solving skills, whereas those in the control group did not. The differences in abstinence self-efficacy for the TC were found for 2 of 3 subscales: Problem-Solving Confidence and Approach-Avoidance Style but not Self-Control. Further study is needed to replicate these findings with larger Korean prison populations and to establish the relationship between these skill dimensions and subsequent drug use and criminal recidivism for this population. Nevertheless, the findings suggest potential benefits of using a TC intervention with imprisoned Korean substance abusers.     

Rehabilitation policy for drug addicted offenders in China: current trends,patterns, and practice implications

ABSTRACT

Drug use in China is both associated with criminal behaviour and regarded as social deviance. Drug addicted offenders can either be assigned criminal punishment or compulsory drug treatment, depending on the severity of the crimes they have committed. Compulsory drug treatment is in many ways similar to imprisonment in China. However, both compulsory drug treatment and imprisonment fail to prevent drug relapse. The authorities have implemented methadone maintenance treatment and non-medical social work interventions, although they are still in their infancy. More efforts should be made to deliver post-institutionalization programmes to help ex-inmates stay away from drugs and crime.     

Validating a Korean Version of the Drug Abuse Screening Test-10 (DAST-10)

ABSTRACT

There are no screening instruments for adults in the Korean language that are specific to drugs other than alcohol and tobacco. The purpose of this study is to validate the Korean version of the Drug Abuse Screening Test-10 (DAST-10). The Korean version of the DAST-10 was validated with 1,000 adults including general adults and at-risk adults. The results indicated that the Korean version of the DAST-10 was unidimensional similar to its English-language counterpart and showed satisfactory internal consistency reliability and convergent validity. The results also showed that the Korean version demonstrated optimal performance at a cutoff score of 2, which is the same as that of its English-language counterpart. It is expected that as the development of Korean-language instruments measuring alcohol problems contributes to the expansion of related research, the development of the Korean version of the DAST-10 will facilitate research on various topics related to substance abuse in Korea. Validation with Korean adults identified as substance abusers is needed to improve the ability of the Korean version to correctly identify substance-abusing adults.     

Pre-arrest drug use and associated risk factors among incarcerated offenders in China

ABSTRACT

Past research has consistently reported a higher rate of drug use before arrest among incarcerated inmates than that of the general population. However, there is a lack of either qualitative or quantitative research on this topic under the Chinese setting. Drawing upon survey data collected from 1,518 inmates in a Chinese province, this study attempts to fill in the research gap by assessing the connection between risk factors associated with pre-arrest use. Roughly a quarter of all inmates in the sample had the experience of drug use before arrest. Regression analysis suggested that impulsivity, volatile temper, and perceived prevalence of drug use in neighborhood were significantly related to drug use among inmates. Two control variables include offense type and stable job, were also found to be significant predictors of drug use. Implications for research and policy were highlighted in the end.     

建立社会工作专业戒毒辅导网站的可行性研究

社会工作专业戒毒辅导网站是将社会工作的专业知识与网络技术结合,为网上吸毒者特别是隐性吸毒者及其家属提供专业化服务的新型辅导模式,在专业理念、工作方法以及服务对象和服务范围等方面具有显著优势,是对现行戒毒工作的补充和拓展,有助于提高服务的专业化水平。     

Maternity and family leave policies: a comparative analysis

This article compares maternity leave data from a 1981 Columbia study, a 1992 two county survey and a 1997 revisit to the same sample of Idaho employers. The data reflect a trend between 1981 and 1997 of shifting costs for specific benefits (pension, life and health insurance) from employer to employee. The findings also indicate that, regardless of the number of employees, all responding employers have health insurance that covers maternity and allow pregnant employees to work until delivery if able to do so. Additionally, the effects of the Family and Medical Leave Act of 1993 are considered by comparing policies reported in 1992 and those reported in 1997 by Idaho employers with 50 or more employees. The conclusions point to substantial changes in some leave benefits since the FMLA took effect but echo again the dilemma faced in the United States, that we are still out of step with most industrial societies in that we have an unpaid leave policy.     

Home as a risk environment: Negotiating the boundaries of homes and social relationships in services for people using illicit drugs

This study focuses on how clients using illicit drugs are supported in managing the boundaries of their homes to avoid the risks that social relationships may have on their daily lives at home. The data consist of 14 client–worker encounters audio-recorded in 2017 in a Finnish home-based service for people using drugs. Discursive interaction analysis and geographies of home were applied to examine how boundaries of homes are negotiated in relation to social relationships and how the home is constructed as a risk environment in the interactions of the service. The results highlight that the tensions between home and social relationships can be complex in the context of illicit drug use. Managing the boundaries of the home and social relationships deserves special attention among welfare services to promote their client's right to privacy and attachment to a home environment. This is also important for preventing the risk of homelessness.     

Treatment Utilization Among Metropolitan and Nonmetropolitan Participants of Corrections-Based Substance Abuse Programs Reentering the Community

ABSTRACT

This study examines differences in drug use and recidivism outcomes at 12 months postrelease from jail or prison as a function of geographic location and treatment utilization. Participants (N= 700) were previously enrolled in drug treatment during the last 6 to 9 months of their incarceration and were released to the community on either parole or serve-out. Findings from this study indicated that offenders returning to metropolitan areas reported more use of community treatment services following release than offenders in nonmetropolitan areas. Although offenders in both metropolitan and nonmetropolitan areas who reported community treatment following release were less likely to be reincarcerated, community treatment utilization was not a significant correlate of relapse. Findings are discussed, and future directions include favorable outcomes when community treatment is utilized.     

Informed Consent and Investigational New Drug Abuses in the U.S. Military

Objective: The focal point of this investigation was to research the ethical issues surrounding the military's requests for informed consent waivers when using investigational drugs, and the recent debate surrounding the anthrax vaccine as an investigational new drug (IND). Design: The military's management of the informed consent process was examined using documents obtained through the Freedom of Information Act, Institutional Review Board (IRB) minutes, consent forms, legal pleadings, and protocols for specific investigational drugs. Results: In December 1990, prior to Operation Desert Storm, the Federal Drug Administration (FDA) granted the Department of Defense (DoD) an unprecedented waiver to the federally mandated informed-consent requirement for the use of investigational drugs. However, the waiver approval was conditional, and the FDA insisted on several safeguards. Partially in response to the subsequent Gulf War Syndrome debate, the FDA recently evaluated the military's use of investigational drugs during the Gulf War. The FDA cited the military for significant deviations from the originally approved protocols. Most notably, the military was found to be abusing the IRB process by convening a second IRB when the first IRB concluded that waiving informed consent was unethical. In addition, there was a gross lack of documentation and no monitoring of adverse reactions. The DoD's plan to use the current anthrax vaccine on all 2.4 million troops against inhalation anthrax has kindled an additional investigational drug controversy. The safety and efficacy of the use of the anthrax vaccine as a prophylactic against inhalation anthrax have been questioned by both military and medical organizations. There have never been any published studies of human efficacy or long-term effects for the anthrax vaccine. In addition, the military is not using the vaccine for its intended purpose, and it is also not adhering to prescribed dosing schedules. There is clear evidence to support the claim that, in fact, the military's use of the anthrax vaccine should be considered experimental. Conclusions: I argue that in medical situations, the military is obligated to treat its troops as autonomous persons entitled to basic rights and protections. The DoD is currently using an approved drug, the anthrax vaccine, for an unapproved purpose and in an unapproved manner. In doing so, the DoD is not only violating the FDA's regulations against such practices, it is also violating an executive order which only allows the president to authorize the use of INDs on service members without their consent.     

Drug abuse, paradigms and social work

Two different treatment practices for the inpatient treatment of drug abusers are described: the pedagogical and the therapeutic. The treatment practices are analyzed from the perspective of sociological theories of human action and from a cultural perspective. The control of the client is of crucial importance but it is exercised in different ways. In the pedagogical treatment practice, the control is manifested in the development of social skills and internalization of conventional roles and norms. In the therapeutic practice, the client's emotions and awareness of ontological facts as freedom and responsibility are objects of control.