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.     

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.     

The HOPE Family Project: A Family-Based Group Intervention to Reduce the Impact of Homelessness on HIV/STI and Drug Risk Behaviors

The HOPE Family Project (HIV Prevention for Parents and Early Adolescents) is an eight- session, family-based group intervention modeled on three evidence-based curricula targeting HIV/AIDS and alcohol and drug abuse prevention. The design and implementation of the HOPE Family Project was carried out by an established community collaborative board. The project aims to educate and provide tailored support to families and their youth (ages 11–14), residing in homeless shelters, regarding HIV and alcohol abuse prevention. The group model proved successful in offering an informal social support network for families living in homeless shelters and improving family functioning and youth mental health outcomes.     

When Everyone Is an Orphan: Against Adopting a U.S.-Styled Orphan Drug Policy in Canada

Putting aside whether diseases that affect only small numbers of people (“rare diseases”) should be prioritized over diseases that are otherwise orphaned, in this article I argue that a new approach to rare, orphan diseases is needed. The current model, first signaled by the United States' Orphan Drug Act and subsequently emulated by several other jurisdictions, relies on a set of open-ended criteria and market-based incentives in order to define and encourage drug therapies for rare, orphan diseases. Given a) the biopharmaceutical industries' growing interest in orphan diseases, b) progress in the sphere of personalized medicines enabling more and more common diseases to be reclassified as rare, and c) empirical evidence suggesting that the most orphan drugs target only a limited, lucrative subset of rare diseases, I argue that Canada, which recently announced plans to develop its own “orphan drug framework” should not follow the United States' orphan drug model.     

塔吉克斯坦禁毒斗争简述

20世纪90年代初,中亚地区成为阿富汗毒品输送到俄罗斯、欧洲乃至世界各地的重要通道,而塔吉克斯坦是中亚毒品贩运量最大的国家之一。塔政府实施了积极而严厉的禁毒政策和措施,与国际社会密切合作,在禁毒斗争中取得了不少成果,但由于多种原因其禁毒效果很不理想,禁毒形势依然严峻。     

PREDICT-1 (CNA106030): the first powered, prospective trial of pharmacogenetic screening to reduce drug adverse events

Pharmacogenetics (PGx) – the study of DNA variation in the human genome and the way this impacts the efficacy and safety of medicines – is becoming an increasingly important research tool as physicians, patients, regulatory authorities and payers look for innovative ways to improve the risk:benefit ratio of medicines. While scientific knowledge about PGx is rapidly increasing, implementation of PGx findings to patient care has yet to be fully achieved. One area where significant progress has been made is in the identification of PGx markers associated with variable response to antiretroviral medicines. For example, the major histocompatibility complex HLA‐B*5701 allele has been associated with hypersensitivity to abacavir (ABC) by several independent researchers. While PGx associations have been identified largely through retrospective examination, the clinical utility of these PGx markers in patient care has not been prospectively determined in a randomized study. This paper outlines the design of a study to evaluate the utility of prospective screening for HLA‐B*5701 to reduce the incidence of ABC hypersensitivity in an ABC‐naïve population of HIV‐infected subjects. This represents the first fully powered, randomized, blinded, prospective study to determine the clinical utility of PGx screening to reduce drug‐associated adverse events in any patient population. This type of trial design may have utility for other important medicines which have treatment‐limiting side effects. Copyright © 2007 John Wiley & Sons, Ltd.     

Addiction severity predictions using client network properties

By statistical analysis of client data it is shown how past or current network information together with other knowledge assesses treatment needs. The main findings are as follows. The client's previous exposure to addicts in the family has almost no influence on his or her present contacts with addicts in daily life. About 30% of the clients have experienced addicts both in family and among friends, about 30% have only family exposure, about 20% have neither kind of exposure, and about 20% have no family exposure but have current exposure to addicts. Exposure to addicts in family implies a higher risk of severe need for professional intervention than no such exposure. For the clients with no family exposure but with current exposure to addicts there is, somewhat surprisingly, a lower risk than for the other three categories of clients. This effect seems to be mainly because the psychiatric status of these clients is somewhat better than for those in the other three categories. The effect disappears if we look solely for drug addiction intervention needs; then there is a clear increase in relative treatment needs for the categories with previous or present addiction exposure compared to those without.     

政府奖惩机制下药品安全质量监管三方演化博弈及仿真分析

药品安全关乎人民群众生命健康、经济发展、社会稳定和国家安全,一直以来都是政府和全社会关注的热点问题之一。但是,近年来频发的各类药品安全事件,揭露了政府监管缺失、药品检测机制不完善、公众投诉失效等诸多问题。本文考虑了药品检测中存在寻租现象,构建了药品生产企业、第三方药品检测机构和政府监管部门之间的三方演化博弈模型,分析了各参与方策略选择的演化稳定性,探讨了各要素对三方策略选择的影响关系,进一步分析了三方博弈系统中均衡点的稳定性。研究结果表明：1)政府增强奖励、惩罚力度均有助于促进企业生产高药效药品、第三方药品检测机构拒绝寻租的规范行为,但是增大奖励力度将不利于政府自身履行监管职责;2)政府设定合理的奖惩机制必须符合对各方的奖惩之和大于其投机收益的条件,才能保障演化稳定市场环境下的药品安全;3)上级政府对监管部门失职的问责对增强企业生产高药效药品的稳健性具有重要意义;4)提升企业的药品销售收益、增加企业寻租成本也是避免企业生产低药效药品的有效途径。最后,利用Matlab 2020b进行了仿真分析,为政府完善药品监管机制提出了对策与建议。     

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.     

Qualitative data analysis with hypertext: A case of New York City crack dealers

Ethnography has become a useful method in procuring sensitive information from the ‘hidden population’ who may not be accessed with quantitative survey techniques. Researchers are generating huge amounts of qualitative/textual data. Qualitative data require careful planning in storage, coding, retrieval, and analysis. Personal computers have solved data management problems, but data analysis remains problematic. The paper describes some qualitative data management and analytic problems faced by a team of ethnographers engaged in a longitudinal epidemiological study of cocaine and crack distribution/abuse in New York City. Ethnographic data was collected through multi-session open-ended interviews with more than one hundred cocaine/crack dealers and extensive field-notes were kept. Compared to other programs, a hypertext software — Folio Views — was more useful in solving (a) data management and (b) analytical problems. Authors used this software to handle more than twenty-five thousand pages of texts; search and sort the database by any words or codes; and retrieve relevant textual materials needed to complete comparative and thematic analysis. Authors analyzed the data from outsiders’ point of view (etic) as well as from the viewpoint of the subject populations (emic).