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Introduction: The growing popularity of e-cigarettes (EC) and tobacco heating systems (THS) raises concerns about their impact on the health of users and passive smokers. These products are attractive to young people due to their lack of unpleasant odor and easy availability, even though they contain addictive nicotine and harmful substances. Materialtrial and Methods of Research: China's first e-cigarette was developed in 2003. The WHO, a leading global health organization, has been actively involved in regulating the advertising and use of EC. They initially allowed the advertising of EC as a healthier cigarette alternative but later banned it due to a lack of scientific evidence. In Poland, the sale of EC to persons under 18 is prohibited, but this law needs to be better enforced. ECs heat a liquid containing nicotine, creating an aerosol with toxic substances such as acetone, glycerol, acrolein, and formaldehyde. Studies show that EC use leads to adverse health effects such as headaches, nausea, contact allergies, increased blood pressure, irregular heart rhythm, thrombosis, and cancer risk. ECs also affect oral health and the respiratory system, increasing the risk of asthma and chronic obstructive pulmonary disease (COPD). THS, introduced in 2019, heats tobacco to 300°C, producing an aerosol containing carcinogenic and toxic substances. These products negatively affect the cardiovascular and respiratory systems, increasing the number of pro-inflammatory cells in the lungs and potentially producing hepatotoxic effects. Conclusion: The increasing use of EC and THS among adolescents raises serious health concerns. These products, although perceived as less harmful, contain toxic substances and addictive nicotine. Further research is needed on their long-term effects to increase patient awareness and limit the availability of these products to minors.

Heutagogy: A Pedagogical Framework for Cultivating Critical Consciousness in Nursing Students

A large proportion of the prison population uses psychoactive substances, which constitutes a major public health problem. We conducted a qualitative survey on drug use practices in prison and the care of addiction. French legislation stipulates that health care for prisoners must be equivalent to that of the general population, including harm reduction, which is the policy implemented in France since HIV epidemic in the late 1980s. Our article explores how this policy is accepted and applied within the prison system. Are the delivery of addiction care and the implementation of harm reduction measures rooted in an ethic of care?

El objetivo de este estudio es comprobar la relación entre las variables de Dependencia del Ejercicio, medida con la Escala de Dependencia del Ejercicio (EDS-R) de Downs et al. (2004), y el Bienestar Psicológico evaluado con la escala de Ryff (1989) y su posible efecto diferencial en función del sexo y la edad. Se contó con una muestra de 316 runners (170 hombres y 146 mujeres), con una media de edad de 38.4 años (DT = 9.8). Los resultados muestran una correlación negativa entre la Dependencia del ejercicio (factores abstinencia, continuación y reducción de la actividad) y el Bienestar Psicológico. Además, las mujeres obtienen una puntuación mayor en Bienestar Psicológico y abstinencia (EDS-R) que los hombres. Los factores de Dependencia del Ejercicio (+tolerancia, -reducción de la actividad, +tiempo empleado y -efectos deseados) representan el 13.9% de la varianza explicada del Bienestar Psicológico. La edad también es un factor relevante, cuanta más edad se tiene mayor es el efecto negativo de la dependencia. Se concluye que cuando la práctica deportiva sobrepasa una intensidad y se hace adictiva, genera un efecto negativo sobre el bienestar, siendo especialmente relevante este efecto en el caso de los hombres, y cuanto más mayores más riesgo.

Introduction and purpose N-acetylcysteine (NAC) is one of the more popular drugs, widely available in pharmacies, used to treat wet cough. NAC's diverse mechanism of action has drawn the attention of researchers for its great potential in the treatment of many conditions. Indeed, it has been noted that administration of NAC allows indirect modulation of the central nervous system, which may be important in the treatment of psychiatric diseases. The following review focuses on recent reports of NAC's potentially beneficial effects on psychiatric conditions such as depression, schizophrenia, obsessive-compulsive disorder, and addiction. Description of the state of knowledge Based on studies conducted on animals (rats), a positive effect of NAC has been proven, observing a reduction in the severity of depressive symptoms. Based on the above data, more and more human studies are being conducted, where the effect of NAC on the symptoms of various mental conditions is being investigated. In recent years, the antioxidant, anti-inflammatory and neurotransmitter function modulating effects of NAC on the brain have been proven, with significant potential in the treatment of mental illness. Conclusions The potential impact of NAC on the treatment of mental illness is a rapidly developing topic in recent years. On the basis of available scientific data, partial reduction of symptoms of mental illnesses through the use of NAC has been confirmed. It is a very promising drug, which in this indication requires additional studies to unequivocally confirm its beneficial effects on the functioning of the central nervous system.

Abstract Background People who use substances (PWUS) encounter significant barriers to accessing care for their complex health needs. As a result, emergency departments (EDs) often become the first point of healthcare access for many PWUS and are a crucial setting for the study of health inequities. This study aimed to understand the ED healthcare experiences of PWUS with the intent of informing ways of improving the delivery of equitable care. Methods This qualitative study was part of a larger cross-sectional, mixed-methods study that examined ED experiences among diverse underserved and equity-deserving groups (EDGs) within Kingston, Ontario, Canada. Participants shared and self-interpreted a story about a memorable ED or UCC visit within the preceding 24 months. Data from participants who self-identified as having substance use experiences was analyzed through inductive thematic analysis. Results Of the 1973 unique participants who completed the survey, 246 participants self-identified as PWUS and were included in the analysis. Most participants were

Over the past few years, there has been a great development of audiovisual electronic media. It brings great opportunities in many scientific fields but is also subject to many judgments of criticism from opponents. Therefore, in view of the enormity of the changes and expansion of the culture, many circles wonder and analyze what changes occur among adults under the influence of these means and especially online games. The author, based on his own research, presents a new psychological approach between the predisposition to addictions and impulsivity in the light of ressentiment. Seventy-two people participated in the study, and the IVE Impulsivity Questionnaire, UPPS-P Impulsive Behavior Scale and Internet Gaming Disorder Test (IGD-20 Test) and Ressentiment Questionnaire were used. The results of the study showed that there is a link between impulsivity and addiction propensity, but it is determined by the degree of impulsivity in a person. On the other hand, ressentiment in the emotion regulatory system appeared as a negative feeling resulting from a sense of unfulfillment in an online game causing a mental state that extends over time and is underpinned by various types of emotionally tinged reactions. What can cause these feelings to turn into revenge without concrete actions-inducing hatred, but not leading to infliction of harm-and causing jealousy, which will not be confirmed by acts of jealousy. In light of this research, the negative emotion that is generated during online game interaction relates to personal experiences and can affect the emotional state and components of environmental attitudes.

The TaqIA polymorphism is a marker of both the Ankyrin Repeat and Kinase Domain containing I gene (ANKK1) encoding a RIP-kinase, and the DRD2 gene for the dopamine receptor D2. Despite a large number of studies of TaqIA in addictions and other psychiatric disorders, there is difficulty in interpreting this genetic phenomenon due to the lack of knowledge about ANKK1 function. In SH-SY5Y neuroblastoma models, we show that ANKK1 interacts with the synapse protein FERM ARH/RhoGEF and Pleckstrin Domain 1 (FARP1), which is a guanine nucleotide exchange factor (GEF) of the RhoGTPases RAC1 and RhoA. ANKK1–FARP1 colocalized in F-ACTIN-rich structures for neuronal maturation and migration, and both proteins activate the Wnt/PCP pathway. ANKK1, but not FARP1, promotes neuritogenesis, and both proteins are involved in neuritic spine outgrowth. Notably, the knockdown of ANKK1 or FARP1 affects RhoGTPases expression and neural differentiation. Additionally, ANKK1 binds WGEF, another GEF of Wnt/PCP, regulating its interaction with RhoA. During neuronal differentiation, ANKK1–WGEF interaction is downregulated, while ANKK1–FARP1 interaction is increased, suggesting that ANKK1 recruits Wnt/PCP components for bidirectional control of F-ACTIN assembly. Our results suggest a brain structural basis in TaqIA-associated phenotypes.

This empirical research on children’s poverty and the accompanying risk behavior was conducted in the Baktalórántháza micro-region, in one of the most disadvantaged micro-regions of Hungary. The study, completed in 2023, was conducted utilizing three methods, a questionnaire for families, interviews, and focus group interviews with social professionals working in the settlements. The region is one of the ten micro-regions with the highest poverty rate in the country. The majority of the population only has an elementary education, and the proportion of graduates is much lower than the national average. The proportion of households with three or more children is higher than the national average and the proportion of unemployed people in households with children is twice as high as the national average. Based on the experience of social workers working in the area, in addition to smoking and drinking alcohol, the consumption of psychoactive and psychotropic substances has increased among adolescents and young adults. Based on various indicators, children regularly consume illegal drugs. The origin and composition of these drugs are typically unknown. According to the reports by drug users, everyday life is easier, and they can escape from problems when under the influence of drugs. Based on the observations of experts, the consumption of various psychoactive substances has harmful effects on behavior, health, learning, and family life. School performance and the ability to think and learn decrease. Drug users are dissatisfied with their lives, have problems with social relationships, engage in partner violence, and may develop antisocial behavior in their lives.

Abstract Background Solitary use of substances is a risk factor for substance use-related mortality. Novel e-health harm reduction interventions such as virtual overdose monitoring services (VOMS) have emerged in North America to improve access to emergency overdose support for people who use substances (PWUS). To date, little research has been published, and the perspectives of PWUS are needed to inform evaluation and policy efforts. Objective To explore the beliefs, values and perceptions of PWUS around using and accessing VOMS in Canada. Methods A qualitative study following grounded theory methodology was conducted. Using existing peer networks, purposive and snowball sampling was conducted to recruit PWUS (≥ 18 years) with previous experience with VOMS. Thematic analysis was used to analyze twenty-three interviews. Several methods were employed to enhance rigor, such as independent data coding and triangulation. Results Twenty-three one-on-one telephone interviews of PWUS with previous experience with VOMS were completed and analyzed. The following themes emerged: (1) feelings of optimism around VOMS to save lives; (2) privacy/confidentiality was highly valued due to stigma and fear of arrest; (3) concerns with reliable cell phones negatively impacting VOMS uptake; (4) concerns around emergency response times, specifically in rural/remote communities; (5) desire for trusting relationships with VOMS operators; (6) importance of mental health supports and referrals to psychosocial services; and (7) possible limited uptake due to low public awareness of VOMS. Conclusion This qualitative study provided novel insights about the VOMS from the perspectives of PWUS. PWUS generally felt optimistic about the potential of VOMS as a suitable harm reduction intervention, but several potential barriers around accessing VOMS were identified that may limit uptake. Future research is warranted.

Pharmacological drugs targeting specific pathways involved in various diseases have seen recent advancement with newer and more efficient emerging drug targets, but these drugs are limited in terms of their side effects and patient adherence. The potential of plant-based diets in the form of functional foods is increasingly being realized as an option to treat and/or prevent several diseases. In this work, we have selected flaxseed (Linum usitatissimum), also known as linseed, to study its pharmacological efficacy and proposed mechanisms of action for medicinal purposes. The target genes of linseed with Disease Specificity Index (DSI >0.6) are compared to the associated genes of diabetes mellitus, decrease in appetite, addictive behavior, cardiovascular diseases (CVDs), inflammatory bowel diseases (IBDs), and Polycystic Ovary Syndrome (PCOS), and the selected genes are further evaluated using in silico methods. The binding affinity of flaxseed to three common target proteins (CCDC28b, PDCD6IP, and USP34) is assessed by docking and molecular dynamics (MD) simulations. The results show that linseed is safe to use for mutagenic toxicity and other cardiotoxicity measures, but linseed is unsafe for embryotoxicity, hERG toxicity, and cardiac failure. The analysis of the protein–protein interaction (PPI) network, Gene Ontology (GO), and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways indicates that flaxseed can be used as a medicinal herb for treatment of diabetes mellitus, cardiovascular diseases, IBDs, and PCOS.

Previous research has indicated that anticipating positive effects from cannabis use may be linked with increased frequency of cannabis consumption, yet these expectancies remain poorly understood in adults with social anxiety disorder (SAD). Thus, our study aimed to investigate the expectancies of the effects of cannabis use in 26 frequently using adults with SAD (age: 27.9 ± 7.3 years; 54% female) and 26 (age: 27.4 ± 6.7 years; 50% female) without. While no between-group differences were observed, both groups reported expecting tension reduction and relaxation (F = 0.001; p = 0.974), cravings, and physical effects (F = 1.10; p = 0.300), but denied global negative effects (F = 0.11; p = 0.744). The trajectory of cannabis use perceptions (further investigated in 12/26 participants/group) also showed no between-group differences. Before the initial use, positive perceptions may have led to initial and continuous cannabis consumption, while the symptoms of cannabis use disorder may have contributed to repeated use. Our data indicate that, regardless of psychiatric history, frequent cannabis-using adults are more likely to report positive expectancies, which are often associated with increased patterns of cannabis consumption. Psychoeducational programs and openly discussing the risks of cannabis may be beneficial in preventing and/or reducing cannabis use in people with SAD.

Les addictions

Non-communicable diseases (i.e., cardiovascular, oncological, respiratory, and endocrine diseases) represent the main cause of death and morbidity in the world, with tobacco and alcohol use, an unhealthy diet, and a sedentary lifestyle being the main risk factors. From reinforcer pathology theory, based on behavioral economics (BE), these health risk behaviors are understood as choice disorders, characterized by an excessive valuation of the reinforcer (e.g., the drug) and a preference for immediate reinforcers over delayed ones. Episodic future thinking (EFT) is a psychological intervention that consists of vividly visualizing future events and projecting oneself into them, in order to increase the valuation of the reinforcers associated with the execution of a healthy behavior. This technique shows promising results in reducing impulsive decision-making and increasing health-related behaviors (e.g., abstinence, diet, physical activity).

According to the prevailing clinical model of Internet addiction disorder, the symptoms of Internet addiction are not substantially different from the ones of other previously known behavioral and chemical addictions. In the present article we argue that this model significantly depsycholizes the phenomenon which stems from the mass use of information technologies providing access to cyberspace. We compare psychological characteristics of the Internet addiction to disembodiment, that is, lack of the physical body of an information technology user, first described by the media theorist M. McLuhan. Alongside anonymity, technological disembodiment is the inevitable consequence of the use of the Internet, and it is just as important in the formation of the addiction and accompanying disorders. But the phenomenon of virtual unsubstantial self which represents the manifestation of the Spirit Archetype in the realities of the digital society obviously exceeds anonymity in terms of importance and scope. Our theoretical model of the disembodiment on the Internet is based on the conceptions of ‘schizoid disembodiment’ and ‘unembodied self ’ by the British existential psychologist R. D. Laing. In particular, there is evidence to suggest likeness between the withdrawal from reality of a schizoid by way of ‘exit’ from their own physical body and the form of escapism specific to the Internet addiction in contrast to other addictions. Respective empirical constructs were measured and compared. We used the adapted version of the Chinese Scale by S.-H. Chen, which implements the clinical model of Internet addiction most consistently, and Disembodiment on the Internet Diagnostic Technique by N. V. Kopteva, A. Yu. Kalugin and L. Ya. Dorfman. The results indicate that with Internet addiction traditional symptoms of addictions correlate to the weakness of the divided self. This causes a range of problems aggravated by the ones caused by disembodiment, namely virtualization, de-realization of the self of a user and experience of illusiveness of existence. The data shows that dependence and disembodiment on the Internet may refer to a specific technological modus of a person’s existence within the information society.

L’allentamento delle restrizioni dovute alla pandemia da Covid-19 hanno portato, negli ultimi mesi, ad un significativo incremento dei dati relativi agli accessi al gioco. Un accesso precoce al gioco, specialmente durante la minore età, potrebbe portare ad una prematura insorgenza di disturbi da gioco d’azzardo, i cui effetti potrebbero protrarsi fino all’età adulta. L’adolescenza rappresenta l’età a cui viene associata la maggiore probabilità di insorgenza di dipendenze, perciò azioni di tipo preventivo sono fondamentali per affrontare questi potenziali disturbi. L’articolo si basa sull’analisi delle percezioni, comportamenti e abitudini di gioco di giovani rispondenti rispetto al fenomeno del gioco d’azzardo, con l’obiettivo di indagare il livello di conoscenza ed informazione rispetto al fenomeno e la consapevolezza rispetto ai rischi correlati. La scuola deve diventare in modo sempre maggiore un mezzo di divulgazione, sulla base del ruolo che ricopre nella società, fungendo da strumento di prevenzione all’insorgenza del fenomeno o da punto di riferimento per il fronteggiamento quando essi insorgessero, attraverso la loro intercettazione e l’indirizzamento verso un supporto professionale. - - - Parole chiave: gioco d’azzardo, ludopatia, prevenzione, dipendenza - - - - Gambling: a young people sample’s perceptions and behaviors - - - Abstract Last month’s Covid-19 pandemic restriction easing leads to a significant increase in gambling access rates in Italy. Early access to gambling, especially for minors, could lead to a premature emergence of gambling disorders, which effects could be protracted until adult age. Given adolescence is characterized by a major probability of addiction disorders, preventive actions are fundamental in order to face these potential disorders. The article is based on the analysis of perceptions, behaviors, and gaming and gambling habits of young respondents. It aims to assess the level of knowledge and information about gambling and the awareness about the correlated risks. The school system has to increase dissemination actions about the risks of gambling, as a preventive strategy and to be a reference point once addiction occurred, able to detect the occurrence and provide professional support to the youngsters. - - - Keywords: gambling, gaming, preventive actions, addictions

Abstract Background Smartphone use has increased significantly, especially during the period of global pandemic caused by the novel SARS-CoV2 coronavirus (COVID-19). Concurrently, smartphone addiction is a growing social problem in children and adolescents with the consequence of adverse health outcomes. This study assessed the prevalence of smartphone addiction, patterns of use, and the experienced body-region discomfort among Iranian school students during the COVID-19 pandemic. Methods A cross-sectional study with students from grades 1–9 recruited n = 585 participants (mean age = 14.49 (2.26 years); female = 65.8%). Data were collected from parents and students through the online 'Smartphone addiction scale-short version’ (SAS-SV), self-reported demographic questionnaires, and extracts of the Nordic musculoskeletal questionnaire for the evaluation of musculoskeletal disorders. Results The prevalence rate of smartphone addiction (53.3%) was relatively high in the overall sample. Participants spent 6.85 (4.62) hours per day on their smartphones, which had increased 53.86% relative to the pre-pandemic period. The primary smartphone uses were for social networking (77.9%), web-surfing (53.3%), and camera activities (50.9%). There was a positive correlation between smartphone addiction as assessed with the SAS-SV and daily use time (r = 0.34, p

Since March 2020, the COVID-19 pandemic has had a disproportionately high toll on vulnerable populations, coinciding with increased prevalence of alcohol-and drug-related deaths and pre-existing societal issues such as rising income inequality and homelessness. This poly-crisis has posed unique challenges to service delivery for people with substance use disorders, and innovative approaches have emerged. In this Perspectives paper we reflect on the poly-crisis and the changes to research and practice for those experiencing substance use disorders, following work undertaken as part of the InterGLAM project (part of the 2022. Lisbon Addictions conference). The authors, who were part of an InterGLAM working group, identified a range of creative and novel responses by gathering information from conference attendees about COVID-19-related changes to substance use disorder treatment in their countries. In this paper we describe these responses across a range of countries, focusing on changes to telehealth, provision of medications for opioid use disorder and alcohol harm reduction, as well as changes to how research was conducted. Implications include better equity in access to technology and secure data systems; increased prescribed safer supply in countries where this currently does not exist; flexible provision of medication for opioid use disorder; scale up of alcohol harm reduction for people with alcohol use disorders; greater involvement of people with lived/living experience in research; and additional support for research in low- and middle-income countries. The COVID-19 pandemic has changed the addictions field and there are lessons for ongoing and emerging crises.

BackgroundSubstance addiction is a chronic disease which causes great harm to modern society and individuals. At present, many studies have applied EEG analysis methods to the substance addiction detection and treatment. As a tool to describe the spatio-temporal dynamic characteristics of large-scale electrophysiological data, EEG microstate analysis has been widely used, which is an effective method to study the relationship between EEG electrodynamics and cognition or disease.MethodsTo study the difference of EEG microstate parameters of nicotine addicts at each frequency band, we combine an improved Hilbert Huang Transformation (HHT) decomposition with microstate analysis, which is applied to the EEG of nicotine addicts.ResultsAfter using improved HHT-Microstate method, we notice that there is significant difference in EEG microstates of nicotine addicts between viewing smoke pictures group (smoke) and viewing neutral pictures group (neutral). Firstly, there is a significant difference in EEG microstates at full-frequency band between smoke and neutral group. Compared with the FIR-Microstate method, the similarity index of microstate topographic maps at alpha and beta bands had significant differences between smoke and neutral group. Secondly, we find significant class × group interactions for microstate parameters at delta, alpha and beta bands. Finally, the microstate parameters at delta, alpha and beta bands obtained by the improved HHT-microstate analysis method are selected as features for classification and detection under the Gaussian kernel support vector machine. The highest accuracy is 92% sensitivity is 94% and specificity is 91%, which can more effectively detect and identify addiction diseases than FIR-Microstate and FIR-Riemann methods.ConclusionThus, the improved HHT-Microstate analysis method can effectively identify substance addiction diseases and provide new ideas and insights for the brain research of nicotine addiction.

Social anxiety disorder (SAD) is a debilitating psychiatric condition. Consequently, it is common for those affected to resort to cannabis to cope with their symptoms. The primary objective of this study was to understand the differences between motivations for cannabis use in adults with and without SAD. We employed convergent, mixed methods to collect the data. Twenty-six individuals (age: 27.9 ± 7.3 years; 54% female) with and twenty-six (age: 27.4 ± 6.7 years; 50% female) without SAD were administered Marijuana Motives Measure (MMM). Motivations to initiate, continue, and maintain cannabis use were assessed in 12/26 participants in both groups using in-depth interviews. Cannabis weekly consumption was 3.8-fold and frequency 1.3-fold higher in the SAD group. Coping (F = 10.02; p 2 = 0.46) and social (F = 2.81; p = 0.036; η2 = 0.19) motivations were also higher in the SAD group, after controlling for age, sex, and current CUD. The need to cope with symptoms of SAD may have been the driving force for repeated cannabis consumption. Psychoeducational programs educating children about the risk of using cannabis to cope with SAD should be implemented in vocational settings early on.

This article ventures into the basic principles of the original Twelve-step program by studying its similarity with the dynamics of the Sacrament of Reconciliation in the Catholic Church. It begins with a short presentation of the theological foundation of confession, and continues with the history of AA’s Twelve-step recovery program while focusing on the latter’s spiritual dimension and that of similar groups. The major analysis is dedicated to demonstrating and discussing the parallels found in the twelve steps content and the Sacrament of Reconciliation; where the twelve steps have their effectiveness written within themselves, the Sacrament of Reconciliation also requires a progression from contrition, an examination of conscience, the confessing sins and satisfaction. In conclusion, the author presents pastoral suggestions meant to facilitate work with believers struggling with various addictions.

Social prescribing is a way of connecting individuals to a source of support within the community to help improve their health and well-being. Social prescribing programmes are being widely promoted within the United Kingdom (UK) and United States as non-pharmaceutical interventions for those living with addiction and substance misuse needs. These needs have been exasperated by the recent COVID-19 pandemic and global economic crisis, with emerging research indicating short-term and long-term detrimental effects on physical and mental health due to substance misuse and addictions. Psychosocial interventions utilize psychological or social factors rather than an overreliance on biological interventions to treat the health impacts of mental illnesses such as addictions and substance use disorder. In this paper, I will discuss the associated determinants of addictions and substance for the military veteran population, as well as how the social prescribing of psychosocial interventions could be used to reaffirm participant’s identity and enhance their sense of belonging for military veterans, using a real-world example in Wales, UK.

Introduction Religiosity is among the factors that determine the doctor’s relationship with his addict patient and the empathy he should have. Objectives To verify whether future doctors are aware of the addictogenic power of certain substances and certain behaviors and to study their perception of different addictions according to religiosity. Methods This was a cross-sectional study with interns and externs of the Sfax medical faculty, in November 2016, via an anonymous questionnaire. Results 141 students were included and 98,6% declared to be believers. The average age was 23 years. The sex ratio was 0.38. Alcoholism was the addiction most considered as a sin (87.9%), smoking 51.8%, hookah 45.4%, cannabis 78%, gambling 77.3%, internet addiction 16.3%, video game addiction 15.6%, work addiction 8.5%, and exercise addiction 5.7%. Female gender was more often correlated with perceived alcoholism, cannabis addiction, and gambling as sins (p = 0.002; p

Introduction Measurement-Based Care (MBC) is an emerging healthcare model with a number of potential advantages over traditional approaches for the treatment of substance use disorder (SUD). Despite SUD treatment programs being theoretically well suited for the implementation of MBC, its uptake has been minimal, which in turn limits further research, knowledge synthesis, and translation into clinical practice. Objectives The goal of this knowledge synthesis project is to stimulate greater consideration of MBC models in addictions programs, with three interrelated objectives: 1. To summarize the existing evidence from research literature 2. To complement the literature findings with the data from our clinical research and quality improvement projects 3. To explore potential risks and difficulties of MBC implementation in the SUD treatment programs Methods Narrative review. Knowledge synthesis. Results To date, only two published randomized controlled trials, which along with the data from our pragmatic clinical research, support the wider implementation of MBC in the substance abuse treatment settings, but also indicate the high need for larger-scale clinical trials and quality improvement programs. Potential barriers to the implementation of MBC for SUD are outlined at the patient, provider, organization, and system levels, as well as challenges associated with the use of MBC programs for clinical research. Critical thinking considerations and risk mitigation strategies are offered toward advancing MBC for SUD beyond the current nascent state. Conclusions The state-of-the-art of MBC in SUD care settings reviewed and the strategies for further development from adminsitrative, clinical, and research prospectives outlined. Disclosure No significant relationships.

ObjectiveIntimate partner violence (IPV) has been related to emotional dependence and addictive disorders. This study aims to provide a global approach to analyse the relationship between these variables and to determine the factors underlying permanence in violent relationships.MethodsIt is a non-experimental, cross-sectional correlational design study. Participants had to have at least one dating relationship for at least 1 month to complete the questionnaire, which included the following instruments: emotional dependence scale (DEN), scale of violence in dating relationships (VREP) and impulse control disorders scale (MULTICAGE CAD 4).ResultsThe sample consisted of 1.533 adolescents, 53.9% were male (n = 826) and 46.1% female (n = 707), between 14 and 18 years. Emotional dependence correlated significantly with received violence (r = 0.37, p < 0.001). Compulsive spending is strongly associated with emotional dependence (r = 0.21, p < 0.001), whereas sex addiction is associated with received violence to a greater extent (r = 0.18, p < 0.001). Received violence mediates on emotional dependence and addictions.ConclusionIPV is a risk factor for the perpetuation of addictive behaviours. It is advisable to promote affective education for developing resilience and adequate coping.

In this initial study on the dependency or addiction to mobile telephony in the university students of the Faculty of Educational Sciences of the University of Granada, two fundamental objectives are intended. First, establish the technical adequacy (reliability and validity) of the instrument and second, determine the degree of addiction / dependence to the mobile device that presents the sample object of investigation at a merely descriptive level. We have used a descriptive methodology per survey, responding to a sample of 60 subjects. Some of the conclusions of the work are: With regard to validity, we can affirm that the instrument claims to measure the construct for which it has been developed through the adaptation of other instruments, that is, it is creditor of content validity. It has also revealed the presence of a remarkable concurrent criterial validity that shows that the items individually measure the same as the scale in its entirety. In the second block of conclusions we highlight the fact that, in a general way, levels of dependency / addiction to the mobile device have been moderately low.

Abstract Background Confinement due to COVID-19 has increased mental ill-health. Few studies unpack the risk and protective factors associated with mental ill-health and addictions that might inform future preparedness. Methods Cross-sectional on-line survey with 37,810 Catalan residents aged 16+ years from 21 April to 20 May 2020 reporting prevalence of mental ill-health and substance use and associated coping strategies and behaviours. Results Weighted prevalence of reported depression, anxiety and lack of mental well-being was, respectively, 23, 26, and 75%, each three-fold higher than before confinement. The use of prescribed hypnosedatives was two-fold and of non-prescribed hypnosedatives ten-fold higher than in 2018. Women, younger adults and students were considerably more likely, and older and retired people considerably less likely to report mental ill-health. High levels of social support, dedicating time to oneself, following a routine, and undertaking relaxing activities were associated with half the likelihood of reported mental ill-health. Worrying about problems living at home, the uncertainty of when normality would return, and job loss were associated with more than one and a half times the likelihood of mental ill-health. With the possible exception of moderately severe and severe depression, length of confinement had no association with reported mental ill-health. Conclusions The trebling of psychiatric symptomatology might lead to either to under-identification of cases and treatment gap, or a saturation of mental health services if these are not matched with prevalence increases. Special attention is needed for the younger adult population. In the presence of potential new confinement, improved mental health literacy of evidence-based coping strategies and resilience building are urgently needed to mitigate mental ill-health.

Traumatic experience in childhood or adolescence has a significant impact on the development of chronic mental and physical conditions in adulthood. Thus, it is very important for health professionals, especially primary care physicians to have an inventory in order to detect early trauma for planning appropriate treatment, such as the Early Trauma Inventory (ETI). The aim of this paper is to test the psychometric properties of the Slovenian translation of the short, self-rated version (ETISR-SF), and to further validate the instrument.

Abstract Background Caregivers experience significant strains as a result of navigating the complex mental health and/or addiction (MHA) system for their youth with MHA issues. We examined the characteristics of Ontario families with youth with MHA issues and their service needs. Methods A cross-sectional survey study investigated the characteristics and service needs of families with youth with MHA issues across the province of Ontario, Canada. A total of 840 caregivers were recruited. Results 259 participants (Mage = 45.94, SD = 7.11) identified as caregiving for at least one youth with MHA issues. The majority of the participants were female (70.7%), married (73.4%), and completed at least some college/Bachelor degree (59.1%). The mean age of youth was 16.72 years (SD = 5.33) and the most frequently reported diagnoses were Depression (30.1%), ADHD (27.8%) and Generalized Anxiety Disorder (21.2%). Regression results demonstrated that presently accessing services, presently seeking services, and higher levels of barriers MHA services were significantly predictive of identifying navigation as helpful for finding appropriate MHA services (χ2(7) = 28.69, p

Abstract Background Citizens affected by substance use disorders are high-risk populations for both SARS-CoV-2 infection and COVID-19-related mortality. Relevant vulnerabilities to COVID-19 in people who suffer substance use disorders are described in previous communications. The COVID-19 pandemic offers a unique opportunity to reshape and update addiction treatment networks. Main body Renewed treatment systems should be based on these seven pillars: (1) telemedicine and digital solutions, (2) hospitalization at home, (3) consultation-liaison psychiatric and addiction services, (4) harm-reduction facilities, (5) person-centered care, (6) promote paid work to improve quality of life in people with substance use disorders, and (7) integrated addiction care. The three “best buys” of the World Health Organization (reduce availability, increase prices, and a ban on advertising) are still valid. Additionally, new strategies must be implemented to systematically deal with (a) fake news concerning legal and illegal drugs and (b) controversial scientific information. Conclusion The heroin pandemic four decades ago was the last time that addiction treatment systems were updated in many western countries. A revised and modernized addiction treatment network must include improved access to care, facilitated where appropriate by technology; more integrated care with addiction specialists supporting non-specialists; and reducing the stigma experienced by people with SUDs.

Behavioral economics is a discipline that can be useful for studying the aspects involved in the genesis and maintenance of addictive behaviors through the application of the principles of economics and psychology. In the addictions field, this discipline has been beneficial not only in explaining and predicting the severity of addictions, but also in designing universal and selective prevention strategies, as well as treatments. However, the described model remains largely unknown among psychologists. The aim of this work is to present the principles of behavioral economics and bring the reader closer to the methodology used in this field. Evidence is presented of its application in the understanding of addictive behaviors. Clinical implications for assessment, prevention, and psychological treatment are highlighted.

Regarding the multifactorial etiology of alcohol and drug addiction, emotional intelligence may explain why there are adults with greater ability to regulate stressful situations. The objective was to know the relationship between emotional intelligence and perceived stress; as well as analyzing the differences of these variables. The sample was two groups of adults with a mean age of 24.83 (SD = 9.79) for drug-dependent adults and 36.20 (SD = 8.91) for non-drug-dependent adults. The Inventory of Emotional Intelligence ([EQ-I], Bar-On, 1997) and the Perceived Stress Scale ([CEP] Levenstein et al., 1993) were used. A negative and significant relationship was found between the emotional intelligence reported by dependent adults (rs = -.419, p

Introduction: the continuous training and certification of primary healthcare professionals support the implementation of brief interventions to address drug use. Objective: our objective was to validate the training materials of the “Universal Treatment Curriculum for Health Professionals” by assessing the knowledge, skills, and attitudes. Method: we worked with 823 health professionals (137 from Argentina, 59 from Colombia, 86 from El Salvador, 398 from Mexico and 143 from Uruguay), regarding the utilization of brief intervention, according to the training modality in which they participated (272 face-to-face, 125 mixed, and 426 online). We applied a written knowledge evaluation, behavioral assessment of skills - attitudes, and a Satisfaction Questionnaire. A post-quasi-experimental design was used, with comparison groups to assess knowledge, skills, attitudes (through direct observation) and satisfaction of health professionals. Results: the results of the written evaluation and direct observation indicate that both, the training materials and the pedagogical strategy, increased knowledge, skills, and attitudes for the implementation of brief interventions. Conclusions: in this way, a successful dissemination tool was obtained, based on the contents recommended by international organizations and validated in the field of clinical application of the basic principles of behavior. -------- Introducción: la capacitación continua y certificación de los profesionales de atención primaria de salud apoyan la implementación de intervenciones breves para abordar el uso de drogas. Objetivo: validar los materiales de capacitación del “Curriculum Universal de Tratamiento para Profesionales de la Salud” mediante la evaluación de los conocimientos, habilidades y actitudes. Método: se trabajó con 823 profesionales (137 de Argentina, 59 de Colombia, 86 de El Salvador, 398 de México y 143 de Uruguay), en cuanto a la utilización de la intervención breve, según la modalidad de capacitación en la que participaron (272 presencial, 125 mixta y 426 a distancia). Se aplicó: evaluación escrita de conocimientos, evaluación conductual de habilidades-actitudes y un cuestionario de satisfacción. Se utilizó un diseño cuasi-experimental post, con grupos de comparación para evaluar los conocimientos, habilidades, actitudes (a través de observación directa) y satisfacción de los profesionales de la salud. Resultados: los de la evaluación escrita y observación directa indican que, tanto los materiales de capacitación como la estrategia pedagógica empleada, incrementaron conocimientos, habilidades y actitudes para la implementación de la intervención breve. Conclusiones: se obtuvo una herramienta de diseminación exitosa, basada en los contenidos recomendados por organismos internacionales y validada en el campo de aplicación clínica de los principios básicos del comportamiento.

Introduction: Impairments in the multifaceted neuropsychological construct of cognitive impulsivity are a main feature of chronic tobacco smokers. According to the literature, these cognitive impairments are relevant for the initiation and maintenance of the smoking behavior. However, the neuroanatomical correlates of cognitive impulsivity in chronic smokers remain under-investigated.Methods: A sample of 28 chronic smokers (mean age = 28 years) not affected by polysubstance dependence and 24 matched non-smoker controls was recruited. Voxel Based Morphometry (VBM) was employed to assess Gray Matter (GM) volume differences between smokers and non-smokers. The relationships between GM volume and behavioral manifestations of impulsive choices (5 trial adjusting delay discounting task, ADT-5) and risky decision making (Cambridge Gambling Task, CGT) were also investigated.Results: VBM results revealed GM volume reductions in cortical and striatal brain regions of chronic smokers compared to non-smokers. Additionally, smokers showed heightened impulsive choices (p < 0.01, Cohen's f = 0.50) and a riskier decision- making process (p < 0.01, Cohen's f = 0.40) compared to non-smokers. GM volume reductions in the left Anterior Cingulate Cortex (ACC) correlated with impaired impulsive and risky choices, while GM volume reductions in the left Ventrolateral Prefrontal Cortex (VLPFC) and Caudate correlated with heightened impulsive choices. Reduced GM volume in the left VLPFC correlated with younger age at smoking initiation (mean = 16 years).Conclusion: Smokers displayed significant GM volume reductions and related cognitive impulsivity impairments compared to non-smoker individuals. Longitudinal studies would be required to assess whether these impairments underline neurocognitive endophenotypes or if they are a consequence of tobacco exposure on the adolescent brain.

Background: The scientific literature was reviewed with the aim of determining the current state of the research on relationships between physical activity programmes and addiction treatment. Methods: The search was carried out in the WOS, Scopus and PubMed databases, restricting the publication language to English and Spanish, and it was limited to studies conducted in the last 5 years, i.e., between 1 January 2016 and 31 November 2021, selecting only open-access articles with physical activity programmes for the treatment of addictions to harmful substances. Results: Of the 38 initial articles selected, a total of 10 articles were ultimately included, as they met the established eligibility criteria after performing a more exhaustive analysis. The results show a positive relationship between physical activity and adherence to addiction cessation treatment. Conclusions: Physical activity has been incorporated into coadjuvant treatments in combination with other pharmacological or behavioural treatments. These results strengthen the importance of promoting physical activity in rehabilitation and substance-withdrawal treatments. Complementarily, physical activity programmes improve other health variables that influence the quality of life, such as sleep quality and mood, and reduce the risk of social exclusion. Physical activity also directly reduces a sedentary lifestyle, which is responsible for more than 40 diseases and chronic disorders.

The Yale Food Addiction Scale (YFAS) is the most commonly used scale for measuring food addiction (FA). The previous approach to the YFAS and its subsequent versions assumed dichotomization of items, separating addiction symptoms and clinical significance items, and factorial validity testing on a subset of items. In this paper, we discuss the drawbacks associated with these procedures. In addition, we present a different analytical approach to investigate the validity of the modified YFAS (mYFAS) along with an alternative scoring method that overcomes limitations related to the previous approach. After establishing the structure of the mYFAS, we investigated the potential antecedents and consequences of FA separately for men and women. The sample consisted of 1182 Polish undergraduate students (613 women, 559 men, 10 missing values on gender) with a mean age of 20.33 years (SD = 1.68; range: 18–36). They were asked to complete self-report questionnaires measuring FA, personality traits (Big Five), self-esteem, narcissism, self-efficacy, social anxiety, loneliness, and well-being indicators. Due to the low content, factorial, and clinical validity, the first three items were excluded from the Polish version of the mYFAS. The six-item mYFAS demonstrated measurement invariance, allowing for meaningful comparisons between genders and yielded almost identical prevalence rates for men and women. The hierarchical multiple regression analysis showed that, narcissism, and social anxiety predicted FA in both genders, whereas important gender differences in antecedents were also noted. In addition, FA was associated with body mass index (BMI) and most of the well-being indicators, even after controlling for relevant variables. The findings suggest that our modified analytical approach allows researchers to measure FA using a valid, useful, and simple tool.

Background: Measuring Quality of Life (QoL) in mental health using self-reported items is important for evaluating the quality of service and understanding the person's experience of the care received.Objective: The aim of this research was to develop and validate a self-reported QoL instrument for inpatient and community mental health settings.Methods: Data were collected from diverse research sites in Canada, Belgium, Russia, Finland, Brazil, and Hong Kong, using the 37-item interRAI Quality of Life Survey for Mental Health and Addictions. The survey was administrated to 2,218 participants from inpatient and community mental health settings, assisted living, and the general community. We randomly divided the sample into a training and a test sample (70 and 30%, respectively). We conducted principal component analysis (PCA) and exploratory factor analysis (EFA) using the training sample to identify potential factor structure. Confirmatory factor analysis (CFA) models were then fitted to finalize and externally validate the measurement model using training and test data, respectively.Results: PCA, EFA, and CFA of the training sample collectively suggested a 23-item scale measuring four latent constructs: well-being and hope (8 items), relationship (7 items), support (5 items), and activity (3 items). This model was supported by the CFA of the test sample. The goodness-of-fit statistics root mean square error, comparative fit index and Tucker-Lewis index were 0.03, 1.00, and 0.99, respectively. Estimated Cronbach's alpha based on the test data was 0.92. Raw Cronbach's alpha values for the subscales were 0.86 for well-being and hope, 0.86 for relationship, 0.69 for support, and 0.72 for activity.Conclusions: The interRAI SQoL-MHA scale is a valid instrument to measure QoL in mental health settings. The instrument will support the evaluation of the quality of care and can also be used for future research to produce SQoL-MHA values on a quality adjusted-life-year scale, facilitating the evaluation of various mental health interventions.

Abstract Background One critical factor in the implementation of evidence-based practice (EBP) in substance use disorder treatment organizations is an inner organizational context that clearly supports implementation efforts. The Implementation Climate Scale (ICS) has been developed to allow researchers and organizations to assess climate for EBP implementation in health and allied health service organizations. The ICS consists of 18 items and measures six dimensions of implementation climate: focus on EBP, educational support for EBP, recognition for EBP, rewards for EBP, selection for EBP, and selection for openness. The ICS was initially developed in a mental health context; thus, the goal of this study was to provide initial validation of the ICS in substance use disorder (SUD) treatment settings. Methods Confirmatory factor analysis (CFA) was used to assess the psychometric functioning of the ICS using survey data from 326 providers in 65 teams in SUD treatment programs. Cronbach’s alpha was examined to assess internal consistency of the ICS, and individual and team level construct-based validity was examined by comparing its correlations with service climate, molar climate, and organizational change. Results We found evidence for the reliability, factor structure, and validity of the ICS in SUD services. The psychometric functioning of the ICS in SUD treatment settings was comparable to that found in mental health contexts. Conclusions The ICS is a brief and pragmatic tool for researchers to better understand a critical antecedent for implementation effectiveness in SUD treatment and for organizational leaders in SUD treatment organizations to evaluate the extent to which providers perceive that their organization supports EBP implementation.

The article discusses types and forms of an addictive behavior of law enforcement officers (in terms of employees of internal affairs bodies) in conjunction with individual psychological characteristics. The attention is focused on the variety of addictive behavior approaches available in the scientific literature. According to the data obtained, such addictions as relationship, Internet-computer, work, adrenaline are most pronounced among employees of the internal affairs bodies in view of the peculiarities of professional activity. It was revealed that more than half of the internal affairs officers have a tendency to manifest addictive behavior. The particular structures of the manifestation of addictive behavior are described using factor analysis. The chosen five-factor model allowed to describe specific forms of addiction: addiction of negative relations, emotional addiction, distance from society, introverted workaholism, emotional interpersonal relations. The patterns of the relationship of addictive behavior with emotional instability, anxiety, social inclusion, suspicion, and emotional regulation of behavior are revealed.

Introduction: addictions represent a serious public health problem. There is a need to conduct more studies on the characteristics of drug users in general to develop more specific treatments. Objective: the objective of this study was to identify the sociodemographic/clinical characteristics of users of a Center for the Rehabilitation of addictions and to establish possible associations between personality profiles and drugs. Method: the study was non-experimental, descriptive and correlational, the sample consisted of 300 participants, mostly single males, high school and undergraduate students. Results: the main drugs of choice reported were alcohol, marijuana and cocaine. A greater number of users with antisocial personality traits were found, followed by borderline and schizoid personality traits. Discussion and conclusion: the need for primary and secondary prevention is observed. Rehabilitation is a favorable and necessary option for the recovery of users and their families. ---- Introducción: las adicciones representan un serio problema de salud pública. Existe la necesidad de realizar más estudios sobre las características de los consumidores de drogas en general para desarrollar tratamientos más específicos. Objetivo: el objetivo de este estudio fue identificar las características sociodemográficas/clínicas de usuarios de un Centro de Rehabilitación de adicciones y establecer posibles asociaciones entre perfiles de personalidad y droga de impacto. Método: el estudio fue no experimental, descriptivo y correlacional; la muestra estuvo conformada por 300 participantes, en su mayoría varones solteros, estudiantes de bachillerato y licenciatura. Resultados: las principales drogas de elección reportadas fueron alcohol, mariguana y cocaína. Se encontró mayor cantidad de usuarios con rasgos de personalidad antisocial, seguidos por rasgos de personalidad límite y esquizoide. Discusión y conclusiones: se observa la necesidad de prevención primaria y secundaria. La rehabilitación es una opción favorable y necesaria para la recuperación de usuarios y sus familias.

Introduction: in the field of addiction, there are remarkable implications for the patient treatment completion in terms of their quality of life from both a clinical and social perspective. Aim: of the current study is to explore the interaction of factors with regards the patient (including family assistance to therapeutic groups), and treatment completion. Method: a retrospective study of 234 patients between the ages of 18 and 75, who had been through treatment at Fundación Recal from November 2014 to May 2018, was carried out. For this research, a group of sociodemographic and clinical variables were registered, and interaction was analyzed, whether the client completed or dropped out, using a CHAID algorithm. Results: it was observed that the principal interaction with treatment completion was family assistance in support groups. At the same time, this variable did interact with the history of previous addiction within the family, in addition to the client’s education level. The model obtained is adequate to classify treatment completion but not drop out. Conclusion: the results obtained provide support for the importance of introducing family into patient therapeutic plans, especially during the preliminary stages of treatment. ---- Introducción: en el área de las adicciones, que un paciente pueda completar su tratamiento tiene notables implicaciones para su la calidad de vida, tanto desde el punto de vista clínico como social. Objetivo: el presente estudio se realizó con el objetivo de explorar la interacción de los factores referidos al paciente y la incorporación de sus familiares en el plan terapéutico, con la finalización de los primeros 90 días de tratamiento. Métodos: se realizó un estudio ex post facto retrospectivo con 234 pacientes entre 18 y 75 años, atendidos en la Fundación Recal en el período desde noviembre de 2014 hasta mayo de 2018. Para ello se registró un grupo de variables sociodemográficas y clínicas, de las que se analizó su interacción con la finalización o abandono del tratamiento, mediante la utilización de un algoritmo CHAID. Resultados: la principal interacción detectada con la finalización del tratamiento fue la asistencia de los familiares a Grupos de Apoyo. A su vez, esta variable interactuaba con la presencia de antecedentes familiares de adiciones y el nivel educacional del paciente. El modelo obtenido es adecuado para clasificar la finalización del tratamiento, pero no así el abandono. Conclusión: los resultados obtenidos brindan soporte a la importancia de introducir a la familia dentro de los planes terapéuticos del paciente, sobre todo en las etapas iniciales de su tratamiento.

Introduction: Community pharmacists are accessible, knowledgeable, and capable of providing mental health promotion and care in communities. This may not be a role that is recognized by the public, and men in particular. Differences between men and women exist in help seeking practices. Headstrong–Taking Things Head-On is a men’s mental health promotion program for community pharmacies that was designed to increase the capacity of community pharmacists in caring for men with lived experience of mental illness and addictions. The program’s core components included signage in pharmacies, education and training for pharmacists, and a website for use with patients. Methods: We applied the Theoretical Framework of Acceptability as the coding scheme to pharmacists’ qualitative interviews to examine the acceptability of Headstrong for pharmacists. Results: Nine pharmacists consented to participate and all chose telephone interviews. With the exceptions of ethicality, affective attitude, and opportunity costs, all components from the TFA were coded in each of the nine transcripts. The most frequently coded constructs were perceived effectiveness of the intervention, burden, and self-efficacy. These were coded at least 20 times. The remaining categories ethicality, intervention coherence, affective attitude, and opportunity costs were coded between 11 to 17 times. Pharmacists’ perceptions of the effectiveness of the program was mixed. The overall burden was perceived to be low, but opportunity costs appear to have limited the participation of some pharmacists in the program. Conclusion: Use of the Theoretical Framework of Acceptability as a coding scheme for qualitative data from community pharmacists in a men’s mental health program was helpful for identifying issues with the program that may require redesign (e.g., signage). Program design should consider how services are advertised in the pharmacy setting, how personal values of pharmacists influence intervention coherence, and whether minimizing the burden of an intervention negates issues related to opportunity costs.

Abstract Background Family navigation in mental health and addictions is a mode of support aimed at helping families through the complex mental health and addictions system, making well-informed service matches, and engaging with families throughout their care journeys. As family navigation services emerge and grow, understanding their unique features and impacts is essential to defining evaluation measures and driving good outcomes for families. Methods This Delphi study investigated the defining features of family mental health and addictions navigation, factors involved in a successful service match, and important outcomes of the process through perspectives of clients and team members of a family navigation program, as well as those of local mental health and/or addictions service providers. In the first phase, participants (n = 41), were asked to respond to a series of prompts pertaining to 1) the key features of a successful family navigation process, 2) the features of good matches between youth or families and the services to which they are navigated, and 3) the outcomes of importance in family navigation. In Phase 2, findings from Phase 1 were presented to participants (n = 32) to select and rank their top ten responses to each prompt. Responses which passed a cut-point were carried into Phase 3, in which participants (n = 20), rated the importance of the remaining items. Items rated as “very” or “extremely” important by 80% or more of participants in Phase 3 had achieved consensus. Intra-class correlation coefficients were calculated to confirm participant agreement on all items having achieved consensus. Results Sample items with 100% consensus were as follows: navigator determines the best fit by understanding and considering the youth and families’ needs, by collaborating with team members and service providers, and by providing individualized suggestions; navigation involves knowledge and understanding of mental health and addictions system and existing services; referred service providers are knowledgeable and up-to-date on evidence-based practice and have multidisciplinary perspectives in service. Overall ICC across all finalized statements following Phase 3 was .84. Conclusions Exploring the key features of successful navigation, outcomes of importance to stakeholders, and elements of successful matches can inform the development of navigation services that address families’ needs, can support service providers in ensuring well-matched services, and lend vital support to families seeking services within a complex system.

Abstract This paper examines a play (Sarah Kane’s Cleansed) and two films (Marc Schölermann’s Pathology and Alex Garland’s Ex Machina) to assess the fallibility of their God-figures. The God-characters’ downfall originates in behaviours that appear both moralized in Christian vein and pathologized in nineteenth-century psychiatric terms: addiction to power is aided by, or alternatively disguised as, substance addictions and/or inordinate sexuality. However different in medium and topic, the three (unrelated) dystopian works betray a concern with moral righteousness strictly circumscribed by the heteronormative and pleasure-prohibitive JudaeoChristian regime which undergirds the modern scientific outlook. Through their overt, consistent dramatization of religious-moral imperatives, all three works explore contemporary fears of and responses to sexual gratification and generally self-indulgence. Our close reading of intertextual echoes in the three works resorts to Michel Foucault’s work on sexuality, alongside recent medical definitions of social pathology. We suggest that at a deeper level the works vent anxieties about the duplicity of the human psyche as the hinge between a normative society (figured as a punishing God) and deeply personal drives and pleasures (deemed sinful).

The article reflects on the effectiveness of preventive actions towards risky behavior of young people. It shows levels and strategies of preventive work and basic methods and concepts of effective prophylaxis. It also draws attention to the assumptions that should be followed by any prevention program.

Abstract Background Nonmedical prescription opioid use (NMPOU) is a serious public health problem in North America. At a population-level, previous research has identified differences in the prevalence and correlates of NMPOU among younger versus older age groups; however, less is known about age-related differences in NMPOU among people who use illegal drugs. Methods Data were collected between 2013 and 2015 from two linked prospective cohort studies in Vancouver, Canada: the At-Risk Youth Study (ARYS) and the Vancouver Injection Drug Users Study (VIDUS). Factors independently associated with NMPOU among younger (ARYS) and older (VIDUS) participants were examined separately using bivariate and multivariate generalized estimating equations. Results A total of 1162 participants were included. Among 405 eligible younger participants (Median age = 25; Inter-Quartile Range [IQR]: 22–28), 40% (n = 160) reported engaging in NMPOU at baseline; among 757 older participants (Median age = 48, IQR: 40–55), 35% (n = 262) reported engaging in NMPOU at baseline. In separate multivariate analyses of younger and older participants, NMPOU was positively and independently associated with heroin use (younger: Adjusted Odds Ratio [AOR] = 3.12, 95% Confidence Interval [CI]: 2.08–4.68; older: AOR = 2.79, 95% CI: 2.08–3.74), drug dealing (younger: AOR = 2.22, 95% CI: 1.58–3.13; older: AOR = 1.87, 95% CI: 1.40–2.49), and difficulty accessing services (younger: AOR = 1.47, 95% CI: 1.04–2.09; older: AOR = 1.74, 95% CI: 1.32–2.29). Among the youth cohort only, NMPOU was associated with younger age (AOR = 1.12, 95% CI: 1.05–1.19), crack use (AOR = 1.56, 95% CI: 1.06–2.30), and binge drug use (AOR = 1.41, 95% CI: 1.00–1.97); older participants who engaged in NMPOU were more likely to report crystal methamphetamine use (AOR = 1.97, 95% CI: 1.46–2.66), non-fatal overdose (AOR = 1.76, 95% CI: 1.20–2.60) and sex work (AOR = 1.49, 95% CI: 1.00–2.22). Discussion The prevalence of NMPOU is similar among younger and older people who use drugs, and independently associated with markers of vulnerability among both age groups. Adults who engage in NMPOU are at risk for non-fatal overdose, which highlights the need for youth and adult-specific strategies to address NMPOU that include better access to health and social services, as well as a range of addiction treatment options for opioid use. Findings also underscore the importance of improving pain treatment strategies tailored for PWUD.

Introduction The Addictions Recovery Community Hillingdon (ARCH) is a specialist addictions treatment service, providing a range of inteventions for substance use disorders. The onset of the COVID-19 pandemic required healthcare services to rapidly adapt clinical care in order to safeguard patients and staff from contracting the virus whilst managing clinical risk. Key changes were made to treatment pathways at ARCH. Objectives 1. Reduce face-to-face contact between patients and staff (including community pharmacists) 2. To get feedback from patients and staff about changes implemented Methods To reduce face-to-face contact, we aimed to decrease the number of patients having supervised consumption of Opiate Substitute Treatment (OST). Furthermore, telephone consultations were encouraged for keyworking and reviews. Patients were randomly selected and interviewed about their experiences and focus groups were be completed with staff. Results Supervised consumption of OST was reduced from 41.5% to 6%. Face-to-face appointments were significantly reduced and telephone consultations were introduced as standard. Telephone reviews became the standard method of contact for keyworking sessions and medical reviews. 53% of services whose interval between instalment collection of OST at community pharmacies was extended found it ‘easy’ or ‘very easy’ to adapt to. 61% of service users who had access virtual platforms finding it ‘easy’ or ‘very easy’ to access support. Focus groups of staff members revealed that stafff felt the changes in instalment collection of OST was positive for patients. Conclusions ARCH implemented a number of changes to treatment pathways and inteventions to minimise the risk of virus transmission amongst patients and staff whilst managing clinical risk.

Introduction In the U.S. approximately11.4 million misused prescription pain relievers; 2.1 million had an OUD in 2017. The Addictions Nursing Subspecialty was created to address this epidemic by expanding a workforce trained in OUD/SUD screening, treatment, and prevention. A curriculum was developed that included integrated/telehealth health care settings in medical and mental health provider shortage areas during their last nine months of training. Courses were developed and taught by aninterprofessional team of university faculty and informed by evidence-based guidelines/clinical competencies for effective OUD/SUD screening/prevention, assessment, treatment, and recovery. Courses were also offered as electives for nursing, clinical-counseling, social work, and other health science disciplines emphasizing an interdisciplinary approach to healthcare. Objectives Expand the OUD/SUD trained workforce in areas with high OUD/SUD mortality rates and high mental health provider shortages emphasizing team-based integrated care and telehealth settings. Methods Program curriculum was informed by evidence-based guidelines/clinical competencies for effective OUD/SUD screening/prevention, assessment, treatment, and recovery using integrated care. Competencies included: Core Competencies for Integrated Behavioral Health and Primary Care that have been set forth by the Center for Integrated Health Solutions, telehealth competencies outlined in the recommended competencies by the National Organization of Nurse Practitioner Faculties (NONPF), and Core Competencies for Addictions Medicine by the American Board of Addictions Medicine. Results Approximately 11 students enrolled in courses received additions integrated/telehealth health care settings. Students responded positively to evaluations regarding timely feedback, unique approach (i.e. intrative content, short videos and discussions). Conclusions The Addictions Nursing subspecialty will continue to be offered allowing enrollment for nurses twice a year.