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A pilot study to explore the effects of substances on cognition, mood, performance, and experience of daily activities
Abstract
Purpose: This pilot study was designed to deliberately examine the enhancement effects and experiences of substances used among professionals and students in professional programs. Methods: A mixed methods design was implemented, involving ecological momentary assessment (EMA) and interviews. The analysis presents interpretations about the perceived impact of substance use on the performance and experience of everyday activities. Results: Caffeine, alcohol, antidepressants, pain suppressant, and cannabis were used by the most participant. Participants reported effects of substances that directly or indirectly enhanced performance (e.g., sleep, socialisation), mood (e.g., manage stress, relax), cognition (e.g., energy and clarity of thought), and the general experience of activities (e.g., enjoyment). Less common effects included impaired work, school, or leisure performance, injury, sleep disruption, and pain or discomfort. Reactivity was an unexpected effect, with almost half of the interviewees reporting changes in their thoughts about their substance use, and 30% of interviewees making active changes. Conclusion: This study was novel in population and data collection. Complex perspectives about substance use were offered by recruiting professionals and students outside at-risk populations or addiction-related services. By examining effects of substances, this research offers nuanced understandings of self-reported effects of psychoactive substances on performance, mood, cognition, and quality of experience.
... They can, on the other hand, substitute for one another; if one becomes too expensive, unavailable, or dangerous, another can be used in its place. If the supply of the usual substance is cut off, finding a supply of a cross-dependent substance as a substitute becomes a matter of urgency for users with substance use disorder (Kiepek et al. 2018;WHO 2018). Alcohol has shown to be a complementary substance for other psychoactive drugs (e.g., nicotine) and risk-taking behaviors (e.g., driving at excessive speed and running red lights and speeding while driving) (Cameron and Williams 2001;Pierani and Tiezzi 2009;Tauchmann et al. 2013). ...
The use of cannabis, alcohol, and other drugs is a major risk factor for assaultive
injuries and violent deaths. Cannabis is one of the most frequently detected drugs
among homicide victims as well as perpetrators. It is evident that as more
countries move toward legalizing cannabis, this drug is playing an increasingly
important role in homicide victimization and perpetration.
... In many countries, the consumption of drugs such as caffeine to enhance work productivity is commonplace (Kiepek, Beagan, & Harris, 2018). However, economic conditions in Nigeria, as in many West African countries mean that workers are under intense pressure to perform. ...
Background
The desire for enhancement is a common motive for non-medical use of prescription drugs in Western countries. Little is known about the factors that motivate use in non-Western contexts.
Methods
The study explores access to prescription drugs and the motivations for using them among educated young adults in a city located in Anambra State, South-Eastern Nigeria. Semi-structured interviews were conducted with 23 participants aged 23–29 years. Data were thematically analysed using NVivo 12 Software.
Results
The data indicate that prescription drugs are widely available and easy to access without a prescription in the unregistered ‘pharmacies’ and medicine shops that form part of Nigeria's informal healthcare system. Social networks are also a source of drugs. Participants shared detailed perspectives on their use of prescription drugs, revealing that codeine, Rohypnol, and high doses of tramadol are used to enhance performance in several social life domains. These drugs were described as enhancing performance and productivity in the workplace, and were taken by participants working as labourers and sales representatives. Male participants also shared accounts of using high doses of tramadol to improve stamina and skill in sports. Some participants took Rohypnol to enhance their creative and academic performance. Participants stated that drug use enabled them to meet the pressures associated with work, academia, and parental expectations.
Conclusion
The findings suggest that prescription drugs are being strategically and instrumentally deployed by users to enhance different domains of social life. This is driven by users’ experiences of the drugs’ bodily effects, and it is supported by a context in which self-medication and informal healthcare are common. Participants’ reasons for seeking drug-induced enhancement reflect sociocultural factors within Nigeria and some West African countries, such as employment scarcity and the championing of sporting prowess. The findings can be used to inform the design of tailored approaches to reduce the harms presented by the non-medical use of pharmaceuticals among young adults.
... In their pilot study with professionals and students in professional programs, Kiepek, Beagan, and Harris (2018) purposefully recruited outside therapeutic and legal contexts and designed the data collection instrument to include a range of effects. They found the reported effects of substances, whether licit, illicit, and prescribed, to be predominantly positive, such as enhanced performance (e.g., sleep, socialisation), mood (e.g., manage stress, relax), and cognition (e.g., energy and clarity of thought). ...
This commentary invites discussion about implicit and explicit factors that impede research about substance use from a nuanced perspective that recognises potential benefits and advantages. It is argued that explicit efforts to engage in scholarship beyond those informed by theoretical and philosophical assumptions that substance use is
inherently risky and problematic can enhance genuine inquisition about substance use and transform which discourses and interpretations are legitimised. Prioritisation of scholarly funding and publication has largely
been predicated on the notion that illicit substances pose an inherent risk for individual and social harm. This has implicitly and explicitly influenced what type of research has been conducted and how substance use is constructed. Researchers who engage in scholarship that suspends assumptions of risk and problems associated with substance use may become subject to judgement about their credibility, ethics, and expertise. Moving forward, we suggest that conscientiously attending to broad, nuanced experiences associated with substance use will contribute to a stronger evidence base. Equal opportunity should be given to examine the complexity of lived experiences. It may also be timely to consider what brings value to scholarly pursuit, recognising that health is but one valued social outcome. Perhaps other outcomes, such as human rights, compassion, and justice are equally commendable. To advance substance use scholarship, it is essential that decision-makers (e.g., funding bodies, editors) embrace research that does not conform to assumptions of risk or inherent problems as exclusively legitimate, advocate for scholarship that resists conforming to dominant discourses, and create spaces for critical perspectives and interpretations.
Our study was designed to pilot a photo elicitation methodology and undertake preliminary examination of substance use from the perspectives of two potentially disparate groups. Photo elicitation methodology involved participant generated photos and elicitation interviews to purposefully explore (i) how people who use substances depict and discuss their own substance use, and (ii) how professionals who prescribe/dispense pharmaceuticals depict and portray how substances impact the lives’ of patients/clients. Individuals who use substances told “stories of self.” Health providers blended “stories of others” and “stories of social worlds” that indirectly revealed “stories of self.” All participants confronted dominant social perspectives, offering alternative interpretations and challenging such opinions as incomplete or erroneous. The social nature of substances held contrasting perspectives, with health professionals seeing incentives of “fitting in” with “peers using” and a “coping strategy” to reduce social anxiety. Participants who use substances told stories of positive social connections through shared experiences of substance use and increased effects of sociability. Findings may contribute to nuanced understandings to destigmatise and mitigate Othering.
Introduction We draw on activity theory of concepts to examine ‘meaning of occupation’ and ‘substance use’ beyond preconceived notions of inherent positive or negative experiences. Objective To explore nuanced meanings of substance use and associated occupations. Method An online survey and semi-structured interviews were used to collect data from professionals about prevalence of substance use, substance effects, and personal experiences. In analyzing the interview data, we attended to substance use as a discrete occupation in itself, substance use co-occurring with other occupations, and substance use altering the performance, participation, and experience of occupations. Results Three broad themes related to meaning: i) complex meanings attributed to substance use, ii) meanings of substance use as shifting and variable, and iii) meanings of substance use in the context of other occupations. Substance use enhances occupations, transforms meaning of occupations, and mitigates less desired aspects of occupations. Work, construed as positively meaningful and valued in occupational therapy literature, was a source of stress, unhappiness, and worry; substance use facilitated relaxation and pleasure. Conclusion This study furthers occupational therapy knowledge with respect to implications for conceptualization that extend beyond dualist framings and implications for occupational therapy education, practice, and policy.
Purpose
The purpose of this paper is to explore the prevalence and patterns of substance use among Canadian social workers. With legalisation of can professional regulatory bodies are pressed to consider implications of substance use for their members.
Design/methodology/approach
An online survey collected data about demographics and substance use prevalence and patterns. Statistical analysis involved pairwise comparisons, binary logistic regression models and logistic regression models to explore correlations between substance use and demographic and work-related variables.
Findings
Among the respondents (n=489), findings indicate that past-year use of cannabis (24.1 per cent), cocaine (4.5 per cent), ecstasy (1.4 per cent), amphetamines (4.3 per cent), hallucinogens (2.4 per cent), opioid pain relievers (21.0 per cent) and alcohol (83.1 per cent) are higher than the general Canadian population. Years of work experience and working night shift were significant predictors of total number of substances used in the past year. Use of a substance by a person when they were a student was highly correlated with use when they were a professional.
Research limitations/implications
Prevalence of substance use among social workers was found to be higher than the Canadian population; potential due to the anonymous nature of data collection.
Originality/value
This study has implications for social conceptualisations of professionalism and for decisions regarding professional regulation. Previous literature about substance use by professionals has focussed predominantly on implications for increased surveillance, monitoring, and disciplinary action. We contend that since substance use among professionals tends to be concealed, there may be exacerbated social misconceptions about degree of risk and when it is appropriate to intervene.
Processes of professional socialization influence types of substances used, patterns of use, and estimation of normalization. This project explores psychoactive substance use among professionals and students in professional programs in Canada, rationales for use, strategies to manage use and potential consequences, and factors within professional education and culture that influence decisions about use. The intent of this study is to uncover social processes through which professional contexts influence substance use. The researchers sought to explore how professionals and professional students described their own decision-making about substance use and their perceptions of professional influences. The mixed methods pilot study involved ecological momentary assessment (EMA), using an app designed for the study, and qualitative interviews. Participants completed a brief survey on the app each time they used a substance during a 4-week period, reporting what substance was used, how much, where, who with, and anticipated or delayed effects. Thirty-four participants were involved in the EMA component, 20 of whom engaged in interviews. The findings suggest a certain amount of substance use is expected, accepted, and even promoted in professional fields. Thematic analysis revealed novel understandings about (i) deliberate decisions, (ii) disclosure and use, (iii) stigmatized substance use, (iv) normative substance use, and (v) the professional context. This study demonstrates potential advantages of undertaking research to explore substance use, as distinct from substance abuse, problematic use, dependence, or addiction. Conceptualizing substance use more broadly can help to identify factors that both encourage use (e.g., performance demands, social norms) and constrain use (e.g., responsibility, role modeling). This can expand approaches to address substance use that look beyond the individual to social and institutional contexts, acknowledging that responsibility is a collective process.
Background: Energy drink is a type of beverage which contains stimulant drugs chiefly caffeine and marketed as mental and physical stimulator. Coffee, tea, soft drinks and other caffeinated beverages are not considered as energy drinks. Purpose of our study was to evaluate the awareness of medical students regarding energy drinks and their pattern and reason of energy drinks consumption. Methods: This was a cross sectional and observational study conducted during the period of January - December 2012 at four Medical Colleges (Dow Medical College, Sindh Medical College, Jinnah Medical College and Liaquat National Medical College) of Karachi, Pakistan. Over all 900 M.B.B.S students were invited to participate after taking written consent but viable questionnaire was submitted by 866 students, estimated response rate of 96%. All data was entered and analyzed through SPSS version 19. Result: Out of 866 participants, majority were females 614 (70.9%) and only 252 (28.5%) were males, with a mean age of 21.43 ± 1.51 years. Energy drinks users were 350 (42.89%) and non users were 516 (59.58%). Only 102 (29.3%) users and 159 (30.7%) non users know the correct definition of Energy drinks. Regarding awareness, mostly user and non users thought that usage of energy drinks had been on rise due to its usefulness in reducing sleep hours [users193 (43.9%), nonusers 247 (56.1%) (p < 0.05)], for studying or completing major projects [users184 (45.0%), nonusers 225 (55.0%) (p < 0.05)] and for refreshment purposes [users179 (44.9%), nonusers 220 (55.1%) (p < 0.05)]. Two main reasons of not using energy drinks by non-users were "awareness from its side effects" 247 (47.8%) and "have no specific reason" 265 (51.3%). Most common side effects reported by users were fatigue 111 (31.7%) and weight gain 102 (29.4%). Conclusion: In sum, the fact that despite serious side effects of weight gaining and fatigue, practice of consuming energy drinks is highly prevalent among medical students, particularly because they are ever ready to boost their energy level and reduce sleep hours due to stress of exams and projects. This warrants the creation of continued public health awareness about the appropriate use of caffeinated beverages, their potential benefits, side effects and correction of wrong perceptions.
Objectives: This research explored drug use from the perspectives of individuals who recreationally used one or more substances on a daily basis and had never attended addiction-related counselling or a mutual support group. The purpose of the research was to identify the ways that narrative accounts were discursively structured to enact, confirm, legitimate, reproduce, or challenge the concept of addiction. Methods: The methodology involved a critical analysis of discourse, drawing on personal accounts of drug use that were elicited using discursive narrative strategies. Results: The finding demonstrated that narrative accounts were constructed in relation to dominant discourses in the North American context. Efforts to refute dominant discourses can be viewed as a response to risks associated with self-disclosure of subjugated positions. The findings presented in this paper pertain to the ways in which research participants adopted indirect discursive practices that challenged distinctions between legal, socially sanctioned drug use (namely, medications) and illegal, socially unsanctioned drug use. Drawing in particular discursive strategies, the research participants blur the lines between categorization of drugs and drug-related practices as healthy or unhealthy, moral or immoral, socially acceptable or socially acceptable. Overall, the findings demonstrate that the research participants challenged dominant discourses that position illicit drug use and distribution as being socially unacceptable. Conclusion: This research uncovers discursive practices of power, authority, legitimacy, dominance, and inequality in relation to drug-related policy, research, and education. The findings offer an alternative interpretation to narrative accounts that might otherwise be interpreted as ego defense mechanisms.
This article focuses on how the categories of ‘normal’ and ‘extreme’ in the context of work might be renegotiated through the development of human enhancement technologies which aim to enable the human body to be pushed beyond its biological limits. The ethical dimensions of human enhancement technologies have been widely considered, but there has been little debate about their role in the broader world of employment—nor, conversely, the recognition that prevailing employment relationships might shape the development and uptake of such technologies. Addressing the organisation of work within ‘advanced’ capitalist economies, this article considers the arguments for the potential use of cognitive enhancers, so-called ‘smart drugs’, in various domains of work such as surgery and transportation. We argue that the development of human enhancement technologies might foster the normalisation of ‘working extremely’—enabling longer working hours, greater effort or increased concentration—and yet at the same time promote the conditions of possibility under which workers are able to work on themselves so as to go beyond the norm, becoming ‘extreme workers’. Looking at human enhancement technologies not only enables us to see how they might facilitate ever greater possibilities for working extremely but also helps us to understand the conditions under which cultures of extreme work become the norm and how workers them/ourselves accept or even embrace such work.
There has been an ongoing research effort to understand the morality of athletes using prescription and illicit drugs to enhance sporting performance. By comparison, perceptions around the ethics of university students using prescription drugs to enhance academic performance (known as cognitive enhancement or neuroenhancement) are less well understood. This study compared how university students responded to the ethical considerations of using performance enhancing substances across sporting and academic contexts. A total of 98 participants from universities in the United Kingdom completed a Brief Implicit Association Test, a brief version of the Performance Enhancement Attitude Scale, an explicit cognitive enhancer attitude assessment and reported their views on four scenarios regarding sports doping and the use of cognitive enhancers by university students. The implicit association did not show a significant polarisation of students’ moral attitudes. Explicit measures showed a stronger disagreement towards doping behaviours. Those professionally involved in sport found chemical enhancement more acceptable than other respondents, suggesting an instrumental viewpoint and a transfer of social knowledge from one domain of drug use to the other. Participants perceived the use of enhancers in sport and education as “cheating” when it affected others, but believed cognitive enhancement could be necessary due to competitiveness of the job market. Results suggest that chemical enhancement was considered acceptable by some student groups. The proportion of the sample knowing someone who used cognitive enhancers (13%) or someone who doped (19%) suggests that substance based performance enhancement may be normalising and increasing in popularity.
Measuring self-reported substance use behavior is challenging due to issues related to memory recall and patterns of bias in estimating behavior. Limited research has focused on the use of ecological momentary assessment (EMA) to evaluate marijuana use. This study assessed the feasibility of using short message service (SMS) texting as a method of EMA with college-age marijuana users. Our goals were to evaluate overall response/compliance rates and trends of data missingness, response time, baseline measures (e.g., problematic use) associated with compliance rates and response times, and differences between EMA responses of marijuana use compared to timeline followback (TLFB) recall. Nine questions were texted to participants on their personal cell phones 3 times a day over a 2-week period. Overall response rate was high (89%). When examining predictors of the probability of data missingness with a hierarchical logistic regression model, we found evidence of a higher propensity for missingness for Week 2 of the study compared to Week 1. Self-regulated learning was significantly associated with an increase in mean response time. A model fit at the participant level to explore response time found that more time spent smoking marijuana related to higher response times, while more time spent studying and greater "in the moment" academic motivation and craving were associated with lower response times. Significant differences were found between the TLFB and EMA, with greater reports of marijuana use reported through EMA. Overall, results support the feasibility of using SMS text messaging as an EMA method for college-age marijuana users. (PsycINFO Database Record (c) 2014 APA, all rights reserved).
Alcohol consumption of college students has a fluctuating nature, which might impact the measurement of intervention effects. By using 25 follow-up time-points, this study tested whether intervention effects are robust or might vary over time.
Data were used from a two-arm parallel group randomized controlled trial applying ecological momentary assessment (EMA) with 30 data time-points in total. Students between 18 and 24 years old who reported heavy drinking in the past six months and who were ready to change their alcohol consumption were randomly assigned to the experimental (n = 456: web-based brief alcohol intervention) and control condition (n = 451: no intervention). Outcome measures were weekly alcohol consumption, frequency of binge drinking, and heavy drinking status.
According to the intention-to-treat principle, regression analyses revealed that intervention effects on alcohol consumption varied when exploring multiple follow-up time-points. Intervention effects were found for a) weekly alcohol consumption at 1, 2, 3, 4, and 7 weeks follow-up, b) frequency of binge drinking at 1, 2, 7, and 12 weeks follow-up, and c) heavy drinking status at 1, 2, 7, and 16 weeks follow-up.
This research showed that the commonly used one and six month follow-up time-points are relatively arbitrary and not using EMA might bring forth erroneous conclusions on the effectiveness of interventions. Therefore, future trials in alcohol prevention research and beyond are encouraged to apply EMA when assessing outcome measures and intervention effectiveness.
Netherlands Trial Register NTR2665.
Healthcare professionals are crucial in access to treatment for patients with substance use disorders. However, healthcare professionals often have negative attitudes towards this patient group. Healthcare professionals' regard for working with patients with substance use disorders was examined and three sectors in which professionals are working were compared.
General practitioners (GPs; N=180), healthcare professionals of general psychiatry (N=89) and specialists in addiction services (N=78) filled out a questionnaire in which regard for working with patients with substance use disorders was assessed. ANOVAs were used to compare the sectors and multiple linear regression analysis tested the association of regard with attribution beliefs, emotional reactions and other characteristics of healthcare professionals.
Regard for working with patients with substance use disorders was different between the three sectors (GPs M=42.00; general psychiatry M=48.18; addiction specialists M=55.41; p=0.00, ω(2)=0.40). Attribution of personal responsibility and feeling of anger and fear were associated with lower regard scores. More familiarity with substance use problems, higher frequency of working with this patients group and more confidence in substance abuse treatment were positively associated with regard. Social desirability bias was present and was positively related to healthcare professionals' regard.
Health care professionals of specialist addiction services showed higher regard for working with patients with substance use disorders compared to professionals of general psychiatry services and GPs. Improvement of education and shared care models in which healthcare professionals are supported by professionals specializing in addiction might address low regard.
We have designed a flexible ecological momentary assessment/intervention smartphone (EMA/EMI) "app". We examine the utility of this app for collecting real-time data, and assessing intra-subject variability, by using it to assess how freshman undergraduates spend their time. We also explore whether its use can promote greater self-awareness. Participants were randomly divided into an experimental group, who used the app, and a control group, who did not. We used the app to collect both randomized in-the-moment data as well as end-of-day data to assess time use. Using a posttest survey we asked participants questions about how they spent time throughout the school semester. We also asked the experimental group about their experience with the app. Among other findings, 80.49% participants indicated that they became more aware of how they spent their time using the app. Corroborating this report, among the experimental group, end-of-semester self-assessment of time spent wasted, and time spent using electronics recreationally, predicted semester GPA at a strength comparable to high school GPA and ACT score (two of the best single predictors for first semester college GPA), but had no correlation among controls. We discuss the advantages and limitations of using apps, such as ours, for EMA and/or EMI.
In-depth interviews with 50 recovering, drug-addicted pharmacists reveal two distinct paths of entry into drug use. One group (N = 23), termed “recreational abusers,” was drawn into the euphoric effects of prescription drugs. The other group (N = 27), termed “therapeutic self-medicators,” began using prescription drugs for medicinal reasons. These two distinct modes of entry eventually converged into a single, common criminal career trajectory with common themes observable among all mature deviants. Early differentiation, followed by subsequent convergence of behaviors and motivations, suggests that some theorists and practitioners alike may have erroneously concluded that they have discovered multiple, static types of crime and criminals when they in fact have examined a single criminal-deviant career at different points along its dynamic trajectory.
How do certain users lose control over the drug or drugs they are using and others manage to achieve and maintain control? The control of drugs is largely established by (sub)culturally based social controls (rituals and rules) which pattern the way a drug is used. Controlled users have a multiplicity of meaningful roles, which give them a positive identity and a stake in conventional daily life, and both these factors anchor them against drifting toward a drug-centered life. Based on an ethnographic study among 111 experienced cocaine users from Antwerp, Belgium, this paper presents qualitative data to illustrate drug users’ perceptions of ‘controlled’ and ‘uncontrolled’ drug use. These perceptions are interpreted as boundary protection mechanisms which help to prevent disruption of everyday life in which users have invested. The data indicate that patterns of drug use and perceptions of control of drugs are dynamic in nature and a product of particular situations, contexts, events, time periods, and drug use career transitions. Findings illustrate that self-regulation is a cycle of processes, and that the drug user continuously learns from his/her own experience and that of others. Becoming a ‘controlled cocaine user’ is a process as knowledge about the product extends. Finally, it is argued that one of the weightiest external stimuli that affects self-regulation, is the social definition of drugs and their users, embodied both in formal drug policy, the traditional ‘addiction’ paradigm, and social definitions of drug use within drug use subcultures.
On average, pharmacists spend six years in college studying the intricacies of prescription medicines and their effects on the human body. Upon graduation, they embark on a career where their expertise and familiarity with the proper use and dangers of prescription drugs continuously grows. Despite this wealth of experience, some pharmacists become prescription drug abusers. The present analysis uses interview data obtained from 50 recovering drug dependent pharmacists to understand the process by which these professionals come to abuse the tools of their trade. Ironically, the data show several ways in which the individuals' knowledge and expertise may actually contribute to progressive prescription drug abuse. The authors argue that being and becoming a pharmacist presents a paradox of familiarity wherein technical knowledge and opportunity, in the absence of proper appreciation of the risks of substance abuse, can delude pharmacists into believing that they are immune to prescription drug abuse.
Background
Surgeons are usually exposed to high workloads leading to fatigue and stress. This not only increases the likelihood of mistakes during surgery but also puts pressure on surgeons to use drugs to counteract fatigue, distress, concentration deficits, burnout or symptoms of depression. The prevalence of surgeons taking pharmacological cognitive enhancement (CE) or mood enhancement (ME) drugs has not been systematically assessed so far.
Methods
Surgeons who attended five international conferences in 2011 were surveyed with an anonymous self-report questionnaire (AQ) regarding the use of prescription or illicit drugs for CE and ME and factors associated with their use. The Randomized Response Technique (RRT) was used in addition. The RRT guarantees a high degree of anonymity and confidentiality when a person is asked about stigmatizing issues, such as drug abuse.
Results
A total of 3,306 questionnaires were distributed and 1,145 entered statistical analysis (response rate: 36.4%). According to the AQ, 8.9% of all surveyed surgeons confessed to having used a prescription or illicit drug exclusively for CE at least once during lifetime. As one would expect, the prevalence rate assessed by RRT was approximately 2.5-fold higher than that of the AQ (19.9%; 95% confidence interval (CI), 15.9% to 23.9%, N = 1,105). An even larger discrepancy between the RRT and AQ was observed for the use of antidepressants with a 6-fold higher prevalence (15.1%; 95% CI, 11.3% to 19.0%, N = 1,099) as compared to 2.4% with the AQ. Finally, logistic regression analysis revealed that pressure to perform at work (odds ratio (OR): 1.290; 95% CI, 1.000 to 1.666; P = 0.05) or in private life (OR: 1.266; 95% CI, 1.038 to 1.543; P = 0.02), and gross income (OR: 1.337; 95% CI, 1.091 to 1.640; P = 0.005), were positively associated with the use of drugs for CE or ME.
Conclusions
The use of illicit and prescription drugs for CE or ME is an underestimated phenomenon among surgeons which is generally attributable to high workload, perceived workload, and private stress. Such intake of drugs is associated with attempts to counteract fatigue and loss of concentration. However, drug use for CE may lead to addiction and to overestimation of one’s own capabilities, which can put patients at risk. Coping strategies should be taught during medical education.
The prospects of enhancing cognitive or motor functions using neuroscience in otherwise healthy individuals has attracted
considerable attention and interest in neuroethics (Farah et al., Nature Reviews Neuroscience 5:421–425, 2004; Glannon Journal of Medical Ethics 32:74–78, 2006). The use of stimulants is one of the areas which has propelled the discussion on the potential for neuroscience to yield
cognition-enhancing products. However, we have found in our review of the literature that the paradigms used to discuss the
non-medical use of stimulant drugs prescribed for attention deficit/hyperactivity disorder (ADHD) vary considerably. In this
brief communication, we identify three common paradigms—prescription drug abuse, cognitive enhancement, and lifestyle use
of pharmaceuticals—and briefly highlight how divergences between paradigms create important “ethics blind spots”.
KeywordsNeuroethics-Enhancement-Prescription drug misuse-Lifestyle drugs-Public health
Understanding the psychological processes that contribute to smoking reduction will yield population health benefits. Negative mood may moderate smoking lapse during cessation, but this relationship has been difficult to measure in ongoing daily experience. We used a novel form of ecological momentary assessment to test a self-control model of negative mood and craving leading to smoking lapse.
We validated short message service (SMS) text as a user-friendly and low-cost option for ecologically measuring real-time health behaviors. We sent text messages to cigarette smokers attempting to quit eight times daily for the first 21 days of cessation (N-obs = 3,811).
Approximately every two hours, we assessed cigarette count, mood, and cravings, and examined between- and within-day patterns and time-lagged relationships among these variables. Exhaled carbon monoxide was assessed pre- and posttreatment.
Negative mood and craving predicted smoking two hours later, but craving mediated the mood-smoking relationship. Also, this mediation relationship predicted smoking over the next two, but not four, hours.
Results clarify conflicting previous findings on the relation between affect and smoking, validate a new low-cost and user-friendly method for collecting fine-grained health behavior assessments, and emphasize the importance of rapid, real-time measurement of smoking moderators.
The purpose of this study was to determine the nonmedical use of prescription attention deficit disorder (ADD) stimulant medication among dental and dental hygiene students. A questionnaire was used to examine demographic information, student experiences, and perceptions of prescription stimulant medication and to determine if students used a prescription stimulant nonmedically. In 2008, 401 surveys were mailed to dental education institutions in the south-central region of the United States, and 243 surveys (61 percent) were returned. The survey found that 12.4 percent of these students used a prescription stimulant nonmedically and, of those, 70 percent took it to improve attention and/or concentration. The most commonly reported stimulant medication used nonmedically was Adderall (77 percent). The majority (87 percent) of the students obtained the medication through friends, and 90 percent began using the drug in college. Even though 74 percent of the students reported being stressed, chi-square analysis found no significant association between nonmedical use of ADD stimulant medication and stress level (p=0.585). Sixteen percent of the students surveyed felt it was easy to obtain stimulant medication for nonmedical use at their school, and 17 percent thought it was a problem within their institution. These results may help administrators and faculty members become aware of potential problems with the misuse of ADD stimulant medication.
The tendency for people to present a favourable image of themselves on questionnaires is called socially desirable responding (SDR). SDR confounds research results by creating false relationships or obscuring relationships between variables. Social desirability (SD) scales can be used to detect, minimise, and correct for SDR in order to improve the validity of questionnaire-based research. The aim of this review was to determine the proportion of health-related studies that used questionnaires and used SD scales and estimate the proportion that were potentially affected by SDR.
We assessed predictors of self-reported excessive drinking (> 5 drinks) in a sample of heavy drinkers. Participants were randomly assigned to moderation training or a waiting-list control condition. They were trained in ecological momentary assessment (EMA) involving self-monitoring of drinking and other variables on a small hand-held computer, the electronic diary (ED). During the 8-week study, participants were compliant in their use of the ED for both random prompts and the entry of data related to specific drinking episodes. Generalized estimating equations were used to fit models involving predictors related to past history of drinking, aspects of the training program, drinking restraint, and episode-specific mood. The models indicated robust predictors of decreased and increased drinking. Our results suggest that EMA is a useful methodology for assessing drinking and related behaviors.
This handbook describes the ways in which society shapes the mental health of its members and further shapes the lives of those who have been identified as mentally ill.
With regards to the social origins of mental health, this handbook covers both the social conditions that lead to the behavior defined as mental illness and the way in which the concept of mental illness is socially constructed around those behaviors. This handbook also covers a third body of work that examines socially conditioned responses to mental illness on the part of individuals and institutions along with the ways in which these responses affect the lives of persons with mental illness.
Sections include:
I: Introduction: Alternative Understandings of Mental Health.
II: Observing Mental Health in the Community.
III: The Social Distribution of Mental Illness.
IV: Social Antecedents of Mental Illness.
V: Social Consequences of Mental Illness.
V I: Institutional Contexts of Mental Illness.
VII: Social Continuities.
Each of these viewpoints survey the field in a critical manner, evaluating theoretical models in light of the best available empirical evidence. Distinctively sociological approaches are highlighted by means of explicit comparison to perspectives characterizing related disciplines such as psychology, psychiatry, and anthropology. This volume seeks to record where the field has been, to identify its current location and to plot its course for the future.
Objective:
This study examines reasons for marijuana use among young adults age 19/20 in the United States and the extent to which patterns of reasons are associated with marijuana use and problems 15 years later.
Method:
The national Monitoring the Future study provided data on marijuana users at age 19/20 who were also surveyed at age 35 (n = 2,288; 50% women; 83% White). Latent class analysis was used to identify distinct patterns of reasons for marijuana use, which were then used as predictors of later marijuana use and problems.
Results:
Five latent classes described the following patterns of reasons for marijuana use at age 19/20: Experimental, Get High + Relax, Typical, Typical + Escape, and Coping + Drug Use. Highest risk for later marijuana use and problems was found for people with Coping + Drug Use and Get High + Relax reasons in young adulthood; those with Experimental reasons were at lowest risk for later use or problems.
Conclusions:
Coping and getting high emerged as strong predictors of later marijuana use and problems. Results support the predictive value of self-reported reasons for using marijuana among young adults.
As work environments change, the demands on working people change. Cognitive abilities in particular are becoming progressively more important for work performance and successful competition in a global environment. However, work-related stress, performance over long hours, lack of sleep, shift work, and jet lag affect cognitive functions. Therefore, an increasing number of healthy people are reported to use cognitive-enhancing drugs, as well as other interventions, such as noninvasive brain stimulation, to maintain or improve work performance. This review summarizes research on pharmacological and technical methods as well as cognitive training, including game apps for the brain, in healthy people. In neuropsychiatric disorders, impairments in cognitive functions can drastically reduce the chances of returning to work; therefore, this review also summarizes findings from pharmacological and cognitive-training studies in neuropsychiatric disorders.
Recent surveys in the UK indicate that approximately half of all young people aged 16-22 have used an illegal drug. Despite such observations, remarkably little research has been conducted in the UK about the motivating factors which shape the decisions that young people make to use drugs or alcohol. This paper reports on a qualitative study exploring the range of factors which young people reported to be influential over such decisions. Results are presented from in-depth interviews conducted with 50 16-21-year-olds. Analysis of the data revealed individual-level influences (the perceived functions of drug use (or specific purpose for using a particular substance), drug-related expectancies, physical/psychological state, commitments and boundaries) and social/contextual-level influences (environment, availability, finance, friends/peers and media) on decision-making. Of these, the perceived function for using a particular substance was identified as particularly influential. The findings are related to existing drug prevention approaches and opportunities for their further development are discussed.
Advances in portable electronic technologies have created opportunities for the real-time assessment of children's physical activity and eating behaviors in naturalistic situations. Mobile phones or PDA's can be used to record electronic surveys, take photographs, or indicate geographic locations of children's behaviors. Unlike self-report instruments, which are prone to recall errors and biases, real-time data capture (RTDC) methods can assess behaviors as they occur. In addition, these strategies are able to provide contextual information about physical activity and healthy eating such as where and with whom the behaviors are taking place; and how children feel before, during, and after these activities. This commentary will describe how RTDC methods can enhance our understanding of factors influencing children's physical activity and eating behaviors. In particular, it will discuss the potential to advance research pertaining to the following questions: (1) How frequently, when, what amount, what intensity, what duration, and what type of food or activity was eaten or performed? (2) Where and with whom do children engage in physical activity and eat, and do these patterns differ according to demographic (e.g., sex, age, ethnic, income) and temporal (e.g., time of day, day of the week, seasonal) characteristics?; (3) How do children's physical activity levels (e.g., intensity, duration) and eating patterns (e.g., amount/content of food) differ across physical and/or social contexts?; (4) To what extent do mood, stress, and psychosocial factors serve as time-related antecedents and consequences to children's physical activity and eating episodes?; and (5) Are patterns of within-daily variability in children's physical activity and eating behaviors related to health outcomes such as body weight, insulin dependence, and the metabolic syndrome? The commentary will also discuss practical and economic challenges associated with employing RTDC methodologies in research studies with children. It will conclude by addressing how these innovative research strategies can inform the design of programs and policies to prevent and treat childhood obesity.
According to theory, depressed individuals self-medicate their negative affect with alcohol. Due to isolation and interpersonal difficulties, undergraduates with elevated depressive symptoms may do much of their drinking alone and/or in intimate contexts (e.g., with family or romantic partners) rather than at normative social events (e.g., parties). Evidence suggests drinking in these contexts leads to heavy use and alcohol-related problems. Accordingly, context may be an explanatory mechanism linking depressive symptoms to problematic drinking. This pathway remains understudied in the literature. Our study aimed to examine solitary and intimate drinking as distinct mediators of the depression-problematic drinking association. We hypothesized that depressive symptoms would be positively associated with solitary and intimate drinking which in turn would be associated with elevated alcohol use and related problems.
Undergraduates (N=295; 72% women) completed online self-reports.
Consistent with hypotheses, path analyses supported depressive symptoms as a positive predictor of solitary drinking, which in turn was a positive predictor of alcohol-related problems, but not of alcohol use. Counter to hypotheses, depressive symptoms were unrelated to intimate drinking. Interestingly, depressive symptoms were negatively associated with drinking at parties, which in turn led to reduced risk for elevated alcohol use and related problems.
Our results shed new light on the depression pathway to problematic drinking in undergraduates by considering the role of drinking context. Our findings suggest undergraduates with elevated depressive symptoms are at risk for potentially problematic drinking because they are drinking alone. Solitary drinking represents a malleable target for clinical interventions aimed at reducing risky depression-related alcohol use.
Copyright © 2014 Elsevier Ltd. All rights reserved.
Background and Objectives
Prescription drug addiction is a significant problem affecting healthcare professionals. The purpose of the present study was to identify common mechanisms of prescription drug diversion by pharmacists, in order to facilitate the development of effective prevention programs and policies for this high-risk group. MethodsA total of 32 pharmacists (71% male) who were being monitored by their State professional health program (PHP) due to substance-related impairment participated in anonymous guided group discussions. ResultsParticipants documented six primary methods of drug diversion by pharmacists: (1) taking expired drugs that can no longer be sold by the pharmacy and are awaiting disposal; (2) assuming responsibility for managing the pharmacy inventory and/or changing inventory records to prevent detection of missing drugs; (3) forging prescriptions for themselves, family members, friends, or customers in order to gain access to the drugs; (4) using “sleight of hand” techniques to acquire drugs while filling prescriptions or shelving products; (5) blatantly stealing drugs from the pharmacy, even in front of coworkers or video cameras, and (6) collecting patients' unused medications and keeping them. Conclusions and Scientific SignificanceEfforts to address the problem of prescription drug abuse and diversion by pharmacists should be expanded in order to safeguard pharmacies and the patients they serve. Future research should extend this study to larger samples and assess best practices for decreasing prescription drug diversion by pharmacists with addiction. (Am J Addict 2013;XX:000–000) “A friend of mine, in the [impaired professionals monitoring] program was also a pharmacist and he does stand-up comedy on the side. He's a funny guy, but in his routine he says, ‘I'm a pharmacist. Unlike most people, I love to go into work!”’–Study participant
Objectives:
To evaluate the prevalence, associated factors, and opinions regarding nonmedical use of prescription stimulants (NMUPS) in Doctor of Pharmacy (PharmD) students.
Methods:
An electronic survey was distributed to professional year 1 through 4 for students at 2 schools of pharmacy (public and private) in North Carolina. The survey was available for 3 weeks. Descriptive statistics (proportion of responders plus 95% confidence intervals [CIs]) were used to describe the primary objective.
Results:
Of the 1043 surveys distributed, 407 were completed giving a 39% response rate. The results indicated that 9% (95% CI: 6.44-11.93) of PharmD students acknowledge NMUPS at least once during their pharmacy education. Additionally, 3% (95% CI: 1.90-5.45) acknowledge NMUPS at least once during the current pharmacy school year (past 5 months). Nonmedical prescription stimulant users were 9 times more likely to participate in NMUPS prior to pharmacy school (P < .0001) and 4.5 times more likely to use other illicit substances (P = .0076).
Conclusion:
The study identified the PharmD student population as high risk of abuse of prescription drug stimulants, which requires further research and attention. Additionally, there was a clear upward trend in the prevalence of NMUPS, and this misuse was associated with other detrimental behaviors.
Survey questions asking about taboo topics such as sexual activities, illegal behaviour such as social fraud, or unsocial attitudes such as racism, often generate inaccurate survey estimates which are distorted by social desirability bias. Due to self-presentation concerns, survey respondents underreport socially undesirable activities and overreport socially desirable ones. This article reviews theoretical explanations of socially motivated misreporting in sensitive surveys and provides an overview of the empirical evidence on the effectiveness of specific survey methods designed to encourage the respondents to answer more honestly. Besides psychological aspects, like a stable need for social approval and the preference for not getting involved into embarrassing social interactions, aspects of the survey design, the interviewer’s characteristics and the survey situation determine the occurrence and the degree of social desirability bias. The review shows that survey designers could generate more valid data by selecting appropriate data collection strategies that reduce respondents’ discomfort when answering to a sensitive question.
Substance-related impairment of physicians is a small but serious problem, with significant consequences for patient safety and public health. The purpose of this study was to identify reasons for prescription drug misuse among physicians referred to a physician health program for monitoring because of substance-related impairment, to develop better mechanisms for prevention and intervention.
A total of 55 physicians (94.5% male) who were being monitored by their State physician health program because of substance-related impairment participated in guided focus group discussions. Participation was anonymous. Discussions were transcribed from 9 separate focus groups, lasting 60 to 90 minutes each. Qualitative analyses were conducted to examine themes.
All participants were diagnosed with substance dependence, and 69.1% of them endorsed a history of misusing prescription drugs. Participants documented the following 5 primary reasons for prescription drug misuse: (1) to manage physical pain, (2) to manage emotional/psychiatric distress, (3) to manage stressful situations, (4) to serve recreational purposes, and (5) to avoid withdrawal symptoms.
Our results emphasize the importance of self-medication as a leading reason for misusing prescription medications, although recreational use was also an important factor. Prevention efforts targeting prescription drug misuse among physicians should be initiated during medical training, with continuing education requirements throughout the physicians' careers.
Emerging data indicates the prevalence and increased use of pharmaceutical enhancements by young medical professionals. As pharmaceutical enhancements advance and become more readily available, it is imperative to consider their impact on medical professionals. If pharmaceutical enhancements augment a person’s neurological capacities to higher functioning levels, and in some situations having higher functioning levels of focus and concentration could improve patient care, then might medical professionals have a responsibility
to enhance? In this paper, I suggest medical professionals may have a responsibility to use pharmaceutical enhancements. In some situations, having higher functioning levels of focus and concentration is conducive to providing the best possible care to a patient. In these circumstances medical professionals should use pharmaceutical cognitive enhancements. I conclude by examining the limitations and implications of this responsibility in the practice of medicine and areas for future research.
The aim of this study was to gain insight into the experience of being a nurse with a substance misuse problem.
Several members of the research team work in a withdrawal programme specifically designed for nurses by nurses. Gaining insight into nurses' experiences will contribute to the development of appropriate guidelines to assist with prevention, identification and intervention strategies.
Published research is almost exclusively from North America. Much of it represents work completed in the 1980s, with very few research-based accounts from the perspective of nurses, highlighting that this is a poorly researched and understood problem in Australia.
This phenomenological study used in-depth, unstructured interviews either face to face or via the telephone with a purposive sample of 12 nurses who had experienced problem substance use.
Five major themes were identified: nurses' justification for using substances, the fear surrounding being 'discovered', the personal meaning for nurses, the professional impact and the turning point in their road to recovery.
The five themes derived from the data are inextricably linked to the nature of nursing and of the nursing workplace. Information about potential risk factors and the experiences of nurses with substance misuse problems is critical to the development of prevention and treatment strategies.
Issues of occupational health and safety are raised due to the increasingly demanding and often traumatic nursing work environment. Fears about stigma and loss of their nursing identity highlight nurses' perceptions that treatment programmes are often punitive in nature. Guidelines for the workplace addressing issues such as confidentiality, stress reduction and strategies for handling situations where a colleague is suspected of having a problem are beginning steps that will help address the problem of substance misuse in the nursing profession.
To better understand the occupational risks for substance use disorders among pharmacists and possibilities for improved prevention.
Descriptive, nonexperimental, cross-sectional study.
A southeastern state from December 2008 to April 2009.
32 participants (72.7% men) from the impaired professionals monitoring groups in the geographic regions within the state that had the greatest number of physicians, pharmacists, and allied health professionals currently under monitoring contracts for substance use disorders.
Guided group discussions regarding substance use among health care providers.
Persistent occupational risks for development of a substance use disorder among pharmacists.
Several occupational hazards unique to the pharmacy profession might contribute to the problem of substance use disorders among some members of this population, including increased access to potent drugs of abuse, a stressful/unpleasant working environment, a culture that unofficially condones medication diversion, lack of education related to addiction, and lack of support for individuals seeking treatment.
These results have important implications for the education of student pharmacists, the continuing education of licensed pharmacists, and the management of pharmacies in which these individuals work. Given the potential occupational risks for substance abuse associated with the pharmacy profession, additional training, monitoring, changes to the work environment, and increased confidential access to treatment may be needed to safeguard pharmacy professionals and the communities they serve.
Recent research indicates that 3,4-methylene-dioxymethamphetamine (MDMA), also known as ‘ecstasy’, is becoming increasingly popular as an illicit drug among young people. This study investigated risk and harm reduction practices among recreational ecstasy users. A semi-structured interview with 40 participants was designed to investigate how ecstasy users identify and manage the harms associated with their drug use, and the underlying decision-making process. Overall, the participants identified both positive and negative effects. The reported positive effects predominantly centred around enhanced psychological, physiological and social experiences. However, there were a number of factors that contributed to regulating ecstasy use. These included specific in-group and out-group practices executed within the peer group, preventative harm-reducing practices, shared decision making, and shared responsibility for harm prevention. Recommendations for promoting harm reduction strategies and suggestions for future research are discussed.
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Many clients with mild to borderline intellectual disability (ID) who are admitted to a treatment facility show serious problems in alcohol and/or drugs use. In the present case file study, we explored differences in coping strategies, adaptive skills and emotional and behavioral problems between clients who showed substance abuse and clients who did not. There were no differences in adaptive skills between groups. However, compared to clients without substance abuse, those who abused substances showed a more palliative coping style, and had more severe emotional and behavior problems such as anxiety/depression and intrusive thoughts and aggressive and antisocial behaviors. Implications for treatment are discussed.
The use of concept mapping in research and evaluation has expanded dramatically over the past 20 years. Researchers in academic, organizational, and community-based settings have applied concept mapping successfully without the benefit of systematic analyses across studies to identify the features of a methodologically sound study. Quantitative characteristics and estimates of quality and rigor that may guide for future studies are lacking. To address this gap, we conducted a pooled analysis of 69 concept mapping studies to describe characteristics across study phases, generate specific indicators of validity and reliability, and examine the relationship between select study characteristics and quality indicators. Individual study characteristics and estimates were pooled and quantitatively summarized, describing the distribution, variation and parameters for each. In addition, variation in the concept mapping data collection in relation to characteristics and estimates was examined. Overall, results suggest concept mapping yields strong internal representational validity and very strong sorting and rating reliability estimates. Validity and reliability were consistently high despite variation in participation and task completion percentages across data collection modes. The implications of these findings as a practical reference to assess the quality and rigor for future concept mapping studies are discussed.
Most writing on sociological method has been concerned with how accurate facts can be obtained and how theory can thereby be more rigorously tested. In The Discovery of Grounded Theory, Barney Glaser and Anselm Strauss address the equally Important enterprise of how the discovery of theory from data--systematically obtained and analyzed in social research--can be furthered. The discovery of theory from data--grounded theory--is a major task confronting sociology, for such a theory fits empirical situations, and is understandable to sociologists and laymen alike. Most important, it provides relevant predictions, explanations, interpretations, and applications. In Part I of the book, "Generation Theory by Comparative Analysis," the authors present a strategy whereby sociologists can facilitate the discovery of grounded theory, both substantive and formal. This strategy involves the systematic choice and study of several comparison groups. In Part II, The Flexible Use of Data," the generation of theory from qualitative, especially documentary, and quantitative data Is considered. In Part III, "Implications of Grounded Theory," Glaser and Strauss examine the credibility of grounded theory. The Discovery of Grounded Theory is directed toward improving social scientists' capacity for generating theory that will be relevant to their research. While aimed primarily at sociologists, it will be useful to anyone Interested In studying social phenomena--political, educational, economic, industrial-- especially If their studies are based on qualitative data.
During the past few years considerable debate has arisen within academic journals with respect to the use of smart drugs or cognitive enhancement pharmaceuticals. The following paper seeks to examine the foundations of this cognitive enhancement debate using the example of methylphenidate use among college students. The argument taken is that much of the enhancement debate rests upon inflated assumptions about the ability of such drugs to enhance and over-estimations of either the size of the current market for such drugs or the rise in popularity as drugs for enhancing cognitive abilities. This article provides an overview of the empirical evidence that methylphenidate has the ability to significantly improve cognitive abilities in healthy individuals, and examines whether the presumed uptake of the drug is either as socially significant as implied or growing to the extent that it requires urgent regulatory attention. In addition, it reviews the evidence of side-effects for the use of methylphenidate which may be an influential factor in whether an individual decides to use such drugs. The primary conclusions are that neither drug efficacy, nor the benefit-to-risk balance, nor indicators of current or growing demand provide sufficient evidence that methylphenidate is a suitable example of a cognitive enhancer with mass appeal. In light of these empirically based conclusions, the article discusses why methylphenidate might have become seen as a smart drug or cognitive enhancer.
This study compares police officers' reported alcohol use with similar reports from age- and gender-matched samples from the general driving population (GDP) and drivers recruited at high-risk hours who are most likely to drink and drive (roadside drivers).
Data were derived from interviews with 239 police officers who spent at least 5% of their time on alcohol or traffic enforcement; 243 subjects from the GDP, selected by random-digit dialing; and 249 drivers recruited at roadside on Friday and Saturday nights between 10:00 PM and 3:00 AM.
Officers report drinking less frequently and in smaller quantities than either of the driver samples. Differences between police and general drivers are modest: e.g., usual frequency of drinking (1 to < 3 vs 3 or 4 times/month; p < or = .001) and number of days/average month with > or = 2 drinks/day (mean = 2.5 [+/- 3.4] vs 4.9 [+/- 6.5]; p < or = .001). There are greater differences between police officers and roadside drivers: e.g., 14.2% and 2.4%, respectively, abstain (vs 15.6% of general drivers; police vs general drivers; NS; police and general drivers vs roadside drivers, p < or = .001).
The data suggest that officers' drinking differs significantly from that of drivers most likely to be driving under the influence of alcohol (DUI). If this is so, police training programs pertaining to DUI and other alcohol-related offenses should pay explicit attention to the effects of alcohol and not assume that all officers have experienced them.
The purpose of this study was to investigate the relationship of gender balance at work, family and home responsibilities and workplace factors to the drinking behaviors of attorneys.
Using a stratified random sampling procedure, attorneys were selected from the bar associations of two large Midwestern cities. Telephone interviews were completed with 300 men and 257 women (37.3% of those originally selected), who were asked about characteristics of their work, the numbers of female attorneys they had contact with in four types of working relationships, overall and work-related drinking, and family and home responsibilities. Multiple regression and discriminant analyses were used to study the influence of these variables on drinking.
Gender balance variables entered several of the analyses. For both men and women the frequency of work-related drinking positively correlated with the number of female attorneys in the organization, but was negatively related to the number of women who were peers. Family and home responsibilities entered predictive equations, both positively and negatively, for both men and women. Size of firm was positively correlated with frequency of business-related drinking and, for men, with frequency of social drinking related to work.
The influence of the gender composition of the workplace on drinking behaviors may vary, for both men and women, by the type of contact involved, with closer or more active involvement with female colleagues associated with decreased frequency of drinking. Work-related drinking may also be related to home and family demands and the size of the firm, again for both genders.
This paper explores the social context of "natural recovery" from problems associated with the misuse of intoxicants. Using data collected from in-depth interviews with 46 former alcohol- and drug-dependent persons, this paper examines how the social capital that these respondents had accumulated prior to their addiction and maintained during it aided in their recovery without treatment. We specifically explore how the relations within their lives and the actual and virtual resources available to subjects through their social capital aided in our respondents' "natural recovery" from drug-use related problems. We conclude with a discussion of the implications an analysis of social capital has for the treatment of drug-associated problems as well as for drug policy.
The author investigated the relationship between drinking and type of practice among U.S. attorneys. Participants were attorneys from 2 large midwestern cities, chosen through stratified random sampling from bar-association membership lists. Type of law practice was related to whether the participants drank in business-related situations but not to the frequency or the quantity of consumption. The participants in solo, corporate, or government practices were more likely than were those in private group practices to report no business-related drinking in the past 30 days. Female and male attorneys in similar practices reported similar abstention rates and quantities of consumption in business situations, suggesting that occupational norms were strongly salient for both genders. Criminal trial work was related to drinking only for the women. Results are discussed in terms of the influence of occupational culture on drinking.
This is the first study to examine whether cell phones could be used to collect ecological momentary assessment (EMA) data with homeless crack cocaine-addicted adults in treatment. The study adapted an EMA method to examine behavior in real time using cell phones and computer-automated telephone interviewing. Participants treated in an intensive outpatient treatment program were given cell phones for a 2-week period to record current states of cocaine craving and using episodes. Results showed cell phone technology could reliably deliver a computerized survey; this homeless population would use a cell phone to report craving and using episodes, and drug use reported via EMA was in agreement with urine toxicology results for 73% of participants. Of 30 participants, 24 (80%) completed the full 2-week protocol. Participants indicated the survey made them more aware of phenomena leading to cravings and use, suggesting the usefulness of EMA as a potential intervention.
This study identifies self-reported factors facilitating initiation of cocaine and heroin among young problem users in Amsterdam to enable interventions to be targeted at issues personally relevant for this population.
A qualitative study using in-depth interviews to obtain retrospective drug use histories. Recruitment took place both directly (by street outreach, outreach at methadone outposts) and indirectly (by respondent-driven sampling). The study started in the year 2001 and included 50 problem drug users, aged 18-30, of whom 72% were male, 64% were polydrug users, and 36% were homeless.
The seven most common self-reported factors facilitating initiation of cocaine and heroin are desire for affect regulation, drug availability, curiosity, desire to be part of a group, misinformation, desire for energy, and starting because it has a depressant effect.
Some factors perceived to facilitate initiation of cocaine and/or heroin revealed in this study are hardly addressed by current prevention programs and could inform future initiatives. Programs can be targeted at young people who we identified to be at high risk. Research using quantitative methods is likely to be valuable in determining the relative importance of mentioned factors for different groups of young people. The study's limitations are noted.
Clinical and demographic profile of anesthesiologists using alcohol and other drugs under treatment in a pioneering program in Brazil
- H N P Alves
- D L Vieira
- R R Laranjeira
- J E Vieira
- L A Martins
Alves, H. N. P., Vieira, D. L., Laranjeira, R. R., Vieira, J. E., & Nogueira Martins, L. A.
(2012). Clinical and demographic profile of anesthesiologists using alcohol and
other drugs under treatment in a pioneering program in Brazil. Brazilian
Journal of Anesthesiology, 62(3), 356-364. http://dx.doi.org/10.1016/S0034-7094(12)70136-8
Use of substances among professionals and students of professional programs: A review of the literature. Drugs: Education Prevention and Policy, printed online
- N Kiepek
- J.-L Baron
Kiepek, N., & Baron, J.-L. (2017). Use of substances among professionals and
students of professional programs: A review of the literature. Drugs: Education
Prevention and Policy, printed online Sept 15. doi:10.1080/09687637.2017.
1375080
Best practices: Concurrent mental health and substance use disorders
Centre for Addiction and Mental Health. (2001). Best practices: Concurrent mental
health and substance use disorders. Ottawa, ON: Publications Health Canada.
A path forward: BC First Nations and Aboriginal People's mental wellness and substance use -10 year plan
- G G Enck
Enck, G. G. (2014). Pharmaceutical enhancement and medical professionals. Medici
Ne, Health Care, and Philosophy, 17(1), 23-28. http://dx.doi.org/10.1007/
s11019-013-9507-z
First Nations Health Authority, Province of British Columbia, & Government of
Canada. (2013). A path forward: BC First Nations and Aboriginal People's
mental wellness and substance use -10 year plan. Retrieved from http://
www.fnha.ca/documents/fnha mwsu.pdf.