The effect of mindfulness-based education given to individuals with substance-use disorder according to self-efficacy theory on self-efficacy perception.

The aim of this research is to find the effect of mindfulness-based education given to individuals with substance-use disorder according to self-efficacy theory on self-efficacy perception. The research was planned as a test model with pretest-posttest control groups. Individuals who have been diagnosed with substance abuse in the substance abuse clinic of Turgut Ozal Medical Center, and at the Substance Abuse Treatment and Education Centre of Gaziantep 25 Aralik State Hospital formed the core of this study. The research was conducted between January 2018-May 2019. 112 patients, 56 in the treatment and 56 in the control group, participated in the study. Scientific research started after ethical approval. Mindfulness therapy was applied to experimental group patients. For the data collection, the Socio-Demographic Characteristics Questionnaire and Self-Efficacy-Sufficiency scale were used. t-Test for dependent variables to compare the mean scores of experimental and control groups and t-test for independent variables were used. It was seen that the average total Self-Efficacy-Sufficiency score of the patients in the treatment group was 76.50 ± 12.62 before the intervention and increased to 85.50 ± 14.95 after the intervention. There is a significant difference between the average scores. Even when the treatment and control groups are compared, a significant difference was still detected between the groups. There was no significant difference between the groups in two of the Self-Efficacy-Sufficiency steps after the intervention in the experimental group, but there were significant differences between the other two factors and total score averages.

Midwives Uniquely Suited to Deliver Woman-Centered Care and Decrease Stigma for Women With Substance Use Disorders.

Midwives are being called to serve a growing population of vulnerable women, those with substance use disorders (SUDs). Increasing numbers of women across the lifespan are being diagnosed with SUDs. In addition, women with SUDs are experiencing very unique and distinct differences in stigma related to their substance use. This stigma is coming from varied sources and through many different forms including mislabeling, misinformation, the media, and a devalued maternal/child relationship. Mothers frequently experience different types of adverse health encounters during the perinatal and postpartum period that also contribute to stigma. Midwives are positioned to provide woman-centered care in a variety of practice settings as integral members of interprofessional teams. Midwives can decrease the stigma women with SUDs are experiencing while improving the health of women, mothers, and families worldwide.

Development and psychometric testing the Health of Body, Mind and Spirit Scale for assessing individuals who have drug abuse histories.

AIMS AND OBJECTIVES: To develop the Health of Body, Mind and Spirit Scale (HBMSS), which was designed to assess drug abusers' health condition. BACKGROUND: Helping drug abusers to become healthy is important to healthcare professionals. However, no instrument exists to assess drug abusers' state of health. DESIGN: A cross-sectional questionnaire survey was implemented to examine the validity of the HBMSS. METHODS: Data were collected from 2015-2016 at one drug abuse prevention centre in Taiwan. Participants (N = 320) who had abused drugs were invited to complete a preliminary 64-item version of the HBMSS. An item analysis, criterion-related validity analysis (using the Relapse Prediction Scale [RPS] score), split-half reliability testing and confirmatory factor analysis (CFA) were conducted to examine the psychometric properties of the HBMSS. RESULTS: The final version of the HBMSS contained 15 items that were divided into three subscales: the health of the body, mind and spirit. Cronbach's α and split-half reliability coefficients were all above .85. The factor loading of each item was between .74-.95. The HBMSS had satisfactory criterion-related validity with the RPS score (r = -.50, p < .001). A second-order CFA was conducted on the HBMSS. The fit indexes were good, χ2  = 184.060, df = 94, χ2 /df = 1.958 (p = .000). CONCLUSIONS: The entire HBMSS and the subscales had satisfactory reliability and validity. RELEVANCE TO CLINICAL PRACTICE: Healthcare professionals could use the HBMSS to evaluate the condition of the health of individuals with a drug abuse history.

Lessons Learned After Losing my Brother to an Overdose: A Call to Action for Nurse Leaders.

The current overdose epidemic we are facing in Canada and internationally calls on nursing leaders to prioritize holistic and compassionate care for people who use drugs (PWUD) and their families. Nurses are well positioned to provide person-centred care and advocate with and for this population. To do so requires an examination of one's personal values and beliefs surrounding drugs and the people who use them. As a nurse leader, I was forced to confront my views about illicit drug use following the untimely death of my brother Brad from overdose. This paper chronicles my personal experience with his death and subsequent journey into advocacy for drug policy reform amidst an emerging overdose crisis. This short paper is written from my personal perspective, and informed by both personal and professional experiences in drug policy reform. It addresses strategies for challenging stigma and opportunities for partnering with PWUD through engagement in harm reduction.

Perceptions of an Adapted Mindfulness Program for Persons Experiencing Substance Use Disorders and Traumatic Brain Injury.

BACKGROUND: Of the 1.4 million Americans who sustain traumatic brain injuries (TBIs) each year up to half experience substance use disorders (SUDs). This often leads to various issues such as increased rates of mental health problems and delay or lack of return to full employment. AIMS: The purpose of this program evaluation was to describe Vinland National Center's (Vinland's) client and staff perceptions of a 4-week mindfulness-based intervention adapted from the original mindfulness-based stress reduction program for persons experiencing SUDs and TBIs. It focused on the possible relevance and applicability of mindfulness practice for this population. METHOD: Four focus groups were conducted based on Krueger's methods in conducting focus groups: two with Vinland staff members and two focus groups with residents. RESULTS: The analysis of staff focus groups revealed general staff satisfactions with the intervention. A general consensus was that the mindfulness intervention fitted well with the needs of Vinland's clients and their current program. Client feedback further revealed general satisfaction with the mindfulness curriculum. No adverse effects were noted related to the mindfulness intervention. CONCLUSIONS: The results of this program evaluation suggest that implementing a mindfulness-based intervention for persons experiencing SUDs/TBIs warrants further investigation.

The Use of the Addiction Severity Index Psychiatric Composite Scores to Predict Psychiatric Inpatient Admissions.

The high prevalence of co-occurring mental health and substance use disorders indicates a need for integrated behavioral health treatment that addresses both types of disorder simultaneously. One component of this integrated treatment is the use of an assessment process that can concurrently identify the presence of each class of disorder. The Addiction Severity Index (ASI) has been extensively used and researched in the field of substance use disorders for over 30 years. The ASI has seven sections, including a section on substance use disorders and a section on psychiatric symptoms, making it a potential candidate for a co-occurring screen during intake. The following study utilized a receiver operating characteristic curve analysis to determine an optimal cutoff score on the ASI psychiatric composite score to identify which individuals seeking substance use disorder treatment were admitted to the Milwaukee County Behavioral Health Division's psychiatric hospital in the year subsequent to their ASI administration. Of the 19,320 individuals who completed an initial ASI in our system, 343 had an inpatient admission. The receiver operating characteristic curve was statistically significant, with an area under the curve of 0.75. A cutoff of 0.27 had a sensitivity of 0.77 and a specificity of 0.61, such that over 60% (11,963/19,320) of the sample was excluded. These results suggest that the ASI psychiatric composite score may be a useful initial screen to identify those with potential mental health problems/needs in a behavioral health system attempting to integrate addiction and mental health services.

Part 1: The Theoretical Basis for Recovery-Oriented Management of Substance Use Disorders in Primary Care.

There is strong evidence in the literature that screening and brief counseling interventions are effective in detecting alcohol problems and decreasing alcohol consumption among patients in primary care settings but somewhat weaker evidence regarding screening and brief intervention for drug problems. In 2014, two published studies made news and caused concern among proponents of substance Screening, Brief Intervention and Referral to Treatment (SBIRT) programs, when their authors concluded that brief interventions were not effective for decreasing drug use among primary care patients identified through screening, and advised that widespread adoption of screening and brief intervention for drug use was not warranted.An evaluation of the theoretical foundations for evidence-based SBIRT services was conducted to produce possible explanations for why traditional SBIRT works well for individuals with unhealthy alcohol use but not as well for those with more serious substance use disorders, including drug use and alcohol/drug dependence. Smith and Liehr's evaluation framework for middle-range theory was utilized to analyze the Chronic Care Model, which was featured prominently in early SBIRT literature, and the newer Recovery Management model, which provides a philosophical framework for organizing modern addictions services and quality-of-life enhancements (Part 1 of this two-part series).Programs are more likely to succeed if guided by theory, and examination of relevant components of theory-based interventions can be useful in developing practical strategies for meeting program objectives. A new, theory-based, recovery-oriented framework for primary care SBIRT is introduced in Part 2 ("SBIRT+RM(C): A Proposed Model for Recovery-Oriented Primary Care").

Part 2: Screening, Brief Intervention and Referral to Treatment Plus Recovery Management: A Proposed Model for Recovery-Oriented Primary Care.

Part 1 of this two-part series (The Theoretical Basis for Recovery-Oriented Management of Substance Use Disorders in the Primary Care) explored the theoretical foundations for evidence-based substance Screening, Brief Intervention and Referral to Treatment (SBIRT) services. The aim was to produce possible explanations for why traditional SBIRT works well for individuals with unhealthy alcohol use but not as well for individuals who have more serious substance use disorders, including drug use and alcohol/drug dependence. Building on that analysis, through meaningful application of recovery management (RM) concepts within an integrated primary care/behavioral health context, a new, theory-based, recovery-oriented framework for primary care SBIRT is now introduced in Part 2. The proposed SBIRT Plus Recovery Management (SBIRT + RM) model moves traditional SBIRT from its original, limited, and narrow focus only on substance detection, brief intervention, and referral to its rightful, structured placement within a comprehensive, multidimensional, recovery-oriented system of care clinical practice environment. SBIRT+RM describes relevant strategies for improving recovery outcomes for individuals identified through primary care substance screening and defines primary care provider roles and responsibilities for sustained recovery support and long-term recovery maintenance.

Consumer-Centered, Collaborative, and Comprehensive Care: The Core Essentials of Recovery-Oriented System of Care.

Recovery from substance abuse and mental health disorders represents a journey through which individuals move beyond treatment of provider-identified problems toward a path of achieving wellness and productive lives. Overcoming obstacles and barriers encountered along the recovery process, individuals reveal their own strengths and resilience necessary to cope, survive, and thrive in the face of adversity. Recovery-oriented system of care (ROSC) is a framework designed to address the multidimensional nature of recovery by creating a system for coordinating multiple systems, services, and supports that are person centered and build on the strengths and resiliencies of individuals, families, and communities. As is common knowledge among substance abuse and mental health providers, consumers often present with high rates of comorbidity, which complicates care. In addition, behavioral health consumers engage in risky health behaviors (e.g., smoking) at a disproportionate rate, which places them at increased risk for developing noncommunicable diseases. ROSCs are ideal for addressing the complicated and varied needs of consumers as they progress toward wellness. The challenges of creating an ROSC framework that is effective, efficient, and acceptable to consumers is formidable. It requires change on the part of agencies, organizations, providers, and consumers. The importance of comprehensive, integrated screening is highlighted as a critical component of ROSC. Key suggestions for initiating ROSC are offered.

Substance misuse: can midwives really make a difference?

Substance misuse makes a woman vulnerable. During pregnancy, in particular, the issues surrounding Substance misuse and its treatment are very emotive. Pregnancy often prompts women who substance misuse to seek help for their addiction for the first time, but for some it is part of a cycle of failure and loss: failure at rehabilitation and facing the loss of yet another child, be it through child protection issues or from the medical complications of addiction. As a midwife only engages with a woman for a relatively short period of time, can their actions have a lifelong impact on the woman and her unborn child? This article aims to examine the stigma of substance misuse and the role a midwife plays, not just as a maternity care provider but also in the continued journey of the woman and her child.

Nursing Care in Alcohol and Drug User Treatment Facilities.

Registered and advanced practice nurses are employed in substance user treatment facilities across the US and in most industrialized countries. Patterns of employment and job descriptions for nurses, however, are highly inconsistent and seriously flawed. Many regulatory system, legislative and government agency factors and to some degree, the nursing profession itself, sustain the flaws and limit the delivery of comprehensive care. Competencies linked to addictions nursing best practices are often underutilized because of narrow job descriptions. This results in limited health and nursing service delivery to vulnerable populations receiving treatment in these government funded programs. This article highlights the increasing demand for the delivery of integrated care to psychiatric and substance using populations. The author considers factors which stake holders can influence to change flawed employment patterns and limited access to comprehensive care for substance users.

Yoga as an alternative intervention for promoting a healthy lifestyle among college students.

Substance use and abuse continues to plague U.S. college campuses. The literature is replete with information from various disciplines on how to identify and intervene in this public health dilemma impacting college students. Identifications, treatments, and interventions are often based on Western medicine, but there is a growing movement and evidence supporting the effectiveness, value, and usefulness of Eastern therapies to combat this problem. Yoga is one Eastern intervention that has proven beneficial for promoting quality of life and wellness relationship to several acute and chronic illnesses. As a result of advocating for the inclusion of yoga in traditional college settings, two college campuses in Central Illinois introduced yoga courses for students, faculty, and staff. The courses are reviewed, and the positive results reported by students are shared. The information and evidence of yoga's benefits collected in this study warrant consideration by college campuses to initiate this practice enhancing primary, secondary, and tertiary prevention in their populations.

NADA protocol: integrative acupuncture in addictions.

National Acupuncture Detoxification Association (NADA) acupuncture is a simple, standardized, 1- to 5-point auricular needling protocol that originated as a grass-roots response to the opiate epidemic of the 1970s. NADA acupuncture is increasingly recognized as a universally useful intervention in the treatment of addictions specifically and in behavior health more generally. It is recognized as a best practice in the treatment of substance use disorders. Integrative programs using the NADA protocol are likely to see improvements in engagement, retention, decreased drug cravings, anxiety, and less physical symptoms.