Starting Points

Points (n.) 1. marks of punctuation. 2. something that has position but not extension, as the intersection of two lines. 3. salient features of a story, epigram, joke, etc.:  he hit the high points. 4. (slang; U.S.) needles for intravenous drug use.

Motivational Interviewing in Recovery

Editor’s note: It’s graduation season, which means a slew of new dissertations! In today’s post, we feature two recent projects on the use of motivational interviewing techniques in recovery settings. These entries are part of an ongoing drug-related dissertation bibliography continuously compiled by Jonathon Erlen, selections of which were formerly published in the Social History of Alcohol and Drugs journal but are now periodically featured on the Points blog. Contact Dr. Erlen through the link above.

Motivational Interviewing Treatment Integrity and Client Change: Using ROC Analysis to Explore the Relationship Between MI Fidelity Level and Drinking Outcome

Author: Fischer, Daniel J.

Abstract: Those engaged in the research and practice of MI have shown interest in treatment adherence as an indicator of effective MI and have expressed curiosity in the threshold at which MI practice could be viewed as “good enough”. The most widely used and often cited of MI integrity measures are the Motivational Interviewing Skills Code (MISC) and the Motivational Interviewing Treatment Integrity code (MITI). These adherence tools share similar descriptive coding systems for therapist in-session behavior. MI fidelity standards are often used as reference points for therapist performance, yet practitioners rarely meet full criteria. Further, substandard ratings have been associated with positive client change. These findings have elicited questions about the necessary levels of therapist treatment adherence to promote client change and suggested the need for empirically-derived fidelity standards. This study analyzed existing data from a sample of Motivational Enhancement Therapy (MET) sessions from Project MATCH (Matching Alcohol Treatments to Client Heterogeneity) that were audio recorded and previously coded with the MISC. MI adherence variables were analyzed along with client drinking outcomes to test the relationship between therapist fidelity and client change. Therapist adherence was determined using behavioral codes common to the MITI and MISC. Client change thresholds were determined using clinically significant change standards developed by Jacobson and Truax. The relationships between therapist adherence level and client change thresholds were examined using Receiver Operating Characteristic (ROC) analysis. Findings showed mixed support for the relationship between therapist adherence level and client drinking outcomes, but yielded levels of therapist MI adherence associated with client changes in drinking outcomes.

Read More »

Problem Drug Use in Social Context: New Research

Editor’s note: It’s graduation season, which means a slew of new dissertations! In today’s post, we include a few recent projects concerning technological interventions in problematic drug use. These entries are part of an ongoing drug-related dissertation bibliography continuously compiled by Jonathon Erlen, selections of which were formerly published in the Social History of Alcohol and Drugs journal but are now periodically featured on the Points blog. Contact Dr. Erlen through the link above.

Illness Representation, Coping, and Treatment Outcomes in Substance Use Disorders

Author: Prater, Kimberly A.

Abstract: This study examined the relationship between illness representation, coping, and treatment adherence in substance use disorders (SUDs). Illness representation refers to the way in which an individual cognitively understands his or her illness. Leventhal, Meyer, and Nerenz’s (1980) Self-Regulation Model (SRM) is one theoretical model of illness representation that addresses how cognitive factors influence illness coping behaviors and outcome. The SRM has been applied extensively to understanding patient perspectives of physical illness. More recently, the model has been applied to individuals with psychological disorders, including psychotic disorders, mood disorders, and eating disorders. In the mental health literature, illness representation has been found to be related to, and at times predictive of, behavioral outcomes, such as treatment adherence. The present study is notable because it is the first to examine the SRM in substance use disorders (SUDs). Moreover, this is one of the first longitudinal studies examining the relationship between the SRM and outcome in a mental health population. The sample was comprised of 70 patients with SUDs who were receiving outpatient treatment at the St. Luke-Roosevelt Hospital’s Addiction Institute of New York. The findings provided partial support for the study’s hypotheses. Specifically (a) patients who identified a psychological or behavioral cause of their SUD were more likely to be treatment adherent, (b) patients who perceived some personal control over their SUD were more likely to be treatment adherent, and (c) several illness representation dimensions were associated with various coping styles in SUD patients. The SRM appears to be a valid model for understanding SUDs, and the Brief IPQ a reliable and valid tool for assessing illness representation in SUDs. The current results underscore the necessity and value of conducting further research to inform the further development of empirically supported SUD treatment approaches.Read More »

Archive Report: The Psychoactive Substances Research Collection at Purdue University

Today’s post is by contributing editor David Korostyshevsky, a history PhD candidate at the University of Minnesota. 

It was a cloudy, rainy, late-March week in West Lafayette, Indiana when I first encountered Purdue University’s Psychoactive Substances Research Collection (PSRC). Maintained by the university library’s Archives and Special Collections, the PSRC offers the papers of important figures in American psychedelic research, from American LSD studies during the 1960s to the resurgence of international medical and scientific research about psychedelic substances during the 1990s. The collection also boasts an incredible shelf list of psychedelic science literature dating to the 1950s, including books, periodicals, and newsletters.Read More »

Technology Use and Drug Using Outcomes: New Research

Editor’s note: It’s graduation season, which means a slew of new dissertations! In today’s post, we include a few recent projects concerning technological interventions in problematic drug use. These entries are part of an ongoing drug-related dissertation bibliography continuously compiled by Jonathon Erlen, selections of which were formerly published in the Social History of Alcohol and Drugs journal but are now periodically featured on the Points blog. Contact Dr. Erlen through the link above.

A New Kind of Therapeutic Relationship: Exploring Factors that Influence the Effectiveness of Computer-Delivered Interventions for Alcohol Use Disorders

Author: Campbell, William P., IV

Abstract: Computer-delivered interventions (CDI) for alcohol use comprise a relatively new treatment for individuals struggling with problematic drinking. While CDIs for alcohol misuse have proliferated over the last decade, much remains unknown about factors that influence their effectiveness. This study evaluated the performance of Overcoming Addictions (OA), a CDI based on the principles of SMART Recovery (SR). Subjects were drawn from a sample of 189 participants enrolled in a randomized clinical trial (RCT) that compared three and six-month outcomes for two interventions for problematic alcohol use: control participants were enrolled in SR meetings (face to face and/or online); experimental participants also had access to OA. Primary analyses of between group differences were conducted to detect an additive effect of OA. Further, this study explored variables thought to mediate the effectiveness of OA, and CDIs for problematic alcohol use more generally. Within the experimental group, analyses were conducted to examine whether participants’ amount of experience navigating the Internet accounted for any variance associated with positive outcomes; also, the study examined the mediating effect of two other closely related variables: participants’ sense of how easy the website was to use, and whether participants were satisfied with the amount of content on the website. Primary analysis indicated that both the control and experimental groups showed significant improvement across outcome variables, although no additional benefit of OA was detected. Finally, no evidence was found to support the hypotheses for the identified variables thought to mediate the effectiveness of OA. Implications of this null finding are discussed.

 

Publication year: 2015

 

Advisor: Dougher, Michael J.

Committee member: Gangestad, Steven W.; Moyers, Theresa B.; Witherington, David C.; Woodall, William G.

University/institution: The University of New Mexico

Department: Psychology

 

Designing and Evaluating a Self-Help Website to Reduce Teen Alcohol Use

Author: Current, Brittany

Abstract: Teen substance use is an issue of major concern. Increasing numbers of teens are using alcohol and at earlier ages, resulting in severe and lasting consequences. Given teenagers’ developmental predispositions for risk-taking, illusions of invincibility, and limited attention to long-term consequences, it is critical for parents and other concerned adults to help teenagers think about and realistically evaluate the consequences of their actions in age-appropriate ways. Teens and young adults have been noted for being highly technically savvy, being regular online users, and obtaining much of their information online. Therefore, it would be helpful to leverage technical and online solutions for supporting teens in resisting pressures to drink. However, existing self-help websites are created and run by mental health professionals, generally without help or feedback from teens. The present action research project contributed to existing literature by inviting teens to participate in the design of a new self-help website by providing evaluative feedback through group interviews. This is the only research project involving focus group evaluations of teen self-help websites known to date. The present project involved designing, evaluating, and modifying a new self-help website for teenagers who are using alcohol or considering using alcohol, with the purpose of helping them avoid underage drinking and its consequences. First, a website was created based on an extensive literature review. Second, a 2-hour workshop of 15 college students was convened to present and evaluate the website. Focus group notes were transcribed and emerging topics for each question were summarized. Third, the website was redesigned based on participant feedback. Recommendations based on the results on the present study are to continue creating and maintaining alcohol and substance abuse self-help websites for teens and to create awareness about these sites so the target population may make use of them. Suggestions for continued research are to repeat the study with a larger sample and improved data collection tools. Another suggestion for continued research is to explore additional self-help options for teens to avoid underage drinking.

 

Publication year: 2016

 

Advisor: Willmarth, Eric

Committee member: Hoffman, Louis; Schmitt, Robert

University/institution: Saybrook University

Department: Psychology

Where Does Addiction Come From? Perspectives from the Past and Present

Editor’s note: It’s graduation season, which means a slew of new dissertations have been published. In today’s post, we include a few recent summaries of historical, psychological, and neurological perspectives on the etiology of addiction. These entries are part of an ongoing drug-related dissertation bibliography continuously compiled by Jonathon Erlen, selections of which were formerly published in the Social History of Alcohol and Drugs journal but are now periodically featured on the Points blog. Contact Dr. Erlen through the link above.

Intoxication and Empire: Distilled Spirits and the Creation of Addiction in the Early Modern British Atlantic
Author: Burton, Kristen D.
Abstract: This dissertation exams how the spread of imperialism in the British Atlantic led to the mass production and consumption of distilled spirits during the seventeenth and eighteenth centuries. Through transatlantic colonization, distilled liquors, once produced as medicinal remedies, developed into a thriving industry by the beginning of the eighteenth century. This change in the purpose and use of distilled spirits prompted political, religious, and medical leaders to ask new questions about the effects and possible threats of consuming such spirits. This dissertation is a study of perceptions; it examines how spirits became the means through which people evaluated the place and proper behavior of women, the working poor, indigenous peoples, enslaved laborers, and backcountry famers, among others. While alcohol was thought by many to be spiritually and physically nourishing, mass production and distribution of rum in the mid-seventeenth century created new questions and concerns among elites about intoxication, bodily health, and the perceived threat of lost control over the laboring poor in England, and over indigenous communities and enslaved peoples throughout the empire. Social elites constructed narratives around new notions of inebriation based upon the loss of physical, as well as moral, control. Through these narratives, physicians came to create new theories of habitual drinking as a compulsive act. Altered perceptions, constructed from unprecedented eighteenth-century drinking practices, redefined alcohol as an intoxicant. This established the framework of what became early addiction theory, which emerged during the initial decades of the modern era. Eighteenth-century imperial, medical, and religious debates over distilled spirits, in turn, established the foundation for early ideas of alcoholism and transatlantic movements advocating temperance.

Read More »

Addiction Treatment Professionals: An Understudied Population within Recovery Settings

Editor’s note: In today’s post, we highlight a few recent dissertations on addiction treatment professionals as an occupational class. These entries are part of an ongoing drug-related dissertation bibliography being compiled by Jonathon Erlen, selections of which were formerly published in the Social History of Alcohol and Drugs journal but are now periodically featured on the Points blog. Contact Dr. Erlen through the link above.

Is There a Relationship Between Alcohol/Drug Counselor’s Strength of Belief in the Disease Concept of Addiction and Burnout?

Author: Dodd, Dan D.

Abstract: This study examined the association between substance abuse counselors’ (a) level of burnout and strength of belief in the disease concept of addiction, (b) level of burnout and recovery status, and (c) recovery status and strength of belief in the disease concept. Participants were recruited via a purposive convenience survey sampling method of counselors who were certified Chemical Dependency Professionals (CDPs) or Chemical Dependency Professional Trainees (CDPTs) who were employed in substance use disorder outpatient treatment facilities. A total of 130 surveys were distributed of which 72 were returned giving a 55% response rate. Six surveys were removed due to not providing evidence of informed consent or high frequency of missed answers. Of the remaining 66 participants, 45 were female, 20 were male, and one declined to report gender status. The largest age cohort was 41 years of age and over. Participants completed a demographic questionnaire, the Maslach Burnout Inventory-HSS (Maslach, Jackson, & Leiter, 1966), and the Addiction Belief Scale (Schaler, 1995). Analysis of data included Spearman rank order correlation, Chi-square Test for Independence, and Fisher’s Exact Test. Results indicated that as strength in the belief in the disease concept increased, level of emotional exhaustion/burnout decreased. There was no association for the burnout subscales of depersonalization and personal accomplishment. In addition, there was no significant association between (a) level of burnout and recovery status, or (b) recovery status and strength of belief in the disease concept. Future research should determine if results of this study can be replicated and shift its focus from why professionals are leaving the addiction field to why individuals remain working in the field.

Publication year: 2015

Committee member: Dunn, Christopher; Heusler, William; Suarez, Alejandra

University/institution: Antioch University

Department: Clinical Psychology

The Role of Spiritual Wellness as a Predictor of Employment Satisfaction in Addiction Treatment Professionals

Author: Leventhal, Belinda

Abstract: The focus of this quantitative research study was to ascertain the role of spiritual wellness as a predictor of employment satisfaction in addiction treatment professionals. Fisher’s (2013) Spiritual Health and Life Orientation Measurement 2 (SHALOM2), Maslach, Jackson, and Leiter’s (1996) Burnout Inventory the Human Services Survey (MBI-HSS), Weiss, Davis, England, and Lofquist’s (1967) Minnesota Satisfaction Questionnaire-Short Form (MSQ-Short Form), and a researcher-designed demographic survey were utilized to study nationwide members of The Association for Addiction Professionals (NAADAC). The method used to collect data was a web-based service: Survey Monkey. Descriptive statistics reported the data collected from the demographic survey. A determinate function analysis of the data collected ( n = 102) explored a correlation between spiritual wellness and job satisfaction, as well as between spiritual wellness and job burnout. The discriminant analysis revealed four discriminant functions; first function explained 51.9% of the variance; second function explained 24.2% of the variance; third function explained 18.4% of the variance; and the fourth explained 5.5% of the variance. In combination, these discriminant functions significantly differentiated among the five levels of spiritual wellness, Λ = .004, x 2 (180) = 228.47, p = .01, however, removing the first function indicated that the remaining functions did not significantly differentiate the spiritual wellness levels. The correlations between outcomes and the discriminant functions revealed that age, highest level of education, race, and relationship status have the highest loadings on all four functions, however three of the 15 hypotheses were supported: all variables taken together, type of license, and household income.

Publication year: 2016

Advisor: Lange, Amber

Committee member: Pate, George; Schooley, AnnaLynn

University/institution: Capella University

Department: Social and Behavioral Sciences

 

 

Factors Associated With Harm Reduction Model Use Among Substance Abuse Counselors

Author: Madden, Tiffany

Abstract: Drug overdose death rates in the United States have more than tripled since 1990 with more than 36,000 dying in 2008. In 2007 the estimated cost of drug use to U.S. society due to lost productivity, increased health care, and criminal justice costs was over $193 billion. Previous researchers have found that harm reduction is a viable treatment option within the field of addiction. The guiding premise in the harm reduction approach is that all people can achieve improved psychological and physiological health even if they are unable to be substance-free. However, there remains an important gap in the current literature regarding factors that may influence substance abuse counselors’ use of the harm reduction model. Specific individual counselor independent variables (recovery status, education level, age, length of time in the field, and understanding of substance abuse conceptualizations) may play a role in counselors’ acceptance of the harm reduction approach as a viable treatment for substance abuse. Therefore, the purpose of this quantitative study was to investigate which variables played a role in counselors’ acceptance of the harm reduction model. This research sampled 100 professional substance abuse counselors selected from the American Counseling Association (ACA) database. Multiple regression analyses were utilized to examine study research questions. Findings of this study indicated that disease and eclectic orientation conceptualizations were significant predictors of harm reduction acceptance, suggesting training targets for increasing acceptance of the harm reduction model among counselors. This is an important contribution to the existing literature and enhances social change initiatives by expanding the use of effective substance abuse treatment options.

Publication year: 2016

Advisor: Davis, Kelly

Committee member: Walters, Marlo

University/institution: Walden University

Department: Psychology

 

 

 

Mass Opium Addiction Treatment in Assam, 1939 (Part I)

by Kawal Deep Kour (PhD, Indian Institute of Technology)

The phenomenon of the “opium habit” was attracting worldwide attention by the 1920s. Most addiction historiography research has focused on the United States, where researchers including Arthur Light and Edward Torrance of the Philadelphia Committee for the Clinical Study of Opium Addiction Research, and Charles Terry and Mildred Pellens of the Bureau of Social Hygiene’s Committee on Drug Addictions, whose 1928 classic The Opium Problem is recognized as a seminal primary source of contemporary addiction study. But it was also an object of concern internationally: In January 1923, a joint sub-committee of the League of Nations Health Committee and the Advisory Committee on Traffic in Opium, consisting of Dr H. Carriere (Vice President, Director of the Swiss Federal Public Health Department, Berne), Dr W. Chodzko (delegate of the Polish government to the Office of International Hygiene), Dr. O.Anselimo (German Minister of Health) and J. Campbell (representative of the Indian government) presented a massive report on the illegitimacy of nonmedical opiate use.Read More »

Psychological Perspectives on Recovery

Editor’s note: In today’s post, we highlight a few recent psychology dissertations on recovery settings, their dynamics, and the people who populate them. These entries are part of an ongoing drug-related dissertation bibliography being compiled by Jonathon Erlen, selections of which were formerly published in the Social History of Alcohol and Drugs journal but are now periodically featured on the Points blog. Contact Dr. Erlen through the link above.

 

Adverse childhood experiences and their impact on substance abuse treatment in adults

Author: Cody, Linzi Bruch

Abstract: The purpose of this study was to expand upon prior research done on the effects of adverse childhood experiences (ACEs) throughout the lifespan within a population of substance abusing adults receiving treatment on a residential chemical dependency treatment facility. Specifically, this study sought to determine the extent to which ACE scores were predictive of a variety of physical, social, and financial variables. To explore these relationships, a sample of 164 behavioral health recipients (BHRs) was included. Additionally, 16 healthcare providers were interviewed with regard to their opinions on these proposed relationships. The medical and financial records of the BHRs included in the sample were compared against their ACE scores, and a series of simple linear and logistic regressions were run in an effort to determine the ability of ACE scores to predict each variable. The contents of the interviews with healthcare providers were transcribed, and run in a content analysis in order to identify themes and patterns in their responses. The results indicated that ACE scores were not significantly predictive of any of the variables with the exception of age of first substance use, and number of days to readmission to treatment. Further, the results indicated that healthcare providers believed ACE scores to be highly predictive of the variables in question. These two sets of results were contradictory to one another, and as such, a discussion regarding the reasons for these discrepancies was included. This information can be of use to practitioners working with survivors of trauma and the substance abuse population in that it illuminates some of the confusion inherent in working with these groups. This study demonstrates that further research is needed in the area of adverse childhood experiences as they relate to the substance abuse population. Future directions for research should make efforts to control for confounding variables, and to make connections between the opinions of healthcare providers and the realities of the behavioral health recipients to whom they are providing treatment.Read More »

New Perspectives on Global Drug Control

Editor’s note: In today’s post, we highlight a few recent dissertations on drug control and politics from national, international, and transnational perspectives. These entries are part of an ongoing drug-related dissertation bibliography being compiled by Jonathon Erlen, which was formerly published in the Social History of Alcohol and Drugs journal but is now periodically featured on the Points blog. Contact Dr. Erlen through the link above.

Martin Behrman and the Regulars: Beer, War, Sex, and the Roots of Modern American Politics

Author: Criss, Ralph Eric

Abstract: The proper role of government at all levels—local, state and federal—has been debated since the birth of the Republic. This project explores that debate by illustrating how a variety of social and political issues manifested themselves in the real life of New Orleans’ longest serving mayor, Martin Behrman, and the lives of millions of other Americans, in the early twentieth century. Integral to the story of Martin Behrman’s life is the tale of Storyville—the infamous red-light district—the growth of the beer industry, and World War I. These matters were bound together in a ball of confusion surrounding the act of congress authorizing the war and its funding. Specifically, questions poured in from across the nation, asking which parts of American cities sailors could visit, whether or not sailors and soldiers were to be treated equally under the law, and even whether or not a civilian could buy a soldier a cold beer to say “thank you” for his service. In this way, the politics of beer, sex, and reform exploded across the United States. In Louisiana, these issues contributed to the defeat of Martin Behrman in the mayoral election of 1920, the weakening of the “Regular” political machine, and the ascent Huey Long, the “Kingfish.” Many of the same legal and moral questions that were asked in 1915 are now asked in 2015 as presidential candidates jockey for position in the presidential primaries of both major parties. How much federal government intrusion into the private lives of citizens is appropriate, given the urgent need to protect the nation from terrorism? Which civil liberties may be encroached upon and to what extent? What is government’s role in promoting public health, fair wages, and morality? What is the appropriate role of the federal government versus states and localities, especially during wartime? How do we handle the large numbers of immigrants flocking to our shores—from both a policy and rhetorical perspective? Answers to such questions constituted the political fault lines of the early twentieth century, as they do today. This study does not attempt to answer the policy questions above. Rather, it seeks to add context to debates surrounding them and to demonstrate their durability. The challenge is how to discuss these complex issues in a concise and cohesive manner. The author chose the political career of the longest serving mayor in the history of New Orleans to act as the glue that holds the narrative together.Read More »

Opium, Empire, and India (Part II)

Editor’s note: Today’s post is a continuation of last week’s piece by Dr. Kawal Deep Kour. Make sure to check out Part I

china-yunnan
Southeast Asia

References to the significance attached to trade with China abound in British diplomatic correspondences, treaties and conventions. Yunnan (in China), with its rich reserves of gold and silver was alluring to adventurer-entrepreneurs, merchants, and explorers alike as much as for its “opium geography.” Of great interest was the location of Yunnan- from here, opium could travel to its destined locations: Hong Kong and Shanghai. Correspondences between the Bengal government and an imperial agent deployed in British Burma refer to instructions relating to the safe passage of Chinese labour to clear ground for tea plantations in Assam, and also to the conveying of Indian opium to Yunnan at the insistence of the British merchants following Chinese hostility. Further, a large amount of goods were smuggled through Margherita (Assam) to the villages of the Khampti and Singpho people inhabiting the area, what is present day Arunachal Pradesh (northeast India), bordering China. The trans-border tribesmen from Borkhamti and from the Hukong valley smuggled large quantities via Margherita and even as far as Titabar in Assam. It was therefore considered that the opening of the Borkhamti country would uncover tremendous possibilities of Assam-China trade being conducted through the river routes-Irrawady-Salwin (present day Myanmar) and thence into Yang-tse-kiang (China). Surveying the region in 1826, Captain Wilcox in his memoirs had taken incidental note of the great demand for opium, apart from salt, among all Indo-Chinese nations.Read More »