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The purpose of this paper is to review the substance misuse literature on how outcome expectancies are measured, how they are related with the level of use and other factors as well as their role into treatment and recovery.

A narrative review of the literature for all major substances of abuse was undertaken.

Existing measurement tools are substance specific. Most research has been in the field of alcohol, and involved students or light and moderate drinkers. Positive expectancies have been found to be related to initiation and level of alcohol, nicotine and cannabis use and also to be modifiable with repeated cue exposure. Negative expectancies have been found to be associated with prevention of smoking, positive changes in drinking and positive effect on treatment outcome for alcohol.

Both positive and negative outcome expectancies have been found to predict development of substance misuse and recovery from it respectively, but cross-substance comparisons are hindered by lack of appropriate measures.

The concept of outcome expectancies is present in several theories of addiction. To date there has been no comprehensive review of the extent to which different types of expectancy play a role in different substances and their treatment.

The Philippines’ nationwide campaign on drugs has been under the limelight due to its controversial approaches in dealing with the problem of addiction. Despite the government’s current efforts, substance use disorders continue to persist within the population. The purpose of this paper is to provide recommendations for addressing the issue of substance use disorder treatment through a modification of the therapeutic community (TC) in the Philippine context.

This conceptual paper reviews the existing facts about the Philippines’ campaign against drugs, the approaches implemented by the government, current state and research developments of TCs, and its resulting impact on contemporary evidence-based treatment for addiction in the country.

A treatment framework outlining a recovery-oriented therapeutic community (ROTC) is presented. The ROTC aims to address addiction as a chronic, relapsing disease. This alternative approach for addiction treatment in the Philippines is based on the concept of recovery, principles of effective substance use disorder treatment, and recent developments in TC best practices from the international community.

This paper discusses different recommendations for policy development, interventions and research, aimed at improving the odds of securing recovery for people suffering from addiction.

Dual diagnosis is a term that describes the co-occurrence of mental health disorders or illness and substance use or abuse disorders. Because this co-occurrence results in multiple diseases, layers of treatment are often needed to successfully create positive change in the individual. The purpose of this study is to explore factors of treatment that could facilitate improvements in functionality and quality of life for those with a dual diagnosis.

A secondary data analysis, using both quantitative and qualitative data, was completed. Secondary analysis is an empirical exercise that applies the same basic research principles as studies using primary data and has steps to be followed, including the evaluative and procedural steps commonly associated with secondary data analysis. Documentation data from the intensive mobile psychosocial assertive community treatment program was gathered for this analysis; this program was used because of the intensive and community-based services provided to patients with a dual diagnosis.

The major findings from this secondary analysis suggested that significant barriers included “denial” (e.g. evasion, suspension or avoidance of internal awareness) of diagnoses, complicated treatment and other barriers related to housing. Ultimately, these findings provided greater insight into potential effective treatment interventions for people living with a dual diagnosis.

This study adds to the growing body of literature showing that patient-centered care allows for more effective treatment and ultimately, improved health outcomes.

This is the second in a series of papers focused on alcohol and substance abuse rehabilitation centers. Centers face the ongoing challenge of validating outcomes to meet the burden of evidence for insurance companies. In the first paper, data mining was used to establish baseline patterns in treatment success rates, for the Futures: Palm Beach Rehabilitation Center, that have a direct impact on a client’s ability to receive insurance coverage for treatment programs. In this paper, we examine 2016 outcomes and report on facility efficacy, alumni progression and sobriety, and forecast treatment success rates (short and long term) in support of client insurability. Data collection has been standardized and includes admissions data, electronic medical records data, satisfaction survey data, post-discharge survey data, Centers for Disease Control (CDC) data, and demographic data. Clustering, partitioning, ANOVA, stepwise regression and stepwise Logistic regression are applied to the data to determine statistically significant drivers of treatment success.

This study aims to describe knowledge of Canada’s Good Samaritan Drug Overdose Act (GSDOA) and take home naloxone (THN) training and kit possession among people being released from provincial correctional facilities in British Columbia.

The authors conducted surveys with clients of the Unlocking the Gates Peer Health Mentoring program on their release. The authors compared the characteristics of people who had and had not heard of the GSDOA and who were in possession of a THN kit.

In this study, 71% people had heard of the GSDOA, and 55.6% were in possession of a THN kit. This study found that 99% of people who had heard of the GSDOA indicated that they would call 911 if they saw an overdose. Among people who perceived themselves to be at risk of overdose, 28.3% did not have a THN kit. Only half (52%) of participants had a mobile phone, but 100% of those with a phone said they would call 911 if they witnessed an overdose.

The authors found that people with knowledge of the GSDOA were likely to report that they would call 911 for help with an overdose. Education about the GSDOA should be a standard component of naloxone training in correctional facilities. More than one in four people at risk of overdose were released without a naloxone kit, highlighting opportunities for training and distribution. Access to a cellphone is important in enabling calls to 911 and should be included in discharge planning.

Less than 15 per cent of people starting opiate substitution treatment (OST) in England are employed, but few gain employment during treatment. Increasingly punitive approaches have been tried to encourage individuals with substance dependence into employment in the hope of facilitating recovery. It is not clear which factors are associated with the successful maintenance of employment whilst receiving OST, and whether this group can be said to be “in recovery”. The paper aims to discuss these issues.

A cross-sectional study of the OST population in one English region was conducted between January and April 2017. Measures of physical health, employment patterns, drug use, mental health, recovery capital, and dependence severity were administered to 55 employed and 55 unemployed clients.

Those in employment had higher levels of “recovery capital”, better physical and mental health, fewer drug problems, and less severe dependence, despite reporting heroin use at a similar level. Three variables were significantly associated with employment: longest period of employment (OR=1.01, p=0.003); number of chronic medical conditions (OR=0.44, p=0.011); and number of days of psychological problems in the last month (OR=0.95, p=0.031).

These results suggest that abstinence may not be required in order to maintain stable employment when OST is in place. Different treatment strategies are required for clients receiving OST already in employment compared with those who are unemployed.

This is the first UK study to the author’s knowledge to focus on people receiving OST who are also in employment.

Integrated care approaches have been recommended for co-occurring substance use and mental health disorders. The purpose of this study is to explore and map the research literature regarding social work and its intersection with co-occurring substance use and mental health disorders.

An iterative and systematic search of five electronic databases CINAHL, Scopus, PsycINFO, Social Science Database and Medline was conducted to identify studies published between 2002 and 2022. Two reviewers independently screened publications in two successive stages of title and abstract screening, followed by a full-text screening of eligible studies. Data from each included publication were screened and extracted using Covidence.

A total of 38 eligible studies were included in the final scoping review. The included studies were conducted in eight different counties, including a range of study designs (e.g. cross-sectional, RCT, pilot studies). Only 8 of the 38 studies included people with co-occurring disorders as participants. Study settings were broad, for example, dual-diagnosis, military, homeless, substance use and community-based settings.

A review of the literature surrounding social work practice and its intersection with co-occurring mental health and Alcohol and other drug was warranted to document the evidence on this largely unexplored area of research. This review found that there was a paucity of literature that focused specifically on the role of social work practice in relation to individuals with co-occurring disorders, with a limited number of studies focusing on dual diagnoses.

The acceleration of Opioid deaths over the last decade has made it a serious national public health crisis. Alabama has not been immune to this epidemic, with dramatically increased age-adjusted drug overdose death rates. These increases have occurred in a state with limited resources for Opioid health prevention, treatment, and recovery services. This chapter introduces the term “o-CHIL” in order to better understand the multi-factorial layers of intertwining health injustices (in the plural) experienced in Alabama’s communities and their embedded public libraries. It highlights the complexities in Opioid consumer health information literacies, the culturally situated dimensions of the Opioid crisis in Alabama, and the uniquely relevant consumer health literacies in its public libraries. Findings are based on an empirical assessment of representative information support services identified in February 2020 on the websites of the 230 public libraries listed as members of the Alabama Public Library Service. The exploratory study applies website content analysis to identify seven examples of information offerings and to class offerings into three categories: (1) information sources (collections, resources); (2) information policy and planning (assigned Opioid-related role, strategic representation); and (3) connections (internal, external, news and events). The discussion potentially provides new directions, approaches, and opportunities to build collaborations of sharing within Alabama’s network of public libraries and beyond for them to better serve their local and regional communities impacted by the Opioid crisis.

Opioid use disorder (OUD) poses a national public health challenge including for the Veterans Health Administration (VHA). However, the responsiveness of VHA, as a centralized national health care system, to local conditions has not been studied. The purpose of this paper is to examine the correlation of measures of population-based OUD case identification and provision of opioid agonist treatment (OAT) in VHA and in local systems at the state level thus evaluating the responsiveness of VA as centralized health system to local conditions.

Correlation of VHA administrative data and local survey data reflecting OUD and OAT rates were evaluated with Pearson correlations. Further analyses examined the correlation of VHA and non-VHA OUD and OAT measures with state rates of opioid-related deaths, median income, health insurance coverage and education levels.

VHA rates of OUD and OAT at the state level were both significantly correlated with corresponding state data from the National Survey on Drug Use and Health (r=0.28, p=0.048 and r=0.71, p=0.002, respectively). Both OUD and OAT in VHA were positively and significantly correlated with state rates of opioid-related deaths, while indicators of OAT were significantly associated with higher state-level median income, health insurance coverage and levels of education.

Although centrally managed from Washington, D.C., VHA case identification and OAT service delivery appear to be correlated with relevant local measures.

Significant associations with general population indicators point to underlying conditions that may shape both VHA and local health system performance.

Public health systems would benefit from performance evaluation data to examine responsiveness to local conditions.

Public libraries are respected local institutions that connect community members to credible information and services, and support lifelong learning. The nature of these libraries means that they are open to all, including individuals who may be experiencing a physical or mental health crisis. A critical way that libraries in the United States are now supporting their communities is by leveraging their assets and their mission to respond to the opioid crisis. These responses have ranged from providing access to information and resources on addiction, prevention, treatment, and recovery support, to training staff and the public to use the drug naloxone to help reverse overdoses. Public libraries have found allies in this work in community organizations including nonprofits and public health departments, and are often working together with these partners toward common goals to bring about collective impact.

Through their programming efforts in response to the opioid crisis, public libraries are also demonstrating the ability to support the Sustainable Development Goals (SDGs) identified by the United Nations (UN) as a call to action for the global community. These goals include ensuring healthy lives, equitable education and lifelong learning, and decent work and economic growth. Public libraries are actively supporting people in their efforts to improve their lives and the lives of those around them. It is important and valuable work, and truly necessary for a functioning society.