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Developing a trauma-informed workforce for the opioid crisis in a rural community in the United States: a case study
- Author:
- CHOWDHURY Dalia
- Journal article citation:
- Journal of Mental Health Training Education and Practice, 17(1), 2022, pp.12-26.
- Publisher:
- Emerald
Purpose: Workforce development in rural communities to address a surge in opioid addiction and overdose related hospitalizations has been an unaddressed issue in the USA. This study aims to present an integrated, trauma-informed, behavioral workforce development initiative in a midwestern rural setting in the USA. Design/methodology/approach: This is a mixed method, two-phased study: the first phase tracked and analyzed two focus group conferences involving experts (n = 6) and professionals (n = 8) to develop a training protocol; the second phase provided a training (n = 101), based on the protocol to future professionals and compared competencies before and after the implementation of the training. Findings: There is a need of a trauma integrated approach in providing interprofessional training connecting health-care workers in rural communities to address the current opioid crisis to bring about cohesion among integrated and interdisciplinary teams. Workforce building will need to implement best practices not only among medical providers but among community mental health practitioners in rural areas. Originality/value: This is a unique trauma-informed workforce development initiative in a rural community. Such studies are extremely limited and almost non-existent. Further initiatives need to be taken in this field to identify unique differences within communities that may hinder implementation. (Edited publisher abstract)
The Misuse Of Drugs Act – a user perspective
- Author:
- SOUTHWELL Mat
- Journal article citation:
- Drugs and Alcohol Today, 21(4), 2021, pp.269-276.
- Publisher:
- Emerald
Purpose: This paper aims to demonstrate the ways in which the Misuse of Drugs Act (MDA) militates against the interests and situations of people who use drugs. The author reflects on the author’s journey as a drug user, drugs workers and drug user organiser to critique the MDA. The author describes the impact of the MDA on the author’s early experimentation with substances and highlights the limitations of simplistic drugs prevention. The author describes how the MDA maximises drug-related risks and undermines the creation of healthy cultural norms and community learning among people who use drugs. The author talks about the author’s work as a drugs practitioner and mourns the vandalism of the UK’s harm reduction and drug treatment system. This paper describes the opportunity to use drug policy reform as a progressive electoral agenda to begin the journey towards racial and social justice. This paper calls for the rejection of the Big Drugs Lie and the repeal of the failed MDA. Design/methodology/approach: Personal reflection based on experience as drug user, drugs worker and drug user organiser. Findings: Successive UK Governments have used the MDA as a tool of social control and racial discrimination. The Big Drugs Lie undermines science-based and rights-compliant drug policy and drug services and criminalises and puts young people at risk. There is the potential to build a progressive political alliance to remove the impediment of the MDA and use drug policy reform as tools for racial and social justice. Practical implications: The MDA maximises the harms faced by people who use drugs, stokes stigma and discrimination and has undermined the quality of drug services. The MDA needs to be exposed and challenged as a tool for social control and racial discrimination. Delivering drug policy reform as a progressive electoral strategy could maximise its potential to improve social and racial justice. Originality/value: This paper represents the view of people who use drugs by a drug user, a view which is seldom expressed in the length and level of argument shown here. (Edited publisher abstract)
More harm than good? Cannabis, harm and the Misuse of Drugs Act
- Authors:
- POTTER Gary R., WELLS Hattie
- Journal article citation:
- Drugs and Alcohol Today, 21(4), 2021, pp.277-288.
- Publisher:
- Emerald
Purpose: This paper aims to consider the nature of cannabis-related harms under the UK’s Misuse of Drugs Act (MDA). Written for the specific context of this four-paper special section on 50 years of the MDA, it argues that the MDA may cause more harm than it prevents. Design/methodology/approach: An opinion piece offering a structured overview of cannabis-related harms under prohibition. It summarises existing evidence of the ways in which prohibition may exacerbate existing – and create new – harms related to the production, distribution, use and control of cannabis. Findings: The paper argues that prohibition of cannabis under the MDA may cause more harm than it prevents. Originality/value: It has long been argued that the MDA does not accurately or fairly reflect the harms of the substances it prohibits, and much existing research points to different ways in which drug prohibition can itself be harmful. The originality of this paper lies in bringing together these arguments and developing a framework for analysing the contribution of prohibition to drug-related harm. (Edited publisher abstract)
From law to regulation: re-appraising the misuse of Drugs Act 1971
- Author:
- SEDDON Toby
- Journal article citation:
- Drugs and Alcohol Today, 21(4), 2021, pp.289-297.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to re-appraise the Misuse of Drugs Act 1971 in order to develop alternative and new ideas for drug law reform. Design/methodology/approach: The approach is to analyse the Act from historical and socio-legal perspectives, drawing on the inter-disciplinary field of regulation studies. Findings: The Act has its roots in radical counter-cultural reform activism in the 1960s. Its innovative legal structure has enabled a diverse range of policy approaches to be possible over the last 50 years. Future drug law reform efforts need to broaden out from a narrow focus on law and also to engage more seriously with the politics of drug law and policy. Originality/value: Drawing on the inter-disciplinary field of regulation studies leads to novel insights about the politics and practice of drug law reform. (Edited publisher abstract)
Fifty years of the UK Misuse of Drugs Act 1971: the legislative contexts
- Author:
- STOTHARD Blaine
- Journal article citation:
- Drugs and Alcohol Today, 21(4), 2021, pp.298-311.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to illustrate the history of relevant legislation before and after the 1971 Misuse of Drugs Act (MDA). Design/methodology/approach: A chronological narrative of laws and reports with concluding discussion. Findings: That UK legislators have not made use of the evidence base available to them and have favoured enforcement rather than treatment approaches. That current UK practice has exacerbated not contain the use of and harms caused by illegal drugs. Research limitations/implications: The paper does not cover all relevant documents, especially those from non-governmental sources. Practical implications: The practical implications centre on the failure of consecutive governments to reflect on and review the impact of current legislation, especially on people who use drugs. Social implications: That the situations of people who use drugs are currently ignored by the government and those proven responses which save lives and reduce harm are rejected. Originality/value: The paper attempts to show the historical contexts of control and dangerousness of which the MDA is one instrument. (Edited publisher abstract)
AUDIT Scotland 10 years on: explaining how funding decisions link to increased risk for drug related deaths among the poor
- Authors:
- MCPHEE Iain, SHERIDAN Barry
- Journal article citation:
- Drugs and Alcohol Today, 20(4), 2020, pp.313-322.
- Publisher:
- Emerald
Purpose: In response to Scottish Government assertions that an ageing cohort explained increases in drug-related death (DRD), the previous research by the authors established that socio-economic inequalities were additional risk factors explaining the significant increases in DRD in Scotland. This paper aims to subject the drug policy narratives provided by Scottish Government in relation to the governance of drug and alcohol services to critical scrutiny and reveal the social consequences of the funding formula used to direct funding to services via NHS Scotland Boards, and Alcohol and Drug Partnerships (ADP). Design/methodology/approach: The paper provides a narrative review in the context of the AUDIT Scotland reports “Drug and Alcohol Services in Scotland” from 2009 and follow-up report published in 2019. The authors refer to the recommendations made in the 2009 report on effectiveness of drug and alcohol services and subject Scottish Government funding processes, and governance of drug and alcohol services to critical scrutiny. Findings: This analysis provides robust evidence that Scottish Government funding processes and governance of drug and alcohol services increased risk to vulnerable drug users and document evidence that link these risk factors to increased DRD. Research limitations/implications: The authors have focused on Scottish drug policy and drug services funding. Alcohol services funding is not subject to critical analysis due to limitations of time and resources. Practical implications: This case study investigates AUDIT Scotland’s recommendations in 2009 to Scottish Government to provide researchers, government policy advisors and media with robust critical analysis that links drug policy decisions to increased DRD. Social implications: Drug policy governance by the Scottish Government and NHS Scotland since 2009 have disproportionately affected communities of interest and communities of place already experiencing stark inequalities. These budget decisions have resulted in widening inequalities, and increased DRD within communities in Scotland. The authors conclude that in diverging politically and ideologically from Public Health England, and the Westminster Parliament, Scottish Government drug policy and financial governance of drugs services contributes to increased risk factors explaining DRD within deprived communities. Originality/value: The 2009 AUDIT Scotland recommendations to Scottish Government subject their governance of drug services to critical scrutiny. This analysis provides a counterpoint to the explanations that rising DRD are unconnected to drug policy and drug services governance. (Edited publisher abstract)
Fathers and substance misuse: a literature review
- Authors:
- BELL Linda, HERRING Rachel, ANNAND Fizz
- Journal article citation:
- Drugs and Alcohol Today, 20(4), 2020, pp.353-369.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to review the following research questions from the available literature: What evidence is there to suggest that substance misuse specifically by fathers (including alcohol and other drugs) causes wider harms, including child welfare concerns? How do professionals respond specifically to substance misuse by fathers? Do interventions aimed at parental substance misuse (particularly in the UK) include both mothers and fathers and if so how? Design/methodology/approach: A scoping literature review was conducted which identified 34 papers (including scoping reviews published in 2006 and 2008, covering the period 1990-2005) and 26 additional studies published between 2002 and 2020. Findings: The review in this paper is organised into six themes: Negative impact of men’s substance misuse problems on their parenting behaviours; quality of the relationship between parents affected by substance misuse of the fathers, in turn affecting the parenting behaviour and outcomes for children; importance to fathers of their fathering role (for example, as a financial provider); difficulties fathers may face in developing their fathering role; sidelining of the fathering role in substance misuse services; and professionals tending to focus on the mother’s role in parenting inventions and services. Originality/value: This paper focusses on fathers and substance misuse, which is an under-researched field within the wider contexts of fathering research and research into parental substance misuse. (Edited publisher abstract)
Covid-19, county lines and the seriously “left behind"
- Author:
- PITTS John
- Journal article citation:
- Journal of Children's Services, 15(4), 2020, pp.209-213.
- Publisher:
- Emerald
Purpose: The purpose of this study is to suggest how the Covid-19 lockdown may affect illicit drug users and vulnerable children and young people who become involved in County lines drug dealing. Design/methodology/approach: This is an “opinion piece” based on data released by central and local government departments and voluntary sector sources concerning the impact of the Covid-19 restrictions on illicit drug users and vulnerable children and young people. The data is augmented with information from recent discussions with police officers, youth workers and social workers in a London borough. Findings: It appears that the Covid-19 restrictions have had, and will continue to have, a deleterious impact upon both illicit drug users and the young people caught up in County lines drug distribution. Originality/value: The study’s originality lies in its attempt to use a range of sources to anticipate the consequences of the Covid-19 restrictions on illicit drug users and vulnerable children and young people. (Edited publisher abstract)
“Act-as-if you are infected and infectious”: what has the global therapeutic community movement learnt from COVID-19?
- Authors:
- GOSLING Helena, YATES Rowdy
- Journal article citation:
- Therapeutic Communities: the International Journal of Therapeutic Communities, 41(3-4), 2020, pp.129-135.
- Publisher:
- Emerald
Purpose: The purpose of this paper is twofold: to reflect upon what the global therapeutic community (TC) movement has learnt from coronavirus and to consider how TCs will continue to adapt and evolve in a post-pandemic climate. Design/methodology/approach: This is a viewpoint paper based on the authors’ participation in an international learning event whereby speakers from TCs from around the world spoke about how they adapted their services to overcome adversity. Findings: The findings are usefully thought out as shelter, creativity, reintegration and employment, technology and roots. Based on the material discussed in the learning event, it would seem that the global TC movement has engaged in a process of looking to the past to move forward by drawing upon founding principles and prescriptions of the TC tradition, rooted in humanistic and indeed humanitarian responses to staff, client and sociocultural needs. Originality/value: According to the author, this paper is one of the first attempts to capture how TCs from across the globe have responded to the threat of coronavirus. (Edited publisher abstract)
The Daytop crisis and its impact on the global Therapeutic Community movement
- Author:
- ZAFIRIDIS Phoebus
- Journal article citation:
- Therapeutic Communities: the International Journal of Therapeutic Communities, 41(1), 2020, pp.25-35.
- Publisher:
- Emerald
The Therapeutic Communities (TCs) movement tends to become from a revolutionary answer to the problem of addiction to another mainstream therapeutic proposal. The author considers that the crisis in 1968 in the seminal TC of Daytop was a pivotal event of this transition. This study aims to evaluate the impact of this historical crisis on the course of the TCs movement, assuming that, to enter into a constructive dialogue that can lead to the overcoming of today’s deadlocks of the movement, an awareness of the history is needed.Design/methodology/approach: The present paper is a perspective/opinion paper and starts with a brief review of the origins of the first TCs for addicts. Emphasis is placed on their inevitable, according to the author, confrontation with the political and scientific status quo of that time. Then, it focuses on the period of the crisis in Daytop TC. The author interprets the events under a whole new scope, based on conversations he personally had with pioneers of that time, on his longstanding experience on the field, and the available literature. Findings: The author attempts a historical and sociological analysis of the course of TCs and the Daytop TC. He concludes with a dispute of the prevailing idea that the Daytop crisis was a product of the confrontation between personal ambitions. He maintains that the collision that took place in Daytop TC was a confrontation between two antipodal perspectives over the notion of therapy. In any case, the subsequent estrangement of the movement from the groundbreaking attributes of the first TCs did not prove to be in the best interests of addicts; it was rather dictated by the need of the leaders of TCs to rescue their professional career. Originality/value: The present paper attempts to offer a different view from the conventional reading of TCs’ history and their present situation for today’s predicaments of this proposal to be understood and possibly overcome. (Publisher abstract)