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Mupara LM, Tapera R, Selemogwe-Matsetse M, Kehumile JT, Gaogane L, Tsholofelo E, Murambiwa P. Alcohol and substance use prevention in Africa: systematic scoping review. JOURNAL OF SUBSTANCE USE 2022. [DOI: 10.1080/14659891.2021.1941356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Lucia M. Mupara
- Department of Health Promotion and Education, School of Public Health, Boitekanelo College, Gaborone, Botswana
- Department of Public Health Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Roy Tapera
- Department of Environmental Health, School of Public health, Faculty of Health Sciences, Gaborone, Botswana
| | - Morekwe Selemogwe-Matsetse
- Department of Health Promotion and Education, School of Public Health, Boitekanelo College, Gaborone, Botswana
| | - Johanne T. Kehumile
- Department of Health Promotion and Education, School of Public Health, Boitekanelo College, Gaborone, Botswana
| | - Lebogang Gaogane
- Department of Health Promotion and Education, School of Public Health, Boitekanelo College, Gaborone, Botswana
| | - Ellen Tsholofelo
- Department of Health Promotion and Education, School of Public Health, Boitekanelo College, Gaborone, Botswana
| | - Pretty Murambiwa
- Department of Health Promotion and Education, School of Public Health, Boitekanelo College, Gaborone, Botswana
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Giacolini T, Conversi D, Alcaro A. The Brain Emotional Systems in Addictions: From Attachment to Dominance/Submission Systems. Front Hum Neurosci 2021; 14:609467. [PMID: 33519403 PMCID: PMC7843379 DOI: 10.3389/fnhum.2020.609467] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 12/22/2020] [Indexed: 12/03/2022] Open
Abstract
Human development has become particularly complex during the evolution. In this complexity, adolescence is an extremely important developmental stage. Adolescence is characterized by biological and social changes that create the prerequisites to psychopathological problems, including both substance and non-substance addictive behaviors. Central to the dynamics of the biological changes during adolescence are the synergy between sexual and neurophysiological development, which activates the motivational/emotional systems of Dominance/Submission. The latter are characterized by the interaction between the sexual hormones, the dopaminergic system and the stress axis (HPA). The maturation of these motivational/emotional systems requires the integration with the phylogenetically more recent Attachment/CARE Systems, which primarily have governed the subject's relationships until puberty. The integration of these systems is particularly complex in the human species, due to the evolution of the process of competition related to sexual selection: from a simple fight between two individuals (of the same genus and species) to a struggle for the acquisition of a position in rank and the competition between groups. The latter is an important evolutionary acquisition and believed to be the variable that has most contributed to enhancing the capacity for cooperation in the human species. The interaction between competition and cooperation, and between competition and attachment, characterizes the entire human relational and emotional structure and the unending work of integration to which the BrainMind is involved. The beginning of the integration of the aforementioned motivational/emotional systems is currently identified in the prepubertal period, during the juvenile stage, with the development of the Adrenarche-the so-called Adrenal Puberty. This latter stage is characterized by a low rate of release of androgens, the hormones released by the adrenal cortex, which activate the same behaviors as those observed in the PLAY system. The Adrenarche and the PLAY system are biological and functional prerequisites of adolescence, a period devoted to learning the difficult task of integrating the phylogenetically ancient Dominance/Submission Systems with the newer Attachment/CARE Systems. These systems accompany very different adaptive goals which can easily give rise to mutual conflict and can in turn make the balance of the BrainMind precarious and vulnerable to mental suffering.
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Affiliation(s)
- Teodosio Giacolini
- Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy
| | - David Conversi
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | - Antonio Alcaro
- Department of Psychology, Sapienza University of Rome, Rome, Italy
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Brown G, Crawford S, Perry GE, Byrne J, Dunne J, Reeders D, Corry A, Dicka J, Morgan H, Jones S. Achieving meaningful participation of people who use drugs and their peer organizations in a strategic research partnership. Harm Reduct J 2019; 16:37. [PMID: 31182099 PMCID: PMC6558880 DOI: 10.1186/s12954-019-0306-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 05/15/2019] [Indexed: 01/03/2023] Open
Abstract
Background Peer-led programs with people who use drugs (PWUD) have been a key characteristic of the harm reduction in many countries, including their involvement in research. However, peer involvement in research is often limited to recruitment, consultation, and reporting back, rather than a genuine collaboration in the priority setting, design, and conduct of research. PWUD peer organizations face ongoing challenges to demonstrate the depth of their knowledge of current and emerging issues within drug-using networks and the value of their peer insights for effective research and policy. The identification of benefits, barriers, and enablers for meaningful participation of PWUD in research has often been limited to methodological rather than system level factors. Methods This paper draws on the experiences and findings of the What Works and Why (W3) Project, a 5-year collaborative study with peer organizations. The study drew on systems thinking methods to develop a framework to demonstrate the role of peer organizations within their community and policy systems. The study required peer staff and researchers to undertake the simultaneous role of drivers, participants, and analysts in the research. To identify the learnings in relation to meaningful participation of PWUD peer organizations in research, we drew together the insights and experiences of peer staff and researchers across the 5 years of the study Results The W3 Project provided insights into the nuances of community-engaged research practice and the ongoing benefits, barriers, and enablers to the meaningful participation of PWUD and their peer organizations. These included system-level barriers and enablers beyond individual research projects or methodology. The capacity of research and peer organizations to maintain meaningful peer participation in research can be restricted or enhanced by the systems in which they are embedded. Conclusions Recognizing peer organizations as active participants and drivers within community and policy systems can help clarify their unique and critical role in research. Achieving meaningful collaboration with PWUD peer organizations requires looking beyond good practice methods to the system-level factors with attention to the system-level benefits, barriers, and enablers.
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Affiliation(s)
- Graham Brown
- Australian Research Centre in Sex, Health and Society, La Trobe University, Bundoora, VIC, 3086, Australia.
| | - Sione Crawford
- Harm Reduction Victoria, PO Box 12720, A'Beckett Street, Melbourne, 8006, Australia
| | - Gari-Emma Perry
- Peer-Based Harm Reduction WA, PO Box 8003, Perth, WA, 6849, Australia
| | - Jude Byrne
- Australian Injecting & Illicit Drug Users League, GPO Box 1555, ACT, Canberra, 2601, Australia
| | - James Dunne
- Australian Research Centre in Sex, Health and Society, La Trobe University, Bundoora, VIC, 3086, Australia
| | - Daniel Reeders
- School of Regulation and Global Governance, Australian National University, ACT, Canberra, 2600, Australia
| | - Angela Corry
- Peer-Based Harm Reduction WA, PO Box 8003, Perth, WA, 6849, Australia
| | - Jane Dicka
- Harm Reduction Victoria, PO Box 12720, A'Beckett Street, Melbourne, 8006, Australia
| | - Hunter Morgan
- Harm Reduction Victoria, PO Box 12720, A'Beckett Street, Melbourne, 8006, Australia
| | - Sam Jones
- Harm Reduction Victoria, PO Box 12720, A'Beckett Street, Melbourne, 8006, Australia
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Brown G, Perry GE, Byrne J, Crawford S, Henderson C, Madden A, Lobo R, Reeders D. Characterising the policy influence of peer-based drug user organisations in the context of hepatitis C elimination. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2019; 72:24-32. [PMID: 31176595 DOI: 10.1016/j.drugpo.2019.05.025] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 05/22/2019] [Accepted: 05/25/2019] [Indexed: 01/24/2023]
Abstract
BACKGROUND Achieving hepatitis C (HCV) elimination goals will require major policy and health service reorientation to scale up testing and treatment among people who inject drugs (PWID). To achieve this, a close partnership with peer-based drug user organisations is required. However, peer organisations have historical and ongoing difficulties in articulating the validity of their service delivery and policy advice, leading to some policy and health services resisting partnership and advice from peer-based drug user organisations. METHODS To develop a deeper understanding of the role of peer-based drug user organisations in the HCV response, we analysed data from the W3 Project which used systems thinking methods to draw together the insights of over 90 peer staff from 10 Australian community and peer organisations in HCV and HIV. The resulting system maps were analysed to identify system dynamics and functions that need to be fulfilled for peer organisations to be influential within their community and policy system. RESULTS We identified the interactions at a system level which can enhance or constrain the quality and influence of policy advice from peer-based drug user organisations. We found the strength of Peer-based drug user organisations to support the scale up of HCV testing and treatment was their capacity to mediate between, and navigate within, the complex community and policy/health service systems. While peer-based drug user organisations endeavour to demonstrate their capacity and credibility in terms of engagement, alignment, adaptation and influence, policy and service organisations also need recognise their own system role to value and enable peer-based drug user organisations to achieve their potential. CONCLUSION If the HCV prevention and treatment system is to reach PWID living with HCV and achieve HCV elimination goals, then policy and health services need to invest in strengthening peer-based drug user organisations as well as recognise, value and act on quality policy advice from PWID peer leadership.
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Affiliation(s)
- Graham Brown
- Australian Research Centre in Sex, Health and Society, La Trobe University, Bundoora, 3086, Victoria, Australia; Centre for Social Research in Health, University of New South Wales, UNSW Sydney, NSW 2052, Australia; STI and BBV Applied Research and Evaluation Network, School of Public Health, Curtin University, GPO Box U1987, Perth WA 6845, Australia.
| | - Gari-Emma Perry
- Peer-based Harm Reduction WA, PO Box 8003, Perth WA 6849, Australia.
| | - Jude Byrne
- Australian Injecting & Illicit Drug Users League, GPO Box 1555, Canberra ACT 2601, Australia.
| | - Sione Crawford
- Harm Reduction Victoria, PO Box 12720 A'Beckett Street, Melbourne, Australia.
| | - Charles Henderson
- New South Wales Users and AIDS Association, PO Box 350, Strawberry Hills, NSW 2012, Australia.
| | - Annie Madden
- Centre for Social Research in Health, University of New South Wales, UNSW Sydney, NSW 2052, Australia.
| | - Roanna Lobo
- Centre for Social Research in Health, University of New South Wales, UNSW Sydney, NSW 2052, Australia.
| | - Daniel Reeders
- School of Regulation and Global Governance, Australian National University, Canberra ACT 2600, Australia.
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Lancaster KE, Hetrick A, Jaquet A, Adedimeji A, Atwoli L, Colby DJ, Mayor AM, Parcesepe A, Syvertsen J. Substance use and universal access to HIV testing and treatment in sub-Saharan Africa: implications and research priorities. J Virus Erad 2018; 4:26-32. [PMID: 30515311 PMCID: PMC6248849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
As universal testing and treatment for HIV, or 'treat all', expands across sub-Saharan Africa (SSA), substance use will likely have a negative impact on the success of scale-up efforts for antiretroviral treatment (ART). Overwhelming evidence highlights the negative impact of substance use on HIV care and treatment outcomes. Yet, as many countries in SSA expand ART, evidence of the extent of substance use, and its impact in the region, is more limited. Stigma, and the psychoactive effects of substance use, are barriers to seeking HIV treatment and adhering to ART regimens for persons with heavy alcohol use or substance use. As a result, we identified several implementation and operations research priorities and metrics for monitoring the impact of substance use and Treat All. Identifying barriers and facilitators to the integration of the prevention and treatment of substance use with HIV care, and assessing effects on HIV outcomes, through longitudinal studies are priorities that will determine the impacts of substance use on 'treat all' in SSA. Future research must use existing infrastructure, including large networks of HIV clinics, to enhance our understanding of the implementation and service delivery of substance use screening, referral and treatment. These networks will also inform robust and standardised substance use estimates and interventions within the 'treat all' era in SSA.
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Affiliation(s)
- Kathryn E Lancaster
- Division of Epidemiology, College of Public Health, Ohio State University,
Columbus, OH,
USA
| | - Angela Hetrick
- Division of Epidemiology, College of Public Health, Ohio State University,
Columbus, OH,
USA
| | | | - Adebola Adedimeji
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine,
Bronx, NY,
USA
| | | | - Donn J Colby
- SEARCH, Thai Red Cross AIDS Research Center,
Bangkok,
Thailand
| | - Angel M Mayor
- Retrovirus Research Center, Universidad Central del Caribe School of Medicine, Bayamón,
Puerto Rico
| | - Angela Parcesepe
- Department of Maternal and Child Health, University of North Carolina at Chapel Hill, Gillings School of Global Public Health,
Chapel Hill, NC,
USA
| | - Jennifer Syvertsen
- Department of Anthropology, University of California,
Riverside, CA,
USA
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Lancaster KE, Hetrick A, Jaquet A, Adedimeji A, Atwoli L, Colby DJ, Mayor AM, Parcesepe A, Syvertsen J. Substance use and universal access to HIV testing and treatment in sub-Saharan Africa: implications and research priorities. J Virus Erad 2018. [DOI: 10.1016/s2055-6640(20)30342-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
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Rhodes T, Stevens A, Ritter A, Decorte T. Advancing the science, methods and practices of drug policy research. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2016; 31:1-3. [PMID: 27174818 DOI: 10.1016/j.drugpo.2016.04.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Tim Rhodes
- London School of Hygiene and Tropical Medicine, London, UK
| | - Alex Stevens
- School of Social Policy, Sociology and Social Research, University of Kent, UK
| | - Alison Ritter
- National Drug and Alcohol Research Centre, University of New South Wales, Australia
| | - Tom Decorte
- Institute for Social Drug Research, Ghent University, Belgium
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Rhodes T, Abdool R. Drug harms and drug policies in Sub-Saharan Africa: Implementation science and HIV epidemics. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2016; 30:1-6. [PMID: 26997543 DOI: 10.1016/j.drugpo.2016.02.025] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Tim Rhodes
- London School of Hygiene and Tropical Medicine, UK; National Centre for Social Research on Health, University of New South Wales, Australia.
| | - Reychad Abdool
- Senior HIV Consultant, formerly United Nations Office of Drugs and Crime, Nairobi, Kenya
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