Continuing care following residential alcohol and other drug treatment: Continuing care worker perceptions

Enhanced detection of Mycobacterium Tuberculosis using nanogold-based silver staining enhancement

BackgroundTuberculosis (TB) is a global health challenge from a single infectious agent, Mycobacterium tuberculosis (MTB), and it demands improved diagnostics and therapies.ObjectiveThis work explored a novel method for detecting MTB by combining nanogold labeling (NGL) technology with silver staining to enhance sensitivity and specificity.MethodsNanogold particles (NGPs) were characterized using ultraviolet absorption spectroscopy (UVAS), and their morphology was observed via transmission electron microscopy (TEM). The silver staining enhancement (SSE) system was optimized for a reaction time of 11 min. Fifty drug-resistant tuberculosis (DRT) patients were randomly assigned to a control (Ctrl) group receiving conventional nursing and an experimental (Exp) group treated with continuous nursing intervention (CNI). Quality of Life Instrument for Tuberculosis Patients (QLI-TB) scores were compared over 6 months.ResultsUnmarked NGPs were evenly distributed, while labeled NGPs maintained complete morphology with a gray halo. The detection limit was established at 0.582, reaching as low as 1 pmol/L. For sputum specimens, detection rates were 38.7% for culture, 41.94% for PCR, and 43.54% for nanogold SSE, with no significant differences (P > 0.05). However, patients in the Exp group exhibited significant improvements in physical, psychological, and social functions, as well as the tuberculosis-specific module (TSM) compared to the Ctrl group (P < 0.05).ConclusionsWe demonstrated an innovative method for detecting MTB, demonstrating promising results through method optimization and analysis.

The continuing care project: A multi-arm randomised controlled trial of a continuing care telephone intervention following residential substance use treatment

BACKGROUND

Previous research suggests telephone-delivered continuing care interventions are effective in reducing rates of substance use. This study assessed the effectiveness of telephone-delivered continuing care for people who had stayed in a residential alcohol and other drug (AOD) treatment facility for at least 4-weeks.

METHODS

Participants were 277 (20 - 71 years; M = 38 years, SD = 10.4; 58 % male) individuals attending residential AOD treatment. Following discharge participants were randomised to: i) 12 weekly telephone sessions; ii) 4 weekly telephone sessions; or iii) no telephone sessions (control group). A multi-centre prospective, randomised, open, blinded endpoint (PROBE) design compared three study arms with follow up at 3- and 6-months. Primary outcome was the odds of complete abstinence and the days of AOD use for those not completely abstinent at 6-months.

RESULTS

At 6-months follow-up, the odds of being completely abstinent in the past month was not significantly different between the three study arms (p > 0.6) and the number of days abstinent was not significantly different (p > 0.4). Participants across all arms were more likely (p <  0.001) to be completely abstinent compared to baseline [12-session OR = 12.86 (5.4, 30.9); 4-session OR = 9.52 (4.0, 22.4); Control OR = 7.02, (3.4, 14.7)].

CONCLUSIONS

The results suggest that the residential programs are associated with positive long-term impacts among participants who complete at least 4 weeks of treatment. Further continuing care research should include those who do not remain in treatment for at least 4 weeks, as they may be likely to benefit the most.

Exploring and describing alcohol harm reduction interventions: a scoping review of literature from the past decade in the western world

CONTEXT

Regular alcohol use is a predominant risk factor for disease, injury, and social harm. While robust evidence is advocating for implementing interventions to reduce the harms of illegal substance use, less literature is dedicated to identifying and understanding interventions aiming at reducing the various harms associated with alcohol.

OBJECTIVES

This review describes how alcohol harm reduction (AHR) interventions are currently conducted and analyzes the facilitators and barriers identified by the studies on their efficacy.

METHOD

This scoping review with evidence appraisal included articles published between 2011 and 2022, addressing one or more AHR interventions for population of at least 18 years (including alcohol user who have an addiction but also alcohol user with harmful drinking), conducted in North industrialized countries (Europe, Nort America, Australia).

RESULTS

Among the 61 articles selected, we identified several forms of support (face-to-face or remote, support in residential settings, structural interventions, and interventions created upon spontaneous initiatives), and strategies of intervention were also analyzed (the ones based upon learning and skill development, the ones based upon psychological support, the ones focusing upon socio-economic conditions, strategies focusing on the coordination and adaptation of the care system, and those strategies based on peer support). The facilitators linked to fundamental characteristics of the interventions were the promotion of empowerment and autonomy of beneficiaries, setting objectives tailored to individual needs, professionals harmonizing their values, evidence-based interventions taking into account cultural contexts, and comprehensive and holistic support. Practical facilitators from the intervention process consist of increasing the number of sessions, involvement, and formation of members of staff, disposing of the necessary resources, and using technological tools.

DISCUSSION

The sheer variety of AHR interventions demonstrates that this is a fertile field in terms of intervention design and innovation. This work illustrates the importance of designing effective, adapted harm reduction interventions, prioritizing interventions that make support more accessible to more people. This also prompts us to consider the potential benefits of invoking proportionate universalism in the design of AHR interventions in order to operationalize alcohol harm reduction philosophy. accessible to more people.

Feasibility and preliminary results of a call centre delivered continuing care intervention following residential alcohol and other drug treatment

INTRODUCTION

To help reduce relapse rates following alcohol and other drug (AOD) treatment, continuing care interventions have been recommended. Previous continuing care interventions have incorporated telephone and face-to-face sessions to help promote participant engagement. The study was conducted as a randomised controlled feasibility study and examined a call centre delivered continuing care intervention for people leaving residential rehabilitation services.

METHODS

Participants were attending AOD residential treatment services in NSW, Australia (N = 154). Participants were randomised to either 12- or 4-sessions of continuing care. Follow up assessments were completed at 6-months. The primary outcomes were demand and implementation. Secondary outcomes were AOD use, mental health and physical health at 6-months.

RESULTS

Interest in continuing care was high, with 93% of participants approached reporting an interest in being involved. Of the participants who completed the consent and baseline procedures, 29% of people were contacted post residential treatment and randomised. For those people randomised, the average number of sessions completed was 2.78 (SD = 1.65) for the 4-session arm and 4.81 (SD = 4.46) for the 12-session arm. Fidelity to the treatment manual was high. Both treatment arms showed higher complete abstinence at 6-months compared to baseline (12-session OR 28.57 [2.3, 353.8]; 4-session OR 28.11 [3.6, 221.2]).

DISCUSSION AND CONCLUSIONS

A major challenge associated with the call centre approach was re-engaging participants once they left the residential facility and delivering the planned dose of treatment. Further work is required to promote greater uptake of these protocols once people leave residential treatment.

Factors associated with problematic substance use before and during the COVID-19 pandemic among a drug addiction recovery cohort: A prospective study in the Netherlands, Belgium, and UK

BACKGROUND

The COVID-19 pandemic and measures have placed various burdens on societies and individuals. Emerging evidence suggests that people in drug addiction recovery were negatively affected. This study investigates whether risk and protective factors associated with return to problematic substance use differed between the periods before and during the pandemic for those in recovery.

METHODS

A convenience sample of persons in drug addiction recovery for at least three months completed an assessment at baseline before the pandemic (T0, N = 367) and at two consecutive follow-ups 12 months apart (T1, N = 311; T2, N = 246). The final follow-up took place during the pandemic (2020-2021). We analyzed rates and predictors of problematic substance use in both periods, and whether relations between predictors and problematic use differed between the periods.

RESULTS

Rates of problematic use did not differ significantly before and during the pandemic for those who were followed-up. However, the relationship between problematic use and commitment to sobriety differed between both periods (OR = 3.24, P = 0.010), as higher commitment was only associated with lower odds of problematic use during (OR = 0.27, P < 0.001), but not before, the pandemic (OR = 0.93, P = 0.762). In both periods, persons who were engaged in psychosocial support had lower odds of problematic use.

CONCLUSIONS

The COVID-19 pandemic was not followed by significant return to problematic substance use in a cohort of people who were already in drug addiction recovery for some time before the pandemic. However, with restricted access to environmental resources, they may have been more dependent on internal motivations. Targeting personal recovery resources with interventions could therefore reduce the chances of return to problematic substance use during a pandemic.