The Ohio Substance Abuse Monitoring Network: constructing and operating a statewide epidemiologic intelligence system

Employment services and substance abuse treatment

This qualitative study of over 800 participants focused on the employment experiences of consumers of substance abuse treatment programs to provide a better understanding of what employment services are offered and what needs treatment agencies have in the area of employment services, examining barriers and facilitators from both the consumer and provider perspectives. Data were collected via a mixed research methodology of focus groups and surveys from July 2015 through June 2016 in a large Midwestern U.S. state. Employment is a challenge for persons with substance use disorders. Only a quarter of this study's large sample of substance abuse treatment consumers reported being cur-rently employed; and of those consumers who reported no current employment, greater than half reported that their current unemployment was due to their substance use. Persons receiving substance abuse treatment face many challenges in obtaining and maintaining employment. Treatment providers identified several barriers to implementation of employment services. They named an array of resources as needed, including increased funding for supportive employment programs and staff appropriate to the delivery of employment services. Some providers believed employment services to fall outside of their scope of practice. Data generated through this study may inform policy to invest resources in employment services within substance abuse treatment settings.

Initiation to Pharmaceutical Opioids and Patterns of Misuse: Preliminary Qualitative Findings Obtained by the Ohio Substance Abuse Monitoring Network

Pharmaceutical opioid misuse has been recognized as a growing public health problem across the nation. To develop appropriate treatment and prevention programs, the population of pharmaceutical opioid abusers has to be well understood. This exploratory study is based on qualitative interviews with 24 people in the Dayton/Columbus, Ohio, area. Interviews were conducted for the Ohio Substance Abuse Monitoring Network, a statewide epidemiological surveillance system. Participants ranged in age from 18 to 48 years; the majority was White and male. To explain initiation and continued use of pharmaceutical opioids, participants discussed a number of different reasons, including self-medication of emotional and physical pain, legitimate medical prescriptions related to chronic pain management, social influences, recreation, and easy access to pharmaceutical opioids. On the basis of participant age and lifetime experiences with pharmaceutical opioid and other drug misuse, six user groups were identified that faced unique risks and prevention/treatment challenges. Research implications are discussed.

Reflections on 40 Years of Ethnographic Drug Abuse Research: Implications for the Future

This paper focuses on past, present, and potential future contributions of ethnographic research to describing and understanding “street cultures” of drug use and the implications these have for informing various interventions. The first section provides an overview of ethnography and drug abuse research. This is followed by a historical perspective on the ethnography of street cultures. Next, the significance of ethnographic drug abuse research is highlighted, with a focus on its methodology. Ethnographic contributions to the development, implementation, and evaluation of interventions are discussed, including ethical issues. Subsequently, the interdisciplinary nature of ethnographic drug abuse research is described. Methodological challenges emerged over time as the definition of street cultures and drug trends shifted. These are illustrated with examples, including the use of prescription drugs, new heroin users, and rural drug and methamphetamine use. The final sections focus on career opportunities for ethnographers and opportunities and barriers for the future. We address training needs for interdisciplinary inquiry, the potential role of ethnographers in prevention and treatment research, and the link to studies on the brain and genetics. The future of ethnographic research on drug use will be influenced by the funding structure. We conclude with a summary of reflections on the past and aspirations for the future.

When the drug of choice is a drug of confusion: embalming fluid use in inner city Hartford, CT

This paper examines the use of a new illicit drug--embalming fluid mixtures--in Hartford, CT based on a recent assessment of drug consumption in an outreach-recruited sample of 242 not-in-treatment active drug users. Sociodemographic, drug use, and health and social problems of drug users who do and do not use embalming fluid mixture are presented, revealing some notable differences between these two groups of street drug users. Despite regular consumption, we report that embalming fluid mixture users are often uncertain about what is in this new drug, despite experiencing often powerful effects. Urine toxicology findings from a subsample of individuals who used embalming fluid mixtures in the last 48 hours, reveal the frequent presence of phencyclidine (PCP) as well as other drugs. The public health implications of this new wave of PCP use are assessed.

The South African Community Epidemiology Network on Drug Use (SACENDU): description, findings (1997-99) and policy implications

AIMS

To (1) describe the South African Community Epidemiology Network on Drug Use (SACENDU), (2) describe trends and associated consequences of alcohol and other drug (AOD) use in South Africa for January 1997 to December 1999 and (3) outline selected policy implications identified by SACENDU participants.

METHODS

A descriptive epidemiological study of AOD indicators based on data gathered from multiple sources, including specialist treatment centres, trauma units and quantitative studies of target groups such as school students and arrestees. Networks were established in five sentinel sites to facilitate the collection, interpretation and dissemination of data.

RESULTS

Over time alcohol has been the most frequently reported primary substance of abuse across sites. Trauma and psychiatric data highlight the burden associated with alcohol abuse. Cannabis and Mandrax (methaqualone), alone or in combination, are the most frequently reported illicit drugs of abuse, generally comprising the largest proportions of drug-related arrests, drug-related psychiatric diagnoses and drug-positive trauma patients. From 1997 to 1999, a significant increase in indicators for cocaine/crack and heroin occurred in two sites. Ecstasy (MDMA) use, alone or in combination with other substances, is reported among young people.

CONCLUSIONS

A broad range of globally abused substances is present in South Africa and the use and burden of illicit substances appears to be increasing. This points to the importance of ongoing monitoring of AOD trends. Through regular, systematic data collection the SACENDU project has made available more evidence-based information to direct AOD abuse policy and practice and has had an impact on research agendas.