Dissertations / Theses on the topic 'Heroin abuse Treatment Case studies'

This is an ethnographic account of peer learning among a group of heroin 'addicts' in Delhi, India. This study responds to the limited attention given to 'naturalistic' or 'informal' peer learning patterns in the educational literature, and the lack of explicit exploration of the phenomenon among drug user populations. The study involved seven and a half months of fieldwork with the predominant use of participant observation and semi-structured interviews to generate data. Analysis was inductive and interpretive with the use of situated learning theory to 'tease out' patterns in the data. The participants were using and non-using addicts affiliated to SHARAN, a non-governmental organization (NGO) in the religious marketplace of Yamuna Bazaar. The group included approximately 300-500 members, 20 of whom were main informants. Analysis of the group organization revealed community-based and masculinity-based characteristics that enabled the group to manage stigma, promote 'positive' ideals, and co-construct nonhegemonic masculinities. Peer-based outreach was identified as a form of 'institutional' peer learning in which peer educators performed the roles of 'doctor', 'role model', and 'counsellor' during interactions with 'clients' that had the effect of disempowering clients in many cases. The practice of poetry in which peers created couplets in alternating exchanges was identified as one form of naturalistic peer learning that entailed processes of legitimate peripheral participation, meaning negotiation, and reflective learning. Street 'doctory' in which peers provided medical care in the form of procedures, illness discussions, and health consultancy was identified as another naturalistic peer learning pattern involving processes of legitimate peripheral participation, meaning negotiation, and learning through teaching. These findings suggest that naturalistic peer learning involved co-participatory processes that manifested in a diversity of everyday practices. It is recommended that engaging these processes and practices would be useful for interventions, while further research should explore such patterns in other contexts.

Includes abstract.
Includes bibliographical references (leaves 90-93).
This study is an examination of the structures and functions of an unregistered faith-based substance abuse treatment facility, the Recovery Home, run by a Church in Mitchells Plain, a historically disadvantaged community (HDC) in the Western Cape. In addition, the challenges that the Organisation faces in meeting the policy requirements set by the Department of Social Development (DoSD) to obtain accreditation by subscribing to evidence-based practices for an in-patient treatment centre are the main issues upon which this research is structured. Information was collected, through a qualitative case study approach. Methods used were the in-depth interview, observation, documentary research relevant to the registration process and a confidential journal exercise conducted with people being treated in the Recovery Home. A lack of resources and evidence-based practices prevents the Recovery Home from providing adequate treatment services. The Organisation is unable to register as it does not meet the minimum norms and standards set by the Department of Social Development (DoSD) to acquire accreditation. It has been suggested by the relevant authorities that the Organisation fits the description of a half way house. However, no official policy for the registration of such insitutions currently exists in South Africa. The Home's definition of the causes of substance use disorders (SUDs) is inadequate in that it is limited to environmental factors, most particularly the unfavourable socio-economic conditions that prevail in the community. The Organisation is providing a valuable service in a community where the state lacks effective intervention capacity. As it is unable to register, however, it remains limited in what it is able to achieve.

The purpose of this research was to understand the lived experience of a person with a substance addiction that uses or has used alternative therapies for treatment. A single-case study approach was used to understand the lived experiences of Jason, a male in his mid-forties who is healing from a substance addiction. Through in-person interviewing and reading personal manuscripts written by the participant, data were collected. The data were analysed and interpreted using phenomenological and integral hermeneutics. Through the interpretations, it was clear that a major contributing factor to Jason’s drug use was the negative experiences he was carrying from his past. Once he was able to let go of the negativity and let his higher power guide him, his healing journey took a positive turn. Today, Jason lives in the moment and does not need drugs to heal the hurt he is feeling inside. He uses his ultimate alternative method, derived from within himself, to guide his journey in recovery.
viii, 155 leaves ; 29 cm

The purpose of this study was to identify barriers to psychotropic adherence regimens in clients with Severe and Persistent Mental Illness (SPMI). Medication non-adherence perpetuates the cycle of psychotic episodes, which leads to rehospitalization, incarceration, and homelessness.

Ho Man Choi.
Thesis (M.Phil.)--Chinese University of Hong Kong, 2006.
Includes bibliographical references (leaves 178-215).
Abstracts and appendices in English and Chinese.
ACKNOWLEDGEMENT --- p.ii
ABSTRACT --- p.iii
研究摘要 --- p.vi
Chapter CHAPTER 1 --- INTRODUCTION
Chapter 1.1. --- Heroin --- p.1
Chapter 1.1.1. --- Manufacture --- p.1
Chapter 1.1.2. --- Administration --- p.2
Chapter 1.1.3. --- Physical and Psychological Effects --- p.4
Chapter 1.1.4. --- Heroin Metabolism --- p.5
Chapter 1.1.5. --- Treatments for Heroin Dependence --- p.6
Chapter 1.2. --- Opioids and Analgesia --- p.8
Chapter 1.2.1. --- Pain Transmission --- p.8
Chapter 1.2.2. --- Pain Modulation and Endogenous Opioid System --- p.9
Chapter 1.2.3. --- Clinical Application of Opiates in Pain Management --- p.11
Chapter 1.2.4. --- Narcotics and Pain --- p.11
Chapter 1.3. --- Biological Basis of Drug Addiction --- p.12
Chapter 1.3.1. --- Mesocorticolimbic Reward System --- p.13
Chapter 1.3.2. --- Molecular Neurobiology of Drug Addiction --- p.16
Chapter 1.3.2.1. --- "Cyclic Adenosine-3',5'-Monophosphate and Protein Kinase A" --- p.16
Chapter 1.3.2.2. --- Transcription Factors: cAMP-Response Element Binding Protein and Delta-Fos B --- p.18
Chapter 1.3.2.3. --- Neurotrophic Factors --- p.23
Chapter 1.4. --- Biological Basis of Relapse --- p.25
Chapter 1.4.1. --- Environmental Stimuli --- p.26
Chapter 1.4.2. --- Drug Re-exposure/Priming --- p.26
Chapter 1.4.3. --- Acute Stress Exposure --- p.27
Chapter 1.5. --- Gene Polymorphisms and Opioid Dependence --- p.30
Chapter 1.5.1. --- Opioidergic System --- p.31
Chapter 1.5.2. --- Dopaminergic System --- p.36
Chapter 1.5.3. --- Serotoninergic System --- p.41
Chapter 1.5.4. --- Noradrenergic System --- p.43
Chapter 1.5.5. --- GABAergic System --- p.44
Chapter 1.6. --- Aim of Research --- p.45
Chapter CHAPTER 2 --- METHODS OF STUDY
Chapter 2.1. --- Subject Recruitment and Demographic Data Collection --- p.49
Chapter 2.1.1. --- Heroin-dependent Subjects --- p.49
Chapter 2.1.1.1. --- Phenotype Assessment --- p.49
Chapter 2.1.1.2. --- Socio-demographics Data and Substance Use History --- p.50
Chapter 2.1.1.3. --- Addiction Severity Index (ASI) --- p.51
Chapter 2.1.1.4. --- History of Detoxifications and Relapse --- p.51
Chapter 2.1.2. --- Control Subjects --- p.51
Chapter 2.2. --- Pain Response Assessment using Cold-Pressor Test (CPT) --- p.52
Chapter 2.3. --- Personality Trait Assessment --- p.53
Chapter 2.4. --- Genotype Analysis --- p.55
Chapter 2.4.1. --- DNA Extraction --- p.55
Chapter 2.4.2. --- Genotyping --- p.56
Chapter 2.4.2.1. --- MORA118G --- p.56
Chapter 2.4.2.2. --- DOR T921C --- p.56
Chapter 2.4.2.3. --- COMTVal108/158Met --- p.57
Chapter 2.4.2.4. --- Prodynorphin 68bp-VNTR --- p.58
Chapter 2.4.2.5. --- DRD2 TaqI A --- p.59
Chapter 2.4.2.6. --- DRD4 -521C/T --- p.59
Chapter 2.4.2.7. --- 5HT1B G861C --- p.60
Chapter 2.5. --- Saliva Collection and Salivary Cortisol Measurement --- p.61
Chapter 2.6. --- Statistical Analysis --- p.62
Chapter CHAPTER 3 --- RESULTS
Chapter 3.1. --- Demographics --- p.64
Chapter 3.1.1. --- Age --- p.64
Chapter 3.1.2. --- Ethnicity --- p.64
Chapter 3.1.3. --- District of Residence and Type of Housing --- p.64
Chapter 3.1.4. --- "Education, Employment and Income" --- p.68
Chapter 3.1.5. --- ASI Scores --- p.71
Chapter 3.1.5.1. --- Family/Social Relationship --- p.71
Chapter 3.1.5.2. --- Employment and Support Status --- p.73
Chapter 3.1.5.3. --- Medical Status --- p.73
Chapter 3.1.5.4. --- Legal Status --- p.75
Chapter 3.1.5.5. --- Psychiatric Status --- p.75
Chapter 3.1.5.6. --- Drug Use Status --- p.76
Chapter 3.1.5.7. --- Alcohol Use Status --- p.79
Chapter 3.1.6. --- Tranquillizer Use Status --- p.79
Chapter 3.1.7. --- Smoking Status --- p.81
Chapter 3.1.8. --- Detoxification and Relapse --- p.83
Chapter 3.2. --- Cold-Pressor Test (CPT) --- p.88
Chapter 3.3. --- Personality Traits --- p.90
Chapter 3.3.1. --- NEO PI-R --- p.90
Chapter 3.3.2. --- BIS/BAS --- p.93
Chapter 3.3.3. --- SSS-V --- p.93
Chapter 3.4. --- Salivary Cortisol Levels --- p.93
Chapter 3.5. --- Genotype and Allele Frequencies of Gene Polymorphisms --- p.96
Chapter 3.5.1. --- MOR A118G Polymorphism --- p.96
Chapter 3.5.2. --- DOR T921C Polymorphism --- p.96
Chapter 3.5.3. --- COMT Val108/158Met Polymorphism --- p.99
Chapter 3.5.4. --- Prodynorphin 68bp-VNTR --- p.99
Chapter 3.5.5. --- DRD2 TαqI A Polymorphism --- p.102
Chapter 3.5.6. --- DRD4 -521C/T Polymorphism --- p.102
Chapter 3.5.7. --- 5HT1B G861C Polymorphism --- p.105
Chapter 3.6. --- "Association of Gene Polymorphisms, Personality Traits and CPT" --- p.105
Chapter 3.7. --- Association of Gene Polymorphisms and CPT --- p.108
Chapter 3.7.1. --- COMT Val108/158Met Polymorphism --- p.108
Chapter 3.7.2. --- DRD4 -521C/T Polymorphism --- p.108
Chapter CHAPTER 4 --- DISCUSSIONS AND CONCLUSIONS
Chapter 4.1. --- Demographics and Potential Environmental Factors of Relapse --- p.111
Chapter 4.1.1. --- Medical and Psychological Status --- p.114
Chapter 4.1.2. --- Substance Use Status --- p.116
Chapter 4.1.3. --- Detoxification and Relapse --- p.118
Chapter 4.2. --- Cold-Pressor Test (CPT) --- p.121
Chapter 4.3. --- Personality Traits --- p.123
Chapter 4.4. --- Salivary Cortisol --- p.125
Chapter 4.5. --- "Association of Gene Polymorphisms, Personality Traits and Cold-Pressor Test" --- p.127
Chapter 4.5.1. --- MORA118G Polymorphism --- p.127
Chapter 4.5.2. --- DOR T921C Polymorphism --- p.129
Chapter 4.5.3. --- COMT Val108/158Met --- p.130
Chapter 4.5.4. --- Prodynorphin (ProDYN) 68bp-VNTR --- p.133
Chapter 4.5.5. --- DRD2 A Polymorphism --- p.134
Chapter 4.5.6. --- DRD4 -521C/T Polymorphism --- p.138
Chapter 4.5.7. --- 5HTlB G861C Polymorphism --- p.141
Chapter 4.5.8. --- Personality Traits --- p.142
Chapter 4.6. --- Limitations --- p.144
Chapter 4.7. --- Potential Clinical Application --- p.145
Chapter 4.8. --- Conclusion --- p.146
APPENDIXES --- p.148
APPENDIX 1 Addiction Severity Index (ASI) with Additional Questions for Heroin Users
APPENDIX 2 Detoxification and Relapse History Questionnaire
APPENDIX 3A Questionnaire for Control Subjects (Chinese version)
APPENDIX 3B Questionnaire for Control Subjects (English version)
APPENDIX 4A NEO PI-R (Chinese version)
APPENDIX 4B NEO PI-R (English version)
APPENDIX 5A BIS/BAS (Chinese version)
APPENDIX 5B BIS/BAS (English version)
APPENDIX 6A SSS- V (Chinese version)
APPENDIX 6B SSS- V (English version)
REFERENCES --- p.178

The purpose of this study was to gain a better understanding of how a problem-determined system developed around a case of drug addiction within the context of a system of relatedness. The epistemological framework informing this qualitative study was constructivism. The six participants who took part in the study represent the most prominent role players in the particular context of living. The individual battling with drug addiction, his parents, older sister, maternal grandmother and maternal aunt were interviewed. The methods of data collection employed were semi-structured interviews, a family-chronological event chart, genograms, and an eco-map. The interviews were interpreted using the hermeneutic approach. The different themes that emerged from each participant’s story were integrated in relation to each other and with respect to the collaborative sources of data. The most dominant themes extracted within this study are the initial reactions to Andrew’s drug addiction, life changes experienced due to Andrew’s drug addiction, support, as well as the meanings attributed to Andrew’s drug addiction. Further research into problem-determined systems in different cultures is recommended.
Psychology
Thesis (M.A. (Clinical Psychology)) Psychology

In South Africa, substance use, abuse and dependency is twice the world norm. To address this trend, the continuum of care guides legislative prescriptions for the treatment of a substance use disorder. This study aimed to address the lack of a description of the utilisation thereof in literature and recent research findings. A qualitative approach was followed and purposive sampling was employed to collect data from both service providers and users of services. Tesch’s framework for qualitative data analysis (Creswell, 2014:218) was used to identify themes, sub-themes and categories, while the data was compared with existing literature on the identified themes. The trustworthiness of the findings was enhanced by the verification of the data through aspects of credibility/authenticity, transformability, dependability and conformability (Schurink, Fouché and de Vos, 2011:397). Informed consent, confidentiality , non-compensation, debriefing of participants, and the management of information were considered to ensure ethical practice.
Social Work
M.A.(S.S.)

Substance abuse is a significant challenge facing the World and in particular South Africa. In this study, various Western and African traditional perspectives were considered to gain an understanding of the substance abuse problem among adolescents. The study was conducted in one of the rural villages of the Ramotshere Moiloa Local Municipality in the North West Province of South Africa. Participants included 24 African male and female adolescents between 13 and 19 years of age, as well as 2 parents and 9 professionals. The 9 professionals are educators, a social worker, a clinical psychologist, a mental health worker, a traditional leader and a traditional healer, between 37 to 53 years of age. A qualitative, explorative research design was employed. Data sources included individual face-to-face interviews, focus group discussions, and a document review. Thematic analysis was employed to analyse data. The findings were based on the perceptions of participants and revealed that adolescents are socially entrapped to substances such as alcohol, tobacco, cannabis, cocaine, glue, nyaope, and segonyamahlo. Reasons for their use of substances included individual, family, and environmental factors. The findings revealed the severe impact of substance abuse on adolescents and their families. There was evidence of primary, secondary, and tertiary levels of substance abuse prevention programmes targeting adolescents and other community members. In addition, stakeholders such as parents, peers, professionals, traditional leaders, traditional healers, government, and non-government organisations were recommended to implement substance abuse prevention programmes to address the substance abuse problem among adolescents. Furthermore, the study highlighted efforts made to reflect on the implemented substance abuse prevention programmes.
Psychology
D. Phil. (Psychology)

Background: Drug rehabilitation is crucial for drug addicts. As much as drug rehabilitation (rehab) centres are helping in dealing with drug addiction. Some drug addicts may find that some of the drug rehabs do not meet their needs. Therefore, the study explored the experience of caregivers caring for nyaope addicts. Method: This study adopted a qualitative research approach and a case study design. The purposive sampling method was employed to select the sample. The sample comprised six caregivers. The structured interview and open-ended questionnaire were employed to collect data. An interview questionnaire was designed allowing the participants to respond at home and provide feedback. Their responses provided through this process were insufficient, participants were then requested face-to-face interviews and they agreed. Results: One of the main findings in this study was that caregiving affects the caregivers negatively. Caregiving has led to psychological and physical effects amongst the caregivers. Conclusion: A need was identified for support and awareness for the caregivers and rehabilitation centres in South Africa. This might reduce the relapse of substance abuse and help eradicate the number of substance abusers in South Africa.
Psychology
M.A. (Psychology (Research Consultation))

Substance abuse among university students is increasing globally. Nigeria, with her peculiar class of university students who are younger than global average is not left out. This paper reports a qualitative Intervention research that utilized narrative inquiry instrument to explore the interface of substance abuse issues, disciplinary dilemmas and family involvement at a private university in Nigeria. This research identified challenges and concerns amongst administrators, parents, students and student support services staff. Primary Socialization and Critical theories formed the theoretical backdrop for the research. The participants in the study were members of administration and disciplinary committee (n=10). Parents (n=10), students (n=20) and student support staff (n=10). The findings showed early onset of substance abuse at an average age of 17, which coincides with the average of entry into Nigerian universities. Alcohol and Marijuana was the most preferred drug of choice. 50% of the student participants had family history of substance abuse involvement and 80% was alcohol use. Parental responses such as reduced levels of trust, strained relationships and withdrawal of support and privileges were motivators for students to engage in treatment. Implementation of institutional disciplinary measures for involvement of student with substance abuse such as suspension or expulsion was also indicated as motivators to engage in treatment and maintenance of sobriety, however both parents and students identified the provision of services such as drug screening, counseling and family conferences as having long term impact on staying sober. Both parents and students recommended strict monitoring measures to reduce the incidences of substance abuse on the university campus. The Nigerian cultural value and above global average of parental involvement was a strength that informed the recommendation for a collaborative approach between the university and families of students involved with substance abuse. The responses of university administrators indicated struggles between service and disciplinary responses. The study concluded by proposing a model of approach with practice guidelines for a collaborative approach between the university and families of students involved with substance abuse. Collaborative „junctions‟ with parents were delineated without compromising the institutional policy on substance abuse.
Social Work
D. Phil. (Social Work)

Bestaande navorsing aangaande die terapeutiese intervensie met die dwelmafhanklike adolessent is beperk, veral navorsing wat fokus op die bewuswordingsproses tydens die terapeutiese intervensie. In hierdie studie is gepoog om die benuttingswaarde van Gestalthulpmiddels ten opsigte van die verhoging van bewuswording by die dwelmafhanklike adolessent, tydens die terapeutiese proses vas te stel. Die navorsingsproses is deur kwalitatiewe navorsing gering om in hierdie doel te slaag. Die navorsingsinligting is met behulp van 'n uitgebreide literatuurstudie, asook deur middel van die waarneming en bestudering van twaalf gevallestudies bekom. Die benuttingswaarde en die toepassingsmoontlikhede van die Gestalthulpmiddels binne die Gestaltterapeutiese proses met die dwelmafhanklike adolessent, is verken en beskryf. Deur middel van die prossesering en integrering van die bevindinge wat tydens die empiries ondersoek verkry is, kon die data vir praktiese doeleindes toegepas word. 'n Riglyn wat vir die verhoging van bewuswording by die dwelmafhanklike adolessent gebruik kan word is aanbeveel. SUMMARY Existing research on the therapeutic intervention with the drug-addicted adolescent is limited, especially research that focused on the awareness process during therapeutic involvement. This study attempt to determine the face value of Gestalt helping aids throughout the improved awareness of the drug-addicted adolescent during the therapeutic process. A qualitative research approach was followed to achieve this goal. The research data is gained by a detailed literature study, as well as by the observation and study of twelve case studies. The value and the possibilities of application of the Gestalt helping aids in the Gestalt therapeutic process with the drug-addicted adolescent, is examined and described. By processing and integrating the assumptions obtained during the empirical study, the data could have been practically applied. As suggested out of this study a guideline can be developed for the improvement of awareness of the drug addicted adolescent.
Social work
M.Diac (Play Therapy)

Text in English
The rationale for the study was to investigate the symbiotic connection of trauma and addiction. The focus is on childhood trauma and the turn to addictive practices to quell the memories and experiences endured as children. Chapter One discusses the methodology regarding the approach of the study and includes an introductory literature review of the phenomena. Additional literature is included in the ensuing chapters. A personal account of the motivation behind the research is chronicled in Chapter Two. In this chapter, I share with the readers my personal experiences around trauma and addiction in my family of origin. The notion of the blending of trauma and addiction is the focus of Chapter Three. It includes the approach to treatment of trauma and addiction as well as addiction counsellor training in the South African context. The storied lives of the participants and their experiences of trauma and addiction are encapsulated in Chapter Four. Finally, Chapter Five rounds off the study with the analyses of the narratives of the unique individuals who contributed to this research undertaking.
Psychology
M.A. (Psychology)