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Classification and diagnosis: ICD-10 and DSM-5 and their application to substance use disorders in young people
Published in Ilana B. Crome, Richard Williams, Roger Bloor, Xenofon Sgouros, Substance Misuse and Young People, 2019
In recent years, we have experienced the emergence of several new substances, the so-called ‘designer or club drugs’, which have found wide use especially among the adolescent population (Crowley, 2006). This pharmacologically diverse group of substances were categorised together only because of the social circumstances of their introduction to the drug culture. Responding to the growing prevalence of the use of these drugs, it was suggested that clinicians and patients could benefit from DSM-5-related post-publication procedures for classifying emerging new substances into its categories (ibid.). Despite the inclusion of a category of Unspecified, Other, or Unknown Substance Related Disorder, DSM-5 does not appear to address this issue. The issue is partially addressed in the recent publication of ICD-11, which includes separate categories for 3, 4-methylenedioxymethamphetamine (MDMA, ecstasy), synthetic cannabinoids, synthetic cathinones and dissociative substances (www.icd.who.int/browse11).
Prognosis
Published in Albert A. Kurland, S. Joseph Mulé, Psychiatric Aspects of Opiate Dependence, 2019
Albert A. Kurland, S. Joseph Mulé
Comparative studies of long-term and shortterm withdrawal of narcotic addicts voluntarily seeking comprehensive treatment have indicated that there is relatively little difference between either of these approaches. In the 21-day detoxification program, it was found that the great majority of patients attempting to pursue this course relapse into heroin use very quickly, with at least two thirds of all addicts returning to heroin use before the end of a 21-day detoxification period and 95% or more returning to heroin within 3 months following detoxification.11 Moreover, some authorities11 have stressed the fact that giving up heroin is impossible without making changes in the life style that will remove the addict from his friends and associates that are still enmeshed in the drug culture. Other negative influences are poor economic conditions, failure to secure employment, continued loss of self-esteem, the use of other drugs and alcohol, the lack of a stable home environment, and inability to cope with the prejudices of the community against addicts and ex-addicts.
Characteristics Of Dependence On And Abuse Of Psychoactive Drugs
Published in S.J. Mulé, Henry Brill, Chemical and Biological Aspects of Drug Dependence, 2019
A very common misinterpretation of drug abuse is that it is an invariable sequel to drug dependence. Since nearly every individual is dependent upon some nonfood substance or drug, dependence is equated in societal terms as “drug culture.” Such commonality of meaning lends admirably to the sequence: drug dependence (meaning self-administration of any drug) → “drug culture” (everyone dependent on something) → drug abuse (individual and social harm). With this illogic, “drug culture” becomes a wastebasket of banalities which is a convenient accounting device for explaining all of the ills which plague society.
CARES: an innovative approach to treating adolescents with co-occurring mental health and substance use disorders
Published in Children's Health Care, 2023
Shilpa R. Taufique, Rachel E. Weller, Brandon Johnson, Jennifer Herring
The densely populated urban communities served by CARES have high rates of unmet substance use, mental health, and physical health needs. The families in these communities face multiple barriers to treatment. Over 70% of our target population live in federally designated “low primary care access areas.” Widespread poverty and limited or lacking insurance coverage represent typical barriers to accessing care. Prevailing beliefs, norms, and values in the communities about drug use, mental health and substance abuse treatment, the education system, and the health care system in general have a significant negative impact on treatment and prevention efforts. Many of our target youth live in communities where drug culture is entrenched and normalized, and mental health problems are unidentified and unaddressed. High levels of stigma related to mental health and substance treatment needs often create additional barriers and prevent individuals and families from seeking care due to concerns about privacy and family honor. Lack of trust in the health care system, education system, and governmental agencies, as well as cultural barriers, create significant roadblocks to seeking and accessing care. In addition, the typical CARES patient represents the complexity of multiple stressors – they are at risk of failing or dropping out of high school; they are classified as Seriously Emotionally Disturbed; they are struggling with significant behavioral difficulties, academic issues, social/emotional challenges, and/or legal problems.
Beyond ketamine: narratives of risk among young psychoactive drug users in Hong Kong
Published in Journal of Substance Use, 2021
There are several limitations to the study. First, the research focused mainly on habitual drug users recruited through the channels of treatment and rehabilitation organizations. Hence, this sample is not representative, and our findings cannot be generalized to the wider population of drug users in Hong Kong. Future research should explore potential differences in the perceptions of drug use between habitual and occasional drug users in the context of a changing drug culture. Second, the period of data collection of the present study (from September to December 2017) confined the scope of our analysis to the drug scene during methamphetamine was still the most popular drug among young users. As noted above, the drug scene of Hong Kong is changing continuously in recent years. According to the latest CRDA figures, the percentage of reported individuals aged under 21 who had used methamphetamine drops steadily since 2017, while the figures for cocaine and cannabis are gradually on the rise (Narcotics Division, 2019b). It is indeed a great challenge for drug researchers and policy makers to respond swiftly to this ever-changing drug scene. To be better prepared for possible changes in the adolescent drug scene, we must enhance our understanding of the drug user population by collecting more empirical evidence in the future. On top of the existing periodic survey on drug use among students in Hong Kong (Narcotics Division, 2019a), conducting qualitative studies at a regular interval could be another useful channel to probe into the changing adolescent drug culture in greater depth.
Combining Alcohol with Benzodiazepines or Psychostimulants. Metaphoric Meanings and the Concept of Control in the Online Talk of Polydrug Use
Published in Journal of Psychoactive Drugs, 2019
Kati Kataja, Jukka Törrönen, Pekka Hakkarainen, Petteri Koivula, Christoffer Tigerstedt, Sanna Hautala
The Internet has become an essential part of drug culture, being a terrain of communication about drug use that enables individuals to disseminate and obtain drug information (e.g. Manning 2014; Murguía, Tackett-Gibson, and Lessem 2007). In online communication, different linguistic meaning making and interpretational strategies, for example metaphors, considering drug use have an essential role (Rosino and Linders 2015). These metaphors do not merely describe the pre-existing realities of drug use but “enact” or “perform” them (Mol 2002). The metaphor can be seen as one of the basic tools in the making and remaking of realities (Moore et al. 2015). Since the realities of drug use vary according to the different social backgrounds and circumstances of users, metaphors of drug use are not singular but multiple and diverse or even contradictory and conflicting (Dwyer and Moore 2013).