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Social and Psychological Interventions to Reduce Alcohol and Drug Use and Related Harm

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Behavior, Chronic Disease and Health Promotion".

Deadline for manuscript submissions: closed (31 March 2023) | Viewed by 34284

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Special Issue Editors

Dr. Ruth McGovern

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Chief Guest Editor

Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, NE2 4AX, UK
Interests: alcohol; drug use; children and families; psychosocial interventions; social care; public health; intervention development and evaluation

Dr. Hayley Alderson

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Assistant Guest Editor

Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, NE2 4AX, UK
Interests: drug and alcohol use; intervention development; social care; young people in care; mental health

Special Issue Information

Dear colleagues,

Alcohol and drug use are common worldwide and are associated with a range of adverse health, social and psychological outcomes for the substance user, their family and wider society. Whilst the type of substance, the level of consumption and route of administration influence the nature and extent of harms, there remains a pressing need to understand how best to respond to this substantial public health problem. Psychological and social interventions are nonpharmacological complex interventions delivered to individuals or groups that seek to tackle the psychological, social, personal and relational problems associated with substance use. There are many different psychosocial interventions, with approaches and techniques that vary according to their theoretical underpinnings. Some of these approaches intervene with the individual user to reduce their substance use or the associated risks. Others intervene with the family or on a social level, either as a means of supporting the user or to address the needs of the affected others in their own right.

This Special Issue in the International Journal of Environmental Research and Public Health is focused on a wide range of topics relating to psychological and social intervention to reduce alcohol and drug use and related harms, including reviews and empirical research on psychological and social interventions delivered to the user and affected others, examining intervention development, effectiveness and implementation.

Dr. Ruth McGovern
Dr. Hayley Alderson
Guest Editors

Manuscript Submission Information

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Keywords

drugs
alcohol
psychological intervention
social intervention
intervention development
effectiveness
implementation

Published Papers (10 papers)

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Research

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11 pages, 1428 KiB

Open AccessArticle

Towards a Dignified Death: A New Approach to Care for People Using Substances Who Are at, or Near, the End of Their Lives

by Sarah Galvani, Sam Wright and Amanda Clayson

Int. J. Environ. Res. Public Health 2023, 20(10), 5858; https://doi.org/10.3390/ijerph20105858 - 18 May 2023

Viewed by 1157

Abstract

There are no effective intervention studies for people using substances who are at, or near, the end of their lives. The needs of this group of people have been consistently overlooked even within the literature that identifies marginalised groups of people in need of greater recognition in palliative and end-of-life care. The aims of the project were to: (i) determine what a new, co-produced, model of care should look like for people using substances needing palliative and end-of-life care, and (ii) establish whether the new model had the potential to improve people’s access to, and experience of, end-of-life care. This paper presents the development of the new approach to care. It was developed using participatory action research principles over a course of online workshops during the COVID-19 pandemic lockdown period in the UK. A theory of change that aims to inform future policy and practice development is presented. While the ambition of the research was stunted by the pandemic, the process of its development and dissemination of the model and its resources has continued. Response from participants highlighted the importance of this work, however, in this new field of policy and practice, preparatory work that engages a wide range of stakeholders is crucial to its success. This relationship building and topic engagement are major parts of implementation before more substantial and sustainable development goals can be met. Full article

(This article belongs to the Special Issue Social and Psychological Interventions to Reduce Alcohol and Drug Use and Related Harm)

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16 pages, 730 KiB

Open AccessArticle

A Community-Based Therapeutic Education Programme for People with Alcohol Use Disorder in France: A Qualitative Study (ETHER)

by Marie Costa, Tangui Barré, Saskia Antwerpes, Marion Coste, Morgane Bureau, Clémence Ramier, Gwenaelle Maradan, Olivier Riccobono-Soulier, Stéphanie Vassas-Goyard, Danielle Casanova and Patrizia Carrieri

Int. J. Environ. Res. Public Health 2022, 19(15), 9228; https://doi.org/10.3390/ijerph19159228 - 28 Jul 2022

Cited by 1 | Viewed by 1995

Abstract

Therapeutic patient education (TPE) aims to help people with chronic disease strengthen their empowerment and psychosocial skills to better manage their condition. Although TPE has great potential for addiction medicine, studies on its benefits for reducing alcohol-related harms and increasing empowerment are sparse. We conducted a qualitative study of people with alcohol use disorder (AUD) who participated in the community-based TPE programme Choizitaconso to assess their perceptions and experiences of it. Semi-structured interviews were conducted with 16 participants who had completed the TPE programme at least six months previously. The interviews were transcribed and analysed using a sequential thematic analysis. We identified four general themes: (1) the context of participation: the TPE programme could be a strategy to facilitate engagement in AUD care; (2) representations and experiences: the programme helped to “normalize” participants’ relationship with alcohol use by increasing empowerment; (3) TPE strengths: improved knowledge about alcohol use, self-image, weight loss, self-stigma reduction; (4) TPE limitations: difficulty putting learning into practice after the programme ended. The Choizitaconso programme met participants’ health and psychosocial expectations, strengthening their empowerment and reducing self-stigma, thereby facilitating engagement in AUD care. Full article

(This article belongs to the Special Issue Social and Psychological Interventions to Reduce Alcohol and Drug Use and Related Harm)

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14 pages, 553 KiB

Open AccessArticle

The Beneficial Role of Involvement in Alcoholics Anonymous for Existential and Subjective Well-Being of Alcohol-Dependent Individuals? The Model Verification

by Marcin Wnuk

Int. J. Environ. Res. Public Health 2022, 19(9), 5173; https://doi.org/10.3390/ijerph19095173 - 24 Apr 2022

Cited by 5 | Viewed by 4823

Abstract

Involvement in Alcoholics Anonymous (AA) is an important psychosocial factor for the recovery of alcohol-dependent individuals. Recent studies have confirmed the beneficial role of involvement in AA for abstinence and reduction in drinking alcohol. Little is known about the mechanism underlying the relationship between involvement in AA and subjective well-being. This study aims to verify whether in a sample of Polish AA participants involvement in AA is indirectly related to subjective well-being through existential well-being consisting of hope and meaning in life. The achieved results have confirmed that involvement in AA is positively related to existential well-being, which in turn positively predicts subjective well-being including life satisfaction as well as positive and negative affect. It was confirmed that AA involvement in self-help groups indirectly via existential well-being is related to subjective well-being. Theoretical and practical implications were discussed. Full article

(This article belongs to the Special Issue Social and Psychological Interventions to Reduce Alcohol and Drug Use and Related Harm)

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14 pages, 355 KiB

Open AccessArticle

A Qualitative Study Exploring Access to Mental Health and Substance Use Support among Individuals Experiencing Homelessness during COVID-19

by Emma A. Adams, Jeff Parker, Tony Jablonski, Joanne Kennedy, Fiona Tasker, Desmond Hunter, Katy Denham, Claire Smiles, Cassey Muir, Amy O’Donnell, Emily Widnall, Kate Dotsikas, Eileen Kaner and Sheena E. Ramsay

Int. J. Environ. Res. Public Health 2022, 19(6), 3459; https://doi.org/10.3390/ijerph19063459 - 15 Mar 2022

Cited by 10 | Viewed by 5963

Abstract

People experiencing homelessness have higher rates of mental ill-health and substance use and lower access to health services compared to the general population. The COVID-19 pandemic led to changes in service delivery across health and social care services, with many adopting virtual or telephone support for service users. This paper explores the experiences of access to community-based mental health and substance use support for people experiencing homelessness during the COVID-19 pandemic. Qualitative telephone interviews were conducted with 10 women and 16 men (ages 25 to 71) who self-identified as experiencing homelessness in North East England between February and May 2021. With five individuals with lived experience, results were analysed using inductive reflexive thematic analysis. Reactive changes to support provision often led to inadvertent exclusion. Barriers to access included: physical locations, repetition of recovery stories, individual readiness, and limited availability. Participants suggested creating services reflective of need and opportunities for choice and empowerment. Community mental health and substance use support for people experiencing homelessness should ensure the support is personalised, responsive to need, inclusive, and trauma-informed. The findings of this research have important implications for mental health and substance use policy and practice for individuals who experience homelessness during a public health crisis. Full article

(This article belongs to the Special Issue Social and Psychological Interventions to Reduce Alcohol and Drug Use and Related Harm)

12 pages, 304 KiB

Open AccessArticle

An Exploration of the Psycho-Social Benefits of Providing Sponsorship and Supporting Others in Traditional 12 Step, Self-Help Groups

by William McGovern, Michelle Addison and Ruth McGovern

Int. J. Environ. Res. Public Health 2021, 18(5), 2208; https://doi.org/10.3390/ijerph18052208 - 24 Feb 2021

Cited by 4 | Viewed by 3560

Abstract

Sponsorship is a key feature of traditional drug and alcohol self-help groups. It is a source of interpersonal support provided by an individual who is in a more advanced stage of recovery to an individual at an earlier stage of recovery. Whilst it is widely recognised that sponsorship is beneficial to the person receiving it, little is known about the psychological and social benefits that sponsors derive from providing sponsorship to others. We conducted in-depth qualitative interviews with 36 long-term self-help users (6 months−10 years) with experience of sponsoring the recovery of others, recruited from three traditional types of self-help groups in the North of England. Interviews examined sponsors’ experiences of providing sponsorship within their own recovery process. Sponsors reported that providing sponsorship to others increased their own self-awareness, social skills, and social competence when it came to engaging with others. In addition, sponsors derived an increased sense of psychological wellbeing and positive social approval from helping others. Over the longer term, sponsorship becomes a meaningful and purposeful activity as it allows those providing it to be productive, make meaning and maintain a non-addicted identity. Additionally, sponsorship is a process which is beneficial for those who have little access to wider social networks. Full article

(This article belongs to the Special Issue Social and Psychological Interventions to Reduce Alcohol and Drug Use and Related Harm)

Review

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18 pages, 663 KiB

Open AccessReview

A Systematic Review of Recreational Nitrous Oxide Use: Implications for Policy, Service Delivery and Individuals

by Julaine Allan, Jacqui Cameron and Juliana Bruno

Int. J. Environ. Res. Public Health 2022, 19(18), 11567; https://doi.org/10.3390/ijerph191811567 - 14 Sep 2022

Cited by 8 | Viewed by 3584

Abstract

Background: Nitrous oxide (N₂O) is a dissociative anaesthetic that is sometimes used recreationally. The prevalence of N₂O use is difficult to quantify but appears to be increasing. Research on N₂O harms and application of harm reduction strategies are limited. The aim of this mixed method systematic review was to collate and synthesise the disparate body of research on recreational nitrous oxide use to inform harm reduction approaches tailored for young people. Methods: To identify publications reporting the recreational use of N₂O, a search of public health, psychology and social science databases was conducted. Databases included PubMed, CIHNAL, PsycINFO, Scopus and Web of Science. Grey literature and Google advanced search were also used. Due to limited published literature on the recreational use of N₂O, no limit was placed on publication date or study type. A thematic synthesis extracted descriptive and analytical themes from the selected studies. Quality appraisal was conducted using the CASP Tool for Qualitative studies and the Joanna Briggs Institute case report assessment tool. Results: The search retrieved 407 reports. Thirty-four were included in the final analysis, including sixteen case reports. The included studies were primarily concerned with raising awareness of the apparently increasing use and subsequently increasing harms of recreational N₂O use. There was limited reference to policy or legislative responses in any published studies, no suggestions for harm reduction strategies or application of service level responses. In general, individuals lack awareness of N₂O-related harms. Conclusion: The review found three key areas that deserve further consideration including: (1) policy, (2) service delivery, and (3) harm associated with N₂O use. We recommend a top–down (policy) and bottom–up (services delivery/services users) approach to harm reduction for N₂O use which also includes further consultation and research with both groups. Future research could explore young people’s experience of N₂O use including benefits and problems to inform contextually relevant harm reduction strategies. Full article

(This article belongs to the Special Issue Social and Psychological Interventions to Reduce Alcohol and Drug Use and Related Harm)

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24 pages, 1156 KiB

Open AccessReview

Psychosocial Interventions to Improve Psychological, Social and Physical Wellbeing in Family Members Affected by an Adult Relative’s Substance Use: A Systematic Search and Review of the Evidence

by Ruth McGovern, Debbie Smart, Hayley Alderson, Vera Araújo-Soares, Jamie Brown, Penny Buykx, Vivienne Evans, Kate Fleming, Matt Hickman, John Macleod, Petra Meier and Eileen Kaner

Int. J. Environ. Res. Public Health 2021, 18(4), 1793; https://doi.org/10.3390/ijerph18041793 - 12 Feb 2021

Cited by 16 | Viewed by 4821

Abstract

It is estimated that over 100 million people worldwide are affected by the substance use of a close relative and often experience related adverse health and social outcomes. There is a growing body of literature evaluating psychosocial interventions intended to reduce these adverse outcomes. We searched the international literature, using rigorous systematic methods to search and review the evidence for effective interventions to improve the wellbeing of family members affected by the substance use of an adult relative. We synthesised the evidence narratively by intervention type, in line with the systematic search and review approach. Sixty-five papers (from 58 unique trials) meeting our inclusion criteria were identified. Behavioural interventions delivered conjointly with the substance user and the affected family members were found to be effective in improving the social wellbeing of family members (reducing intimate partner violence, enhancing relationship satisfaction and stability and family functioning). Affected adult family members may derive psychological benefit from an adjacent individually focused therapeutic intervention component. No interventions fully addressed the complex multidimensional adversities experienced by many families affected by substance use. Further research is needed to determine the effect of a multi-component psychosocial intervention, which seeks to support both the substance user and the affected family member. Full article

(This article belongs to the Special Issue Social and Psychological Interventions to Reduce Alcohol and Drug Use and Related Harm)

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Other

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13 pages, 663 KiB

Open AccessStudy Protocol

Evaluation of a Community Intervention to Reduce Harmful Alcohol Consumption among Adult Population: A Study Protocol

by Victoria Porthé, Irene García-Subirats, Catrina Clotas and Elia Diez

Int. J. Environ. Res. Public Health 2022, 19(14), 8746; https://doi.org/10.3390/ijerph19148746 - 18 Jul 2022

Viewed by 1426

Abstract

Harmful alcohol consumption is shaped by a complex range of structural, social, and individual determinants that interact with inequality axes, which can be addressed at the community level. Under the framework of Barcelona Health in the Neighborhoods, which is a community strategy to reduce health inequalities in Barcelona’s most deprived neighborhoods, a community steering group will co-design a multicomponent community intervention. Aims: to assess its effects on: (1) alcohol accessibility, availability, and consumption at the environmental level, and (2) psychosocial and cognitive determinants of harmful alcohol consumption at the individual level. Methods: Quasi-experimental design with a comparison group, and pre- and post-intervention measures. Three Barcelona neighborhoods will be assigned to the intervention or comparison group based on three criteria: healthcare data on alcohol use, socioeconomic characteristics, and population size. The intervention includes activities promoting community mobilization, law enforcement, and communication campaigns in the intervened neighborhoods. Non-participant observations in standardized census sections will be performed in public spaces to collect information on three outcomes: alcohol accessibility, availability, and signs of alcohol consumption. Data collection includes a survey to a sample of 622 subjects to detect differences on these outcomes: risk awareness, knowledge, and self-efficacy about harmful alcohol consumption and drinking patterns. Discussion: This protocol to assess the effects of a multicomponent community intervention on harmful alcohol consumption at the environmental and population level will provide evidence on effective community health interventions and enable informed decisions for policy makers. This protocol could also be used as an implementation guide for studies aimed at reducing harmful drinking in cities with similar characteristics. Full article

(This article belongs to the Special Issue Social and Psychological Interventions to Reduce Alcohol and Drug Use and Related Harm)

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5 pages, 259 KiB

Open AccessProtocol

Exploring Interventions to Improve the Oral Health and Related Health Behaviours of Adults Experiencing Severe and Multiple Disadvantage: Protocol for a Qualitative Study with Stakeholders

by Emma C. Joyes, Laura J. McGowan, Emma A. Adams, Martha Paisi, Martin Burrows, Hosein Shabaninejad, Fiona Beyer, Kate Haddow, Aishah Coyte, David Landes, Suzanne Moffatt, Richard G. Watt, Falko F. Sniehotta, Clare Bambra, Dawn Craig, Eileen Kaner and Sheena E. Ramsay

Int. J. Environ. Res. Public Health 2021, 18(22), 11755; https://doi.org/10.3390/ijerph182211755 - 09 Nov 2021

Viewed by 2268

Abstract

The number of individuals in England experiencing homelessness, substance use, and involvement with the criminal justice system is increasing. These issues, referred to as severe and multiple disadvantage (SMD), are often interlinked and co-occur. Health inequalities, particularly poor oral health, persist for those facing these inter-related issues and are closely linked with high levels of substance use, smoking, and poor diet. However, evidence for interventions that can improve these health outcomes for those experiencing these issues is limited. This paper outlines the design of a qualitative study which aims to explore the perspectives of stakeholders to understand what interventions can help to support SMD groups with their oral health and related health behaviours (i.e., substance use, smoking, diet). Interviews and focus groups will be undertaken with stakeholders comprising two groups: (1) individuals with experience of SMD, and (2) service providers (staff and volunteers), policy makers, and commissioners who support such individuals. Public involvement and engagement is central to the project. For example, stakeholders and research partners in policy and practice and people with lived experience of SMD will provide input at all stages of this study. Findings from the study will inform an ‘evidence for practice’ briefing outlining recommendations for policy. Dissemination will occur through presentations to a range of practice, policy and academic beneficiaries, and through peer-reviewed publications. Full article

(This article belongs to the Special Issue Social and Psychological Interventions to Reduce Alcohol and Drug Use and Related Harm)

12 pages, 566 KiB

Open AccessStudy Protocol

Investigating the Effectiveness and Acceptability of Oral Health and Related Health Behaviour Interventions in Adults with Severe and Multiple Disadvantage: Protocol for a Mixed-Methods Systematic Review

by Laura J. McGowan, Emma C. Joyes, Emma A. Adams, Aishah Coyte, Richard Gavin, Catherine Richmond, Hosein Shabaninejad, Fiona Beyer, Angela Broadbridge, Kevin Dobson, David Landes, Suzanne Moffatt, Richard G. Watt, Falko F. Sniehotta, Ruth Freeman, Martha Paisi, Clare Bambra, Dawn Craig, Eileen Kaner and Sheena E. Ramsay

Int. J. Environ. Res. Public Health 2021, 18(21), 11554; https://doi.org/10.3390/ijerph182111554 - 03 Nov 2021

Cited by 2 | Viewed by 2852

Abstract

Increasing numbers of people in England experience homelessness, substance use, and repeated offending (known as ‘severe and multiple disadvantage’; SMD). Populations experiencing SMD often have extremely poor oral health, which is closely inter-linked with high levels of substance use, smoking, and poor diet. This study aims to undertake an evidence synthesis to identify the effectiveness, resource requirements, and factors influencing the implementation and acceptability of oral health and related health behaviour interventions in adults experiencing SMD. Two systematic reviews will be conducted using mixed-methods. Review 1 will investigate the effectiveness and resource implications of oral health and related health behaviours (substance use, smoking, diet) interventions; Review 2 will investigate factors influencing the implementation of such interventions. The population includes adults (≥18 years) experiencing SMD. Standard review methods in terms of searches, screening, data extraction, and quality appraisal will be conducted. Narrative syntheses will be conducted. If feasible, a meta-analysis will be conducted for Review 1 and a thematic synthesis for Review 2. Evidence from the two reviews will then be synthesised together. Input from people with experience of SMD will be sought throughout to inform the reviews. An initial logic model will be iteratively refined during the review. Full article

(This article belongs to the Special Issue Social and Psychological Interventions to Reduce Alcohol and Drug Use and Related Harm)

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