Repetitive transcranial magnetic stimulation (rTMS) is a well-established treatment with efficacy for several psychiatric disorders and has yielded promising yet mixed data showing reductions in craving for substance use. Patients with substance use disorders and comorbid depression may encounter obstacles to receiving rTMS in outpatient settings for treatment of depression. In turn, implementation of rTMS in residential substance use programs would greatly benefit those with comorbid treatment resistant depression. This paper aims to provide recommendations for implementing rTMS within residential substance use treatment centers.
Using PubMed, the authors conducted a narrative review of manuscripts using various combinations of the following search terms: rTMS, depression, substance use and substance use disorder. The authors read manuscripts for their methodology, outcomes and adverse events to synthesize their results, which correspond to their recommendations for patient selection, safely implementing rTMS in residential substance use facilities and optimal rTMS protocols to start with.
Advantages of this approach include increased compliance, monitoring and access to care. Recommendations to safely incorporate rTMS in residential substance use disorder treatment centers revolve around selection of patients eligible for rTMS, allowing for sufficient time to elapse prior to commencing rTMS, monitoring for signs of recent substance use or withdrawal and using rTMS protocols compatible with the therapeutic programming of a treatment center.
This paper details the challenges and benefits of implementing rTMS for patients with dual diagnosis and provides recommendations to safely do so. To the best of the authors’ knowledge, this is a novel and unpublished endeavor.
]]>This paper aims to describe the development, implementation and evolution of a multi-media educational tool to improve health profession students’ knowledge and awareness of stigma and ageism on the treatment of older adults with substance use disorder (SUD). In addition, this paper outlines the relationship between mental health and SUD and the impact of health provider stigmatization of older adults with behavioral health needs and the relationship between SUD and mental illness.
A literature review was conducted and initial project outlines was developed. Ten interviews were completed with content experts. The draft video was reviewed and minor revisions were incorporated. The facilitator guide accompanying the video was developed. A draft of the facilitator guide was shared with several interprofessional university faculty and the older adults with SUD. The video was presented to groups of health professions students, and following each video viewing, discussion content was used to provide additional edits.
The educational resources created for this project are appropriate for health professions curriculums related to older adults. Interprofessional health professions students are developing a basic foundation of knowledge on SUD through their standard coursework. More compassionate vocabulary is slowly being incorporated into health provider. Knowledge related to treatments and resources to treat SUD is lacking. In addition, health professions students need more education focused on assessment and interventions for individuals suspected of problematic substance use.
This paper fulfills an identified need to facilitate discussion and education around SUD for health professions students.
]]>The purpose of this study is to see if the affirmative results seen in the pilot study of the positive addiction recovery therapy (PART) programme are replicable and durable given a new cohort of participants. PART is a programme of work designed to improve the recovery and well-being of people in early addiction recovery. Its foundation is in the G-CHIME (growth, connectedness, hope, identity, meaning in life and empowerment) model of addiction recovery. It also uses the values in action character strengths and includes a set of recovery protection techniques.
This study uses a mixed method experimental design, incorporating direct replication and a follow-up study. Measures for recovery capital, well-being and level of flourishing are used to collect pre-, post- and one-month follow-up data from participants. The replication data analysis uses the non-parametric Wilcoxon test, and the follow-up analysis uses the Friedman test with pairwise comparison post hoc analysis. The eligibility criteria ensure participants (n = 35) are all in early addiction recovery, classified as having been abstinent for between three and six months.
This study found a statistically significant improvement in well-being, recovery capital and flourishing on completion of the PART programme. These findings upheld the hypotheses in the pilot study and the successful results reported. It also found these gains to be sustained at a one-month follow-up.
This study endorses the efficacy of the PART programme and its continued use in a clinical setting. It also adds further credibility to adopting a holistic approach when delivering interventions which consider important components of addiction recovery such as those outlined in the G-CHIME model.
This study adds to the existing evidence base endorsing the PART programme and the applied use of the G-CHIME model.
]]>The purpose of this paper is to examine recovery through lived experience. It is part of a series that explores candid accounts of addiction and recovery to identify important components in the recovery process.
The G-CHIME model comprises six elements important to addiction recovery (growth, connectedness, hope, identity, meaning in life and empowerment). It provides a standard against which to consider addiction recovery, having been used in this series, as well as in the design of interventions that improve well-being and strengthen recovery. In this paper, a first-hand account is presented, followed by a semi-structured e-interview with the author of the account. Narrative analysis is used to explore the account and interview through the G-CHIME model.
This paper shows that addiction recovery is a remarkable process that can be effectively explained using the G-CHIME model. The significance of each component in the model is apparent from the account and e-interview presented.
Each account of recovery in this series is unique and, as yet, untold.
]]>Those who care for people with schizophrenia and substance use disorders (PLS-SUD) are faced with the complex demands of a long journey to recovery. For the carers, this translates into specific needs related to various areas of their lives. However, few studies have contributed to the understanding of these carers’ needs. The purpose of this qualitative evaluative study is to identify, understand and prioritize the needs of PLS-SUD carers in the context of intervention design from the viewpoint of carers themselves (n = 9), those they were accompanying (n = 5) and other key actors involved (n = 10).
A design of action research was employed. Data analysis was done in three phases: concept map analysis, thematic analysis and transversal analysis of the results from two focus groups, 28 interview transcriptions and a logbook.
Over 60 needs were identified. After review, 39 of those were selected for prioritization. For needs related to the carers’ role as clients of the health-care system, the committee prioritized the needs for support, sharing with other carers and improving their own well-being. For the role of supporter, knowledge about substance use disorders and their interactions with psychotic disorders as well as skills such as communication and problem resolution were considered priorities. Needs to be prioritized relating to the role of partner were fewer.
The results of this study highlight the diversity and complexity of the needs experienced by carers.
This is among the first needs surveys carried out by stakeholders to describe the needs of PLS-SUD carers.
]]>The purpose of this paper is to examine recovery through lived experience. It is part of a series that explores candid accounts of addiction and recovery to identify important components in the recovery process.
The G-CHIME model comprises six elements important to addiction recovery (growth, connectedness, hope, identity, meaning in life and empowerment). It provides a standard against which to consider addiction recovery, having been used in this series, as well as in the design of interventions that improve well-being and strengthen recovery. In this paper, a first-hand account is presented, followed by a semi-structured e-interview with the author of the account. Narrative analysis is used to explore the account and interview through the G-CHIME model.
This paper shows that addiction recovery is a remarkable process that can be effectively explained using the G-CHIME model. The significance of each component in the model is apparent from the account and e-interview presented.
Each account of recovery in this series is unique and, as yet, untold.
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