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Substance Use Research Methods: Ethics, Culture, and Health Equity

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Behavioral and Mental Health".

Deadline for manuscript submissions: 30 November 2024 | Viewed by 2634

Special Issue Editors


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Guest Editor
School of Public Health, Faculty of Medicine, The University of Queensland, Herston 4006, Australia
Interests: substance use; injecting drug use; hepatitis C; epidemiology

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Guest Editor
Institute for Social Science Research, Faculty of Humanities, Arts and Social Sciences, The University of Queensland, Brisbane 4072, Australia
Interests: substance use/misuse; mental health disorders; alcohol related harm

Special Issue Information

Dear Colleagues,

The social marginalization of people who use alcohol or other psychoactive substances, driven by factors such as stigma, discrimination, and the criminalization of substance use, undermines health and wellbeing and is a barrier to health equity, including health service access. Conversely, this social marginalization  is also a barrier to public health practitioners and researchers who are seeking to reduce substance-related harm. People who use substances are often wary of participating in research and disclosing their personal information. This contributes to non-response and response biases, which can undermine the value of substance use research. For example, studies of public health and therapeutic interventions for substance use are hindered by significant loss to follow up [1]. Survey instruments can have inherent biases that impact the validity of the data collected for different groups, including First Nations and other cultural minority populations [2]. Further, a lack of consumer involvement in research design or program delivery may perpetuate deficit views of people who use alcohol or other substances [3]. Innovative and ethical research methods underpin high-quality research, which can support effective public health responses to substance use issues. An important part of this is the participation of people who use substances and peer substance use treatment programs in the design and evaluation of the public health responses intended to support them. This is fundamental for improving program quality and outcomes, and strategies are needed to overcome stigma and discrimination to ensure this can occur effectively and ethically and modify the related social determinants of health over time [4]. This Special Issue is open to any studies of substance use research methods, particularly those that reflect on public health, the behavioral environment, comorbid mental health disorders, risk and treatment for sexually transmitted and other infections, ethics, culture, health equity, and/or consumer participation.

References

  1. Stockings, E.; Bartlem, K.; Hall, A.; Hodder, R.; Gilligan, C.; Wiggers, J.; Sherker, S.; Wolfenden, L. Whole-of-community interventions to reduce population-level harms arising from alcohol and other drug use: a systematic review and meta-analysis. Addiction 2018, 113, 1984–2018. https://doi.org/10.1111/add.14277.
  2. Weatherall, T.J.; Conigrave, K.M.; Conigrave, J.H.; Lee, K.S.K. What is the prevalence of current alcohol dependence and how is it measured for Indigenous people in Australia, New Zealand, Canada and the United States of America? A systematic review. Sci. Clin. Pract. 2020, 15, 32. https://doi.org/10.1186/s13722-020-00205-7.
  3. van der Sterren, A.E.; Nathan, S.; Rawstorne, P.; Yarbakhsh, E.; Gough, C.; Bowles, D. Involvement of people who use alcohol and other drug services in the development of patient-reported measures of experience: a scoping review. Health Expect 2023, 26, 2151–2163. https://doi:10.1111/hex.13829.
  4. Goodhew, M.; Stein-Parbury, J.; Dawson, A. Consumer participation in drug treatment: a systematic review. Drugs Alcohol Today 2019, 19, 97–112. https://doi.org/10.1108/DAT-05-2018-0023.

Dr. Andrew Smirnov
Dr. Caroline Salom
Guest Editors

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Keywords

  • substance use
  • drug harm reduction
  • research methods
  • research ethics
  • stigma and discrimination
  • health equity
  • culture and health
  • consumer participation
  • program design and evaluation
  • sampling and measurement

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Published Papers (3 papers)

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Research

9 pages, 259 KiB  
Article
Medicine and Pharmacy Students’ Role in Decreasing Substance Use Disorder Stigma: A Qualitative Study
by Alina Cernasev, Rachel Barenie, Hayleigh Hallam, Kenneth C. Hohmeier and Shandra Forrest
Int. J. Environ. Res. Public Health 2024, 21(12), 1542; https://doi.org/10.3390/ijerph21121542 - 21 Nov 2024
Viewed by 268
Abstract
Background: A strong body of research has established stigma as a barrier to care for patients with substance use disorders (SUDs), which can lead to poorer patient outcomes. Prior qualitative research on healthcare practitioners’ perceptions is limited. This study aimed to describe healthcare [...] Read more.
Background: A strong body of research has established stigma as a barrier to care for patients with substance use disorders (SUDs), which can lead to poorer patient outcomes. Prior qualitative research on healthcare practitioners’ perceptions is limited. This study aimed to describe healthcare professional students’ perceived roles in decreasing SUD stigma. Methods: A qualitative design using focus groups (FGs) was employed. This study applied the stigma conceptualization approach by Link and Phelan to develop the FG guide, including labeling, stereotyping, separation, status loss, and discrimination. These components are linked to the construction of cognitive categories that lead to stereotyped beliefs. The FG participants were graduate-level healthcare students recruited via email from the University of Tennessee Health Science Center (UTHSC). The research team analyzed the transcripts using Braun and Clarke’s approach to identify emergent themes in the data. Dedoose® Version 9.0.107, a qualitative data analysis software platform, was utilized to facilitate data manipulation and retrieval during the analysis. Steps were taken to ensure the reliability of the qualitative data using Lincoln and Guba’s criteria. Results: Among thirty-one pharmacy and medical student participants, three themes emerged from the data: (1) student recognition of stigma, (2) the role of healthcare professionals in harm reduction, and (3) calls to enhance advocacy efforts to improve patient outcomes. These themes collectively encompass key members of the healthcare team’s perceptions and solutions to SUD stigma. Conclusions: This research reveals the importance of expanding training opportunities to go beyond the SUD disease state, to other evidence-based approaches such as effective advocacy, harm reduction, and stigma, which impact the delivery of that care. Full article
(This article belongs to the Special Issue Substance Use Research Methods: Ethics, Culture, and Health Equity)
13 pages, 331 KiB  
Article
The Association between Post-Traumatic Stress Disorder and Problematic Alcohol and Cannabis Use in a Multi-Ethnic Cohort in The Netherlands: The HELIUS Study
by Christin Kühner, Joanne P. Will, Sera A. Lortye, Henrike Galenkamp, Anja Lok, Mirjam van Zuiden, Arnoud R. Arntz, Kathleen Thomaes, Anna E. Goudriaan and Marleen M. de Waal
Int. J. Environ. Res. Public Health 2024, 21(10), 1345; https://doi.org/10.3390/ijerph21101345 - 11 Oct 2024
Viewed by 1029
Abstract
(1) Background: Ethnic minorities exhibit a higher prevalence of post-traumatic stress disorder (PTSD), while results for problematic substance use among ethnic groups remain mixed. PTSD and problematic substance use often co-occur; however, the impact of ethnicity on this association has not yet been [...] Read more.
(1) Background: Ethnic minorities exhibit a higher prevalence of post-traumatic stress disorder (PTSD), while results for problematic substance use among ethnic groups remain mixed. PTSD and problematic substance use often co-occur; however, the impact of ethnicity on this association has not yet been investigated. (2) Methods: Self-report data on problematic alcohol/cannabis use (AUDIT/CUDIT) and presence of severe PTSD symptoms (PSS-SR) of N = 22,841 participants of Dutch (n = 4610), South-Asian Surinamese (n = 3306), African Surinamese (n = 4349), Ghanaian (n = 2389), Turkish (n = 3947), and Moroccan (n = 4240) origin were available from the HELIUS study. (3) Results: We found a positive association between the presence of severe PTSD symptoms and problematic alcohol and cannabis use. Ethnicity did not moderate the association between the presence of severe PTSD symptoms and problematic alcohol/cannabis use. (4) Conclusions: We demonstrated the relationship between the presence of severe PTSD symptoms and problematic alcohol/cannabis use in a multi-ethnic sample. The relationship between the presence of severe PTSD symptoms and problematic alcohol/cannabis use was similar between ethnic groups. We recommend screening for PTSD symptoms in those exhibiting problematic substance use and vice versa, regardless of ethnic background. Full article
(This article belongs to the Special Issue Substance Use Research Methods: Ethics, Culture, and Health Equity)
11 pages, 283 KiB  
Article
A Collaborative Approach to Understanding the Intersections of Practice and Policy for Peers in the Alcohol and Other Drugs Sector
by Timothy Piatkowski and Emma Kill
Int. J. Environ. Res. Public Health 2024, 21(9), 1152; https://doi.org/10.3390/ijerph21091152 - 30 Aug 2024
Cited by 1 | Viewed by 891
Abstract
Introduction: Peers in the alcohol and other drug sectors possess lived–living experience (LLE) crucial for shaping community care. However, genuine consumer collaboration is often confounded by stigma. This study examined peers’ perceptions, exploring their experiences regarding workforce dynamics, policy implications, and impacts on [...] Read more.
Introduction: Peers in the alcohol and other drug sectors possess lived–living experience (LLE) crucial for shaping community care. However, genuine consumer collaboration is often confounded by stigma. This study examined peers’ perceptions, exploring their experiences regarding workforce dynamics, policy implications, and impacts on health equity. In presenting the research, we sought to synthesise the research methods and illustrate the methodological innovation and knowledge production in substance use research through authentic collaboration. Methods: We purposively sampled peer networks and community organisations, involving peer-researchers in planning, design, and analysis. We conducted semi-structured digital interviews with 18 peers and applied iterative coding to analyse the data. Results: This collaborative process provided nuanced insights into sectoral challenges. Peers expressed emotional strain revisiting personal substance use experiences, blurring personal and professional boundaries. Tokenistic peer involvement critiques underscored the need for genuine leadership and organisational support. Conclusion: We advocate for a shift towards equitable and inclusive policy development through both organisational and systemic restructuring. However, these changes are hamstrung by broader policy frameworks, which require a shift to peer-led principles, ensuring the expertise of peers is genuinely valued. Policymakers should invest in expanding peer frameworks, acknowledging the diversity within communities of people who use drugs to improve health equity and public health outcomes. This innovative approach to substance use research emphasises the transformative impact of integrating LLE into research. Full article
(This article belongs to the Special Issue Substance Use Research Methods: Ethics, Culture, and Health Equity)
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