G. Hussein Rassool

Nursing Students' Perceptions of the Curricula Content on Drug and Alcohol Education in Brazil: An Exploratory Study

&NA; In Brazil, there is a dearth of research in addictions nursing and the educational preparation of nurses in the care and management of substance abuse. The aim of this study was to explore the students perceptions of their teaching and learning strategies and their nursing care experiences with substance abusers. The method used in this exploratory study was a descriptive survey among students enrolled in 25 schools of nursing in Brazil. The findings suggested that the teaching received by undergraduate nurses on drug and alcohol education was mainly during the third and fourth year of graduation especially in the discipline of psychiatric nursing. The learning and teaching activities were based on theory (37%), clinical practice development (26%), group discussion (6%), and research (3%). The majority of nursing students in the Brazilian sample perceived substance abuse as a psychiatric disturbance and the predominant view was that it was categorized as a medical/disease model. This orientation may be due to the prevailing treatment and intervention philosophy in the management of psychiatric disorders and substance use problems. The findings suggested that undergraduate nurses in Brazil are receiving limited amount of instruction in drug and alcohol dependence and abuse. The need for a change in nurse education curricula to meet the demands of a public health program on drug and alcohol abuse is a key priority.

Substance Abuse in Black and Minority Ethnic Communities in the United Kingdom: A Neglected Problem?

&NA; Historically, black and minority ethnic communities have been the victims of negative stereotypes in respect to substance abuse. There has been a notable absence from recent national drug policies in the UK to address the health status and health care needs of black and ethnic minority. Evidence from both quantitative and qualitative surveys strongly indicated that the rate of prevalence of drug abuse within the black and minority ethnic groups, particularly among South Asians, was lower than that of the white population but with increasing trends. The evidence from quantitative surveys strongly indicated that the prevalence of alcohol misuse within black and minority groups was increasing, especially among the Indian and black Caribbean communities. There is evidence to suggest that black and minority ethnic substance misusers, especially those from South Asian communities and women, were under‐presented in treatment services. Substance abuse among the growing diversity of black and ethnic minority communities has strong implications for the provision of health care in substance abuse services. Nurses and other health care professionals need to be aware of the existence of ethnic minorities within the community they serve.

Sexual Dysfunction and Sexual Behaviors in a Sample of Brazilian Male Substance Misusers

The aim of this study was to evaluate the potential relationship between self-reported sexual dysfunction, sexual behavior, and severity of addiction of drug users. A cross-sectional design study was conducted at an inpatient addiction treatment unit in Sao Paulo, Brazil, with a sample of 508 male drug users. Sociodemographic data, sexual behavior, and severity of dependence were evaluated.The prevalence of sexual dysfunction was 37.2% and premature ejaculation was 63.8%. Men with sexual dysfunction presented from moderate to severe level of alcohol, tobacco, and other drugs of dependence. The findings from this study are particularly relevant identifying those sociodemographic factors, severity of drug use, and sexual behavior are related to men who experience sexual dysfunction. Health promotion and motivational interventions on sexual health targeted to male drug users can contribute in reducing these at-risk behaviors. More interdisciplinary research is desirable in future in considering men’s sexual health.

Prescription for Change: Perspectives on Prescribing Authority for Addiction Nurses in the United Kingdom

&NA; Nurses, pharmacists or other health professionals in England are now able to prescribe “prescription only medicines” (POMs). This prescribing initiative has been extended to controlled drugs. Nurse prescribing has advantages for nurses and patients, including enhanced career development opportunities, nurse led‐services and better quality of patient care. Future prescribing directions for addiction nurses would include prescribing for minor injuries, pain, nutritional supplements, antibiotics, emergency contraceptives, medications for detoxifications and psychotropic substances. Nurse prescribing, such as methadone for opiate dependence would significantly reduce the waiting time for service‐users to gain access to appropriate services. However, there are issues of concerns such as the relationship between nurse prescribers and non‐prescribers, and the relationship between nurse prescribers and medical supervisors, clinical supervision and ongoing professional support for nurse prescribers. This paper examines some perspectives on aspects of nurse prescribing with reference to addiction nursing in the UK, with selected literature reviews on nurse prescribing.

Criminality and Sexual Behaviours in Substance Dependents Seeking Treatment.

ABSTRACT The aim of this study was to investigate the link between violence, crime, and sexual behavior among patients with substance-related disorder admitted to a specialized inpatient care unit. This was a cross-sectional study using a questionnaire on socio-demographic characteristics, drug of choice (DOC), questions about sexual behavior, and instruments to evaluate the severity of dependence (SADD, DAST, FTND), level of impulsivity (BIS-11), and a screening sex addiction scale. The sample consisted of 587 adult subjects, of which 82.3% were men, 66.4% had used cocaine (sniffed and smoked) as their DOC, 24.4% had a history with the criminal justice system, 26.8% had committed crimes, 19.3% had engaged in violent behavior, and 12.2% had been involved in drug trafficking. In this sample, crime was strongly associated with various sexual behaviors and the severity of substance dependence.

Professional Education in Co-occurring Disorders: Some Considerations towards Practice Development

&NA; The aims of this paper are to provide a brief overview of the types of education and training as well as a framework for co‐occurring disorders courses at foundation and advanced levels. Mental health nurses encounter substance abuse problems as part of their workload and should be prepared adequately to work with individuals with the co‐existence of mental health and substance abuse. However, co‐occurring disorders are not often picked up by substance abuse or mental health services, indicating a need for improvement in ongoing professional development. The targeted audience for education and training in core competencies should be staff working in community mental health teams, inpatient services, assertive outreach teams, early intervention teams, crisis resolution teams, primary care, mental health services for older people, independent mental health projects, accommodation services, day care services, statutory drug and alcohol services, independent drug and alcohol service providers, and those working in hostel accommodations, housing, prison health care probation, and others in the criminal justice system. The theoretical and skills‐based training will need to adopt a two‐tiered approach as individuals working within mental health services will by definition need a higher emphasis on training around substance misuse and vice versa for individuals working in substance misuse services. One of the agenda items for interagency training is to challenge negative attitudes and prejudices around both mental health problems and substance misuse.

Assessment of Sexual Dysfunction Symptoms in Female Drug Users: Standardized vs. Unstandardized Methods

ABSTRACT Aims: The aim of this study is to evaluate whether there is a difference in the identified prevalence between the assessment of symptoms of sexual dysfunction in female drug users using a standardized scale and by means of a nonstandardized set of questions about sexual dysfunctions. Method: A cross-sectional study was conducted with two groups of substance-dependent women using the Drug Abuse Screening Test, the Short Alcohol Dependence Data questionnaire, the Fagerström Test for Nicotine Dependence for the evaluation of the severity of dependence, and the Arizona Sexual Experience Scale. Findings: In both groups, the severity of dependence and the prevalence of symptoms of sexual dysfunctions in women were similar. Conclusion: The use of standardized and nonstandardized instruments to assess sexual dysfunction symptoms is an essential resource for the provision of good-quality care to this clientele.

Perception of Addiction Nurses Towards Clinical Supervision: An Exploratory Study

Abstract Clinical supervision as a priority for addiction nurses is beyond dispute. It is acknowledged that adequate supervision would enable addiction nurses to develop professional competencies and reduce stress and burnout. This paper reports on an exploratory study of the perceptions of clinical supervision among addiction nurses. Their knowledge of the concept, and their views and experiences of clinical supervision are examined. The Clinical Supervision Perception Questionnaire (CSPQ) was administered to 40 addiction nurses. The findings show that addiction nurses with more than 6 years of experience felt supervision was an integral part of their nursing work. The value of clinical supervision was highly regarded by addiction nurses working in combined drug and alcohol services. The study also reveals different supervision requirements among different subgroups, nurses working in combined services, and nurses working in the field for longer period of time having different needs and perceptions of supervision. This has implications for both educational programs and clinical practice.

Silent Voices--Women and Substance Abuse in Hong Kong: Right Access to Services?

&NA; Drug abuse is a long-standing problem in Hong Kong. Although the majority of abusers are male, recent trends suggest that there is an increasing population of females, under 21-years-old, abusing both drugs and alcohol. Despite the increase in the number of female substance abusers in Hong Kong, there is still a service gap in meeting the specific needs of this client group. Many current services remain biased towards the needs of male substance abusers, whose substance using career may be different from their female counterparts. The majority of women who misuse drugs and alcohol are of child bearing age and so the issue of care of the pregnant drug user is of vital importance when planning service provision. Women often fear that their children will be taken into care if their substance abuse becomes known. Many services have limited child care facilities and this may prevent some women from presenting to services. Care and treatment offered must be individually tailored if needs are to be met and if the planned outcomes are to be successful. It is imperative that treatment services challenge the subjugated and disempowered status of women substance users and aim to deal with the specific difficulties associated with this client group.

The Addictions Nurse as Part of a Drug and Alcohol Liaison Team: Pioneering New Frontiers in England

The incidence of medical morbidity is high among substance misusers, particularly those who inject drugs or those with problem alcohol use. Consequently, the need for regular administration to hospital is also high, either as an outpatient in an Accident and Emergency Room (A&E) or as an inpatient on a general medical or surgical ward. Tomlinson (1992), in his report on London hospitals, found that 30% of all acute admissions to the general hospitals have an alcohol problem. While Ghodse et al. (198 1) found that 18.3 per lo00 attendees at the A&E departments in London hospitals had drug-related problems, 32% of these fulfilled the criteria for dependence. The Drug ad Alcohol Liaison Team (D.A.L.T.) takes a wider focus, however, working not only with patients admitted for a primary substance misuse problem but also emphasizing the role of screening to identify those patients admitted for other reasons but who also have problems with substance misuse (Hapke et al., 1998). This is an important secondary prevention role, which has the giving of information and advice as its core. The Drug and Alcohol liaison team at St. George’s Hospital, London, was developed in response to the research in United Kingdom hospitals and A&E departments. It was estab-