Category: Community

Posts by Jano Klimas about community, collaboration, charity and social welfare.

INVEST-ing: Jan Klimas teams up with US university

NIDA CTN WSN

Jan Klimas, PhD, joins the Western States Node on March 1, 2013, as a NIDA CTN INVEST Fellow.  NIDA is the National Institute on Drug Abuse, and INVEST is International Visiting Scientists & Technical Exchange Program for drug abuse research. Oregon Health & Sciences University hosts Dr. Klimas’ six months fellowship during which he will assess the use of Screening and Brief Intervention (SBIRT) for alcohol use disorders among patients receiving agonist medication for opioid use disorders. 

Professor Dennis McCarty, Co-PI for the Western States Node, will supervise Dr. Klimas during his fellowship.  The research examines addiction treatment in primary and specialty care settings with respect to implementation of screening and treatment for unhealthy alcohol use among opioid-dependent patients in methadone or buprenorphine agonist treatment in Ireland and Oregon.  Dr. Klimas’ prior work in Ireland informs the U.S. investigation… Read more in the NIDA CTN bulletin, issue November 15th, 2012: (http://ctndisseminationlibrary.org/bulletin/20121115.pdf

Symposium of the Society for the Study of Addiction: A cultural shift? (#ssa)

Among the Top 5 conferences in the Addiction field worldwide, the SSA symposium (http://www.addiction-ssa.org/) came to pass last week in York (UK). For obvious reasons, the conference organisers are loyal to the same venue for a number of years. Not only it is a spectacular historical town, but it’s accessible from most of the UK research centres of excellence by a couple of hours drive.

Our group brought to the conference a set of related presentations honouring the results of our hard work in the past years. They were all linked by a genuine need to come up with realistic solutions to drinking among methadone users (or other problem drug users):

Problem alcohol use among DUs in primary care: evidence, barriers, research agenda

 The following are titles of three related papers presented together at the conference:

  1.  Problem alcohol use among problem drug users: Development of clinical guidelines for general practice
  2.  The management of problem alcohol use among drug users in primary care: Exploring patients’ experience of screening and treatment
  3.  Psychosocial interventions to reduce alcohol consumption in concurrent problem alcohol and illicit drug users: Cochrane review

To our greatest surprise, we found ourselves amidst a long thought-provoking discussion with the interested audience following our  presentations. This had to be cut off by a chair who was mindful of a long line-up of subsequent talks. I hope this wasn’t only a mere reflection of a hight need or interest in the proffesional community but also an acknowledgement of our expertise in conducting and presentig this research programme.

Following this positive reception of our research we resolved to focus more on quality, than quantity for our research endeavours in 2013; so that we can make for better candidates for the next year’s poster prizes and/or for publishers of the top drugs journal – The Addiction.

Visiting this event for the first time 2 years ago, I couldn’t pass without notice a heavy focus on medical aspects of addiction, e.g. medicines and treatment. That changed. This year, there were many presentations from the community/ practitioner crowd on topics unheard of at this meeting before (e.g. John Roche’s New drugs, new problems? Responding to club drugs in Leeds or Duncan Raistrick’s Payment by Results) – all attended by a number of attendees. The same – non-medicinalising – trend apperead in the conference tweets:

Excellent final talk at #SSA by Tim Leighton. Recovery is not new. Recovery movement = contemporary Temperance movement.
— Dr Vanessa Crawford (@addictionpsych) November 9, 2012

My second observation is about the symposium audience. Many new (young) faces appeared among the seasoned veterans of this conference. This influenced conference’s social programme too, as the conferring crowd quickly dispersed into their rooms following some modest dinner celebrations. Is the crushing hand of recession strengthening its grip and forcing addiction experts to work more – celebrate less? Or are we witnessing a cultural shift in the UK’s most established addiction meeting?

Youth Mental Health Conference: Press release (#Acamh2012)

Youth mental health is a key health priority in Ireland; early intervention, engagement and innovation are central to its promotion.

The Third National Research Conference in Ireland on Youth Mental Health will focus on this key theme. Hosted by the Association for Child and Adolescent Mental Health (ACAMH) and Graduate Entry Medical School, University of Limerick (UL), it will present insights, perspectives, and valuable updates.

Ian Kelleher, Winner of the the 2011 Eadbhard O’Callaghan Youth Mental Health Research Award with Professor Mary Cannon, RCSI.

The day’s key aim of encouraging research by under- and postgraduate students and trainees will again provide the platform for presentation of projects and, importantly, recognise the most excellent piece of research work with the award of “Annual ACAMH Youth Mental Health Research Prize”, in memory of the late Professor Eadbhard O’Callaghan and in recognition of his outstanding contribution to mental health in young people. In an innovative development, young people will be highly involved with the organisation and delivery of the conference.

Conference organising committee chair, Walter Cullen (UL Professor of General Practice and GP) states: ‘UL, the Midwest region and ACAMH are delighted to come together to host this important meeting – mental health is a major challenge for our population’s national health, especially here in the Midwest, and this conference will showcase some of the excellent work being carried out by colleagues, associations and health agencies to address this issue. We are especially honoured that the prestigious Eadbhard O’Callaghan Memorial Prize will be awarded for work presented on the day’.
Speaking at the announcement of the programme for this year’s conference, Mary Cannon, RCSI Professor of Psychiatry and Secretary of ACAMH Special Interest Group on Youth Mental Health states “we hope to showcase research and innovation relevant to youth mental health. Our first two conferences promoted interaction between all stakeholders, especially researchers and young people, and dialogue between young people, researchers and policy makers will remain at the forefront of this year’s programme”.

The conference will be opened by Dan Neville T.D (Deputy Mental Health Spokesperson), and Don Barry, President, UL. Confirmed keynote speakers include Ella Arensman (Director of Research, National Suicide Research Foundation), Bob Illback (Deputy CEO, Headstrong), Eric Taylor (Emeritus Professor of Child Psychiatry, King’s College London Institute of Psychiatry), Mary Clarke (Clinical Lead, DETECT), and Ian Daly (HSE Mental Health Clinical Lead).

Interactive Workshops invite delegates to explore in greater depth, the key themes of ‘Disadvantage and its Impact on Youth Mental Health’ (UL-based Orla Muldoon, Professor of Psychology, Sarah Jay, Post-Grad Scholar and Jan Klimas, Postdoctoral Researcher and Cochrane Fellow) and ‘Technology and Youth Mental Health’ (Director of Programmes and Policy Derek Chambers and Research & Evaluation Officer Fenella Murphy, Inspire Ireland; Aleisha Clarke, Health Promotion Research Centre, NUI; and Gavin Doherty, TCD School of Computer Science and Statistics). In addition, Colman Noctor (Psychotherapist, St Patrick’s University Hospital) will launch ‘The Way Forward, Young People and their Parents’ Experiences of Youth Mental Health Services’.

Further information:
Walter Cullen, Professor of General Practice, UL. [email protected]
Ingrid King, Executive Director, ACAMH [email protected]; www.acamh.org.uk
Mary Cannon, Dept Psychiatry RCSI; Secretary, ACAMH Special Interest Group: [email protected]

Facebook: http://www.facebook.com/events/392553024142420/
Twitter: #Acamh2012

Trust: the usual suspect in the addiction story

Believe me, or not, trust is something that has been emphasized in addiction treatment for many years. One can hardly argue that it has become one of the usual suspects in the life stories of most recovering drug users.

In this post, I write about two main findings of my latest research published in the current issue of the Czech academic journal Adiktologie (Addictiology). Although they may not be the key findings, which I discovered, this blog gives me an opportunity to illuminate what I feel people should take away from this paper.

 

 


This comes with no surprise – trust is key for building or restoring relationships of all people. No matter if they have drug problems, or not. In this way, my research confirmed what common sense tells us without any special knowledge of research. Re-prioritisation of relationships during treatment was facilitated by the experience of help, support and restoration of trust in relationships.

Because I was able to look at the pre-recovery years of drug users lives, when they actively used drugs, I could go with the trust issue a little further. Changes in relationship priority during active drug use occurred on the basis of barriers (e.g. the need to obtain drugs, stigma), which restrained active drug users from engaging in and maintaining the social relationships.

 

This research has further deepened my understanding of how problem drug users function and indeed how similar they are to people who don’t have drug problems. Some readers may not like this, but they may be less different to ‘us’ than we thought. The key factors that keep them function in a way that is hardly acceptable  by the main-stream population are drug-related barriers. These barriers prevent them from engaging in the usual social life pleasures, such as keeping in touch with non-drug-using friends, visiting parents etc. My research highlighted that they don’t do these things because they have different priorities, which are not compatible with them (See Figure 1 below).

Saying that they are not bothered with relationships or that they’ve no interest in them is too simplistic, and as suggested by this research, not true. Other research showed that people with drug problems do engage in social relationships, pro-social activities, social relationships, raising children – they just don’t do it in a way that ‘we’ are willing to accept. The question that remains to be answered by future research is what would happen if the barriers of engaging in culturally-acceptable social activities were removed? Would ‘they’ be more like ‘us’? The first signals supporting this question come from the opioid agonist treatment. People maintained on pharmaceutical opioids, substituting their illicit drug use, lead more stable lives, commit less crime and have better chances of being employed than people without these substitutes.


Original abstract:
Background: interpersonal problems among drug users (DU) are frequent, are related to other problems, and improve during the addiction treatment.
Aims: to better understand changes in relationships which occur in the course of drug use and drug treatment, as well as their subjective appraisal by ex-drug users, using retrospective methodology.
Method: semi-structured interviews with DUs in a therapeutic community (TC) were analysed with descriptive-interpretive method. The coding of interview transcripts into categories was performed in two phases using qualitative software NVivo 7. Five interviews were coded in the pilot phase, followed by an audit by an external psychologist and progressive coding of the rest of the transcripts, with data saturation being reached in the second phase.
Participants: nine male and one female client, aged 18-36 years (mean: 25.9), participated in the study and the length of their stay in the TC was 2-35 months (mean: 9.9). The approximate mean age of drug use onset was 15.6 years (12-28).
Results: the analysis provided 21 categories which were divided into three domains based on chronological order. Changes in relationship priority during active drug use occurred on the basis of barriers (such as the need to obtain drugs and stigma), which restrained active DUs from engaging in and maintaining their social relationships. Re-prioritisation of relationships during treatment was facilitated by the experience of help, support and the restoration of trust in relationships.
Conclusions: this study builds on the previous work exploring the broad issue of social consequences of drug use and offers clients’ perspective on this topic.
Cite as: Klimas, J. (2012) Interpersonal relationships during drug use and treatment from the perspective of clients in a therapeutic community. [Interpersonálne vzťahy v priebehu užívania drog a liečby závislosti z pohľadu klientov/iek v terapeutickej komunite.]. Adiktologie (12)1, 36-45
More at: www.adiktologie.cz

Figure 1. Evolution of relationships during drug use, addiction and treatment

 

Integrative GP Research Group started in Dublin

How important is it to integrate research? Why do we need to integrate it at all? Well, because things are disintegrated!
This is the first blog post about the General Practice Research Group (GP), established on May 2nd, 2012 in Dublin, Ireland. It contains my musings about the first group meeting and research plans for future. I think I’m not capable of writing an exquisite research blog, but I will write about research because it consumes 80% of my waking hours.
The six of us met officially as a group on Wednesday. Finally! We made it and a new research group was born. We met to establish a research group which should be integrative. It means that we will work together to use our research for improving lives of people that we care about, patients, clients, participants… we call them different names depending on the situation.
Doing things together is much more fun than on our own. Especially if we talk about things that we are passionate about. And passion we have! It was clear in the lengthy discussions that we mean business. We spent about half of a day sunk in these talks and then I left.
After the meeting, all planned to go for a personalised sight-seeing tour around the UCD Belfield campus. In Walter’s words:

“Tour 5’ for the non-UCD people, which might involve a tour of the new(ish) Health Sciences Building, the (in)famous Belfield bar (home to the legendary Pre-Med class party of 1989) and the soccer pitch where the ‘Casual Heroes’ soccer team won division 3B of the ‘UCD Superleague’ in 1993.”