Key Concepts in Substance Misuse

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Aaron Pycroft

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    About the Contributors

    Devin Ashwood has worked therapeutically in several substance misuse settings and now lectures in addictions counselling for Action on Addiction and the University of Bath. He teaches mindfulness to professionals and clients in secular contexts and leads numerous Buddhist groups throughout the year including working as a Buddhist prison chaplain.

    Rosanna Bartholomew graduated from the Institute of Criminal Justice Studies at the University of Portsmouth with a BSc in Criminology with Psychology in 2014. Her dissertation on the topic of legal highs was carried out under the supervision of Dr Aaron Pycroft.

    Pamela Campbell, a Queen’s Nurse, is Consultant Nurse for Homelessness and Health Inequalities for Solent NHS Trust. Pamela has worked in homelessness for the past 20 years and in 2010 set up the Alcohol Day Detoxification Service in Southampton which won the Nursing Standard Public Health Nursing Award in 2014.

    Dr Anita Green is a Nurse Consultant in Education and Training for Sussex Partnership NHS Foundation Trust and a visiting fellow with the University of Brighton. Prior to this role she was a Dual Diagnosis Nurse Consultant working for the same Trust. She is a member of the editorial board for Advances in Dual Diagnosis.

    Bernie Heath is a Senior Lecturer in Community Justice in the Institute of Criminal Justice Studies at the University of Portsmouth. Formerly a Senior Probation Officer, she has a long and varied experience which include working in the field of substance misuse. Academic areas of interest include substance misuse, mentally disordered offenders and the assessment and management of risk and dangerousness.

    Dr Rebecca Lee is a Consultant Addiction Psychiatrist, working for Greater Manchester West NHS Foundation Trust, currently in Blackburn with Darwen and previously in Salford treating those with drug and alcohol problems and until recently was the co-chair of the North West Specialists in Addictions meeting.

    Tim Leighton is Action on Addiction’s Director of Professional Education and Research. He has been leading professional education courses and degrees in the field of addiction for over 25 years. His current research interests are in the theory-based evaluation of treatment programmes, attempting to identify mechanisms of change leading to recovery.

    Dr Aaron Pycroft is Senior Lecturer in Addiction Studies in the Institute of Criminal Justice Studies at the University of Portsmouth, where he teaches, researches and writes on the theory and practice of addressing substance related problems. (twitter: @aaronpycroft)

    Tony Shea is currently the Harm Reduction Service Manager with Lancashire Care NHS Foundation Trust. He has worked in both statutory and third sector organisations around the country and is committed to demystifying the Harm Reduction vs Recovery debate and thereby reducing the potential harm of polarised approaches.

    Trevor Smith is engaged on a Doctorate in Health and Social Care Practice (D.Prac.) course at the University of Derby and is a counsellor, supervisor and trainer in private practice based in Warminster, Wiltshire, specialising in addictions work. Prior to private practice, he spent eight years as a tutor on a BSc in Addictions Counselling course, delivered on behalf of The University of Bath, and has also spent time as a Shared Care Worker in a Tier 2/Tier 3 drugs agency in Swindon and as a counsellor in a young person’s residential rehabilitation centre in rural Wiltshire.

    Ann Spooner is a Business Manager for Solent NHS Trust. Along with Pamela Campbell, Ann set up the Alcohol Day Detoxification Service, which won the Nursing Standard Public Health Nursing Award in 2014. She continues to provide business management support to the service and to the Homeless Healthcare Team in Southampton.

    Tony Wilkinson has had over 30 years of experience in the substance misuse field. He has worked in community and residential settings in a variety of roles both at an operational and strategic/commissioning level. He currently teaches at Accrington and Rossendale College and works for Greater Manchester West Mental Health NHS Foundation Trust.

    Dr Jane Winstone worked as a probation officer for a number of years before moving to the University of Portsmouth to support the Probation Qualification Training and now the Professional Doctorate in Criminal Justice. Her research interests include responses to mentally disordered offending, sex offending and ethical research strategies.

    Angela Woods is Training Team Manager / Teacher at Alcohol & Drugs Education Publications and Training (ADEPT), Lancashire Care NHS Foundation Trust, and delivers learning opportunities to both specialist and generic staff, service users, peer mentors and volunteers. Angela is involved with Accrington and Rossendale College in the development and delivery of a Foundation Degree in Alcohol and Substance Misuse Work.

    Introduction

    The Key Concepts series is intended to provide accessible and authoritative knowledge of essential topics. This book will particularly complement the existing titles in the series covering drugs and society and also mental health. Drug use (whether legal or illegal) is a major challenge on a global scale to governments, policy makers, communities, public services, individuals and their families. An understanding of the range and complexity of the issues and problems involved is therefore essential to a spectrum of academic disciplines and professional groupings. Given the interdisciplinary nature of studying substance use and misuse there is a need for a textbook that draws together the key elements of this area of study and in a concise manner for both students and practitioners. The book will be of relevance to students and practitioners in medicine, nursing, occupational therapy, social work, criminal justice, counselling and social and community studies.

    This book aims to provide a systematic and accessible introduction to the issues involved in substance use and misuse by:

    • An exploration of the key concepts involved in understanding the use and misuse of psychoactive substances;
    • The exploration of these concepts from an interdisciplinary approach and will include insights from biology, psychology, policy and political theory, social and religious studies;
    • Each entry will draw upon the international literature as well as practice examples and offer guidance on resources for further learning.

    This book will comprehensively examine the key aspects involved in the production and supply of psychoactive substances, the epidemiology of their use and the problems associated with that use. The book will consider the policies implemented to prohibit and regulate that use, and the effectiveness of interventions to both prevent and ameliorate drug-related harm.

    Debates about drug use go to the very heart of liberal democracy and our understanding of personal freedom balanced with the need to protect vulnerable groups in society. However these arguments are also to be found in the ways in which we conceptualise and respond to drug problems as they arise with the field of substance misuse often finding itself riven by ideological differences. These differences tend to be expressed in binary terms such as prohibition versus abstinence, recovery versus harm reduction, disease versus learned behaviour, self help versus formal treatment and so on. Problems such as these are further compounded by researchers and academics working within their own silos as biologists, psychologists or social theorists, despite the indisputable need for a biopsychosocial paradigm to understand these complex problems.

    This book is intended at introductory level to provide an overview of this biopsychosocial paradigm by addressing some of what we know about the use of psychoactive substances in society and the nature of addiction, policy responses and interventions. At one level this may sound as if all that is required is a clear evidence base of scientific research to determine the best course of action in addressing drug use and its harms. However one of the features of being human is that we have differing ethical paradigms by which we assess the ‘rightness’ of a particular course of action. It is the interactions between evidence, ethics and democracy that lead to many of the challenges that we find in the field of substance use and misuse.

    One of the key challenges is deciding what to include and what to leave out in a book such as this. There is also the challenge of how to teach a biopsychosocial paradigm within curricula that have a tendency to be discipline centric, and each contributor to the book has a significant amount of practice and teaching/training experience. Hopefully this practice experience will bring to life some of the complex issues and do so in a way that can be used as teaching resources as well.


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