Substance Abuse and Addiction Commons^™

Public Awareness Of Controlled Drug Abuse And Dependence In Saudi Arabia: A Cross-Sectional Study, Khalid Mohammed Alharbi, Amal Faraj Alotaibi

Saudi Toxicology Journal

Background: This study examines public awareness in Saudi Arabia regarding con- trolled drug abuse and dependence. It aims to evaluate public knowledge of controlled drugs, their complications, legal considerations, and exposure to related campaign. The study also explored predictors of public awareness of controlled drug abuse and dependence. Methods: A cross-sectional survey utilized a random sampling technique to recruit 529 participants aged 18 or older across Saudi Arabia. Participants were recruited via an online questionnaire distributed from January to February 2024, targeting diverse demographics (e.g., age, gender, region). The survey assessed knowledge of controlled drugs, their effects, and explored perceptions …

Toward A Unified Neuroaesthetic Framework For Art-Based Interventions In Substance Use Recovery - A Review, Piper Hutson, James Hutson

Faculty Scholarship

Art-based interventions have gained increasing recognition as complementary strategies for substance use disorder (SUD) recovery and prevention, yet the field remains fragmented across clinical art therapy, community-based programs, and expressive digital practices. This article advances a unified neuroaesthetic framework that integrates sensory regulation, narrative integration, and interpersonal synchronization as the core mechanisms of healing. Drawing on recent U.S.-based empirical studies (post-2020), the paper synthesizes evidence from multiple modalities, including visual arts, music therapy, dance/movement practices, and digital storytelling, each demonstrating measurable effects on craving reduction, stress regulation, identity reconstruction, and social connection. Neuroscientific insights are central: findings highlight how creative …

Applying Contextual Behavioral Science To Address Addictions In Monsters, Chase Hollander

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

The dominant essentialist paradigm in addiction treatment often conceptualizes addiction as a curse or plague which seizes the individual afflicted by it. Such views are reinforced by neurobiological interventions like Medication-Assisted Treatment (MAT). While MAT can reduce cravings and withdrawal symptoms, its long-term efficacy is mixed, and its emphasis on abstinence as a primary outcome limits its scope. Addiction is a multifaceted phenomenon shaped by physiological, psychological, social, and systemic factors—including stigma, moral judgment, and structural oppression. Essentialist approaches frequently pathologize individuals and obscure these broader influences. In contrast, contextual behavioral sciences and therapies aligned with functional contextualism such as …

Enhancing Research Training Curricula Through The Ethical Integration Of Ai-Powered Tools: Opportunities And Challenges For Counselor Educators, Joshua C. Watson, Chris Leeth, Kevin Wong, Justen Schroeder

Journal of Counselor Preparation and Supervision

This article reviews existing training models used to teach research courses and facilitate researcher identity development in counselor education curricula and suggests how generative artificial intelligence (GenAI) can be incorporated into these courses as an instructional aid that improves researcher efficiency. Various GenAI tools used across stages of the research process are introduced with a discussion of their ethical implications and how they can be integrated into exiting lesson plans.

Counselor-In-Training Perceptions Of Artificial Intelligence: Implications For Counselor Education, Leo Gonzalez Jr., Deija Mccalla

Journal of Counselor Preparation and Supervision

This study examined the perceptions of counselors-in-training (CIT) on artificial intelligence (AI) in counseling practice and training. 31 CIT responded to three open-ended questions about the benefits, drawbacks, and overall attitudes of integrating AI into counseling practice and education. Thematic analysis was used to analyze the responses. The findings showed that CIT perceive AI as a clinical support tool, especially for tasks such as diagnosis and treatment planning. Additionally, CIT voiced concerns of potential overreliance on AI, ethical risks, confidentiality concerns, and the possible loss of human connection. Furthermore, although several CIT expressed cautious optimism regarding AI's use in counselor …

A Pilot-Study Evaluating The Fidelity Of Chatgpt In Client Simulations, Eric Tod Beeson, Yusen Zhai, Russell Fulmer, Andrew M. Burck, Rakesh Maurya

Journal of Counselor Preparation and Supervision

Generative AI (genAI) is expanding in counselor education. This pilot study evaluated ChatGPT 4o's voice mode for simulating client scenarios during 53-minute mock-intake sessions with master’s-level counseling students. Analyzing eight domains (authenticity, consistency, emotional expression, empathy, cultural dynamics, self-awareness, goal setting, and role play confusion), ChatGPT’s responses showed good to excellent fidelity when compared to a typical client. Limitations such as formulaic and idealized responses raised authenticity concerns. ChatGPT offers a scalable, cost-effective tool for pre-practicum training, with potential to enhance skill development across the curriculum. Educators are encouraged to integrate genAI thoughtfully, prioritizing ethical considerations and iterative prompt refinement.

Utilizing Artificial Intelligence Therapeutic Adjuncts To Support Autistic Adults Between Counseling Sessions, Carlos J. Castaneda Jr, Nicole Noble, Afroze N. Shaikh

Journal of Counselor Preparation and Supervision

The integration of artificial intelligence (AI) into mental health care presents innovative opportunities for therapeutic interventions. This pilot study examined the use of a customized Artificial Intelligence Therapeutic Adjunct (AITA) as a supplementary counseling tool for adults with level one autism spectrum disorder who attended weekly counseling sessions. Using a Single Subject Design to review trends in mental health symptoms and perceptions of the AITA, participants engaged with the AITA over four weeks, completed weekly anxiety and depression assessments, and post-intervention and satisfaction surveys. Thematic Analysis identified common counseling concerns and the AITA’s use of counseling techniques. Although findings suggest …

Reimagining The Counseling Profession: Preparing Counselors For Ai And Digital Health Integration, Carl J. Sheperis, Dusti L. Annan-Coultas, Caronne C. C. Rush

Journal of Counselor Preparation and Supervision

Digital health technologies including artificial intelligence (AI) are transforming mental healthcare delivery, creating new opportunities and challenges for counseling practice. This article examines digital health applications in counseling, including telehealth, mobile apps, digital therapeutics, virtual reality, and AI-powered tools. We explore key implications for practice, including enhanced accessibility, impacts on therapeutic relationships, and ethical considerations. The article presents a six-domain competency framework covering privacy and security, technical proficiency, ethical literacy, clinical integration, therapeutic adaptability, and administrative management. A case study illustrates the practical application of hybrid digital care, while a discussion of counselor education highlights the need for curriculum updates. …

Letter From The Editors: Special Issue: Artificial Intelligence In Professional Counseling And Counselor Preparation, Rachel Jacoby, Sandra Logan-Mckibben

Journal of Counselor Preparation and Supervision

No abstract provided.

Courtroom To Clinic: Where I Found The Work I Love, Christina Fay Bucarey

Graduate Student Portfolios, Professional Papers, and Capstone Projects

This portfolio reflects my journey through the Master of Social Work program, highlighting my growth in clinical practice, policy advocacy, and cultural responsiveness. Drawing from experiences in treatment court, addiction counseling, tribal and non-tribal community contracts, and my generalist- and specialist-year practicum, it demonstrates my application of trauma-informed, evidence-based interventions, including adapted DBT groups within Indigenous communities. Through the lens of the Five Elements of Advanced Integrated Practice, I connect coursework, practicum learning, and professional development, such as my involvement with the NASW board, to show how I’ve developed the competencies required for ethical, effective, and community-centered social work practice.

Mental Health And Substance Use Interventions Within Muslim Community Spaces: A Community Based-Participatory Research Proposal, Halah Mansour Alayleh

Master's Projects and Capstones

Background. Muslim Americans face significant mental health and substance use challenges compounded by Islamophobic discrimination, cultural stigma, and barriers to accessing culturally competent services. They also significantly underuse professional mental health services. Purpose. This study aims to collaborate with Muslim communities within the San Francisco Bay Area to develop a replicable intervention framework for addressing mental health and substance use stigma within mosques and other Muslim community spaces. Methods. The proposal uses a community-based participatory research (CBPR) methodology while integrating the theory of planned behavior (TPB) and stigma theory in the framework. This proposal outlines the four phases of intervention …

Review Of Alcohol Use Among Aboriginal And Torres Strait Islander Peoples: Patterns, Impacts And Community-Led Responses, Teagan J. Weatherall, Ks Kylie Lee, Annalee Stearne, Monika Dzidowska, Nicole Hewlett, Lynette Bullen, Taleah Reynolds, Summer Loggins, James H. Conigrave

Journal of the Australian Indigenous HealthInfoNet

This review provides an overview of alcohol use among Aboriginal and Torres Strait Islander peoples using the latest research available. It has been designed to update the evidence published since the previous review conducted in 2018 on this topic (Review of the harmful use of alcohol among Aboriginal and Torres Strait Islander people by Prof Dennis Gray, Dr Annalee Stearne and colleagues) (Gray et al., 2018).

In this updated review, we discuss the historical context and scope of alcohol use among Aboriginal and Torres Strait Islander peoples, impacts on individuals and whole communities, relevant national policies and strategies, present …

Exploring The Relationship Between Cannabis Use Motives And Readiness To Change Among Young Adult College Students, Emma Kathryn Rawls

Psychology Theses & Dissertations

Cannabis use among young adult college students has risen steadily over the past decade, raising concerns about the associated health, academic, and psychological consequences. While cannabis use motives and readiness to change have each been linked to use patterns and outcomes, limited research has examined how these factors interact. The current study investigated whether readiness to change, based on the Transtheoretical Model (TTM), moderates the relationship between cannabis use motives and cannabis-related consequences as well as past-30-day use frequency. A sample of 100 college students 18-25 years old (M_age = 20.08, SD = 2.12; 67% female; 55.0% Black or …

How Was Rehab? A Follow-Up To A Randomized Effectiveness Control Trial Of A Brief Acceptance And Commitment Therapy Protocol For Inpatient Detoxification Patients, Alexander J. Twohy

Dissertations

Residential treatment for Substance Use Disorders (SUD) is a common treatment modality. However, the literature is sparse on modifiable predictors that affect change during the residential treatment stay. Acceptance and Commitment Therapy (ACT) has been shown to be an effective treatment for SUDs. Weststrate et al. (2023), in a randomized controlled effectiveness trial, compared ACT plus medication management to medication management during detoxification. The addition of ACT increased consumer satisfaction and ACT skills use, while decreasing psychological inflexibility and reducing withdrawal symptoms.

This study explored whether the brief ACT intervention had impacts during participants' subsequent residential stay. Forty out of …

“Medication Is Only 10% Of Recovery”: A Mixed-Method Analysis Of Facilitators And Barriers To The Equitable Implementation Of Medications For Opioid Use Disorder Treatment, Alexandra Hernandez-Vallant

Psychology ETDs

Medications for opioid use disorder (MOUD), the gold standard treatment for OUD, are underutilized. Yet, research on MOUD clinical encounters is limited. Attention to social determinants of health (SDOH) can help improve engagement and retention in MOUD treatment. This dissertation project describes development of a clinical vignette-based survey using a two phase exploratory sequential design to examine the extent to which SDOH influence clinical decision-making among MOUD providers. Study 1 included interviews with 23 providers to learn their perspectives on facilitators/barriers to MOUD treatment and the clinical and social determinants most influential to their clinical decision-making. Study 2 involved development …

Use Of A Shoulder-Mounted Wearable Sensor Prototype Designed To Detect Opioid-Related Overdose: A Qualitative User Experience Study, Alexis M. Roth, Ally K. D'Angelo, David Gordon, Benjamin Cocchiaro, Anush Lingamoorthy, Rose Laurano, Matthew Salzman, Jacob S. Brenner, Cameron Baston

SKMC Student Presentations and Publications

BACKGROUND: For over a decade, drug overdose has been the leading cause of injury and accidental death in the United States. Most fatal overdoses involve opioids and occur during solitary drug use events when no one is available to initiate lifesaving responses (eg, naloxone). While there is a growing interest in devices providing early overdose detection and automated responses, little research has engaged end users in a device design process.

OBJECTIVE: This study aimed to describe user experience, perceived harms and benefits, and the acceptability of a shoulder-mounted wearable sensor among people who inject drugs who wore a device prototype …

Pharmacogenetic Exploration Of Burenorphine And Related Metabolites In Umbilical Cord Blood, Amelia Monfared, Derek E. Murrell, Darshan S. Shah, Melissa Hoang, Stacy D. Brown, Sam Harirforoosh

Pharmacy Faculty Articles and Research

The goal of this study was to explore associations between single-nucleotide polymorphisms (SNPs) and umbilical cord blood concentrations of buprenorphine and its metabolites following maternal administration. This is a sub-study of a prospective observational cohort investigation which included pregnant women receiving buprenorphine for opioid use disorder during pregnancy. Following delivery, umbilical cord blood samples were collected and genotyped using a pharmacogenetic panel. The drug and metabolite concentrations were analyzed through liquid chromatography-mass spectrometry, and genetic association analysis was completed using PLINK software. The included neonates (n = 14) had a mean birth weight of 3.00 ± 0.39 kg and were …

Qualitative Insights Into Drug Use Safety Strategies And Social Support Among Sexual Minority Women Who Inject Drugs In Baltimore, Maryland, Jennifer L. Glick, Leanne Zhang, Aimee Huang, Megan Nguyen, Danielle German

School of Public Health Faculty Publications

Background: Sexual minority women (SMW) experience higher rates of substance use relative to heterosexual women in the U.S. but remain an under-studied population. SMW who inject drugs (SMWWID) navigate an unpredictable drug market and may experience complex relationships within their social spheres. We explore cisgender SMWWID’s strategies to maintain safety while injecting drugs, and the influence of their social support systems on those strategies. Methods: We conducted N = 16 phone-based, semi-structured, in-depth interviews with SMWWID in Baltimore, Maryland between June-October 2021. The interviews explored participants’ sexual orientation and gender identities, social networks and support systems, drug use behaviors and …

Feasibility Of A Peer-Facilitated Video-Based Mental Health And Substance Use Service-Learning Program, Mara Carmina A. Tamayo, King Filart, Maria Regina Hechanova

Journal of Community Engagement and Higher Education

This study examined the feasibility of implementing a peer-facilitated mental health and substance use video-based program delivered by psychology students as part of service learning. The program was delivered on-site and online. Findings reveal improvements in knowledge, attitudes, refusal self-efficacy, and adaptive coping among on-site participants. However, there was no effect on online participants given many implementation challenges. Recommendations include delivering the program on-site, strengthening training for facilitators, increasing program duration, and shortening the videos.

Teaching About Substance Use Recovery: The Pedagogical Power Of Community-Based Learning, Jumi Hayaki, Isabelle Jenkins

Journal of Community Engagement and Higher Education

Community-based learning (CBL) is a form of experiential learning that integrates academic theory and content with active service in an applied setting. CBL is especially well suited for teaching about complex social issues. We present the case study of a psychology course on substance use recovery that leverages CBL to dismantle stereotypes, humanize a highly stigmatized mental health problem facing society, and afford students the opportunity to consider their own privilege and positionality.

Gender Differences In Regretted Consensual Sexual Experiences And Problematic Alcohol Use Among First-Year College Students, Shannon Shen, Soyoung Kwon, Sukho Lee

Journal of Social, Behavioral, and Health Sciences

Regretted sexual behaviors and alcohol use often occur in tandem for college students; however, few studies have examined their interrelationships or the variance across gender. This study tested gender differences in how regretting a consensual sexual experience is related to college students’ alcohol use. One hundred and forty first-year students (63% women, 69% Hispanic) surveyed in 2018 and 2019 reported their sexual behavior and alcohol use (following the Rutgers Alcohol Problem Index [RAPI]). Twenty-one percent of men and 16% of women reported a regretted sexual encounter. Interaction effects from regression models revealed that men with sexual regret had a significantly …

Urban-Rural Divide In Inequality’S Impact On Substance Abuse, Jonathan E. Flores

Undergraduate Theses, Capstones, and Recitals

This thesis focuses on investigating the relationship between income inequality, measured through the Gini coefficient, and drug addiction, proxied through substance-related mortality. Specifically, this thesis focuses on how these dynamics vary across rural and urban counties in the United States, using population size as a proxy. County-level data from 2016 to 2020 were collected through both the CDC and the Census Bureau and subsequently analyzed using Stata, with crude death rates from drug and alcohol causes serving as a function of the Gini coefficient, labor force participation, racial composition, and other socioeconomic indicators. Through a quadratic version of the model, …

The Incidence Of Peripartum Invasive Group A Streptococcal Infections And Association With Illicit Drug Use, Elizabeth Wagman, Elizabeth Wagman, Rupsa Boelig, Sarah Boudova

Department of Obstetrics and Gynecology Faculty Papers

No abstract provided.

Evaluating Depression In Adults Undergoing Substance Abuse Treatment: A Program Evaluation Of Intensive Outpatient Program, Chidochomoyo E. Zvirawa

Dissertations

Problem: Depression and substance use disorders (SUDs) frequently co-occur, complicating recovery outcomes. Despite screening recommendations, depression remains underdiagnosed in many SUD treatment settings.

Methods: This mixed-methods program evaluation examined depressive symptoms among adults in an Intensive Outpatient Program (IOP) using the Patient Health Questionnaire (PHQ-8). Depression screenings were conducted at intake, four weeks, and eight weeks. Eight participants meeting inclusion criteria were assessed. Data included demographics, treatment engagement, and PHQ-8 scores.

Results: PHQ-8 scores significantly declined from baseline (M = 11.75, SD = 6.52) to eight weeks (M = 5.13, SD = 5.05), t(7) = 2.76, p = .028, indicating …

Molecular Insights Into The Role Of Estrogen Receptor Beta In Ecdysterone Mediated Anabolic Activity, Syeda Sumayya Tariq, Madiha Sardar, Muhammad Shafiq, Hendrick Heinz, Mohammad Nur-E-Alam, Aftab Ahmad, Zaheer Ul-Haq

Pharmacy Faculty Articles and Research

Ecdysterone, often dubbed a “natural steroid,” has garnered significant attention among athletes for its reputed growth-promoting and anabolic properties. Unlike synthetic anabolic steroids, which are classified as controlled substances, ecdysteroids remain largely unregulated in many countries and are widely marketed as dietary supplements. Notably, ecdysterone has been included in the World Anti-Doping Agency (WADA) monitoring program, highlighting its potential impact on athletic performance and raising questions about its regulation. Emerging evidence indicates that, unlike traditional anabolic steroids that act primarily via the Androgen Receptor (AR), ecdysterone’s anabolic effects may be mediated through Estrogen Receptors (ERs), particularly Estrogen Receptor beta (ERβ). …

An Assessment Of Maine's Capacity To Support Transitions Of Care Through The Substance Use Disorder Continuum, Mary Lindsey Smith Phd, Sarah Mclaughlin Mph, Rachel M. Gallo Mph

Substance Use Research & Evaluation

This report evaluates Maine's capacity to support effective transitions of care across the substance use disorder (SUD) treatment continuum. Using data collected from a statewide survey of 65 SUD providers, conducted from February to April 2025, the study examines organizational practices, inter-provider communication, and coordination strategies related to transitions between levels of care: medically supervised withdrawal, inpatient, and outpatient treatment programs. Key findings reveal strong intra-organizational communication, widespread understanding of ASAM criteria, and a general commitment to patient-centered care. However, gaps persist in coordination between care levels, particularly in withdrawal management programs, which rarely conduct follow-ups or collaborate with outpatient …

Withdrawal Management In Maine: Capacity Challenges And Opportunities For Improvement, Mary Lindsey Smith Phd, Katie Rosingana Ba, Tyler Egeland Ba, Sarah Mclaughlin Mph

Substance Use Research & Evaluation

This summary report presents findings from healthcare provider interviews conducted in 2024 to assess the current landscape of withdrawal management (WM) services in Maine. Sixteen providers, across eight counties and representing a range of substance use disorder (SUD) service types, were interviewed to evaluate capacity, challenges, and opportunities for improvement across the continuum of care. Thematic analysis identified widespread gaps in withdrawal management capacity, especially in ASAM Levels 1.7 to 4.0, with critical shortages in ambulatory and low-intensity residential services. Key barriers included geographic inequities, insufficient infrastructure, long waitlists, inadequate reimbursement, and workforce shortages exacerbated by stigma and provider discomfort. …

Feedback On Withdrawal Management Services In Maine From Persons With Lived Experience, Mary Lindsey Smith Phd, Katie Rosingana Ba

Substance Use Research & Evaluation

This summary report presents findings from interviews with twelve persons with lived experience of substance use disorder (PWLE). The interviews asked persons in recovery about their experiences accessing withdrawal management and broader substance use treatment services across Maine. Participants identified key barriers to treatment including high costs, limited bed availability, long wait times, geographic inaccessibility, and lack of centralized information. Gaps in service infrastructure, particularly for opioid withdrawal management, long-term treatment, and transition supports post-detox, were widely reported. Participants emphasized the critical need for more localized and individualized services, particularly for parents, rural residents, and low-income individuals. Recommendations include expanding …

Assessing The Relationship Between Combat Exposure, Wartime Service, And Barriers To Substance Use Disorder Treatment In Post 9/11 Veterans., Robert Near

Dissertations

Substance use disorders (SUDs) represent a critical public health concern, particularly within military and veteran populations. The complex interplay of mental health challenges, combat exposure, and the unique stressors associated with military service contribute to a heightened vulnerability among veterans. Research from the United States Department of Veterans Affairs (USDVA) underscores the prevalence of these issues, indicating that approximately 1 in 10 veterans from the Iraq or Afghanistan wars treated by the VA are diagnosed with a SUD (Veterans Affairs, 2023). Additionally, veterans from all eras show a higher propensity for binge drinking when compared to the general population, further …

Opioid Use Patterns After Nonsurgical Management Of Distal Radius Fractures: A Call For Opioid Stewardship, Sina Ramtin, Sara Khan, Vijay Chhabra, Wali Pirzada, Mohammad Khak, Asif M. Ilyas

Rothman Institute Papers

PURPOSE: While most opioid research focuses on postoperative use, limited data exist on prescribing patterns in nonsurgical management of common injuries such as distal radius fractures (DRFs). This study aimed to assess opioid prescribing trends and identify factors linked to prolonged use in nonsurgically treated DRFs.

METHODS: A retrospective cohort study of 591 patients aged 18-50 with nonsurgically managed DRFs between 2018 and 2024 was conducted. Opioid use was classified as prior opioid use (POU), fracture-related opioid use (FxOU), or delayed opioid use (DOU). Prescription data were obtained from the Prescription Drug Monitoring Program and analyzed for morphine milligram equivalents, …