Staff in opioid treatment programs (OTPs) face elevated risk of secondary traumatic stress, yet the availability and effectiveness of training and clinical supervision to address this risk remain unclear. This study characterized current OTP training and supervision practices and examined their associations with staff vicarious trauma (VT) and burn-out. In a cross-sectional survey of OTPs, administrators (N = 44, 21 U.S. states) reported on staff training. Staff (N = 83) completed validated measures of VT and burnout. Counselors (n = 30) reported on clinical supervision. Training in VT and burnout was widely available, and most administrators (83.3%) and staff (89.6%) expressed interest in reflective supervision tailored to OTPs. In regression models, clinical supervision was associated with lower VT and burnout, whereas training availability was associated with higher VT and burnout. Findings suggest existing training models may be insufficient to address OTP staff stress. Expanding relationally-focused supervision may buffer the emotional toll of substance use treatment work.
This study examined factors influencing effective supervision of peer support specialists (PSS) integrated into medical settings. The research used a survey incorporating quantitative measures-the Brief Assessment of Recovery Capital (BARC-10), the Assessment for Collaborative Environments (ACE-15), and an adapted Quality of Supervision Scale (QSS)-as well as qualitative open-ended questions. Results indicated that quality supervision was linked with higher levels of recovery capital (mean BARC-10 score = 54.89, surpassing the remission threshold of 47) and team connectedness (mean ACE-15 score = 59.81, above previous averages). Qualitative responses emphasized the value of consistent and trusting supervisory relationships for professional development and well-being, which corresponded with improvements in client care, resource access, and ethical practice. The study outlines approaches for delivering effective supervision and its potential to strengthen recovery capital, promote workforce retention, improve team functioning, and support patient outcomes.
Concerned significant others (CSOs) of individuals with alcohol-related problems experience substantial emotional, psychological, and relational burdens, including elevated stress, anxiety, depression, diminished quality of life, and social isolation. This scoping review explores what is currently known about formal support for adult CSOs of individuals with alcohol-related problems. Thirty-three articles, were included, encompassing quantitative, qualitative, mixed-methods, and review designs. Findings indicate that interventions such as Community Reinforcement and Family Training (CRAFT) can improve coping, mental health, and relationship satisfaction, while web-based formats facilitate accessible, low-threshold support and reduce barriers related to stigma. However, support often prioritizes individual psychological outcomes, with less attention to relational and social aspects, and lacks a strength-based perspective. The review highlights tensions between individualized and family-oriented support and identifies gaps in long-term effectiveness and inclusivity. Future research should address underrepresented CSO groups and incorporate broader psychosocial and relational outcomes to inform more comprehensive and responsive interventions.
Parental substance use disorder is a significant public health concern in the United States, affecting millions of families and placing children at heightened risk for adverse developmental outcomes. West Virginia has been among the most heavily impacted states by the opioid epidemic, with some of the highest rates of overdose deaths and SUD prevalence in the nation. This study examined the prevalence of emotional and behavioral problems among children of mothers in substance use disorder (SUD) treatment. Surveys from 109 mothers in West Virginia revealed that 31.7% of children experienced emotional problems, 26.9% experienced conduct problems and 27.9% experienced hyperactivity problems. Maternal ACE scores and parent-child conflict were positively linked to children's externalizing problems. Parent-child conflict and children's ACE score were significantly associated with internalizing problems. Findings suggest that children whose mothers suffer from SUD face a greater risk for emotional and behavioral challenges, emphasizing the need for targeted interventions and support for affected families.
People with drug use disorders (DUD) use the emergency department (ED) at rates several times higher than the general population. Screening and brief intervention (SBI) identifies individuals with risky substance use and engages them in a short intervention to reflect on risk and motivate behavior change. SBI can be delivered by social workers and other providers who offer holistic care in the ED. The effects of SBI on health service utilization, particularly among people with DUD, are underexplored. This study compared all-cause and drug-related ED utilization in the 12 months before and after an index ED visit in which intervention participants (n = 420) received SBI. The intervention group was compared with a matched comparison group (n = 420). Incidence of either outcome did not differ significantly between groups. These findings suggest SBI alone may not be sufficient to reduce ED utilization in populations with complex social and medical needs.
Enduring disparities in healthcare access contribute to disproportionately poor health outcomes among racial/ethnic minority groups in the U.S. This study explores how barriers to mental healthcare influence substance use patterns within these communities. Seven focus groups (N = 43) were conducted among racial/ethnic minority adults who use multiple substances and revealed two themes: (1) socioeconomic and insurance barriers functioned not only as financial obstacles but also redirected individuals toward substance use when care was inaccessible, and (2) substance use emerged as a deliberate and accessible strategy for managing stressors including psychological pain and unmet health needs, rather than passive or incidental behavior. These findings contradict the view of substance use as an out-of-control behavior, instead situating use within the structural conditions that restrict healthier options. Policy reform must prioritize dismantling barriers that disproportionately affect minority communities and advance care models that provide accessible and trustworthy mental health services.
This study explored the lived experiences of social workers involved in managing substance use disorder within psychiatric teams at Harare Psychiatric Hospital, Zimbabwe. Using a descriptive phenomenological design, data were collected through in-depth, semi-structured interviews with 10 purposively selected social workers. Data were analyzed using Giorgi's five-step method to identify shared themes. Findings revealed systemic barriers, including marginalization in decision-making, role ambiguity, inadequate resources, limited training, and poor communication. These challenges undermine effective collaboration and holistic care. The study highlights the urgent need for inclusive policies, institutional support, and role clarity to enhance social work's contribution to integrated addiction care.
Heavy alcohol consumption and opioid overdose rates continue in the United States. Master's-level social workers (MSWs) work with individuals who experience alcohol use disorder (AUD) and opioid use disorder (OUD). This study explores MSWs' attitudes toward the conditions, and by extension, attitudes toward those who experience the disorders, through the use of the Medical Condition Regard Scale (MCRS). A repeated measures ANOVA identified MSWs from Indiana, Kentucky, and Ohio (N = 140) having more favorable statistically significant (p < .001) attitudes toward individuals with AUD than those with OUD. Further analysis revealed the source of the difference. Social workers who reflect on their biases could improve attitudes toward the disorders and toward those who experience them. Social work programs must also increase their addiction-related educational offerings. By doing so, future social workers can be better prepared to serve individuals with these disorders, thereby potentially improving their regard for them.
There has been an increase in problematic substance use among women, yet little is known about their access to substance use disorder (SUD) treatment services. This qualitative study employed an exploratory-descriptive research design to examine the availability and scope of treatment services for women in the Limpopo Province of South Africa. Data was collected through telephonic interviews with 20 social workers employed by the Department of Social Development in Limpopo Province and analyzed using thematic content analysis. Findings revealed that there is no standardized treatment specifically for women, and the available government treatment facility in Limpopo Province is not sufficient for the demand that arises from women in need of SUD treatment services. The study suggests that increased government investment in SUD treatment facilities and services is essential to improve treatment access for women in need of these services.
This study examined barriers to accessing treatment and recovery support for opioid use disorder (OUD) among women and suggested solutions to overcoming them. Ten in-depth focus groups (27 participants) were conducted with women in recovery from August 2023 to January 2024. Transcripts were analyzed by two coders using an inductive approach guided by grounded theory methods. Major themes that emerged highlighted the ways compounding challenges make accessing treatment and entering recovery difficult, as well as the unique hardships encountered by mothers. Themes related to potential solutions included fostering supportive communities of women, improving the availability of gender-specific resources and support, and providing comprehensive, individualized recovery services. Further research on implementation strategies is needed to integrate these suggestions into treatment and recovery settings. Moving forward, it is critical that the hard-won victories of women in recovery are directly translated into action to improve OUD treatment and recovery settings for women.
Research has shown the health impacts of classism, sexism, and racism, yet few interventions help oppressed individuals address internalized and structural oppression. This study used data from an intervention designed to build Critical Consciousness, a precursor to health behavior change, focusing on the process of Critical Reflection. We analyzed voice recordings from Critical Dialogues in a randomized clinical trial involving oppressed and underserved men (n = 56) with incarceration and substance use histories. Participants discussed a painted illustration representing oppressive systems. Participants generated dialogue threads expressing Descriptions, Explanations, Interpretations, and Implications. These dialogues enhanced their capacity for Critical Reflection, which motivates Critical Action such as civic and political engagement. Critical Dialogue enabled participants to examine social, political, and economic tools of oppression, advancing understanding of how Critical Reflection can mitigate the effects of oppression on health.
Stigmatization of substance misuse within health care settings is a public health issue that negatively affects health care providers (HCPs) and people who misuse substances (PWMS) alike. A large body of research has been dedicated to understanding each population's unique experiences when interacting with the other, but little research has been presented that analyzes their perspectives concurrently. The purpose of this narrative literature review is to understand the effects of stigmatization of substance misuse on the therapeutic alliance by analyzing the literature on interactions between PWMS and HCPs A total of 39 articles were identified: 24 on PWMS, 12on HCPs, and 3 that highlighed both perspectives. Across the literature, stigmatization was connected to language, severity of use, emotional experiences, the power imbalance between patients and providers, and treatment engagement. Mitigating the harms of stigma and increasing opportunties for therapeutic engagement is essential for creating better patient outcomes and mitigating the broader health disparities associated with substance use.
Addiction remains a major global health challenge, with relapse rates persisting despite pharmacological and psychotherapeutic advances. This article introduces the Quantum Mindfulness Framework an integrative, culturally grounded model that synthesizes teachings from the Bhagavad Gita, mindfulness-based interventions, and carefully framed metaphorical quantum metaphors to enrich addiction care. A narrative review covering 2000-2024 was conducted using PubMed, PsycINFO, and Google Scholar, synthesizing philosophical texts, empirical studies, and conceptual reviews. Literature was organized into (a) Indian philosophical psychology, (b) empirically supported therapies (CBT, ACT, mindfulness-based relapse prevention), and (c) metaphorical quantum concepts. The framework highlights convergences among Gita principles Dhyana, Atma-Samyama, Dharma, Bhakti, and Bhavana and practices like MBRP, values clarification, and guided imagery. Quantum metaphors are explicitly metaphorical not scientific: tools that enhance therapeutic dialogue and client engagement. This exploratory framework promotes dialogue, empirical testing, and culturally sensitive recovery with scientific and ethical integrity.
This narrative review examines the current state of recovery housing in the United States and the integration of medication for opioid use disorder (MOUD) within Level II recovery homes. The review identifies key themes including the role of recovery capital among individuals using MOUD in recovery homes, the social model philosophy and MOUD integration, and barriers to MOUD implementation found in the current literature. Findings demonstrate the influence abstinence-based recovery models have had on the integration of MOUD in recovery homes, challenges at the policy level, and the need for universal data collection to assess and sustain recovery. The review concludes with recommendations for future research and practice in the field of recovery housing.
