Intersecting Themes in Addiction Care

Welcome to the 42^nd volume of the journal. We open the year with a focus on young adulthood. This is a critical period in terms of the development of different types of substance use disorders and behavioral addictions (BAs) like problem gambling, internet use, video gaming, and/or social media use, globally.

Tok & Cumurcu performed a bibliometric analysis of the conceptual structure of research in addiction among adolescents by examining studies indexed in the Web of Science database. Among their findings are a general trend of increasing studies on addiction in adolescents, ranging from drug and alcohol use disorders to internet addiction, with many of these being institution-based publications and the most coming out of the USA.

Process or behavioral addictions (PBAs), defined as a pathological involvement in an activity that may alter mood without drugs, are an emerging genre within addiction research and clinical service delivery models. These include disorders recognized in Diagnostic and Statistical Manual (DSM) like gambling disorders and internet gaming disorders but could also potentially include other behavioral addictions to sex, shopping and exercise. Ricciutti & Storlie reported on the experiences of licensed counseling professionals (LCPs) who treat clients with PBAs and found three significant overarching themes: the need for continued education and expanding their existing knowledge, difficulty and questions with a PBA diagnosis, and the need to use a holistic approach when working with and supporting their clients.

The study by Mushonga & Gaiza presented in-depth interviews and draw-write-tell assessments of young, undergraduate students in Lesotho who were raised by caregivers who have substance use disorders. Working with constructivist grounded theory methods, they analyzed the internal dialogue and conversations that allowed the youth cohort to have positive outcomes despite their childhood experiences. They found four themes in positive self-talk that played a role in facilitating emotional regulation, coping and perspective-taking. They noted that these positive, resilient self-talks were goal-oriented, motivational, promoted abstinence from substances and character molding.

The next section of this issue deals with intimate partner violence and grief in treatment and therapy, as well as the perspective of peer recovery specialists and community health workers in SUD treatment and recovery. There is a bidirectional relationship between SUDs and intimate partner violence (IPV). The estimates of IPV among women with SUD, in particular, can be as high as 90%. Sedgewick and peers reported on a pilot study that examined the feasibility of and satisfaction rate in an outpatient empowerment and psychoeducational skills group for women with SUD who have experienced intimate partner violence (IPV). Among the important factors they have endorsed were and IPV-informed content, women only participants and a female therapist.

Price-Spratlen worked with multi-year data from a faith-charity funded, community-based health initiative for SUD care in a high poverty neighborhood to understand how peer-based, 12 Step meeting model contributes to resilience and emotional regulation. The author found addiction recovery to be similar and strongly linked with prolonged and pathological grief. Grief-related topics were frequently shared in these meetings and addressing grief contributed to improved health outcomes.

Alavi, Soske et al. used semi-structured interviews with peer recovery specialists and community health workers in substance use disorder (SUD) treatment and recovery support to characterize their workplace experiences. In their study, they elaborate on themes of system failures, organizational hierarchies, as well as experiential themes involving the benefits and challenges of their role, reciprocity, duality of lived experience, and relationships with supervisors and medical professionals.

Finally, we close with a medical review article concerning alcohol-related liver diseases, a report on substance use in educational institutions in Ireland, and a psychiatric case report.

Alcohol consumption is a major risk factor for alcohol-related liver diseases that include asymptomatic liver steatosis to advanced liver cirrhosis. Nelaturi, Ravikumar & colleagues presented a review article summarizing the role of aberrant regulation of microRNAs involve in oxidative stress, epigenetic modulations and inflammatory response in alcohol-related liver disease.

Murphy reported on a 2022 national study in Ireland on the prevalence of substance use among students in institutions of higher learning. Over half of these students reported having use or using substances with harms including negative effects on their academics, retention and graduation as well as mental and physical well-being.

We close this first issue of ATQ with a letter to the editor from Ahmad describing an adolescent who experienced alcohol-induced psychotic symptoms that included vivid hallucinations. Although these psychotic episodes were transient, the youth perceived them to be “paranormal activities” that induced substantial fear and lead to his abstinence from alcohol.