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      Strengths, weaknesses, opportunities and threats (SWOT) analysis of reinitiation into methamphetamine abusers: qualitative findings from an exploration of methamphetamine abusers in Shanghai, China

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          Abstract

          Background

          Despite high relapse rate among methamphetamine (MA) abusers, there still have been little empirical data to date detecting the risk factors related to craving and relapse from the perspective of MA abusers. Therefore, the aim of this study was to use qualitative research methods exploring the strengths, weaknesses, opportunities and threat factors that could facilitate or impede individuals’ abstinence in a real-life context from the perspectives of MA abusers.

          Aim

          To use qualitative research methods exploring the strengths, weaknesses, opportunities and threat factors relating to individuals’ abstinence in a real-life context.

          Method

          Semistructured interviews were conducted with 32 MA abusers recruited in Shanghai guided by open-ended questions on narrating the real-life catalysts and inhibitors related to craving, initiation, relapse and abstinence. All data were transcribed verbatim and analysed using a strengths, weaknesses, opportunities and threats (SWOT) analysis.

          Results

          The results of the SWOT analysis revealed that contextual factors including peer influence, prevalence and availability of MA, familiar venue of MA use, discrimination, sexual behaviours, alcohol, emotional states and their attitudes towards smoking MA were important factors that contribute to reinitiation and relapse. Surveillance systems, antidrug social workers, vocational skills trainings, moving to another city and family responsibility might serve as counter measures targeting those mentioned weaknesses and threats above.

          Conclusion

          This SWOT analysis highlights the complex nature of relapse. Comprehensive interventions strengthening coping skills such as virtual reality techniques are desperately needed to facilitate individuals’ sustained abstinence.

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          Most cited references28

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          Cognitive enhancement as a treatment for drug addictions.

          Drug addiction continues to be an important public health problem, with an estimated 22.6 million current illicit drug users in the United States alone. For many addictions, including cocaine, methamphetamine, and marijuana addiction, there are no approved pharmacological treatments. Behavioral treatments are effective but effects vary widely across individuals. Treatments that are effective across multiple addictions are greatly needed, and accumulating evidence suggests that one such approach may be pharmacological or behavioral interventions that enhance executive inhibitory control in addicts. Current evidence indicates that most forms of chronic drug use may be associated with significant cognitive impairments, especially in attention, working memory, and response inhibition functions. In some studies, these impairments predict poor treatment retention and outcome. A number of cognitive enhancing agents, including galantamine, modafinil, atomoxetine, methylphenidate, and guanfacine, have shown promising findings in human studies. Specific behavioral interventions, including cognitive remediation, also show promise. However, whether improvement of selective cognitive functions reduces drug use behavior remains to be determined. Cognitive enhancement to improve treatment outcomes is a novel strategy worthy of future research, as are related questions such as whether these approaches may be broadly beneficial to most addicts or best reserved for substance users with specific demonstrated cognitive impairments. This article is part of a Special Issue entitled 'Cognitive Enhancers'. Published by Elsevier Ltd.
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            Assessing reactivity to virtual reality alcohol based cues.

            The use of virtual reality (VR) programs in behavioral science research has been gaining prominence over the past several years. In the field of substance abuse, VR cue reactivity programs have been successfully tested for feasibility in nicotine and cocaine dependent samples. Seeking to expand VR applications in alcohol cue research, a novel VR alcohol cue reactivity assessment system incorporating visual, auditory, and olfactory stimuli was developed and tested. In a controlled trial, 40 non-treatment-seeking drinkers with alcohol use disorders were exposed to VR alcohol cue environments. Subjective craving, attention to alcohol cues, and level of presence (realism of experience) in VR were assessed across the environments. Overall, subjective craving for alcohol increased across the VR alcohol-related cue environments versus VR neutral cue environments. Participants reported high levels of presence in VR, indicating that the environments were perceived as realistic and compelling. These initial findings support the use of VR based cue reactivity environments for use in alcohol cue-based treatment and research.
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              Incubation of Cue-Induced Craving in Adults Addicted to Cocaine Measured by Electroencephalography

              A common trigger for relapse in drug addiction is the experience of craving via exposure to cues previously associated with drug use. Preclinical studies have consistently demonstrated incubation of cue-induced drug-seeking during the initial phase of abstinence, followed by a decline over time. In humans, the incubation effect has been shown for alcohol, nicotine, and methamphetamine addictions, but not for heroin or cocaine addiction. Understanding the trajectory of cue-induced craving during abstinence in humans is of importance for addiction medicine.
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                Author and article information

                Journal
                Gen Psychiatr
                Gen Psychiatr
                gpsych
                gpsych
                General Psychiatry
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                2517-729X
                16 July 2019
                2019
                : 32
                : 3
                : e100062
                Affiliations
                [1 ]departmentShanghai Mental Health Center , Shanghai Jiao Tong University School of Medicine , Shanghai, China
                [2 ]Shanghai Bureau of Drug Administration , Shanghai, China
                [3 ]Shanghai Gaojing Compulsory Drug Dependence Treatment Center , Shanghai, China
                [4 ]Shanghai Key Laboratory of Psychotic Disorders , Shanghai, China
                Author notes
                [Correspondence to ] Dr Min Zhao; drminzhao@ 123456gmail.com
                Article
                gpsych-2019-100062
                10.1136/gpsych-2019-100062
                6677938
                1f18e657-46fc-4ed0-bfb9-e4b70044d2c0
                © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

                This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

                History
                : 01 March 2019
                : 24 April 2019
                : 25 April 2019
                Funding
                Funded by: Program of Shanghai Academic Research Leader;
                Award ID: 17XD1403300
                Funded by: Shanghai Municipal Health and Family Planning Commission;
                Award ID: 2014ZYJB0002
                Funded by: National Key R&D Program of China;
                Award ID: 2017YFC1310400
                Funded by: Shanghai Health and Family Planning Commission Clinical Research Project;
                Award ID: 20184Y0134
                Funded by: National Nature Science Foundation of China;
                Award ID: U1502228, 81501148
                Funded by: Qihang project of Shanghai Mental Health Center;
                Award ID: 2018-QH-02
                Funded by: Shanghai Key Laboratory of Psychotic Disorders;
                Award ID: 13DZ2260500
                Categories
                Original Research
                1506
                Custom metadata
                unlocked

                methamphetamine,qualitative research,relapse,abstinence,swot analysis

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