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Insomnia Linked to Substance Abuse in Adolescents

A study in the Oct. 1 issue of the journal Sleep shows that adolescent insomnia symptoms are associated with depression, suicide ideation and attempts, and the use of alcohol, cannabis and other drugs such as cocaine.

Findings suggest that the presence of insomnia in adolescents increases the risk of developing mental health problems and also may increase the severity of these problems. Results indicate that adolescents who had symptoms of insomnia were 2.3 times more likely to develop depression in early adulthood than adolescents without symptoms of insomnia. Specifically, at baseline, the insomnia group was more likely to use alcohol, cannabis, and non-cannabis drugs, and was more likely to suffer from depression, suicide thoughts, and suicide attempts. The insomnia group also had a greater risk of developing new incidences of depression and suicide attempts after excluding participants who suffered from these specific psychopathologies at baseline.

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International Aspects of Social Work Practice in the Addictions

Columns - Media Review

Monday, 31 May 2004

International Aspects of Social Work Practice in the Addictions offers the reader a highly informative examination and comparative analysis of the socioeconomic and political influences on substance abuse policy and practice around the world. Editors Shulamith Lala Ashenberg Straussner and Larry Harrison have skillfully selected a diverse international group of academics, researchers, and practitioners to present the substance abuse policies, prevention and treatment efforts, and specific role of social workers in the United States, Israel, Ireland, Germany, the Netherlands, Singapore, and the Former Soviet Union. The book includes a panel discussion regarding the complexities of the decriminalization and legalization of drugs with perspectives from Australia, the United Kingdom, and the United States.

The first article provides a current look at the controversies surrounding the U.S. “War on Drugs,” the federal government’s emphasis on law enforcement and drug interdiction, and how this policy impacts prevention and treatment efforts and consumer access to substance abuse services. By placing the treatment of the individual into a larger context, the article may encourage practitioners to become more involved in advocating for policy reform.

A second article examines the policy and practice of the management of alcohol and drug problems in the Republic of Ireland. The author goes so far as to suggest that policy makers in Ireland have completely rejected the disease concept as a “bad import” from the United States, giving the U.S. reader an important counterpoint to this strongly held belief. While the disease concept has been useful in destigmatizing addiction, the public health model described raises awareness that substance abuse, while having a biological component, is also a complex, multidimensional phenomenon.

A third article explores the dual treatment system in Germany, where individuals with alcohol problems and individuals with drug problems are treated separately, partly because drug addicts tend to dominate the treatment programs and are more aggressive in their efforts to advocate for services. In contrast, in the United States, people who suffer from alcoholism tend to have a stronger voice in advocating for social policy reform and therefore have more treatment services available to them. The reader gains a broad understanding of the range of treatment options and Germany’s transition (similar to the movement in the U.S. treatment system) from confrontational approaches to the more humanistic focus of motivational interviewing.

In the remaining articles, authors examine: (1) the development and treatment of substance abuse problems in Israel, including the rise of alcohol and psychoactive substances in the wake of massive immigration waves during the 1990s — this analysis makes an important contribution to both practitioners and policy makers worldwide who may be involved in managing substance abuse problems related to immigration patterns; (2) the history of substance abuse policy in the Netherlands and the current efforts to find a middle road between harm minimization and punishment and its impact on treatment; (3) Singapore’s strategy of controlling the supply of drugs in order to reduce demand; and (4) some preliminary data on the scope of alcohol and drug dependence problems in individuals from the former Soviet Union who have immigrated to Israel, Germany, and the United States — all of the information is of great value to those working directly with refugee and immigrant populations.

The articles in this volume represent a cross section of the current thinking on multinational perspectives in substance abuse policy and treatment. While the authors agree that addiction problems are a complex biopsychosocial/cultural phenomenon, there is a wide range of responses, based on cultural, historical, and political factors, to the way policy is shaped and how that policy impacts the types of treatment services made available to individual substance abusers and their families, and the delivery of and access to those services. While two of the articles mention the role of spirituality and religion as part of the social/cultural aspects of addiction, treatment, and recovery, a more thorough cross-cultural analysis of this factor, which has been demonstrated by research in the United States to enhance prevention and recovery efforts, would have enhanced this volume’s overall impact.

While this book is a valuable resource for students, addictions counselors, policy makers and researchers who wish to understand the multicultural forces that shape substance abuse policy and treatment efforts around the world, it will be of particular interest to social workers who can gain a better understanding of their own role in this arena. The grounding U.S. social workers receive in cultural competence and social policy analysis, through graduate education and training, places them in a unique position to understand the impact of multicultural forces and to take an active role in shaping substance abuse social policy in the future.

Patricia A. Burke, MSW, LCSW, BCD, CCATODSW, is co-founder of the Beyond Mind Healing Center in West Baldwin, Maine, where she is in private practice. She may be contacted through www.patriciaburke.com.