As a complement to research evaluating botanical marijuana as a medical therapy for various somatic and psychiatric conditions, there is a growing body of research assessing marijuana users' self-reports of the symptoms and conditions for which they use marijuana without a physician's recommendation. As part of two larger web-based surveys and one in-situ survey at an outdoor marijuana festival, we asked regular marijuana users if they consumed the drug without a physician's recommendation and, if so, to describe (or select from a checklist) the conditions for which they used marijuana as a medication. Participants reported using marijuana to self-medicate a wide variety of both somatic conditions (such as pain, diabetes, and irritable bowel syndrome) and psychiatric conditions (such as depression, anxiety, and insomnia). Because fewer than half of the American states, and only a few countries, allow physicians to recommend medicinal marijuana, these findings may be of interest to clinicians as they treat patients, to lawmakers and policymakers as they consider legislation allowing physicians to recommend botanical marijuana for somatic and psychiatric conditions, and to researchers evaluating conditions that individuals elect to self-medicate using botanical marijuana.
The research examined the role of mental health care providers' perceptions of their professional relationships with consumers in understanding their reports of agency recovery-oriented services and their own sense of job satisfaction and personal growth. Multidisciplinary community mental health care providers (N = 105) responded to an online self-report questionnaire. Providers' reports of higher levels of working alliance and greater provider directiveness in working with consumers was significantly related to providers' reports of higher levels of agency recovery-orientation and higher levels of personal growth. Providers' reports of working alliance accounted for the largest proportion of variance in providers' reports of job satisfaction. Mental health providers' perceptions of relationships with consumers are central to understanding providers' views of agency recovery-orientation and sense of professional and personal well-being.
The American State Hospital has survived over 200 years. Society once viewed state hospitals as an absolute necessity and each state constructed numerous hospitals. Over time, the image of the state hospital as a means to cure the mentally ill changed drastically. The public perceived state hospitals as snake pits that warehoused the mentally ill and the state hospital was nearly destroyed. Nevertheless, the state hospital remains today with purposes similar to its ancestors and some that are very different. This paper examines the many influences that created the state hospital. Additionally, this paper addresses the Kirkbride Model, treatment methods and practices over time, and how the state hospital fell into disfavor as a means to treat the mentally ill. The paper concludes with comments on the mental health system today, in relation to the state hospital's role in treatment.
Given the variety and potential toxicity of synthetic cathinones, clinicians and educators would benefit from information about patterns of and motivations for use, frequency of psychosocial consequences, and experience of acute subjective effects. We administered a comprehensive, web-based survey to 104 recreational users of synthetic cathinones. Sixty percent of respondents consumed synthetic cathinones once or more per month, usually snorting or swallowing these drugs, typically at home, usually with others, customarily during the evening and nighttime hours, and often in combination with another drug such as alcohol or marijuana. Acute subjective effects attributed to synthetic cathinones were similar to those of other psychostimulants, including increased energy, rapid heartbeat, racing thoughts, difficulty sleeping, euphoria, decreased appetite, open-mindedness, and increased sex drive. Reported reasons for using synthetic cathinones included its stimulating effects, curiosity, substitution for another drug, and being at a party/music event. Respondents had experienced an average of six negative consequences of using synthetic cathinones during the previous year (e.g., tolerance, neglecting responsibilities, personality change). In combination with previously published investigations, these findings increase our understanding of the reported rationales and outcomes of recreational use of synthetic cathinones.
The present qualitative study examined community mental health providers' accounts of their therapeutic interactions with adults with serious mental illness in a recovery-oriented model of care. Ten long-time mental health care providers discussed their understanding of recovery principles, their use of directive practices, and factors that shape their work with consumers. Content analysis of mental health providers' accounts suggest that providers had no difficulty articulating basic principles of recovery-oriented care. Providers reported engaging in directive practices with consumers and described using traditional clinical factors such as level of functioning, degree of psychiatric symptoms, safety concerns, and legal status to assess consumers' ability for autonomous decision making. Providers generally did not express tension between their views of mental health recovery and their beliefs about utilizing directive approaches with consumers. Implications of present findings for research and practice are discussed.
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