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Joanne Neale

Publications and source records attributed to Joanne Neale.

8 recordsLinked to original sources
PubMed2006

Homelessness among problem drug users: prevalence, risk factors and trigger events.

The present paper uses data from a prospective cohort study of 877 problem drug users entering treatment in Scotland to extend knowledge of homelessness and drug misuse in three important respects: First, the prevalence of homelessness among problem drug users is investigated; secondly, key risk factors for homelessness among problem drug users are identified; and thirdly, trigger events associated with movements into or out of homelessness by problem drug users over time are explored. Data were collected during two waves of interviewing which were conducted 8 months apart. Thirty-six per cent of problem drug users entering treatment were homeless at either or both interviews, a prevalence rate that is at least seven times greater than among the general population. Whilst many of the risk factors found to be associated with homelessness are common to homeless people in general, at least one homelessness risk factor - recent drug injection [OR = 1.40; 95% confidence interval (CI) = 1.01-1.96]- is clearly specific to those who take drugs. Movements into homelessness among problem drug users were associated with recently losing residency of children (OR = 2.28; 95% CI = 1.27-4.08), other recent family problems (OR = 1.88; 95% CI = 1.21-2.94) and worsening general health (OR = 2.17; 95% CI = 1.15-4.09). Movements out of homelessness were associated with not having recent family problems (OR = 0.43; 95% CI = 0.24-0.79). The findings provide empirical support for the good practice guidelines now being published by various UK Government departments, but also suggest that the relatives of problem drug users should be offered increased assistance to help them deal with the many stresses that having a drug-dependent family member can bring.

Adult↗
PubMed2005

Recent life problems and non-fatal overdose among heroin users entering treatment.

AIMS: To investigate the role of recent life problems in non-fatal overdose among heroin users entering various drug treatment settings. DESIGN: Cross-sectional data from a longitudinal study investigating drug treatment effectiveness. SETTING: Five prison drug treatment services, three residential rehabilitation units, three residential detoxification units and 21 community drug treatment services located in rural, urban and inner-city areas of Scotland. PARTICIPANTS: Of a total of 793 primary heroin users commencing drug treatment during 2001-02, 337 (42.5%) were prison drug service clients; 91 (11.5%) were residential rehabilitation clients; 97 (12.2%) were residential detoxification clients; and 268 (33.8%) were community drug treatment clients. MEASUREMENTS: Univariate and stepwise multivariate logistic regression analyses examined associations between overdosing in the 90 days prior to treatment entry and basic demographic characteristics, recent drug use and recent life problems. FINDINGS: Ninety-one study participants (11.5%) reported at least one overdose and 19 (2.4%) reported more than one overdose in the 90 days prior to treatment entry. A chi2 test revealed no significant difference in rates of recent overdosing between the four treatment settings (P = 0.650). Recent drug use and recent life problems-but not demographic characteristics-were associated independently with recent overdosing. However, recent life problems were not associated independently with recent overdosing among clients entering prison, clients entering residential rehabilitation or with multiple recent overdosing. CONCLUSIONS: Associations between recent life problems and recent overdose were evident, but varied by treatment setting. Treatment providers should identify and address heroin users' life problems as part of a broad strategy of overdose prevention.

Adolescent↗
PubMed2003

Comparisons of self-report data and oral fluid testing in detecting drug use amongst new treatment clients.

Drug testing is widely used and employed in diverse contexts, including drug treatment clinics. Building on previous research, this paper aims to (i) compare self-report data and oral fluid (OMT) testing in detecting drug use amongst individuals beginning a new episode of drug treatment and (ii) identify factors that may predict drug users who have discordant self-report and OMT test results. Two hundred and seventy-one new drug treatment clients completed a structured questionnaire that included questions relating to drug use during the preceding 3 days and provided an oral fluid sample that was independently tested for opiates, benzodiazepines, methadone and cannabis. Data were analysed using kappa statistics (Cohen, 1960) and univariate and multivariate logistic regression. Findings indicated a high level of consistency between self-reported drug use and OMT testing. However, agreement varied by drug type and respondents commonly reported consumption that screening failed to identify. Inconsistencies appeared to relate to a number of factors and were not necessarily a function of deliberate distortion by the drug user. Overall, it is concluded that OMT testing is a good indicator of the validity and reliability of drug users' self-report data. Nonetheless, its accuracy might be greater for some drug categories than for others. Equally, further study comparing test results and self-reported drug use amongst different populations and in different contexts is required.

Adult↗
PubMed2002

Good practice towards homeless drug users: research evidence from Scotland.

Evidence of large numbers of people who are both homeless and drug dependent, the complexity of their needs, and the many difficulties which they can encounter when trying to access assistance highlight the importance of basic standards of good practice in working with homeless drug users. This is particularly relevant given the growth of new managerialism and the expansion of social care markets occurring within the UK public sector since the 1980s. Within this context, the aim of the present paper is to further understanding of how best to provide support to homeless drug users by examining good practice from the perspectives of both service providers and service users. Data were collected from 48 semi-structured interviews (12 with staff and 36 with clients) conducted in six case study agencies (three homelessness agencies and three drug agencies). Interviews were audio-recorded and the data were analysed using Framework. Findings from the study revealed that good practice related to five broad areas. These were: (1) staffing; (2) agency environment; (3) support provided; (4) service delivery; and (5) agency aims and objectives. Similarities between the views of service providers and users were evident. However, differences of opinion suggested that the best definitions of good practice are achieved by consultation with a range of stakeholders (including staff and clients). Data also showed that good practice is fundamentally related to the qualitative and intangible aspects of service provision, and not just to more easily quantifiable inputs, processes, outputs and outcomes. The paper concludes by arguing that the challenge for new managerialism is to build evaluation frameworks which can accommodate this complexity, and thus, begin to portray good practice in a more accurate and meaningful light.

Adult↗
PubMed1998

Drug users' views of drug service providers.

In Britain, there are a wide range of agencies providing many types of service to drug users. Such provision, it is argued, should be monitored and evaluated in the same way as provision to other client groups. To this end, the paper focuses on one aspect of drug service evaluation; users' views of service providers. Semi-structured qualitative interviews were conducted with 124 illicit drug users in rural, urban and inner city areas of Scotland and the respondents' comments were analysed inductively using the software package, Winmax. The study revealed three main findings. First, there was a high level of consensus amongst users regarding desired and undesired provider characteristics; and these characteristics held regardless of agency type. Secondly, users simultaneously retained different expectations of the different agencies and did not consider these agencies to be interchangeable. Thirdly, gender differences in attitudes to, and use, the different providers were apparent. The paper concludes that it is necessary to recognize the fundamental role that process factors, particularly providers' attitudes, play in terms of drug users' overall perception and evaluation of services. Additionally, although agencies should aim to provide a broad range of flexible forms of assistance, providers are not interchangeable and the continued development of a flexible mixture of interactive drug services and providers is recommended. Finally, drug users do not provide the definitive statement about the value of drug service provision. Nevertheless, their views and experiences are an important aspect of service evaluation and consequently deserve careful attention from policy, practice and research.

Journal Article↗