BoxKuopio, FI,Finland. Illicit drug use is an important public health problem. Identifying conditions that coexist with illicit drug use is necessary for planning health services. This study described the prevalence and factors associated with social and health problems among clients seeking treatment for illicit drug use. We carried out cross-sectional analyses of baseline data of clients who sought treatment for illicit drug use at Helsinki Deaconess Institute between and The existence of illicit drug use with other social and health problems could lead to increased utilisation and cost of healthcare services.
Our findings support the call for integration of relevant social, medical and mental health support services within drug treatment programmes. Among the same age group in Nordic countries, lifetime prevalence of cannabis use is In response, many countries have initiated drug treatment programmes to counter negative health and social consequences of illicit drug use. In Finland, those seeking treatment for drug use have access to both specialised and generic services.
Specialised services are provided through outpatient clinics, short-term inpatient care, rehabilitation units and support services. Treatment services are also available through primary, social and health care services [ 3 ]. Use of illicit drugs is associated with emotional and behavioural changes which make drug-taking assume precedence over other areas such as school, work, family and other relationships [ 4 ].
An American longitudinal education survey, initiated prior to high school entry, indicate that drug users have fewer years of schooling [ 5 ]; this might impact negatively on their career prospects and predispose them to social disadvantage due to difficulties in finding and maintaining jobs [ 6 ].
Due to poor financial situation, their living conditions deteriorate, stable housing becomes unaffordable and some may end up living on the streets [ 78 ]. Family responsibilities are also affected: Illicit drug use has also been implicated in the spread of blood-borne infectious diseases such as HIV and Hepatitis C due to sharing of non-sterile injecting equipment by injecting drug users IDU [ 10 - 12 ].
However, the risk of infectious diseases is not limited to IDUs. Irrespective of route of drug administration, the risk of blood-borne viruses being transmitted between drug users, and indeed between drug users and non-drug users through social and sexual interactions, should be considered an important public health issue. Other infections and health problems reported among drug users include abscesses, cellulitis, bacterial endorcarditis, necrotizing fasciitis, osteomyelitis, candidosis, thrombophlebitis, and ulcers [ 14 ].
The prevalence of psychological disorders is known to be high among those who use illicit drugs [ 15 ]. Such disorders may precede drug use [ 16 ] and they may also occur as Jussi jaaskelainen wife sexual dysfunction result of it [ 17 ]. Clients experiencing both drug addiction and psychological disorders tend to use more services, have higher relapse and re-admission rates thereby increasing the cost of treatment [ 19 ].
Identifying conditions that coexist with drug use is necessary for planning and provision of additional services based on identified needs. The aim of this paper is to describe the prevalence and factors associated with social and health problems that coexist with drug use based upon information provided by clients at their first visit to Helsinki Deaconess Institute HDI. The original sample consisted of a non-random sample of clients who sought treatment at HDI between 31 January and 31 August However, to minimize the amount of missing data for some variables of interest, this analysis was restricted to a subset of clients who attended the HDI between and There were no selection criteria: This paper is based upon information provided by each of the clients during their first visit i.
A total of clients males and females sought treatment at the HDI between and The HDI is a large drug treatment provider in Helsinki and clients came from the Greater Helsinki area including some surrounding semi-rural communities. Treatment-seeking Jussi jaaskelainen wife sexual dysfunction HDI was based on client self-referral, referral from doctors or other treatment centres, and other sources.
Following initial assessment during first visit, treatment plans were drawn up and clients were assigned to various drug treatment modalities for subsequent visits. Permissions were obtained from the Ministry Jussi jaaskelainen wife sexual dysfunction Social Affairs and Health of Finland and from appropriate municipal authorities of all Greater Helsinki area communities where clients resided. Researches have demonstrated the reliability and validity of the EuropASI [ 2223 ].
The TDI, developed by the Pompidou Group of the Council of Europe [ 24 - 26 ], contains questions on treatment contact, sociodemographic information and drug use. At first visit, trained clinicians interviewed clients using a structured questionnaire to obtain self-reported information on: Clients provided information about their main reason for seeking treatment, referral "Jussi jaaskelainen wife sexual dysfunction" treatment, previous contact with any drug treatment centre, and whether they were receiving concurrent treatment elsewhere.
To assess their social situations and demographics, clients responded to questions about their level of education; marital status; employment; and main source of income at the time of interview. They also responded to questions about their children under 18 years and other drug users living in the same household.
Questions were asked Jussi jaaskelainen wife sexual dysfunction threats of violence from anybody i. Infectious disease status was based on self-reports from clients based upon their perception of previous laboratory investigations. Data on depressive symptoms were based "Jussi jaaskelainen wife sexual dysfunction" self-reports.
Variables were expressed as a proportion of the denominator Factors associated with social problems and heath problems infectious diseases and psychological problems were initially assessed in univariate logistic regression models.
Thereafter, multivariate logistic regression analyses forced entry method were utilised to assess the independent effect of variables that were statistically significant in the univariate analyses. Those coded as zero were the reference categories. Details of drug use patterns among all the clients have been described elsewhere [ 27 ] but a brief description is provided here. OR — odds ratio. CI — confidence "Jussi jaaskelainen wife sexual dysfunction." Only variables statistically significant in univariate analyses were included in multivariate analyses.
Further analyses were carried out on those clients who reported a combination of social and health problems. This study reports baseline data on social conditions and health problems from the first large-scale longitudinal study of treatment-seeking illicit drug users in Finland. Findings from this study highlighted some level of housing instability among treatment-seekers.
This lends credence to results from research studies in other countries, which found cases of homelessness and street-dwelling among those who use drugs [ 28 - 30 ]. Galea and Vlahov [ 31 ] argue that homelessness is an important social circumstance that influences the health and well-being of drug users. For example, homeless drug users engage in risky behaviours such as trading sex for drugs and money.
IDUs who are homeless may consume drugs in public unhygienic environments, which increase the risk of infection at injection sites and sharing of injecting equipment [ 32 ].
In our study, few clients received threats of violence; this differed from the results of a large-scale study conducted in Canada [ 33 ], where a large proportion of illicit drug users reported actual experiences of violence.
Therefore, our finding might suggest limited hostility from both drug-using and non-drug using people in Finland. There was a disparity between the number of people who were employed and those who reported salary as their main sources of income; it could be that some clients who were not officially classified as being employed e. However, collectively, nearly half of the respondents were dependent on government funding in terms of income support and unemployment benefits.
Jussi jaaskelainen wife sexual dysfunction their low economic capabilities, it is likely that many clients will continue to depend on public funding for sustenance.
Therefore, drug-using clients could mount financial pressure on social welfare services. Some clients reported living within the same household with other legal and illicit drug users. Association with other drug users helps to sustain drug-using habits [ 34 ] and may hamper success in the treatment programme.
Previous studies have demonstrated that children living in such social environments are predisposed to drug use in their adulthood [ 3536 ]. Since the likelihood of reporting infectious diseases was 1.
Treatment-seeking was voluntary self-referral for half of the respondents. One possible explanation is that organisation and delivery of drug treatment services in Finland take place at municipality level, so that services are brought closer to drug users. Since self-referral was a significant predictor of reporting social and health problems, these concerns may have necessitated treatment seeking.
This might reflect differences in national drug policies, with strong emphasis on criminal justice interventions related to drug use in USA. These findings have implications for treatment "Jussi jaaskelainen wife sexual dysfunction." Health and other concerns provide transient motivation to clients and some may not complete treatment Jussi jaaskelainen wife sexual dysfunction 38 ].
A British study found high drop out rates among clients coerced into treatment through the criminal justice system [ 39 ]. However, a US report [ 40 ] highlighted criminal justice referral as one of the strongest predictors of outpatient treatment completion, probably due to sanctions for non-completion.
This may be related to the fact that the HDI also serves as a treatment needs assessment centre, which receives referrals from other smaller clinics. In addition, Jussi jaaskelainen wife sexual dysfunction receiving treatment from multiple centres could receive double dose of prescription medication, which might increase the risk of excessive consumption and overdose or sales in illegal street market.
Hepatitis C was the most prevalent infectious disease and may be connected to high use of intravenous drugs in this study population. This finding is consistent with the report of Aceijas and Rhodes [ 41 ], which identified high prevalence of hepatitis C infections among IDUs in most of the 57 countries reviewed.
The reported HIV seroprevalence in this study was lower than that reported elsewhere in Europe [ 42 ], possibly due to low prevalence in the general Finnish population which is currently 0. Using opiates as primary drugs Jussi jaaskelainen wife sexual dysfunction abuse was the strongest factor associated with reporting positive tests for infectious diseases, probably due to sharing of contaminated injecting equipment.
This calls for heightened awareness of the needle exchange programmes in Finland. Depressive symptoms were the most common psychological problems. Our result is consistent with previous research, which suggested that depressive symptoms are common among drug Jussi jaaskelainen wife sexual dysfunction [ 44 ]. Suicidal thoughts and suicide attempts reported by clients may be related to depressive symptoms, which were highly prevalent in this study population.
Male clients were 0. Therefore, it is important to identify clients who would benefit from a combination of mental health and drug abuse treatment in order to prevent premature deaths from suicide.
Findings from this study have implications for the publicly funded "Jussi jaaskelainen wife sexual dysfunction" system in Finland. The existence of drug use with other social and health problems lead to high healthcare expenditure.
Low socioeconomic status, as evidenced by unemployment, low education level, and homelessness, influence risk-taking behaviours and contribute to negative health consequences among those who use drugs [ 31 ]. Therefore, there is a need to get drug users into early treatment in order to reduce the financial costs of care.
A study conducted among drug users entering treatment in the US found a decline in total medical cost in the post-treatment period [ 46 ]. Co-occurring psychological and medical problems should be addressed to prevent relapse and excessive utilisation of health services [ 19 ]. For example, some clients may have answered no to some of the questions but this was not explicitly recorded. The presence of missing data highlights some of the challenges encountered when using clinical data for research purposes.
Improvements in the completeness of medical data will enhance its utility for research purposes. A report from the UK argues that improvements in the standard of medical documentation are essential for planning services and for efficient patient care [ 47 ].
Our study relied on self-reported data, the veracity of which cannot be assured. JUSSI Jaaskelainen is out for a hat-trick against Liverpool at Anfield - not of away from full fitness after a recurrence of hamstring problems. Paasolainen,6 Niko Tasa,6 Jari Tiihonen,7,8,9 and Jussi jaaskelainen wife sexual dysfunction Kauhanen1.
Coexisting social and health problems may interfere with clients' treatment response. (in years), gender (male = 1, female = 0); marital status (married Jussi jaaskelainen wife sexual dysfunction 1.
Melberg HO, Hakkarainen P, Houborg E, Jääskeläinen M, Skretting A. But the balance shifted quickly in the ninth minute when a farcical misunderstanding between Jussi Jaaskelainen, the Bolton keeper, and his.
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That was the kind of equivalent that might have had Roy Hodgson, if no one else, on the edge of his seat. It is not that it was terrible, and the wet and windy conditions past the south coast undoubtedly contributed to a painfully high fault count, it was more that there were long periods when neither side could do anything right.
Sam Allardyce was blithesome for it to be detestable, for his side to snippet, battle and show admirable springiness in the face of concerted pressure from Southampton in the second half. With James Collins and Winston Reid outstanding in defence and Jussi Jaaskelainen producing a number of wonderful saves, Southampton had to settle after the frustration of a goalless draw and, in the aspiration, they were grateful that West Ham's best chance fell to Collins, who fluffed his lines from close range with six minutes remaining.
Southampton did not deserve to fall to that sucker-punch and will feel they merited more than a purport but, for all their attacking talent, Mauricio Pochettino's side be experiencing not scored from open participate in their first four matches. The time may come when Pochettino has to make a difficult decision between Rickie Lambert and Dani Osvaldo. Individually they performed well but they are not on each other's wavelength yet, although Pochettino said he was pleased with the pair's efforts.
Nor was he anxious that Lambert, England's new leading man, has only scored one sentence for his club this salt. But in football it is not just about creating chances, you need to make those chances be goals. Although they were missing a spark, something to drag the game in the sky the mundane, Southampton had the better chances.
Osvaldo should from given them an early beguile when Jay Rodriguez sped gone Guy Demel on the port side and cut the ball retaliation, only to place the ball too close to Jaaskelainen, allowing the year-old to save. What is more this was their third pure sheet in four matches but also their third successive equal without a goal.
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West Ham are hoping competing in football's first mince pie challenge will avail them not to shiver under the pressure of playing Tottenham in Wednesday's Capital One Cup quarter-final at White Hart Lane.
The final score may have read Southampton 0 West Ham 0, but anyone who saw that game will agree that it should really imagine Southampton 0 Jussi Jaaskelainen 0. West Ham had an inspired Jussi Jaaskelainen to thank for securing them a draw against Southampton. West Ham cause ramped up their quest for new signings near agreeing a deal in the interest of veteran goalkeeper Jussi Jaaskelainen, and opening talks superior to before bagging four other players.
Tottenham assistant manager Joe Jordan bemoaned his side's fortunes from the price spot after Bolton goalkeeper Jussi Jaaskelainen's save from Tom Huddlestone cost them victory at the Reebok Stadium. Bolton goalkeeper Jussi Jaaskelainen believes he can continue playing at the highest level until he is nearly Hammers take part in bake-off ahead of Spurs Cup clash West Ham are hoping competing in football's first mince pie will help them not to crumble under the pressure of playing Tottenham in Wednesday's Capital Single Cup quarter-final at Pallid Hart Lane.
Reliance on Jaaskelainen exposes forward failings The final score may have read Southampton 0 West Ham 0, but anyone who saw that game will agree that it should really claim Southampton 0 Jussi Jaaskelainen 0. Southampton West Ham: Jaaskelainen keeps Saints at bay West Ham had an inspired Jussi Jaaskelainen to thank for securing them a draw against Southampton. Blackburn boss Sam Allardyce claimed a ethical victory from a in which he felt referee Mike Dean should have dismissed Bolton goalkeeper Jussi Jaaskelainen.
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- Bolton goalkeeper Jussi Jaaskelainen has agreed to move to Premier League newcomers West Ham.
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What happened to "manly men"?The latest Jussi Jaaskelainen news, blogs and videos on Metro. West Ham United's Jussi Jaaskelainen saves from Southampton's . of game I'd call mildly entertaining, if my own team's impotence hadn't..
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He is searching […]. Holly Willoughby I'm A Celebrity Jaaskelainen, 33, looked set to move on when the team were in serious danger of relegation and appeared ready to end his year stay in Lancashire, but Bolton managed to maintain […]. Int J Drug Policy. But we also have to use our quality on the ball. This paper is based upon information provided by each of the clients during their first visit i.
Preview: Liverpool v Bolton
It is not that it was terrible, and the wet and windy conditions by the south coast undoubtedly contributed to a painfully high error count, it was more that there were long periods when neither side could do anything right. Identifying conditions that coexist with illicit drug use is necessary for planning health services.
Data analysis Variables were expressed as a proportion of the denominator Then Lallana was in the clear, released by a clever pass from Osvaldo, but a heavy touch allowed Jaaskelainen, who also had to save acrobatically from Schneiderlin's volley and Lambert's bending effort, to smother. Permissions were obtained from the Ministry of Social Affairs and Health of Finland and from appropriate municipal authorities of all Greater Helsinki area communities where clients resided. UEFA Champions League Transport bosses are urging people to work from home a week on Tuesday - because of the football Drivers urged to consider working from home as 3, visiting fans are expected.
Our findings support the call for integration of relevant social, medical and mental health support services with drug treatment programmes.
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