Addicta: The Turkish Journal on Addictions
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Learnings from a German research network on substance use among refugees (PREPARE) with a focus on an intervention to improve emotion regulation
Refugees face a unique constellation of pre-, peri-, and post-migration stressors that can increase vulnerability to hazardous substance use while simultaneously limiting access to appropriate care. To address this gap, the PREPARE consortium was established as the first coordinated German research network on substance use among refugees, combining empirical assessment, diagnostic innovation, and intervention development. This article provides an overview of the network and synthesizes cross-project learnings with a particular focus on Subproject 4 (STARC-SUD), an emotion-regulation–based group intervention adapted for refugees with hazardous alcohol or drug use. Across multiple sites, PREPARE identified substantial barriers to recruitment and engagement, including stigma, legal insecurity, language difficulties, and the structural conditions of communal accommodation. The adaptation and translation of screening instruments improved diagnostic accuracy, while iterative modifications of STARC-SUD enhanced cultural fit and feasibility. Early implementation experiences highlight the importance of trust-building, flexible delivery formats, and close cooperation with community actors. The Sucht-und-Flucht.de platform (https://www.sucht-und-flucht.de/en/) emerged as a central dissemination tool, providing multilingual materials, diagnostic instruments, and project information to practitioners and supporting long-term knowledge transfer. The preliminary observations from the ongoing trial underscore the need for integrated, culturally sensitive, and trauma-informed approaches within European addiction-care systems. PREPARE demonstrates the potential of emotion-regulation interventions for refugee populations and points to the importance of sustained, multi-level strategies involving research, practice, and policy to improve access and outcomes for displaced individuals affected by substance use.
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A prevention model against addiction for migrant youth: Bavul
Migration-related stress, discrimination, and disrupted support systems increase vulnerability to addictive behaviors among youth. Despite this, few prevention programs address the intersection of migration, trauma, and identity development in culturally responsive ways. This article presents a prevention model against addiction for migrant youth, Bavul, grounded in a trauma-informed, rights-based, and youth-centered approach and built on a strengths-based framework. Designed to be low in language demand and high in experiential participation, the model integrates resilience-building, the normalization of stress responses, life skills development, identity formation, critical thinking, and well-being through accessible, youth-friendly coping and decision-making strategies. Structured in eight modules, the model combines interactive learning, reflective storytelling, and creative group activities. Core principles include non-judgmental facilitation, cultural sensitivity, and empowerment through agency. The article discusses Bavul model’s contribution to preventive practice within multicultural contexts and its potential to inform future prevention and mental health frameworks targeting migrant youth.
Syrian refugees under temporary protection and the YEDAM Service Network in Türkiye: An ecological perspective on regional balance
This study aimed to examine, at an ecological level, the relationship between the regional distribution of Syrian refugees under temporary protection across Türkiye and the numerical distribution of Green Crescent Counseling Centers (YEDAM). This descriptive and cross-sectional study was conducted using publicly accessible data from the Presidency of Migration Management of the Republic of Türkiye Ministry of Interior and YEDAM, obtained in October 2025. For each province and region, the number of registered Syrians under temporary protection, the ratio of registered Syrians to the total provincial population, and the number of YEDAM centers constituted the study variables. The Kruskal–Wallis H test, Bonferroni-corrected Dunn multiple comparison test, and Spearman correlation analysis were applied for statistical analyses. A statistically significant positive correlation was found between the number of registered Syrians and the number of YEDAM centers nationwide (p = 0.015). The number of Syrians per YEDAM center was significantly higher in the Mediterranean and Southeastern Anatolia regions compared with the Black Sea and Eastern Anatolia regions (p < 0.01). The findings indicate that YEDAM has established a strong foundation with its nationwide service network; however, increasing the number of centers in regions with high immigrant density could further enhance equity in service provision.
Addressing substance use and vulnerability among unaccompanied migrant youth in Spain: A narrative review
Spain’s geographic position has made it a key entry point for forced migrants, including unaccompanied minors (UMs), from regions such as North Africa and the Middle East. These minors often face pre-migration trauma and post-migration stressors—including social isolation, economic hardship, and administrative insecurity—significantly increasing their risk of mental health disorders and substance use as a maladaptive coping mechanism. Given the specific focus on youth in migration contexts, this narrative review evaluated existing psychosocial and treatment interventions for forced migrants with substance use disorders in Spain. The analysis of available literature reveals significant regional disparities in protection systems for UMs, exacerbating vulnerabilities such as emotional distress and migratory grief, while substance use was consistently identified as a symptom of deeper systemic and psychological issues rather than a primary disorder. A key finding was the notable absence of specific intervention models for this population. In light of this gap, a community-based participatory action research (CBPAR) model emerged as a promising, though yet to be adapted, framework for developing culturally sensitive interventions that could address structural drivers of risk. The review concludes that effective intervention requires a dual approach: policy reforms to standardize equitable, trauma-informed care across regions, and investment in the development and implementation of participatory, community-driven programs prioritizing holistic healing and integration. It also underscores the urgent need for a paradigm shift toward culturally competent, empowerment-focused strategies in Spain and to inform international responses to the complex needs of forced migrant youth.
Addiction vulnerability among immigrant youth: Psychosocial risk, protective processes, and intervention approaches
Addiction among immigrant youth is a phenomenon associated with individual experiences, family relationships, and social environment. The migration experience constitutes an important context shaping this phenomenon. Although the literature on this topic has expanded, comprehensive studies addressing addiction together with psychosocial risk factors, protective processes, and intervention approaches remain limited. This study aims to examine addiction among immigrant youth within these three dimensions. The study employs document analysis. In this context, studies indexed in Web of Science, Scopus, and Google Scholar were reviewed, and the findings were analyzed thematically. The findings indicate that three main domains shape addiction among immigrant youth. Psychosocial risk factors include trauma exposure, family disruption, and social exclusion. In contrast, protective processes such as family support, emotional regulation, cultural identity, and school connectedness mitigate these effects. Intervention approaches are primarily structured around family-based, culturally adapted, and psychosocial support-oriented models. Overall, addiction among immigrant youth emerges as a phenomenon that requires the joint consideration of psychosocial factors operating at different levels. These findings suggest that intervention approaches should be addressed within a contextual and multidimensional framework.
Navigating power in outreach youth work: Relationship-based approaches to substance use prevention
Outreach youth work, defined as relationship-based social work conducted in young people’s own environments, aims, among other things, to identify and prevent substance use by building relationships and connecting individuals to relevant services. This is critical when engaging marginalized groups, such as migrant and refugee youth, who may face vulnerabilities related to resettlement, trauma, and social exclusion, as well as youth in open drug scenes, with a high prevalence of adverse childhood experiences. The task has an inherent tension between providing support and exerting varying degrees of professional power, which may shape how outreach youth workers sustain their relevance in contexts where substance use holds meaning for youth. This article draws on two qualitative studies based on semi-structured interviews and focus groups with 12 outreach youth workers from a large outreach service in a major Norwegian city. Both studies explored relationship-building in marginalized urban environments, and the combined analysis examined how power influences outreach youth workers’ ability to prevent substance use. The analysis indicates that outreach youth workers are well-positioned to reach and build relationships with youth, such as youths involved in buying, selling, and using illegal substances. Power dynamics play a significant role in this interaction. Enduring rejection, professional transparency, and professional reflection may reduce the impact of power when building relationships. Finally, we propose how the article’s findings can be integrated into practice and recommend future research.
Problematic digital use among migrant adolescents in Türkiye: A PISA 2022 analysis of risk and protective factors
This study examined the demographic, social-behavioural, and psychosocial determinants of problematic digital use among migrant adolescents in Türkiye using data from the PISA 2022 migration subsample. The sample included 7,137 first- and second-generation migrant students. Problematic digital use was measured using students’ self-reports about their digital habits, while bullying experiences, perceptions of school safety, weekend digital activity, and levels of teacher support, family support, and emotional control were assessed through established background questionnaire scales. Analyses included t-tests, correlations, and hierarchical binary logistic regression. Results showed that males and older students reported significantly higher levels of problematic digital use. Problematic use was positively associated with bullying, perceived lack of school safety, and intensive weekend digital activity, and negatively associated with teacher support, family support, and emotional control. The regression model explained 22.8% of the variance, with weekend digital use emerging as the strongest risk factor and emotional control as the strongest protective factor. Overall, the study findings show that problematic digital engagement among migrant adolescents reflects an interplay of social stressors and self-regulatory resources. Interventions targeting both emotional regulation and supportive school-family environments may help promote healthier digital behaviours in this migrant population.
Substance use among refugee adolescents: A systematic review from a public health perspective
Refugee children and adolescents represent one of the most vulnerable populations in terms of health and psychosocial well-being due to exposure to war, forced displacement, family separation, poverty, discrimination, and acculturation-related stressors. This review aims to examine substance use among refugee adolescents within the context of migration from a public health perspective and to synthesize current empirical evidence on associated risk and protective factors. A systematic literature review of studies published between 2015 and 2024 was conducted using PubMed, Scopus, Web of Science, Google Scholar, and national Turkish databases. The review was conducted and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. Eight empirical studies conducted in Türkiye, Australia, Sweden, Palestine, Jordan, and Serbia met the inclusion criteria. The findings indicate that, in a limited number of studies including direct comparisons, substance use among refugee adolescents tends to be higher than among their non-refugee peers. Tobacco use emerged as the most prevalent behavior, while alcohol and illicit substance use were more prominent in resettlement contexts characterized by acculturative stress. Key risk factors included trauma exposure, psychological distress, disrupted family functioning, peer influence, low socioeconomic status, and limited access to education and psychosocial support. Substance use frequently co-occurred with mental health problems such as anxiety, depression, and post-traumatic stress disorder, increasing vulnerability to violence, victimization, and other high-risk behaviors. Conversely, school connectedness, supportive family relationships, and social support networks functioned as important protective factors. Overall, the findings suggest that substance use among refugee adolescents should be conceptualized as a multidimensional public health concern shaped by the interaction of developmental sensitivity and displacement-related adversity. Culturally sensitive, community-based prevention and intervention strategies targeting refugee adolescents are urgently needed.
Is rural-to-urban migration related to smoking, alcohol, and substance use a cross-sectional study among medical students
The prevalence of smoking, alcohol, and substance use and the factors associated with these behaviors show marked regional variations. This study aimed to determine the prevalence of these behaviors among medical students and examine their associations with migration and other related factors. All medical students at a faculty were invited to participate (n = 1056). Of these, 780 (73%) completed a self-report form. Of them, %58.8 (n=447) were male and %41.8 were female (n=313). The median age of the sample was 22. The form included Drug Use Disorders Identification Test (DUDIT), Alcohol Use Disorders Identification Test (AUDIT), the Childhood Trauma Questionnaire (CTQ-28), smoking characteristics, migration history, residential area characteristics, history of perinatal complications, and mental illness. Prevalence of smoking, alcohol use, risky drinking, and illicit substance use were assessed. Migration history was defined as relocation across provincial boundaries during childhood for reasons related to security threats or other social, familial, or economic factors. The prevalence of smoking among students was 33%, lifetime alcohol use was 30.5%, risky alcohol consumption in the past year was 2.0%, lifetime use of illicit substances was 4.3%, and problematic substance use in the past year was 2.5%. A history of mental illness was associated with all variables except smoking (p < 0.01). Other factors associated with smoking included a history of migration, the CTQ-28 score, and residence in a student house. In addition to well-known risk factors, the findings highlight relatively underrecognized factors such as internal migration and a history of perinatal complications.
Between borders and substances: Body packer cases among refugees in Van, Türkiye
Van, Türkiye’s eastern border province, is a major transit corridor for irregular migrants and lies on the Balkan route for drug trafficking. This study describes the clinical and radiological features of body packer cases presenting to an emergency department in this critical border region. This retrospective case series included all 13 confirmed body packer patients who presented to the University of Health Sciences, Van Training and Research Hospital Emergency Department between January 2021 and November 2025. Data on demographics, clinical presentation, imaging findings, and management were extracted from medical records. Eleven patients (84.6%) were refugees or irregular migrants; all 13 were brought by law enforcement, with no voluntary self-presentations. The median age was 33 years, and 12 were male. The concealed substances were predominantly methamphetamines (69.2%), followed by opioids (15.4%) and cocaine (15.4%). Seven patients (53.8%) were asymptomatic. CT imaging, used in all cases, showed a 100% detection rate. A key finding was the observation of two patients with rectal packet clustering and marked bladder distension, both reporting deliberate avoidance of defecation and urination—a behavioral cue for high-risk screening. The single female patient had multiluminal concealment (rectal and vaginal). No toxicity or mortality occurred; median hospital stay was 3 days. Body packing among migrants in Van is an under-recognized phenomenon at the intersection of migration, trafficking, and substance use vulnerability. The small number of detected cases, all law-enforcement-driven, suggests a significant underestimation of the true burden. The predominance of methamphetamines suggests a significant stimulant trafficking trend. Border-region emergency departments must implement risk-based screening strategies, integrate addiction services, and adopt trauma-informed care frameworks to address the complex needs of this vulnerable population.
Interdisciplinary perspectives on migration and addiction
Gambling disorder among young migrants in Germany
This study examines the development of gambling disorder among young migrants in Germany, focusing on the interaction between migration-related experiences and social contexts. The study adopts a qualitative, practice-based exploratory design, drawing on anonymized composite case vignettes derived from professional counseling practice in the fields of family and gambling disorder support. The empirical material consists of analytically condensed case representations reflecting three predominant migration constellations in Germany: marriage migration, forced migration, and second-generation migration. The data were analyzed using an inductive thematic approach, informed by sociological and psychological theories, including acculturation stress, stigma, social exclusion, and behavioral addiction models. The findings identify five central mechanisms shaping gambling trajectories among young migrants: migration-related vulnerability, the social embedding of gambling practices, the increasing role of digital gambling environments, escalation dynamics, and the emergence of debt, shame, and social withdrawal. Gambling behavior emerges not only as a coping strategy in response to psychosocial stressors such as discrimination, unemployment, and identity conflicts, but also as a socially embedded practice that provides temporary inclusion and recognition. This study contributes to existing research by offering a practice-based qualitative perspective that complements predominantly quantitative findings. It highlights the importance of culturally sensitive prevention and intervention strategies, particularly in addressing barriers related to stigma, language, and institutional trust. The findings underline the need for integrated approaches that connect social policy, public health, and community-based support structures.
“Dealer raus”: A retrospective case study of the Mothers Without Borders Initiative in Berlin’s Kreuzberg
This article presents a retrospective case study of community-based responses to substance use and street-level distribution in Kottbusser Tor, known as “Little Istanbul,” a neighborhood in Berlin’s Kreuzberg with a high concentration of immigrants from Türkiye and their descendants. The study examines the Mothers Without Borders (Mütter ohne Grenzen) initiative, active in the early 2000s under the leadership of second-generation immigrant Turkish women. It is based on a document analysis of media coverage from 2005 to 2013, including news reports, interviews, blog posts, social media content, and institutional brochures. These are examined thematically to explore how the experience of Mothers Without Borders can be interpreted in the context of media representations and these women’s statements. Conceptually, the study engages with debates concerning migration, motherhood, and neighborhood space, and draws notably on perspectives that understand addiction as embedded within broader socio-spatial and political processes rather than just as an individual or purely medical issue. The findings show that the women, as long-term Kreuzberg residents, mobilized to disrupt the emerging cycle of substance use and street-level distribution among younger generations. Instead of seeing the neighborhood solely as a site of anti-drug activism, they reconceptualized it as a space where belonging and intergenerational care could be rearticulated. Their experience indicates that efforts to address the conditions fostering substance use and distribution can also be viewed as resistance to the stigmatization of immigrant neighborhoods. In this context, the women’s positionality is constructed through “dual positioning,” in which motherhood is strategically mobilized as both a tool for activism and for neighborhood protection. By emphasizing grassroots mobilization, the article contributes to migration, space, and addiction studies by foregrounding immigrant women’s agency against addiction as relationally constituted within intersecting power relations and socio-spatial inequalities.
A sociological study of substance use among Turkish youth in Germany
Migration is a complex system that can lead to stress among migrants who are uprooted from their homes. Immigrants are often associated with increased risk factors for behaviors such as substance use and addiction. A multitude of intersecting factors determines this relationship. One issue that has been a subject of study by public-health and sociology academics has been the substance use among immigrants stemming from this displacement. This study focuses on the increase in substance use among Turkish youth in Germany, who are part of the Germany’s largest immigrant population. Five main themes emerged from the analysis: (1) generational patterns in substance use, (2) identity conflict, acculturation stress and mental health issues, (3) structural and social exclusion, (4) barriers to addiction treatment, and (5) protective factors. The results of the literature review reveal the need for empirical studies that consider the specific characteristics and context of Turkish youth in Germany regarding their substance use trends.
A review of compulsory drug treatment: The recommendations for the Civil Code of Türkiye and National Anti-Drug Action Plan
Despite the fact that compulsory drug treatment has been common and systematic practice in many countries, there has been little systematic evaluation and scientific evidence on the effectiveness of compulsory drug treatment. Moreover, the available limited data, does not always suggest positive or improved outcomes. As far as Turkish law is concerned, compulsory drug treatment can be implemented and enforced in two different ways: compulsory sentence-based treatment through the order of criminal courts and court- mandated treatment through the order of civil courts. The compulsory drug detention and rehabilitation centres also raise concern over human rights, as the detainment or deprivation of liberty for treatment sometimes takes place without due process, legal safeguards or judicial review. International consensus now requires comprehensive and integrated voluntary services implemented in the community which are person-centred and include drug addiction treatment, harm reduction and social support services. In the light of UNODC Practical Planning and Implementation Guide, this article recommends that meeting the various needs of people involved in drug requires developing and putting into practice a variety of methods and a multi-agency response. Such responses personalized to the needs of individual need to be implemented through multi-purpose centers. For these purposes, by taking into account current research evidence and concerns over human rights, Turkish Civil Code needs to be amended in a way that allows operation of the private and public multi-purpose centers, oversees, and regulates all phases of the treatment from early identification to social integration in such centers.
the effectiveness of compulsory treatment
Contextual therapies for substance use, experiential avoidance, and emotional dysregulation: A clinical case study
The use of psychoactive substances is a major global public health issue with profound physical, mental, and social consequences for individuals and their communities. Dialectical behavior therapy and acceptance and commitment therapy have gained recognition as effective interventions for addressing problematic substance use and associated emotional challenges. This case study details a 26-year-old Colombian patient with a history of problematic use of cannabis, cocaine base, and heroin, presenting with primary concerns including severe emotional dysregulation, experiential avoidance, and difficulties in maintaining social relationships. A unique aspect of this case is the application of an integrated dialectical behavior therapy and acceptance and commitment therapy treatment program, specifically tailored to Colombian cultural factors, targeting both substance use behaviors and emotional challenges. The treatment program included dialectical behavior therapy skills training to manage emotional dysregulation and reduce impulsive behaviors, combined with acceptance and commitment therapy–based techniques to enhance psychological flexibility and decrease experiential avoidance. Clinically, the patient exhibited significant improvements in emotional regulation and a reduction in substance use frequency. These changes, along with improved social functioning, emphasize the efficacy of this culturally adapted approach. This case contributes to the existing literature by demonstrating the adaptability and effectiveness of dialectical behavior therapy and acceptance and commitment therapy in treating substance use disorders within a Colombian context. It highlights the importance of cultural adaptations in therapeutic methods and sets a foundation for future studies. However, the descriptive nature of this case study and its inherent limitations regarding generalizability should be taken into account. Continued research with more rigorous methodologies is essential to validate and expand upon these findings, ensuring broader applicability across similar populations.
Interrelationships among gambling-related cognitions, gambling severity, depression severity, and treatment motivation in individuals with gambling disorder
This study aims to identify the factors influencing treatment motivation in individuals with gambling disorder, assess the presence of co-occurring depression, and examine cognitive distortions related to gambling to inform targeted treatment strategies. The study included 60 patients who sought help for gambling-related issues. Participants were assessed for depression severity, gambling-related cognitive distortions, and treatment motivation. Additionally, information regarding their gambling history was obtained from both themselves and their relatives. The results indicated that higher depression severity was positively associated with greater gambling problem severity and an increased inability to control gambling behavior. Conversely, depression severity was negatively associated with confidence in treatment. Furthermore, gambling problem severity showed positive associations with heightened gambling-related expectations, interpretative biases, and extrinsic treatment motivation. These findings suggest that depression severity, cognitive distortions related to gambling, and treatment motivation play a significant role in gambling disorder. Consequently, these factors should be carefully assessed in individuals seeking treatment to develop effective intervention strategies.
Nomophobia and psychological well-being: Chain mediating role of social network sites addiction and doomscrolling
The integration of mobile phones into everyday life has become unavoidable, shifting lifestyles across generations. Most likely, emerging adults suffer from repercussions caused by their dependence on smartphones and exposure to social networking sites, potentially associated with adverse outcomes for their mental health. This study investigated the mediating roles of social network sites addiction and doomscrolling within the interaction between nomophobia and the psychological well-being of emerging adults, utilizing a theoretical model grounded in the transactional model of stress. A cross-sectional study was conducted with 399 college students aged 18–24 in Tamil Nadu, India. The data analysis involved the Pearson correlation coefficient and structural equation modeling to examine the mediating roles of social network sites addiction and doomscrolling. It was observed that there was a positive link between nomophobia, social network sites addiction, and doomscrolling and a negative correlation between these factors and psychological well-being. Moreover, the results revealed that social network sites addiction and doomscrolling fully mediated the relationship between nomophobia and psychological well-being. The study recommends that college administrators, teachers, behaviorists, and researchers employ acceptance commitment therapy, cognitive behavioral therapy, and mindfulness to help individuals manage smartphone use, reduce nomophobia, and adopt healthier online habits for better well-being.
Multidisciplinary work and ethical approaches in rehabilitation services
Psychometric validity and reliability of the Turkish exercise addiction inventory-3
The Exercise Addiction Inventory-3 is the latest version of the Exercise Addiction Inventory, whose use has become more frequent in several countries. The present study investigated its psychometric properties among Turkish adults. The study recruited 389 participants through online social media platforms. Reliability was tested through Cronbach’s alpha and McDonald’s omega. Validity was tested through correlations among the Exercise Addiction Inventory-3 score and scores on the Exercise Dependence Scale-Revised, Ten-Item Personality Inventory, SCOFF Questionnaire, and Obsessive-Compulsive Inventory-Revised. Structural validity was tested via confirmatory factor analysis and measurement invariance. The findings suggested that the Turkish version of the Exercise Addiction Inventory-3 is reliable. Moreover, confirmatory factor analysis indicated that the models demonstrated good to excellent fit indices. Partial measurement invariance was observed. The Exercise Addiction Inventory-3 scores were positively correlated with the Exercise Dependence Scale-Revised and Obsessive-Compulsive Inventory-Revised scores. The total scale score and the Addiction Tendency subscale score were negatively correlated with SCOFF scores but not the Health Relevance subscale scores. The Turkish Exercise Addiction Inventory-3 is a reliable and valid instrument to assess the risk of exercise addiction that differentiates at-risk groups from passionate exercisers. Implications for future studies are discussed.
Brief psychoeducational intervention to decrease parental distress and increase self-efficacy of parents of video game players: A pilot study
Gaming is prevalent, especially for children and adolescents. It is a modern form of entertainment if within considerable limits. However, the definition of excessive gaming is unclear and parents have difficulties managing gaming behavior. The current study aims to test a pilot brief psychoeducational intervention for parents to help them gain a broader comprehension of gaming behavior and to support managing caregiver burden. Intervention participants attended a 90-minute brief psychoeducation intervention and wait-list control participants received no treatment. The Depression Anxiety Stress Scale Short Form, Parental Self-Efficacy Scale, and the Demographic Form were used. There was a significant decrease in depression, anxiety, and stress scores from pre- to post-measurement only in the intervention group. There were no significant differences in parental self-efficacy scores. The results revealed the effectiveness of a brief psychoeducational intervention to support parents of gamers. Future studies are necessary to tailor specific interventions depending on differential needs and delivery methods.
The nexus of video gaming experiences: The associations among basic needs in games, real-life basic needs, well-being indicators, and problematic online gaming
Recent research highlights the vital roles of basic needs in video gaming experiences. Both need-supportive and need-frustrating video gaming experiences have theoretical and practical implications for real-life need satisfaction and frustration, and well-being outcomes. This study aimed to adapt the Basic Needs in Games Scale into Turkish, tested the psychometric properties of “gaming in general” and “gaming in a particular game” versions of the Turkish Basic Needs in Games Scale, and investigated the associations among the Basic Needs in Games Scale, problematic online gaming, life satisfaction, meaning in life (i.e., coherence, purpose, significance), and real-life basic psychological needs. This study recruited a sample of 247 Turkishspeaking participants who played at least one video game over the past 2 weeks. The results provided evidence for the structural validity of the Turkish Basic Needs in Games Scale versions, and demonstrated good reliability for the Basic Needs in Games Scale subscales. The findings indicated that indicators of need satisfaction and frustration in games were primarily associated with their real-life counterparts and showed complex associations with life satisfaction, meaning in life, and problematic online gaming. The implications for further research on basic needs in video games are discussed.
Aging and exercise: Addiction risks unveiled
This study aims to investigate exercise addiction among middle-aged and older adults and examine the psychological, social, and biological factors influencing this addiction. Among the participants, 41 middleaged and 26 older adults were identified as exercise addicts. Exercise addiction levels were assessed using the Exercise Addiction Inventory. Health-promoting behaviors were evaluated with the Health-Promoting Behavior Scale, health anxiety with the Health Anxiety Inventory, and death anxiety with the Death Anxiety Scale. Scores on the Exercise Addiction Inventory, Health-Promoting Behavior Scale, Health Anxiety Inventory, and Death Anxiety Scale were significantly higher in the older group compared to the middleaged group (p = .001, p = .041, p = .002, and p = .047, respectively). In the middle-aged group, no significant associations were found between exercise addiction and health-promoting behaviors, health anxiety, or death anxiety (p > .05). In the older group, however, moderate and significant correlations were observed between exercise addiction and health-promoting behaviors (r = 0.454, p = .020) as well as death anxiety (r = 0.425, p = .030). A strong and significant relationship was also identified between exercise addiction and health anxiety in the older group (r = 0.717, p < .001). The findings suggest that exercise addiction in older adults is associated with psychological and behavioral factors, including health anxiety, health-promoting behaviors, and death anxiety.
From a punitive reflex to a rehabilitative philosophy: The Turkish Judiciary’s cognitive challenge with Article 191 of the Turkish Penal Code
This study analyzes the practical implementation and judicial reception of the paradigm shift introduced by Article 191 of the Turkish Penal Code, which reframed the state’s response to drug users from a punitive to a rehabilitative model. Employing a qualitative document analysis, the study thematically analyzes 44 purposively sampled decisions from the Criminal General Assembly of the Court of Cassation issued between 2005 and 2024. Findings reveal that the judiciary’s adaptation was a complex process marked by initial cognitive resistance, procedural confusion, and the development of counter-principles. Key results include the judiciary’s creation of an “incorrigible offender” profile to set limits on rehabilitation through risk assessment, and the emergence of a “ripple effect” that gave users a unique legal status by interacting with other legal institutions. The study concludes that a significant gap exists between the “law in books” and “law in action,” highlighting that the success of legal reforms depends not only on legislative text but also on the adaptive capacity of the judicial system and a holistic anticipation of systemic consequences.
Mental health problems and substance use among iraqi adolescents: Retrospective study from the global school-based health survey
Mental health problems and addiction are interconnected public health concerns among adolescents. The objective was to examine the estimated prevalence and identify shared predictors of mental health and addiction problems among Iraqi adolescents using data from the Global School-Based Student Health Survey (GSHS). Data from 1611 students aged 11–16 years were analyzed. Binary outcomes were derived from Global School-Based Student Health Survey items; Chi-square tests and logistic regression examined associations with demographics and psychosocial factors. Overall, 10.3% reported mental health problems and 2.1% exhibited substance use problems . Beyond prevalence, the risk of substance addiction was substantially higher among students with mental health problems; female students had higher odds of mental health problems, while male students had a higher odd of substance addiction. Bullying and the lack of close friendships were strongly associated with substance addictions, and smoking and drug use were strong predictors of mental health distress. Older age and higher grade were associated with increased mental health problems. Emotional distress and risky behaviors co-occur and cluster around social adversities (bullying, weak peer ties) in Iraqi schools. This study provides the first national analysis of Iraq’s Global School-Based Student Health Survey data to jointly examine mental health and substance use problems and their shared social predictors, establishing a baseline for trend comparisons. The findings support early integrated, school-based approaches that are gender-responsive, incorporate bullying prevention and peer support structures, and link to cessation and referral pathways in school and primary care systems. These data offer concrete goals for Ministries of Health/Education when updating school health programs and child protection policies.
E-cigarette use, thirdhand smoke awareness, and motivation to participate in physical activity in adolescents
This study aims to investigate the levels of e-cigarette use, thirdhand smoke awareness, and motivation to participate in physical activity among adolescents, to reveal the relationship between these variables and to contribute to reducing future health risks. This descriptive and cross-sectional study included 657 volunteer students from a vocational and technical Anatolian high school. Data were collected using the “Thirdhand Smoke Awareness Scale” and the “Physical Activity Participation Motivation Scale,” and analyzed using SPSS 26 software. Among the participants, 21.5% reported cigarette use, and 19.6% reported e-cigarette use. Non-smoking students demonstrated significantly higher physical activity motivation scores (54.67 ± 9.91) than smokers (52.08 ± 7.74) (p < .01). The mean thirdhand smoke awareness score was 32.44 ± 9.38, with awareness levels correlating with parental education levels (p < .05). A weak positive correlation was identified between physical activity motivation and thirdhand smoking awareness (r = 0.153, p < .01). Students who exercised regularly exhibited significantly higher physical activity motivation scores (57.09 ± 10.64) than those who did not (52.02 ± 8.08) (p < .01). This study reveals that cigarette and e-cigarette use is a widespread public health problem among young people and that these behaviors begin at an early age. This study emphasizes the importance of educational programs and regulatory measures to reduce cigarette and e-cigarette use, promote physical activity, and increase awareness of thirdhand smoke.
Development and validation of caregiver’s attitudes toward drug addict’s recovery scale
Caregiver’s attitudes toward recovery of their drug addicted loved one significantly influence their behavioral orientation toward recovery, adherence to treatment procedures, and sustainability of sobriety. There is, however, a lack of any scale for its assessment, and thus the present study aimed to develop and validate the caregiver’s attitudes toward drug addict’s recovery scale. In-depth interviews were conducted with caregivers (N = 17, Mage = 39.35), and interpretative phenomenological analysis was used to generate superordinate themes of beliefs, negative feelings, and active involvement toward recovery. The items for each theme were generated, and after content validity, a pool 44 items was obtained. The factor structure of the scale was determined on a sample of 284 caregivers (Mage = 39.57), resulting in four subscales (i.e., negative recovery expectations, positive recovery expectations, emotional resentment, therapeutic pessimism) explaining 49.01% variance. The construct validity was assessed through confirmatory factor analysis (N = 400, Mage = 43.38), demonstrating good indices of fit for 42 out of 44 items. The convergent and discriminant validity of the retained item pool with scores on internalized stigma demonstrated a significant positive correlation with negative recovery expectations, emotional resentment, and therapeutic pessimism, whereas there was no correlation with positive recovery expectations. The reliability coefficients for subscales ranged from 0.77 to 0.92. The caregiver’s attitudes toward drug addict’s recovery scale is thus a psychometrically sound tool for the assessment of caregiver’s attitudes toward drug addict’s recovery in Pakistan.
Motivational interviewing on smoking cessation decisions of university students in Türkiye: A randomized controlled trial
The study aims to examine the effect of the motivational interviewing intervention on smoking cessation decisions among university students in Türkiye. The study was conducted with the participation of 64 firstyear university students (experimental group 32, control group 32) who were smokers and wanted to quit. Motivational interviews were completed with students in the experimental group based on quitting smoking (first interview, first month, and third month). Data collection comprised the first interview and the interviews on the first, third, and sixth months, performed on the experimental and control groups using five scales. The team determined that the smoking cessation rate of the students in the experimental group (37.6%) was four times higher than that of the control group (9.4%). A significant difference was found when comparing the smoking cessation status of students according to the follow-ups in the experimental and control groups. In the study, students in the experimental group progressed toward moving to the next stage in the stages of behavior change, aiming at smoking cessation. In contrast, in the control group, there were reversals. Motivational interviewing increases students’ smoking cessation rates and provides positive progress in the stages of behavior change, aiming at smoking cessation.
The association of opium addiction with prostate volume: A cross-sectional study
Benign prostatic hyperplasia is a condition in which the prostate gland enlarges in a non-cancerous manner. Opioids can decrease prostate-specific antigen levels along with testosterone and can lead to changes in prostate volume. The main objective of the present study was to determine whether there is an association between opioid addiction and prostate volume. This observational cross-sectional study included 174 male patients admitted to Loghman Hakim Hospital in Tehran, Iran, between December 2023 and November 2024. Participants were categorized into 2 groups: opioid users (exposed group; N = 87) and non-users (non-exposed group; N = 87). Prostate volume was measured using ultrasound, and statistical analyses involved independent samples t-tests, Mann–Whitney U tests, and Spearman’s correlation coefficient. A p-value of less than .05 was considered statistically significant. Among opioid users, 71.3% primarily consumed opium, while the remaining individuals used methadone, refined opium, or heroin. The average prostate volume for all participants was 29.5 cm3 , with no significant difference observed between opioid users and non-users (p = .268). However, a significant positive correlation was found between the duration of opioid use and prostate volume (Spearman’s rho = 0.353, p < .001). Additionally, age showed a strong correlation with prostate volume in both opioid users (Spearman’s rho = 0.476, p < .001) and non-users (Spearman’s rho = 0.591, p < .001). This study found no significant association between prostate volume and opium addiction, smoking, body mass index, and past medical history. Age and duration of opium consumption were the only significant factors associated with prostate volume. To achieve definitive results, prospective studies with larger sample sizes are needed.
Effects of addiction-related education on the knowledge and awareness levels of civil servants: An intervention in a district of İzmir
This single-group quasi-experimental study was conducted with a pretest-posttest design to measure changes in the knowledge and awareness levels of religious officials in the context of an education program about addiction. Data were collected using the Substance Addiction Awareness Scale and the Substance Addiction Knowledge Test before and after the education given to the participants. Paired-samples t-tests were used in the analyses of the data. After the education program, significant increases were seen in the scores of the participants on the overall Substance Addiction Awareness Scale and all its dimensions except for the personal attitudes and opinions dimension. The results of the Substance Addiction Knowledge Test showed that the knowledge levels of the participants about addiction increased after the education program. The results of this study showed that providing a group of professionals who are in contact with society with education about addiction could increase the awareness and knowledge levels of these professionals.