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0000-0003-1984-0096
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Research Topics
In Research Link Australia (RLA), "Research Topics" refer to ANZSRC FOR and SEO codes. These topics are either sourced from ANZSRC FOR and SEO codes listed in researchers' related grants or generated by a large language model (LLM) based on their publications.
Top 5 Research Topics
ANZSRC Field of Research (FoR)
Environmental Chemistry (incl. Atmospheric Chemistry) | Health, Clinical and Counselling Psychology | Public Health and Health Services | Environmental and Occupational Health and Safety | Human Bioethics | Environmental Monitoring | Public Health and Health Services not elsewhere classified | Analytical spectrometry | Law And Society | Environmental Science and Management | Health Policy | Medical Biotechnology | Analytical Chemistry not elsewhere classified | Health services and systems | Medical Biotechnology | Other Chemical Sciences | Health surveillance | Law | Psychology | Research, Science And Technology Policy | Environmental Sciences not elsewhere classified | Public Policy | Health Promotion | Health Information Systems (incl. Surveillance) | Occupational and workplace health and safety |
ANZSRC Socio-Economic Objective (SEO)
Expanding Knowledge in the Environmental Sciences | Bioethics | Public Health (excl. Specific Population Health) not elsewhere classified | Substance Abuse | Health policy evaluation | Behaviour and Health | Expanding Knowledge in the Chemical Sciences | Health related to ageing | Justice and the law not elsewhere classified | Environmental Health
Related Links
Publications
Association between purity of drug seizures and illicit drug loads measured in wastewater in a South East Queensland catchment over a six year period
Publisher: Elsevier BV
Date: 09-2018
DOI: 10.1016/J.SCITOTENV.2018.04.192
Abstract: This study aimed to examine associations between the annual average purity of seized illicit drugs and their corresponding load measured in wastewater. Daily loads (averaging 81 s les/year) and purity of seized meth hetamine (average 287 s les/year), cocaine (50/year) and MDMA (70/year) were collected from a catchment that serviced approximately 220,000 persons in Queensland, Australia during 2010-2015. Using regression models for mass load and purity data, we found a strong linear increase in the mass load of meth hetamine detected across study years (363-1126 mg/1000 people/day, R
Drug Addiction, Society and Ethics
Publisher: Wiley
Date: 15-06-2006
The brain disease model of addiction: challenging or reinforcing stigma?–Authors' reply
Publisher: Elsevier BV
Date: 04-2015
Public Attitudes Toward the Treatment of Nicotine Addiction
Publisher: Oxford University Press (OUP)
Date: 18-03-2013
DOI: 10.1093/NTR/NTT037
Abstract: The increasing use of medications for smoking cessation has concerned some commentators, who believe that emphasizing medications for smoking cessation may lead to a belief that there are "magic bullets" for nicotine dependence, or alternatively that unassisted quitting is very difficult, thereby discouraging such quit attempts. There is little evidence on which to test these speculations. This article aims to address this gap by examining public understandings of nicotine addiction in order to assess the extent to which medical explanations of smoking have permeated public beliefs about treatments for smoking cessation. Interviews were conducted with a representative s le of 55 members of the Australian public that included smokers, ex-smokers, and nonsmokers. The data were analyzed using a standard content analytic method to identify recurrent themes. The results revealed that although pharmacological cessation aids were the most commonly mentioned method for quitting, they were often recommended alongside methods such as behavioral strategies or counseling. Unassisted quitting was mentioned frequently, but there were mixed views on its effectiveness. Seeing a doctor was rarely recommended. Two common themes were that smokers had to "really want to quit," and that the best treatment method would depend on the in idual. Medical discourse of smoking cessation does not dominate public understandings of smoking cessation. Rather, ideas about in idual choice, motivation, and willpower are emphasized.
Commentary on K elty & H ulse (2012): Is the comparison of mortality between patients prescribed implanted or oral naltrexone an unbiased and unconfounded comparison?
Publisher: Wiley
Date: 10-09-2012
Meta‐analytic review of the efficacy of smoking cessation interventions
Publisher: Wiley
Date: 04-1994
DOI: 10.1080/09595239400185231
Abstract: A meta-analysis of randomized and controlled evaluations of the efficacy of smoking cessation interventions compared 146 estimates of the difference in abstinence rates between treated and control conditions (effect sizes) from 85 publications. Simple advice to quit and other brief intervention techniques, nicotine chewing gum and behavioural techniques were all found to be significantly better than relevant control conditions in promoting abstinence, although the results were not homogeneous. In five studies of acupuncture compared with control, consistent results were found showing no benefit for acupuncture.
BEWARE OF ALLOWING THE IDEAL TO BE THE ENEMY OF THE GOOD
Publisher: Wiley
Date: 05-08-2011
Would vaccination against nicotine be a cost‐effective way to prevent smoking uptake in adolescents?
Publisher: Wiley
Date: 23-01-2012
DOI: 10.1111/J.1360-0443.2011.03718.X
Abstract: We used epidemiological modelling to assess whether nicotine vaccines would be a cost-effective way of preventing smoking uptake in adolescents. We built an epidemiological model using Australian data on age-specific smoking prevalence smoking cessation and relapse rates life-time sex-specific disability-adjusted life years lived for cohorts of 100,000 smokers and non-smokers government data on the costs of delivering a vaccination programme by general practitioners and a range of plausible and optimistic estimates of vaccine cost, efficacy and immune response rates based on clinical trial results. We first estimated the smoking uptake rates for Australians aged 12-19 years. We then used these estimates to predict the expected smoking prevalence in a birth cohort aged 12 in 2003 by age 20 under (i) current policy and (ii) different vaccination scenarios that varied in cost, initial vaccination uptake, yearly re-vaccination rates, efficacy and a favourable vaccine immune response rate. Under the most optimistic assumptions, the cost to avert a smoker at age 20 was $44,431 [95% confidence interval (CI) $40,023-49,250]. This increased to $296,019 (95% CI $252,307-$355,930) under more plausible scenarios. The vaccine programme was not cost-effective under any scenario. A preventive nicotine vaccination programme is unlikely to be cost-effective. The total cost of a universal vaccination programme would be high and its impact on population smoking prevalence negligible. For these reasons, such a programme is unlikely to be publicly funded in Australia or any other developed country.
Policy forum
Publisher: Emerald
Date: 24-09-2009
DOI: 10.1108/17459265200900024
Abstract: This editorial will contend that the execution of people convicted of drug trafficking and other drug‐related offences is a penalty that should be abolished, as it is both ineffective as a policy measure and abhorrent in terms of human rights violation (Lines, 2007). That conclusion will be offered after due examination of contrary arguments, and with respectful acknowledgement of the fact that different cultures have different beliefs as to what constitutes justice. The editorial will go on to argue that the international addictions science community has a responsibility to support the abolitionist cause ‐ silence cannot be an appropriate response in the face of such continued and irrational judicial killings.
Prevalence and correlates of suicidal thoughts and suicide attempts in people prescribed pharmaceutical opioids for chronic pain
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 04-2016
Association between the implementation of tobacco control policies and adolescent vaping in 44 lower‐middle, upper‐middle, and high‐income countries
Publisher: Wiley
Date: 11-05-2022
DOI: 10.1111/ADD.15892
Abstract: To (i) estimate the prevalence of adolescent vaping in 47 lower‐middle, upper‐middle and high‐income countries, and (ii) test the association between implementation of World Health Organisation (WHO) tobacco control policies and adolescent e‐cigarette use (also known as vaping) in 44 countries where implementation data were available. Cross‐sectional surveys. A total of 47 lower‐middle, upper‐middle and high‐income countries. A total of 151 960 adolescents (typically ages 13–15) who participated in WHO's Global Youth Tobacco Survey between 2015 and 2018. Prevalence of past‐30‐day vaping and past 30‐day frequent vaping (≥10 days) were estimated from the surveys. Data on the implementation of six tobacco control measures including monitoring, smoke‐free policies, cessation programs, warning about the dangers of tobacco, advertising bans and taxation were taken from WHO's report on global tobacco epidemic. The overall weighted prevalence of adolescent vaping and frequent vaping in the past 30 days was 8.6% (95% CI, 8.3‐8.9) and 1.7% (95% CI, 1.6‐1.8), respectively. For five of WHO's policies (monitoring, smoking‐free environment, cessation programs, health warning and advertising bans), their association with adolescent vaping was inconclusive because of large variation of their effects across countries. Higher tax on combustible tobacco products was associated with higher adolescent vaping ( = 75% tax vs 25% tax odds ratio = 2.58 95% CI, 1.25‐5.21). In 47 lower‐middle, upper‐middle and high‐income countries from 2015 to 2018, ~1 in 12 (8.6%) adolescents reported vaping in the past 30 days, but prevalence of frequent vaping was low (1 in 60 1.7%). A higher tobacco tax was associated with higher adolescent vaping.
The Adverse Health and Psychological Consequences of Cannabis Dependence
Publisher: Cambridge University Press
Date: 2001
Parental supply of alcohol to Australian minors: An analysis of six nationally representative surveys spanning 15 years
Publisher: Springer Science and Business Media LLC
Date: 14-04-2016
The Implications of Genetic Susceptibility for the Prevention of Colorectal Cancer: A Qualitative Study of Older Adults’ Understanding
Publisher: S. Karger AG
Date: 2008
DOI: 10.1159/000121399
Abstract: i Objective: /i To assess whether public understandings of inherited predisposition to colorectal cancer may undermine preparedness to respond to preventive messages. i Methods: /i Structured in-depth interviews with 31 women and men, aged 50 years and over. i Results: /i Most participants viewed genetic factors as prompts for taking preventive measures rather than as reasons for fatalism and inaction. They were optimistic about the potential benefits of new developments in cancer prevention and treatment. i Conclusions: /i There was little evidence of perceived genetic determinism in relation to colorectal cancer, but there were some significant misunderstandings about causes, prevention and treatment. These findings have important implications for public health communications about the contribution of genetics to cancer causation.
Control and Responsibility in Addicted Individuals: What do Addiction Neuroscientists and Clinicians Think?
Publisher: Springer Science and Business Media LLC
Date: 06-10-2013
The Global Epidemiology and Disease Burden of Cannabis Use and Dependence
Publisher: Elsevier
Date: 2017
The “gateway” effect of e-cigarettes may be explained by a genetic liability to risk-taking
Publisher: Public Library of Science (PLoS)
Date: 18-03-2021
Adolescent predictors of a typology of dsm-5 alcohol use disorder symptoms in young adults derived by latent class analysis using data from an Australian cohort study
Publisher: Alcohol Research Documentation, Inc.
Date: 09-2016
DOI: 10.15288/JSAD.2016.77.757
Abstract: There is little research examining alcohol use disorder (AUD) symptoms (based on criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition [DSM-5]) in young adulthood. We assessed symptom structure at 24 years using latent class analysis (LCA), examining relationships between class membership and (a) concurrent alcohol use and DSM-5 AUD severity and (b) adolescent risk factors. A stratified, random s le of 1,943 adolescents ages 14-15 years was recruited from 44 secondary schools in Victoria, Australia, and interviewed during adolescence and young adulthood. We report findings on drinkers who completed the AUD module (N = 1,268 51% male). Data clearly fit a three-class, dimensional model, comprising "mild symptoms" (63.2%), "moderate symptoms" (32.2%), and "severe symptoms" (4.6%) classes. Class membership was validated by concurrent drinking patterns and in reasonable agreement with DSM-5 AUD severity categories. Relative to mild symptoms class membership, moderate symptoms class membership increased odds of adolescent alcohol problems (odds ratio [OR] = 2.0, 95% CI [1.2, 3.5]) and persisting anxiety/depression symptoms (OR = 1.9, 95% CI [1.2, 3.1]). Daily smoking (OR = 2.6, 95% CI [1.1, 5.9]), persisting anxiety/ depression symptoms (OR = 2.5, 95% CI [1.3, 5.0]), and antisocial behavior (OR = 3.2, 95% CI [1.5, 6.8]) increased odds of severe symptoms class membership. Adolescent daily smoking (OR = 0.3, 95% CI [0.11, 0.81]) and antisocial behavior (OR = 0.3, 95% CI [0.14, 0.64]) were less likely among members of the moderate symptoms class, relative to the severe symptoms class. We found support for a dimensional AUD typology like that in DSM-5. Young adults with more severe AUD symptoms had a different adolescent risk profile than those in the low and moderate classes. These findings provide a focus for preventive intervention in adolescence to limit the severity of AUDs in young adulthood.
Substance Use and Mental Health in Longitudinal Perspective
Publisher: Wiley
Date: 2005
Realising the technological promise of smartphones in addiction research and treatment: An ethical review
Publisher: Elsevier BV
Date: 10-2016
DOI: 10.1016/J.DRUGPO.2016.05.013
Abstract: Smartphone technologies and mHealth applications (or apps) promise unprecedented scope for data collection, treatment intervention, and relapse prevention when used in the field of substance abuse and addiction. This potential also raises new ethical challenges that researchers, clinicians, and software developers must address. This paper aims to identify ethical issues in the current uses of smartphones in addiction research and treatment. A search of three databases (PubMed, Web of Science and PsycInfo) identified 33 studies involving smartphones or mHealth applications for use in the research and treatment of substance abuse and addiction. A content analysis was conducted to identify how smartphones are being used in these fields and to highlight the ethical issues raised by these studies. Smartphones are being used to collect large amounts of sensitive information, including personal information, geo-location, physiological activity, self-reports of mood and cravings, and the consumption of illicit drugs, alcohol and nicotine. Given that detailed information is being collected about potentially illegal behaviour, we identified the following ethical considerations: protecting user privacy, maximising equity in access, ensuring informed consent, providing participants with adequate clinical resources, communicating clinically relevant results to in iduals, and the urgent need to demonstrate evidence of safety and efficacy of the technologies. mHealth technology offers the possibility to collect large amounts of valuable personal information that may enhance research and treatment of substance abuse and addiction. To realise this potential researchers, clinicians and app-developers must address these ethical concerns to maximise the benefits and minimise risks of harm to users.
Is deep brain stimulation a prospective cure for addiction?
Publisher: Faculty Opinions Ltd
Date: 02-2011
DOI: 10.3410/M3-4
Why young people's substance use matters for global health
Publisher: Elsevier BV
Date: 03-2016
Spatial variations in the consumption of illicit stimulant drugs across Australia: A nationwide application of wastewater-based epidemiology
Publisher: Elsevier BV
Date: 10-2016
DOI: 10.1016/J.SCITOTENV.2016.05.207
Abstract: Obtaining representative information on illicit drug use and patterns across a country remains difficult using surveys because of low response rates and response biases. A range of studies have used wastewater-based epidemiology (WBE) as a complementary approach to monitor community-wide illicit drug use. In Australia, no large-scale WBE studies have been conducted to date to reveal illicit drug use profiles in a national context. In this study, we performed the first Australia-wide WBE monitoring to examine spatial patterns in the use of three illicit stimulants (cocaine, as its human metabolite benzoylecgonine meth hetamine and 3,4-methylendioxymeth hetamine (MDMA)). A total of 112 daily composite wastewater s les were collected from 14 wastewater treatment plants across four states and two territories. These covered approximately 40% of the Australian population. We identified and quantified illicit drug residues using liquid chromatography coupled with tandem mass spectrometry. There were distinctive spatial patterns of illicit stimulant use in Australia. Multivariate analyses showed that consumption of cocaine and MDMA was higher in the large cities than in rural areas. Also, cocaine consumption differed significantly between different jurisdictions. Meth hetamine consumption was more similar between urban and rural locations. Only a few cities had elevated levels of use. Extrapolation of the WBE estimates suggested that the annual consumption was 3tonnes for cocaine and 9tonnes combined for meth hetamine and MDMA, which outweighed the annual seizure amount by 25 times and 45 times, respectively. These ratios imply the difficulty of detecting the trafficking of these stimulants in Australia, possibly more so for meth hetamine than cocaine. The obtained spatial pattern of use was compared with that in the most recent national household survey. Together both WBE and survey methods provide a more comprehensive evaluation of drug use that can assist governments in developing policies to reduce drug use and harm in the communities.
Prevention, early intervention, harm reduction, and treatment of substance use in young people
Publisher: Elsevier BV
Date: 03-2016
Ethical Concerns in the Community About Technologies to Extend Human Life Span
Publisher: Informa UK Limited
Date: 14-12-2009
DOI: 10.1080/15265160903318368
Abstract: Debates about the ethical and social implications of research that aims to extend human longevity by intervening in the ageing process have paid little attention to the attitudes of members of the general public. In the absence of empirical evidence, conflicting assumptions have been made about likely public attitudes towards life-extension. In light of recent calls for greater public involvement in such discussions, this target article presents findings from focus groups and in idual interviews which investigated whether members of the general public identify ethical issues surrounding life-extension, and if so, what these ethical issues are? In this study, while some participants were concerned primarily with the likely personal consequences of life-extension, for others the question of whether or not to pursue interventions to extend longevity, and how they should be implemented, clearly raised important ethical issues, many of which have been prominent in debates among bioethicists.
Smokeless tobacco use in Australia
Publisher: Wiley
Date: 05-2009
DOI: 10.1111/J.1465-3362.2009.00058.X
Abstract: There has been little research published on the use of smokeless tobacco (SLT) in Australia. This study aimed to determine the prevalence of SLT use and the potential for harm reduction in current SLT users and smokers. We undertook secondary analysis of data from a national household survey of drug use and surveyed 108 Australian SLT users about their patterns of SLT use and tobacco smoking. The low prevalence of SLT use in the past year in Australia (0.57% 95% confidence interval 0.48–0.66) might reflect the difficulty in importing these products. Prevalence of recent use was highest among males aged 18–29 who were current weekly smokers. US style oral snuffs were the most popular SLT products in Australia. Most of those surveyed were introduced to SLT by a personal contact and about half had used SLT to quit smoking. Australians who import SLT pay per can AU$21.30 on average and face substantial delays before receiving the product. Cost and poor access present a substantial barrier to SLT use as a tobacco harm reduction measure for Australian smokers. Permitting low nitrosamine varieties of SLT to be sold in Australia might reduce harm in current SLT users and provide a viable alternative to cigarettes for some current smokers.
Informed consent to opioid agonist maintenance treatment: Recommended ethical guidelines
Publisher: Elsevier BV
Date: 02-2008
DOI: 10.1016/J.DRUGPO.2007.09.007
Abstract: Some bioethicists have questioned whether opioid addicted in iduals are able to provide free and informed consent to opioid agonist maintenance treatment. Conflicting motives for providing such treatment (e.g. improving the personal health of addicts and protecting public health and order) can also influence what in iduals are required to consent to, and how that consent is obtained. We discuss both issues and attempt to specify the conditions for obtaining informed consent to agonist maintenance treatment for opioid addiction. We briefly review the neuroscientific literature on the effects of addiction on the autonomy and decision-making capacity of opioid dependent in iduals, and ascertain how informed consent to the treatment of opioid addiction should be obtained. We also provide an ethical analysis of the competing social and medical forces that influence the consent process and make some recommendations on how to ensure that in iduals enter maintenance treatment that is provided in an effective and ethical way. Our analysis shows that whilst the autonomy of opioid dependent in iduals is impaired by their addiction, they do retain the ability to consent to treatment provided they are not in acute withdrawal or intoxication. These symptoms should have abated, either by supervised withdrawal or stabilisation on agonist maintenance, before they are asked to consent to a detailed treatment contract. Once stabilised, in iduals should be provided with detailed information about the risks and benefits of all treatments, and restrictions and regulations under which they are provided. Informed consent is an important part of the treatment process that should be obtained in ways that increase the autonomy and decision-making capacity in opioid addicts.
Ethical issues in the neuroprediction of addiction risk and treatment response
Publisher: Springer Netherlands
Date: 29-09-2015
Lee Robins' studies of heroin use among US Vietnam veterans
Publisher: Wiley
Date: 20-09-2016
DOI: 10.1111/ADD.13584
Abstract: The work of Robins and her colleagues on heroin addiction among Vietnam veterans sets out in microcosm many of the key factors that play out in the development and maintenance of substance addiction beyond the pharmacology of the drug: price, availability, the process of delivery of the addictive substance, availability of other substances, social norms, education and life circumstances. Robins' studies found high rates of heroin use (34%) and symptoms of heroin dependence (20%) among US soldiers while serving in Vietnam. In the first year after returning to the United States only 1% became re-addicted to heroin, although 10% tried the drug after their return. Like other seminal studies, this work needs to be read in the original, because relying upon secondary interpretations risks being given a selectively edited version of their findings in service of varied policy and theoretical agendas.
The is and ought of the Ethics of Neuroenhancement: Mind the Gap
Publisher: Frontiers Media SA
Date: 08-01-2016
A randomised controlled trial of methadone maintenance treatment versus wait list control in an Australian prison system
Publisher: Elsevier BV
Date: 10-2003
DOI: 10.1016/S0376-8716(03)00187-X
Abstract: The aim was to determine whether methadone maintenance treatment reduced heroin use, syringe sharing and HIV or hepatitis C incidence among prisoners. All eligible prisoners seeking drug treatment were randomised to methadone or a waitlist control group from 1997 to 1998 and followed up after 4 months. Heroin use was measured by hair analysis and self report drugs used and injected and syringe sharing were measured by self report. Hepatitis C and HIV incidence was measured by serology. Of 593 eligible prisoners, 382 (64%) were randomised to MMT (n=191) or control (n=191). 129 treated and 124 control subjects were followed up at 5 months. Heroin use was significantly lower among treated than control subjects at follow up. Treated subjects reported lower levels of drug injection and syringe sharing at follow up. There was no difference in HIV or hepatitis C incidence. Consideration should be given to the introduction of prison methadone programs particular where community based programs exist.
Impulse control disorders in patients with Parkinson's disease receiving dopamine replacement therapy: Evidence and implications for the addictions field
Publisher: Wiley
Date: 07-12-2011
DOI: 10.1111/J.1360-0443.2010.03218.X
Abstract: To describe the prevalence, phenomenology and correlates of 'impulse control disorders' (ICDs) in patients with Parkinson's disease (PD) treated with dopamine replacement therapy (DRT) to assess the strength of the evidence that DRT plays a contributory causal role in these disorders and to highlight the implications of these disorders for research in the addiction field. PubMed and Web of Science databases were searched and the reference lists of papers examined. The prevalence of ICDs in Parkinson's patients using DRT varied between 3.5% and 13.6%, depending on the severity and range of disorders assessed. PD patients with ICDs were: generally younger had an earlier onset of PD had a personal or family history of substance abuse or an ICD and were more likely to be treated with dopamine receptor agonists (DA agonists) than levodopa (l-dopa). There is reasonable evidence that dopaminergic medications play a causal role in ICDs in that they occur at a higher rate in an otherwise low-risk population of adults, begin after initiation of DA agonist therapy and cease upon its discontinuation. A causal relationship is biologically plausible, but the role of other factors (such as concurrent mood disorders) remain to be clarified by better-controlled studies. Impulse control disorders among patients with Parkinson's disease receiving dopamine replacement therapy may provide a unique opportunity for addiction researchers to study the neurobiology of impulsive forms of behaviour (such as problem gambling) that appear to be caused, in part, by the therapeutic use of dopamine receptor agonists.
Benzodiazepine use and HIV risk-taking behaviour among injecting drug users
Publisher: Elsevier BV
Date: 10-1992
DOI: 10.1016/0376-8716(92)90005-W
Abstract: This paper examines the prevalence of benzodiazepine use, and its relationship to other drug use and HIV risk-taking among a s le of 1245 injecting drug users (IDU). Approximately a third (36.6%) of the s le had used benzodiazepines during their last typical month of injecting. Benzodiazepine users had injected more frequently, injected more heroin and hetamines, and had more poly-drug use than other IDU. They also had higher levels of HIV risk-taking, having shared injecting equipment more frequently and with more people. There were no differences between groups in number of sexual partners or condom use, although benzodiazepine users were more likely to have been paid for sex. The demographic and drug use variables indicate that benzodiazepine users are a more dysfunctional subgroup of IDU who require particular attention in HIV interventions.
Concerns and help-seeking among patients using opioids for management of chronic noncancer pain
Publisher: Oxford University Press (OUP)
Date: 11-05-2019
DOI: 10.1093/PM/PNY078
Abstract: The safety and efficacy of long-term opioid treatment for chronic noncancer pain (CNCP) remains controversial. This study examined whether patients who report problematic opioid use sought help and/or perceived barriers to help-seeking. Data were collected from 1,086 people prescribed opioids for CNCP via a large prospective cohort called the Pain and Opioids IN Treatment (POINT) study. Patients' characteristics and help-seeking were examined according to scores on the Prescribed Opioids Difficulties Scale (PODS). Participants scoring "intermediate" (17%) or "high" (30%) on the PODS were younger and reported more complex pain presentations, higher opioid doses, poorer physical health, moderate to severe anxiety and depression, aberrant behavior, past month opioid use disorder and help-seeking (compared with the "low" PODS group, 53%). One-quarter (26%) had sought help, most commonly from a primary care physician, specialist pain clinic, family member artner, counselor sychologist, and the Internet. Participants in the "high" PODS group were more likely to have sought help from an alcohol or other drug service, addiction specialist, or drug information helpline. Common barriers to help-seeking were desire for self-management and concern that their opioid treatment may be discontinued. Although 35% met criteria for likely opioid use disorder, only 4.8% reported lifetime treatment with methadone or buprenorphine participants' ratings indicated significant perceived stigma associated with these medications. The PODS is effective in identifying patients who are concerned about their opioid use. Strategies to address stigma related to drug treatment, including better integration of primary health, specialist pain, and addiction services, are important in reducing opioid-related harm.
Differences in associations between cannabis and stimulant disorders in first admission psychosis.
Publisher: Elsevier BV
Date: 07-2013
DOI: 10.1016/J.SCHRES.2013.04.017
Abstract: Substance use in early psychosis is associated with male gender and earlier onset. Evidence about other correlates of substance use is less consistent. Stimulants (e.g. meth hetamine, cocaine) may precipitate psychosis. However the associations of stimulant disorders in early psychosis are difficult to examine because of lower prevalence and overlap with cannabis disorders. Hospital records were used to identify 9919 persons aged 15-29 with a first hospital admission with psychosis in New South Wales (NSW), Australia. Correlates of illicit drug disorders, cannabis disorders and stimulant disorders were examined using univariate and multivariate logistic regression. Half of first psychosis admissions had comorbid substance diagnoses. Cannabis and stimulant disorders were increased more than ten-fold compared to the age-matched Australian population. Stimulant disorders were equally common in women and men and associated with urban location, social advantage and older age at first admission. Cannabis disorders were associated with male gender, younger age and non-metropolitan location. Diagnoses of drug-induced psychoses were more strongly associated with stimulants than with cannabis. Compared to people with cannabis diagnoses alone, those with both cannabis and stimulant disorders were older, more likely to have a diagnosis of drug-induced psychosis and more likely to have comorbid alcohol disorders. Cannabis is the most commonly used substance in psychosis, and the associations of illicit drug use in psychoses are largely those of cannabis disorders. There are significant differences between the personal, socio-economic and diagnostic correlates of cannabis and stimulant disorders in young people with first admission psychosis.
Predicting the future prevalence of cigarette smoking in Australia: how low can we go and by when?
Publisher: BMJ
Date: 29-01-2009
Abstract: In Australia, smoking prevalence has declined in men since the 1950s and in women since the 1980s. Future smoking prevalence in Australia is predicted from estimates of previous and current age-specific and sex-specific cessation rates and smoking uptake in young people derived from national survey data on the prevalence of smoking between 1980 and 2007. A dynamic forecasting model was used to estimate future smoking prevalence in the Australian population based on a continuation of these current trends in smoking uptake and cessation. The results suggest that Australia's smoking prevalence will continue to fall while current rates of initiation and cessation are maintained. But a continuation of current smoking cessation and initiation patterns will see around 14% of adults still smoking in 2020. Smoking cessation rates will need to double for Australian smoking prevalence to reach a policy target of 10% by 2020.
Smoking and mental health in young women – challenges in interpretation: a reply
Publisher: Cambridge University Press (CUP)
Date: 22-10-2012
What can we learn from the history of research on psychedelic drugs in the addictions?
Publisher: Wiley
Date: 12-08-2021
DOI: 10.1111/ADD.15560
A systematic review of randomized controlled trials and network meta-analysis of e-cigarettes for smoking cessation
Publisher: Elsevier BV
Date: 08-2021
DOI: 10.1016/J.ADDBEH.2021.106912
Abstract: E-cigarettes, or nicotine vaping products, are potential smoking cessation aids that provide both nicotine and behavioural substitution for combustible cigarette smoking. This review aims to compare the effectiveness of nicotine e-cigarettes for smoking cessation with licensed nicotine replacement therapies (NRT) and nicotine-free based control conditions by using network meta-analysis (NMA). We searched PubMed, Web of Science and PsycINFO for randomised controlled trials (RCTs) that allocated in iduals to use nicotine e-cigarettes, compared to those that used licensed NRT (e.g., nicotine patches, nicotine gums, etc), or a nicotine-free control condition such as receiving placebo (nicotine-free) e-cigarettes or usual care. We only included studies of healthy in iduals who smoked. Furthermore, we identified the latest Cochrane review on NRT and searched NRT trials that were published in similar periods as the e-cigarette trials we identified. NMA was conducted to compare the effect of e-cigarettes on cessation relative to NRT and control condition. Cochrane risk-of-bias tool for randomized trials Version 2 was used to access study bias. For the e-cigarette trials, our initial search identified 4,717 studies and we included 7 trials for NMA after removal of duplicates, record screening and assessment of eligibility (Total N = 5,674). For NRT trials, our initial search identified 1,014 studies and we included 9 trials that satisfied our inclusion criteria (Total N = 6,080). Results from NMA indicated that participants assigned to use nicotine e-cigarettes were more likely to remain abstinent from smoking than those in the control condition (pooled Risk Ratio (RR) = 2.08, 97.5% CI = [1.39, 3.15]) and those who were assigned to use NRT (pooled RR = 1.49, 97.5% CI = [1.04, 2.14]. There was a moderate heterogeneity between studies (I Smokers assigned to use nicotine e-cigarettes were more likely to remain abstinent from smoking than those assigned to use licensed NRT, and both were more effective than usual care or placebo conditions. More high quality studies are required to ascertain the effect of e-cigarette on smoking cessation due to risk of bias in the included studies.
The association between cannabis use and depression: A review of the evidence
Publisher: Cambridge University Press
Date: 27-10-2011
Should burden of disease estimates include cannabis use as a risk factor for psychosis?
Publisher: Public Library of Science (PLoS)
Date: 29-09-2017
Analysis of national data shows mixed evidence of hardening among Australian smokers
Publisher: Elsevier BV
Date: 10-2012
DOI: 10.1111/J.1753-6405.2012.00908.X
Abstract: According to the 'hardening hypothesis', the proportion of smokers that are 'low-probability quitters' will increase as societal disapproval of smoking increases. This paper examines whether there has been increased hardening in Australian smokers over the past decade as reflected in an increased prevalence of psychological distress and social disadvantage among current smokers. The relationship between psychological distress, living in a disadvantaged area and level of education was determined using logistic regression at two time points 7 to 10 years apart in three cross-sectional household survey series: National Drug Strategy Household Survey (NDSHS), National Health Survey (NHS) and National Survey of Mental Health and Well-being (NSMHW). The relationships between smoking and living in the most disadvantaged areas and having completed less than 12 years of schooling strengthened between 2001 and 2010 in the NDSHS, but there were no significant changes between survey years in the NHS and NSMHW. There was no significant change in the relationship between smoking and psychological distress between survey years in any of the survey series. Social disadvantage may be increasing among current smokers, but the results were inconsistent between survey series, presenting weak evidence that the population of Australian smokers hardened as smoking prevalence declined by approximately 4% over the last decade. A greater focus on intensive in idual-level tobacco cessation interventions does not appear warranted at this time.
Stimulating debate in the field of addiction
Publisher: Wiley
Date: 17-01-2012
Cannabinoids for the treatment of mental disorders – Author's reply
Publisher: Elsevier BV
Date: 02-2020
The EVALI outbreak makes a strong case for better regulation of all vaporizer products
Publisher: Wiley
Date: 16-02-2021
DOI: 10.1111/ADD.15437
Disease or Developmental Disorder: Competing Perspectives on the Neuroscience of Addiction
Publisher: Springer Science and Business Media LLC
Date: 02-2017
Effects of a sustained heroin shortage in three Australian States.
Publisher: Wiley
Date: 14-06-2005
DOI: 10.1111/J.1360-0443.2005.01094.X
Abstract: In early 2001 in Australia there was a sudden and dramatic decrease in heroin availability that occurred throughout the country that was evidenced by marked increases in heroin price and decreases in its purity. This study examines the impact of this change in heroin supply on the following indicators of heroin use: fatal and non-fatal drug overdoses treatment seeking for heroin dependence injecting drug use drug-specific offences and general property offences. The study was conducted using data from three Australian States [New South Wales (NSW), Victoria (VIC) and South Australia (SA)]. Data were obtained on fatal and non-fatal overdoses from hospital emergency departments (EDs), ambulance services and coronial systems treatment entries for heroin dependence compiled by State health departments numbers of needles and syringes distributed to drug users and data on arrests for heroin-related incidents and property-related crime incidents compiled by State Police Services. Time-series analyses were conducted where possible to examine changes before and after the onset of the heroin shortage. These were supplemented with information drawn from studies involving interviews with injecting drug users. After the reduction in heroin supply, fatal and non-fatal heroin overdoses decreased by between 40% and 85%. Despite some evidence of increased cocaine, meth hetamine and benzodiazepine use and reports of increases in harms related to their use, there were no increases recorded in the number of either non-fatal overdoses or deaths related to these drugs. There was a sustained decline in injecting drug use in NSW and VIC, as indicated by a substantial drop in the number of needles and syringes distributed (to 1999 levels in Victoria). There was a short-lived increase in property crime in NSW followed by a sustained reduction in such offences. SA and VIC did not show any marked change in the categories of property crime examined in the study. Substantial reductions in heroin availability have not occurred often, but in this Australian case a reduction had an aggregate positive impact in that it was associated with: reduced fatal and non-fatal heroin overdoses reduced the apparent extent of injecting drug use in VIC and NSW and may have contributed to reduced crime in NSW. All these changes provide substantial benefits to the community and some to heroin users. Documented shifts to other forms of drug use did not appear sufficient to produce increases in deaths, non-fatal overdoses or treatment seeking related to those drugs.
A Neuroethics Framework for the Australian Brain Initiative
Publisher: Elsevier BV
Date: 02-2019
DOI: 10.1016/J.NEURON.2019.01.004
Abstract: Neuroethics is central to the Australian Brain Initiative's aim to sustain a thriving and responsible neurotechnology industry. Diverse and inclusive community and stakeholder engagement and a trans-disciplinary approach to neuroethics will be key to the success of the Australian Brain Initiative.
Social, demographic, and economic correlates of food and chemical consumption measured by wastewater-based epidemiology
Publisher: Proceedings of the National Academy of Sciences
Date: 07-10-2019
Abstract: To date, wastewater-based epidemiology has focused on reporting drug and pharmaceutical consumption patterns by analyzing domestic wastewater. Here we explore the relationships between chemicals in wastewater and social, demographic, and economic parameters of the respective populations. We show the extent to which consumption of chemicals such as opioids and illicit drugs are associated with sociodemographics. We also examine chemicals that reflect in iduals’ consumption of food components in wastewater and show that disparities in diet are associated with educational level. Our study shows that chemicals in wastewater reflect the social, demographic, and economic properties of the respective populations and highlights the potential value of wastewater in studying the sociodemographic determinants of population health.
The perceived health risks of cannabis use in an Australian household survey
Publisher: Wiley
Date: 04-03-2012
DOI: 10.1111/J.1465-3362.2012.00421.X
Abstract: Perceived risks of cannabis use have rarely been researched in Australia. This paper reports on the beliefs about the adverse effects of cannabis use on health, social well-being, driving, mental health and changes in cannabis over time. Survey of 918 Australian adults was conducted as part of a quarterly omnibus self-report survey of an established panel. Respondents believed that cannabis use can cause health and social problems, can adversely affect a person's ability to drive a car, can be addictive, and can lead to use of other illicit drugs. They were uncertain as to whether cannabis can cause schizophrenia and depression, and whether cannabis had become more potent over time. Prevention efforts should focus on educating the Australian people about the nature of cannabis-related harms.
Systematic and day-to-day effects of chemical-derived population estimates on wastewater-based drug epidemiology
Publisher: American Chemical Society (ACS)
Date: 26-12-2015
DOI: 10.1021/ES503474D
Abstract: Population size is crucial when estimating population-normalized drug consumption (PNDC) from wastewater-based drug epidemiology (WBDE). Three conceptually different population estimates can be used: de jure (common census, residence), de facto (all persons within a sewer catchment), and chemical loads (contributors to the s led wastewater). De facto and chemical loads will be the same where all households contribute to a central sewer system without wastewater loss. This study explored the feasibility of determining a de facto population and its effect on estimating PNDC in an urban community over an extended period. Drugs and other chemicals were analyzed in 311 daily composite wastewater s les. The daily estimated de facto population (using chemical loads) was on average 32% higher than the de jure population. Consequently, using the latter would systemically overestimate PNDC by 22%. However, the relative day-to-day pattern of drug consumption was similar regardless of the type of normalization as daily illicit drug loads appeared to vary substantially more than the population. Using chemical loads population, we objectively quantified the total methodological uncertainty of PNDC and reduced it by a factor of 2. Our study illustrated the potential benefits of using chemical loads population for obtaining more robust PNDC data in WBDE.
Drug trafficking: Time to abolish the death penalty
Publisher: Informa UK Limited
Date: 18-07-2011
Commentary on Ogeil et al. (2016): Explaining increased alcohol‐related harm and stable per capita consumption in Australia
Publisher: Wiley
Date: 14-03-2016
DOI: 10.1111/ADD.13246
Estimating the burden of disease attributable to injecting drug use as a risk factor for HIV, hepatitis C, and hepatitis B: findings from the Global Burden of Disease Study 2013
Publisher: Elsevier BV
Date: 12-2016
Looking to the future: Clinical and policy implications of the brain disease model of addiction
Publisher: Oxford University Press
Date: 21-09-2017
DOI: 10.1093/OSO/9780198786832.003.0025
Abstract: The increasing recognition of addiction as a brain disease promises to significantly improve clinical treatment, reduce the stigma and discrimination aimed at people with an addiction, increase treatment funding and access, and discourage the use of punitive responses. This chapter argues that the brain disease model of addiction is not supported by the evidence sought in laboratories worldwide, and has failed to provide the clinical, social, and public policy benefits espoused by its proponents. Treating addiction solely as a brain disease may in fact reduce treatment-seeking, increase stigma, and focus attention on the medical treatment of addiction at the expense of more broadly effective public health policies that reduce the harms of drug use. The neuroscience research of addiction needs to be framed in a way that both accurately reflects the impact of drug use on the brain and communicated in a way that realizes the clinical and social benefits while eschewing avoidable harms.
Content analysis of cannabis vaping videos on YouTube
Publisher: Wiley
Date: 09-02-2021
DOI: 10.1111/ADD.15424
Abstract: There has been an increase in the potency of cannabis during the last two decades and adoption of a novel method of administration—vaping. YouTube, a social media platform, has become a popular source to access cannabis‐related information. This study aimed to identify cannabis vaping YouTube videos from 2016 to 2020 and examine the themes and metrics. Cross‐sectional s le of 200 YouTube videos. YouTube, an on‐line video sharing platform. Videos related to cannabis vaping were identified using the search terms: ‘vaping cannabis’, ‘vaping weed’, ‘vaping marijuana’ and ‘vaping THC’ [tetrahydrocannabinol]. Videos were independently coded by two researchers. The number of views, likes, dislikes and comments were also collected. Robust regression was used to analyse the relationship between identified video themes and video metrics. Six themes were identified: ‘advertisement’, ‘product review’, ‘celebratory’, ‘reflective’, ‘how‐to’ and ‘warning’. The ‘how‐to’ and ‘celebratory’ videos received the highest number of views and likes. The most popular video was viewed more than 4 000 000 times. Many videos portrayed risky behaviour (e.g. vaping a whole THC cartridge in a single setting). Fifty‐two percent of these videos had no age access restrictions. The robust regression model also found that engagement metric was positively associated with ‘reflective’ videos and negatively associated with ‘advertisement’ videos. A large number of videos on cannabis vaping are available on‐line without age‐restriction. Videos that portrayed risky behaviour appear to be prevalent.
Did the under‐reporting of meth/amphetamine use increase in a general population survey in Australia as negative media coverage increased?
Publisher: Wiley
Date: 19-01-2022
DOI: 10.1111/ADD.15783
Abstract: To test (1) if there was a change in self‐reported lifetime prevalence of meth/ hetamine use by birth cohort and (2) if the extent of under‐reporting of meth/ hetamine use was associated with the proportion of the population who nominated meth/ hetamine as a drug problem. Observational study using seven waves of repeated cross‐sectional nationally representative household surveys between 2001 and 2019. Australia. Participants were from three birth cohorts: 1951–60 (age 68–77 at the 2019 survey n = 29 458 55% female), 1961–1970 (age 58–67 n = 29 859 57% female) and 1971–1980 (age 48–57 n = 28 758 59% female). Data were weighted to align the s le to the Australian population. Past year meth/ hetamine use under‐reporting of lifetime meth/ hetamine use in each birth cohort, year and survey stratum (operationalised as the difference between self‐reported lifetime prevalence in 2001 and that of each subsequent year) proportion of the population who nominated meth/ hetamine as a drug problem in each birth cohort, year and survey stratum. Under‐reporting was regressed on the proportion of people holding negative attitude towards meth/ hetamine. Survey year and birth cohort were adjusted for. Between 2001 and 2019, the lifetime prevalence of meth/ hetamine decreased from 6.1% (95% CI = 5.3–6.9) to 1.7% (95% CI = 1.2–2.2) in the 1951–1960 birth cohort (p 0.001), from 13.0% (95% CI = 12.0–14.1) to 4.4% (95% CI = 3.7–5.2) in the 1961–1970 birth cohort (p 0.001) and from 21.4% (95% CI = 19.9–22.9) to 11.2% (95% CI = 10.0–12.4) in the 1971–1980 birth cohort (p 0.001). The proportion who nominated meth/ hetamine as a ‘drug problem’ increased significantly in all three cohorts (all p 0.001) and the degree of under‐reporting of meth/ hetamine use was significantly associated with proportion of people who nominated meth/ hetamine as the ‘drug problem’ (b = 0.09, SE = 0.01, p 0.001). In Australia, the actual prevalence of lifetime meth/ hetamine use may be two‐ to fourfold higher than that estimated in the most recent national household surveys (2019). The level of under‐reporting is strongly associated with increasing negative attitudes towards methyl hetamine and d‐ hetamine use over the same period.
Scare-Mongering and the Anticipatory Ethics of Experimental Technologies
Publisher: Informa UK Limited
Date: 14-05-2009
Advocates need to show compulsory treatment of opioid dependence is effective, safe and ethical
Publisher: WHO Press
Date: 02-2013
A National Wastewater Monitoring Program for a better understanding of public health: A case study using the Australian Census
Publisher: Elsevier BV
Date: 2019
DOI: 10.1016/J.ENVINT.2018.12.003
Abstract: Wastewater contains a large range of biological and chemical markers of human activity and exposures. Through systematic collection and analysis of these markers within wastewater s les it is possible to measure the public health of whole populations. The analysis of effluent and biosolids can also be used to understand the release of chemicals from wastewater treatment plants into the environment. Wastewater analysis and comparison with catchment specific data (e.g. demographics) however remains largely unexplored. This manuscript describes a national wastewater monitoring study that combines influent, effluent and biosolids s ling with the Australian Census. An archiving program allows estimation of per capita exposure to and consumption of chemicals, public health information, as well as per capita release of chemicals into the environment. The paper discusses the study concept, critical steps in setting up a coordinated national approach and key logistical and other considerations with a focus on lessons learnt and future applications. The unique combination of archived s les, analytical data and associated census-derived population data will provide a baseline dataset that has wide and potentially increasing applications across many disciplines that include public health, epidemiology, criminology, toxicology and sociology.
Young adult sequelae of adolescent cannabis use: An integrative analysis
Publisher: Elsevier BV
Date: 09-2014
Does the social context of early alcohol use affect risky drinking in adolescents? Prospective cohort study
Publisher: Springer Science and Business Media LLC
Date: 16-11-2015
The Global Epidemiology and Contribution of Cannabis Use and Dependence to the Global Burden of Disease: Results from the GBD 2010 Study
Publisher: Public Library of Science (PLoS)
Date: 24-10-2013
Direct-to-consumer genetic testing for addiction susceptibility: a premature commercialisation of doubtful validity and value
Publisher: Wiley
Date: 17-04-2012
DOI: 10.1111/J.1360-0443.2012.03836.X
Abstract: Genetic research on addiction liability and pharmacogenetic research on treatments for addiction have identified some genetic variants associated with disease risk and treatment. Genetic testing for addiction liability and treatment response has not been used widely in clinical practice because most of the genes identified only modestly predict addiction risk or treatment response. However, many of these genetic tests have been commercialized prematurely and are available direct to the consumer (DTC). The easy availability of DTC tests for addiction liability and lack of regulation over their use raises a number of ethical concerns. Of paramount concern is the limited predictive power and clinical utility of these tests. Many DTC testing companies do not provide the consumer with the necessary genetic counselling to assist them in interpreting and acting on their test results. They may also engage in misleading marketing to entice consumers to purchase their products. Consumers' genetic information may be vulnerable to misuse by third parties, as there are limited standards to protect the privacy of the genetic information. Non-consensual testing and inappropriate testing of minors may also occur. The United States Food and Drug Administration plans to regulate DTC genetic tests. Based on the ethical concerns we discuss below, we believe there is a strong case for regulation of DTC genetic tests for addiction liability and treatment response. We argue that until this occurs, these tests have more potential to cause harm than to contribute to improved prevention and treatment of addiction.
Capacity, control and responsibility in Parkinson's disease patients with impulse control disorders: Views of neurological and psychiatric experts
Publisher: Elsevier BV
Date: 07-2019
DOI: 10.1016/J.IJLP.2018.04.003
Abstract: Dopamine replacement therapy can induce impulse control disorders (ICDs) (e.g., hypersexuality) in susceptible Parkinson's disease patients. ICDs can sometimes result in criminal offending. In a number of past Commonwealth cases, it appears offending ICD patients have been considered to be suffering from 'irresistible impulses' such that their decision-making capacity, behavioural control and responsibility were totally compromised. This contrasts with courts' general scepticism of drug-induced 'compulsion' in cases of addiction-related offending. In one case of explicit ICD-related offending, testimony was limited to three experts and not contested by the prosecution. We explored whether the testimony offered in this particular case, and another similar case, reflects the views of the neurological and psychiatric communities at large. Thematic analysis revealed that neurologists, geriatricians and psychiatrists (n = 11): (a) attributed ICDs to a variety of causes (b) considered ICD patients' decision-making capacities and behavioural control to be partially, but not totally, compromised (c) were ided or ambivalent about ICD patients' responsibility and (d) astutely noted the difficulties inherent in assessing complex constructs such as 'control' and 'responsibility'. We suggest that there is sufficient ergence between our findings and expert testimony from past cases for prosecution teams to engage their own experts in future cases of ICD-related offending.
Supping with the Devil? The role of law in promoting tobacco harm reduction using low nitrosamine smokeless tobacco products
Publisher: Elsevier BV
Date: 03-2009
DOI: 10.1016/J.PUHE.2008.12.018
Abstract: In Sweden, male cigarette smoking has declined as snus, a smokeless tobacco product which is low in carcinogenic nitrosamines, has gained popularity among male tobacco users. Epidemiological modelling based on the Swedish experience indicates that there would be major public health gains if a substantial number of current smokers in other countries could also be persuaded to switch to this product. This form of 'tobacco harm reduction' is very controversial in the public health community for many reasons. These include: objections in principle to the use of less harmful but still addictive nicotine products uncertainties about the long-term effects of these products on health doubts about the likely interest in and uptake of these products among existing smokers concerns that increasing the availability of these products will increase the number of new tobacco users and eventually the number of smokers in the population and anxiety about how the tobacco industry may use these products to undermine current tobacco control policies. This paper concludes with suggestions for a graduated series of policies that may allow exploration of the public health costs and benefits of encouraging smokers to switch to snus.
Galvanizers, Guides, Champions, and Shields: The Many Ways That Policymakers Use Public Health Researchers
Publisher: Wiley
Date: 12-2011
Artificial Cell Encapsulation for Biomaterials and Tissue Bio-Nanoengineering: History, Achievements, Limitations, and Future Work for Potential Clinical Applications and Transplantation
Publisher: MDPI AG
Date: 30-11-2021
DOI: 10.3390/JFB12040068
Abstract: Pancreatic β-cell loss and failure with subsequent deficiency of insulin production is the hallmark of type 1 diabetes (T1D) and late-stage type 2 diabetes (T2D). Despite the availability of parental insulin, serious complications of both types are profound and endemic. One approach to therapy and a potential cure is the immunoisolation of β cells via artificial cell microencapsulation (ACM), with ongoing promising results in human and animal studies that do not depend on immunosuppressive regimens. However, significant challenges remain in the formulation and delivery platforms and potential immunogenicity issues. Additionally, the level of impact on key metabolic and disease biomarkers and long-term benefits from human and animal studies stemming from the encapsulation and delivery of these cells is a subject of continuing debate. The purpose of this review is to summarise key advances in this field of islet transplantation using ACM and to explore future strategies, limitations, and hurdles as well as upcoming developments utilising bioengineering and current clinical trials.
The effects of the market withdrawal of temazepam gel capsules on benzodiazepine injecting in Sydney, Australia
Publisher: Wiley
Date: 03-2008
DOI: 10.1080/09595230701829413
Abstract: This study assessed the impact on benzodiazepine injection among IDU in Sydney of removing temazepam gel capsule preparations from the Australian market. Several data sources were used: (1) data from the NSW Illicit Drug Reporting System (IDRS) (an annual, cross-sectional survey of regular IDU in Sydney) for the period 1996 - 2005 (2) data from inner Sydney outreach services and the Sydney Medically Supervised Injecting Centre (MSIC) on last drug injected and (3) national benzodiazepine prescription data, by formulation, from the Drug Utilisation Sub-Committee for the period 2001 - 06. Removal of temazepam gel capsule formulations from the Australian market in 2004 resulted in increased prescribing of tablet formulations but overall benzodiazepine prescription numbers remained stable. Injection of benzodiazepines ceased as a mode of administration of benzodiazepines among IDU in inner Sydney, but very frequent oral use of benzodiazepines remained highly prevalent. Removal of an easily injectable form of benzodiazepines appeared to halt injection of benzodiazepines among disadvantaged IDU. However, IDU continue to use the drug heavily and interventions to assist IDU with reducing dependent benzodiazepine use are warranted. There is a need for continued vigilance to emergent injecting drug use risks to implement timely harm reduction strategies.
Public health impacts to date of the legalisation of medical and recreational cannabis use in the USA
Publisher: Elsevier BV
Date: 08-2021
The changing patterns and correlates of population‐level polysubstance use in Australian youth: a multi‐group latent class analysis of nationally representative samples spanning 12 years
Publisher: Wiley
Date: 30-08-2020
DOI: 10.1111/ADD.14761
Abstract: To (1) identify population-level classes of polysubstance use among young Australians between 2004 and 2016, (2) test if these classes changed over the same period, in terms of class prevalence and probabilities of substance use within each class, and (3) identify demographic and health-related correlates of polysubstance use. Repeated cross-sectional nationally representative household surveys. All Australian states/territories. Young adult s les (aged 18-30 years 58% females) from the National Drug Strategy Household Surveys (n = 20 350) MEASUREMENTS: Outcomes were the extent of past-year use of 10 licit (e.g. alcohol), and illicit substances (e.g. cannabis) were used to derive polysubstance use classes. The correlates were gender, age, psychological distress, general health, language background, personal income, education level, remoteness of residence and socio-economic index for area of residence. Three polysubstance use classes were consistently identified between 2004 and 2016 (SSABIC: 188349): minimal users (MU, ~60%), mainly tobacco, alcohol and cannabis users (TAC, ~30%) and extended range polysubstance users (POLY, ~10%). There were substantial changes in use of different substances within each class over the study period. For ex le, smoking decreased in all classes (P < 0.05), while harmful alcohol use only decreased in the first two classes (P < 0.05). Factors associated with TAC and POLY were similar over the study period. These included: being male and having an English-speaking background, a high level of psychological distress, suboptimal health and high personal income. Living in an affluent area was associated with reduced likelihood of being TAC, but an increased likelihood of being POLY. At the population-level among young Australians between 2004 and 2016, six in 10 did not engage in polysubstance use four in 10 used a limited range of substances (mainly alcohol, tobacco and cannabis) and one in 10 used an extended range of substances. Over time, the types of substance within the extended polysubstance use class changed substantially.
Causal inference with observational data in addiction research
Publisher: Wiley
Date: 21-06-2022
DOI: 10.1111/ADD.15972
Abstract: Randomized controlled trials (RCTs) are the gold standard for making causal inferences, but RCTs are often not feasible in addiction research for ethical and logistic reasons. Observational data from real‐world settings have been increasingly used to guide clinical decisions and public health policies. This paper introduces the potential outcomes framework for causal inference and summarizes well‐established causal analysis methods for observational data, including matching, inverse probability treatment weighting, the instrumental variable method and interrupted time‐series analysis with controls. It provides ex les in addiction research and guidance and analysis codes for conducting these analyses with ex le data sets.
Quitting smoking: estimation by meta-analysis of the rate of unaided smoking cessation
Publisher: Wiley
Date: 12-02-2010
DOI: 10.1111/J.1753-6405.1995.TB00361.X
Abstract: The rates (after 12 months' follow-up) of unassisted smoking cessation reported in the literature have varied from 13.8 per cent to 8.5 per cent. A meta-analysis was conducted of the abstinence rates observed in 14 s les of smokers who presented at primary health settings and received either no intervention aimed at smoking or usual care (which involved no deliberate intervention for smoking cessation). The estimated rate of stopping smoking without intervention, over an average 10-month period, was 7.33 per cent. This rate is consistent with others reported in the literature when motivation to quit is taken into account. The estimate provides a baseline to judge the effects of smoking-cessation interventions.
Drug use, HIV risk-taking and psychosocial correlates of benzodiazepine use among methadone maintenance clients
Publisher: Elsevier BV
Date: 12-1993
DOI: 10.1016/0376-8716(93)90047-T
Abstract: Methadone maintenance clients who used benzodiazepines were compared with other methadone maintenance clients on a range of drug use and psychosocial treatment outcome measures. Despite being on higher methadone doses, benzodiazepine users were more likely to have recently injected, to have used cocaine and hetamines, to have borrowed or lent used needles and syringes, and to have reported polydrug use in the preceding month. Benzodiazepine users also exhibited higher levels of psychopathology and social dysfunction than other methadone maintenance clients. It is concluded that benzodiazepine-using methadone maintenance clients are a dysfunctional subgroup of the methadone population, who may require more clinical intervention than other clients.
A licence to vape: Is it time to trial of a nicotine licensing scheme to allow Australian adults controlled access to electronic cigarettes devices and refill solutions containing nicotine?
Publisher: Elsevier BV
Date: 06-2015
DOI: 10.1016/J.DRUGPO.2015.02.003
Abstract: Australia has some of the most restrictive laws concerning use of nicotine in e-cigarettes. The only current legal option for Australians to legally possess and use nicotine for vaping is with a medical prescription and domestic supply is limited to compounding pharmacies that prepare medicines for specific patients. An alternative regulatory option that could be implemented under current drugs and poisons regulations is a 'nicotine licensing' scheme utilising current provisions for 'dangerous poisons'. This commentary discusses how such a scheme could be used to trial access to nicotine solutions for vaping outside of a 'medicines framework' in Australia.
Drug Legalization is Not a Masterstroke for Addressing Racial Inequality
Publisher: Informa UK Limited
Date: 03-04-2021
Age-related trends in cannabis use in Australia. Findings from a series of large nationally representative surveys
Publisher: Elsevier BV
Date: 12-2021
Addiction's priorities when evaluating submissions
Publisher: Wiley
Date: 07-02-2011
Deep Brain Stimulation in Parkinsonian Patients—Implications for Trialing DBS in Intractable Psychiatric Disorders
Publisher: Informa UK Limited
Date: 13-01-2011
Amphetamine use in the fourth decade of life: Social profiles from a population-based Australian cohort
Publisher: Wiley
Date: 11-07-2018
DOI: 10.1111/DAR.12840
Abstract: To estimate the prevalence and frequency of hetamine use in a cohort of Australians aged in their mid-30s. Cross-sectional analysis of wave 10 data collected in 2014 from the Victorian Adolescent Health Cohort Study: a s le of 1435 persons originally selected in a stratified, random community survey of secondary school students from the state of Victoria that commenced in 1992. Weighted multinomial regression models were used to evaluate the social, health and other substance-use correlates of lifetime and current (12-month) hetamine use and current frequency of use. Lifetime hetamine use was reported by 23.2% (95% confidence interval 21.0-25.5%) of respondents, and 6.5% (95% confidence interval 5.2-7.8%) reported current (12-month) use. A quarter (26%) of those currently using hetamines, 1.7% (95% confidence interval 1.0-2.4%) of all respondents, reported frequent (at least weekly) use. Men reported greater hetamine use than women. Current hetamine use was associated with disrupted family circumstances, socioeconomic adversity, polydrug use and high levels of drug use within the social and familial environment. Frequent use was associated with greater likelihood of multiple adversity, unemployment, anxiety disorders and use of mental health services. The current results show that lifetime, current and frequent hetamine use was common amongst adults in the fourth decade of life in this cohort, and associated with the experience of social disadvantage, poor mental health and living in a social context in which drug use is the norm.
Estimated verbal IQ and the odds of problem gambling: a population-based study
Publisher: Cambridge University Press (CUP)
Date: 05-09-2013
DOI: 10.1017/S0033291713002195
Abstract: The neurocognitive deficits and other correlates of problem gambling are also observable in in iduals with lower cognitive abilities, suggesting that a low IQ may be a determinant of problem gambling. There has been very little research into this possibility. This study aimed to investigate the characteristics associated with problem gambling in a large population-based study in England, with a particular focus on IQ. The Adult Psychiatric Morbidity Survey (APMS) 2007 comprised detailed interviews with 7403 in iduals living in private households in England. Problem gambling was ascertained using a questionnaire based on DSM-IV criteria. Verbal IQ was estimated using the National Adult Reading Test (NART). Confounders included socio-economic and demographic factors, common mental disorders, impulsivity, smoking, and hazardous drug and alcohol use. More than two-thirds of the population reported engaging in some form of gambling in the previous year, but problem gambling was rare [prevalence 0.7%, 95% confidence interval (CI) 0.5–1.0]. The odds of problem gambling doubled with each standard deviation drop in estimated verbal IQ [adjusted odds ratio (OR) 2.1, 95% CI 1.3–3.4, p = 0.003], after adjusting for other characteristics associated with problem gambling including age, sex, socio-economic factors, drug and alcohol dependence, smoking, impulsivity and common mental disorders. There was no strong relationship observed between IQ and non-problem gambling. People with lower IQs may be at a higher risk of problem gambling. Further work is required to replicate and study the mechanisms behind these findings, and may aid the understanding of problem gambling and inform preventative measures and interventions.
Stimulant use disorders: Characteristics and comorbidity in an Australian population sample
Publisher: SAGE Publications
Date: 18-09-2012
Abstract: To describe the correlates of stimulant use disorders (abuse, dependence) in an Australian population s le, to compare the characteristics of stimulant users with and without stimulant use disorders and to describe the patterns of service use and help-seeking in people with stimulant use disorders. Data were drawn from the 2007 National Survey of Mental Health and Wellbeing, which s led 8841 residents of private dwellings in Australia in 2007. Lifetime DSM-IV substance use and mental disorder diagnoses were obtained from interviews conducted by lay interviewers, using the Composite International Diagnostic Interview (CIDI). Socio-demographic, socio-economic and clinical correlates of stimulant use disorders were identified using binary logistic regression models. Stimulant users with and without stimulant use disorders were compared to non-stimulant users via multinomial logistic regression models. Compared to Australians without stimulant use disorder, people with stimulant use disorders were younger, more likely to be male, of non-heterosexual orientation and born in Australia, but were not more socially disadvantaged. Lifetime comorbidity rates were high: 79% of persons with stimulant use disorders had a lifetime alcohol use disorder, 73% a lifetime cannabis use disorder, and more than one third a lifetime mood or anxiety disorder. Stimulant use disorders were associated with a family history of substance use, affective disorders and psychosis. One in five people with lifetime stimulant use disorders had been imprisoned, homeless or hospitalised for substance or mental health problems, and 13% reported at least one symptom of psychosis. Nearly half had sought help for substance or mental health problems, primarily from General Practitioners (GPs), psychologists or psychiatrists. Stimulant use disorders in a representative population s le are associated with significant comorbidity and harm. Many persons with stimulant use disorders had sought care and found this helpful. There is scope for screening and intervention in this group.
Causes of death in a cohort treated for opioid dependence between 1985 and 2005
Publisher: Wiley
Date: 09-10-2013
DOI: 10.1111/ADD.12337
Abstract: To examine changes in causes of death in a cohort treated for opioid dependence, across time and age quantify years of potential life lost (YPLL) and identify avoidable causes of death. People in New South Wales (NSW) who registered for opioid substitution therapy (OST), 1985-2005, were linked to a register of all deaths in Australia. NSW, Australia. Crude mortality rates (CMRs), age-sex-standardized mortality rates (ASSRs) and standardized mortality ratios (SMRs) across time, sex and age. Years of potential life lost (YPLL) were calculated with reference to Australian life tables and by calculating years lost before the age of 65 years. There were 43 789 people in the cohort, with 412 216 person-years of follow-up. The proportion of the cohort aged 40+ years increased from 1% in 1985 to 39% in 2005. Accidental opioid overdoses, suicides, transport accidents and violent deaths declined with age deaths from cardiovascular disease, liver disease and cancer increased. Among men, 89% of deaths were potentially avoidable among women, 86% of deaths were avoidable. There were an estimated 160 555 YPLL in the cohort, an average of 44 YPLL per decedent and an average of 29 YPLL before age 65 years. Among a cohort of opioid-dependent people in New South Wales, 1985-2005, almost nine in 10 deaths in the cohort were avoidable. There is huge scope to improve mortality among opioid-dependent people.
The challenge of reducing smoking in people with serious mental illness.
Publisher: Elsevier BV
Date: 10-2016
Fluctuations in heroin purity and the incidence of fatal heroin overdose
Publisher: Elsevier BV
Date: 04-1999
DOI: 10.1016/S0376-8716(98)00159-8
Abstract: In order to determine the role played by heroin purity in fatal heroin overdoses, time series analyses were conducted on the purity of street heroin seizures in south western Sydney and overdose fatalities in that region. A total of 322 heroin s les were analysed in fortnightly periods between February 1993 to January 1995. A total of 61 overdose deaths occurred in the region in the study period. Cross correlation plots revealed a significant correlation of 0.57 at time lag zero between mean purity of heroin s les per fortnight and number of overdose fatalities. Similarly, there was a significant correlation of 0.50 at time lag zero between the highest heroin purity per fortnight and number of overdose fatalities. The correlation between range of heroin purity and number of deaths per fortnight was 0.40. A simultaneous multiple regression on scores adjusted for first order correlation indicated both the mean level of heroin purity and the range of heroin purity were independent predictors of the number of deaths per fortnight. The results indicate that the occurrence of overdose fatalities was moderately associated with both the average heroin purity and the range of heroin purity over the study period.
The long‐term effectiveness of brief interventions for unsafe alcohol consumption: a 10‐year follow‐up
Publisher: Wiley
Date: 28-05-2002
DOI: 10.1046/J.1360-0443.2002.00080.X
Abstract: To examine the long-term impact of brief and early interventions for hazardous and harmful alcohol consumption. A 9-month and 10-year follow-up of subjects recruited into a randomized controlled trial of a range of alcohol-related brief interventions. General practices, the outpatient or acute care services of a major city hospital, and a privately run health screening programmeme. The cohort of 554 (non-dependent) hazardous and harmful drinkers recruited into the Australian arm of the Phase II World Health Organization collaborative project on identification and treatment of persons with harmful alcohol consumption. The effectiveness of three forms of intervention, ranging from 5 to 60 minutes in duration, were compared with a no-treatment control condition. Included drinking behaviour and biological markers of alcohol use. In addition, at 10 years subjects were asked about symptoms of diagnosable alcohol use disorders and their experience of alcohol-related psychological, social and physical harm. Mortality was also assessed. Results provide further evidence for the short-term effectiveness of alcohol-related brief interventions. In comparison to controls, subjects offered intervention: (1) report significantly lower consumption and (2) less unsafe drinking at 9-month follow-up. The intensity of intervention was not related to the amount of change in drinking behaviour. Analysis at 10 years failed to find any differences in outcomes between intervention and control groups in median consumption, mean reduction in consumption from baseline to follow-up, mortality and ICD-10 diagnoses of alcohol dependence or harmful alcohol use. This study failed to find evidence that brief advice and counselling without regular follow-up and reinforcement can sustain significant long-term reductions in drinking behaviour at 10-year follow-up.
Hair morphine concentrations of fatal heroin overdose cases and living heroin users
Publisher: Wiley
Date: 28-07-2002
DOI: 10.1046/J.1360-0443.2002.00148.X
Abstract: To compare heroin and other opiate use of heroin overdose fatalities, current street heroin users and drug-free therapeutic community clients. Hair morphine concentrations that assess heroin use and other opiate use in the 2 months preceding interview or death were compared between heroin overdose fatalities diagnosed by forensic pathologists (FOD) (n = 42), current street heroin users (CU) (n = 100) and presumably abstinent heroin users in a drug-free therapeutic community (TC) (n = 50). Sydney, Australia. The mean age and gender breakdown of the three s les were 32.3 years, 83% male (FOD), 28.7 years, 58% male (CU) and 28.6 years, 60% male (TC). The median blood morphine concentration among the FOD cases was 0.35 mg/l, and 82% also had other drugs detected. There were large differences between the three groups in hair morphine concentrations, with the CU group (2.10 ng/mg) having concentration approximately four times that of the FOD group (0.53 ng/mg), which in turn had a concentration approximately six times that of the TC group (0.09 ng/mg). There were no significant differences between males and females in hair concentrations within any of the groups. Hair morphine concentrations were correlated significantly with blood morphine concentrations among FOD cases (r = 0.54), and self-reported heroin use among living participants (r = 0.57). The results indicate that fatal cases had a lower degree of chronic opiate intake than the active street users, but they were not abstinent during this period.
Navigating the enhancement landscape
Publisher: EMBO
Date: 15-01-2013
The persistence of adolescent binge drinking into adulthood: Findings from a 15-year prospective cohort study
Publisher: BMJ
Date: 08-2013
What data are available on the extent of illicit drug use and dependence globally? Results of four systematic reviews
Publisher: Elsevier BV
Date: 09-2011
DOI: 10.1016/J.DRUGALCDEP.2010.11.032
Abstract: We systematically reviewed availability and quality of data on the prevalence of use and dependence on meth/ hetamine, cannabis, cocaine and opioids. Multiple search strategies: (a) peer-reviewed literature searches (1990-2008) using methods recommended by the Meta-analysis of Observational Studies in Epidemiology (MOOSE) group (b) systematic searches of online databases (c) Internet searches to find other published evidence of drug use (d) repeated consultation and feedback from experts around the globe (e) a viral email sent to lists of researchers in the illicit drug and HIV fields. Data were extracted and graded according to predefined variables reflecting quality of data source. Qualitative evidence of illicit drug use and dependence was found for most countries, which hold over 98% of the world's population aged 15-64 years. Countries where use was identified but prevalence estimates had not been made (evidence of drug supply, trafficking, reports of use, treatment data) were mainly from Asia, Africa, the Middle East, and Oceania. Estimates of the prevalence of use were located in 77 countries for meth/ hetamine, 95 for cannabis, 86 for cocaine and 89 for opioids. Dependence prevalence estimates existed in very few countries 9 meth/ hetamine dependence estimates, 7 cannabis dependence estimates, 5 cocaine dependence estimates, and 25 opioid dependence estimates were located. Data on the extent of meth/ hetamine, cannabis, cocaine and opioid use and dependence must be improved in quality and coverage. Dependence estimates are lacking even in high income countries that have required resources. Responses to illicit drug dependence require better estimates of its scale.
DEPRESSION SUB-TYPING - UNITARY, BINARY OR ARBITRARY
Publisher: SAGE Publications
Date: 03-1991
DOI: 10.3109/00048679109077720
Abstract: The strongest statistical support for the binary view of depression has been provided by factor (principal components) analytic studies which delineate a bipolar factor with features interpreted as reflecting “endogenous depression” and “neurotic depression” at opposing poles. We review the seminal studies to suggest instead that the bipolar factor has generally polarised depression and anxiety, and that no such entity or symptom complex of “neurotic depression” has been isolated. Instead, “neurotic depression” has been defined principally by features of anxiety and personality style. We argue that the suggested entity is, in fact, a pseudo-entity, being no more than a residual group of non-depressive features without any significant intrinsic depressive characteristics. We support our interpretation by showing comparable solutions in published studies of depressives alone, contrasted with separate analyses of anxious and depressed patients. We also report two studies in which the “neurotic depressive” pole is made to appear and disappear by the inclusion and exclusion of anxiety items. As factor analytic studies have defined the “residual” pole so variably, we argue that some features held to distinguish neurotic depression are of no utility and that such a diagnosis is meaningless. We suggest that the clinician should not proceed (after excluding endogenous depression) to conclude that the default option is necessarily an entity “neurotic depression” and that instead a heterogeneous group of options (e.g. anxiety, personality disorder) require review. If the “neurotic depressive” type of the multivariate analytic studies is a pseudo-entity, then a modified unitary view of depression may be valid.
Should the Health Community Promote Smokeless Tobacco (Snus) as a Harm Reduction Measure?
Publisher: Public Library of Science (PLoS)
Date: 03-07-2007
Who is responsible for the public's health? The role of the alcohol industry in the WHO global strategy to reduce the harmful use of alcohol
Publisher: Wiley
Date: 25-10-2013
DOI: 10.1111/ADD.12368
Australian policymakers do not have to choose between protecting youth and allowing smokers to use nicotine vaping products
Publisher: Wiley
Date: 14-04-2021
DOI: 10.1111/ADD.15512
The effectiveness, safety and cost-effectiveness of cytisine versus varenicline for smoking cessation in an Australian population: a study protocol for a randomized controlled non-inferiority trial.
Publisher: Wiley
Date: 03-02-2019
DOI: 10.1111/ADD.14541
Abstract: Smoking cessation medications are effective, but often underutilized because of costs and side effects. Cytisine is a plant-based smoking cessation medication with more than 50 years of use in central and eastern Europe. While cytisine has been found to be well-tolerated and more effective than nicotine replacement therapy, direct comparisons with varenicline have not been conducted. This study evaluates the effectiveness, safety and cost-effectiveness of cytisine compared with varenicline. Two-arm, parallel group, randomized, non-inferiority trial, with allocation concealment and blinded outcome assessment. Australian population-based study. Adult daily smokers (n = 1266) interested in quitting will be recruited through advertisements and Quitline telephone-based cessation support services. Eligible participants will be randomized (1 : 1 ratio) to receive either cytisine capsules (25-day supply) or varenicline tablets (12-week supply), prescribed in accordance with the manufacturer's recommended dosing regimen. The medication will be mailed to each participant's nominated residential address. All participants will also be offered standard Quitline behavioural support (up to six 10-12-minute sessions). Assessments will be undertaken by telephone at baseline, 4 and 7 months post-randomization. Participants will also be contacted twice (2 and 4 weeks post-randomization) to ascertain adverse events, treatment adherence and smoking status. The primary outcome will be self-reported 6-month continuous abstinence from smoking, verified by carbon monoxide at 7-month follow-up. We will also evaluate the relative safety and cost-effectiveness of cytisine compared with varenicline. Secondary outcomes will include self-reported continuous and 7-day point prevalence abstinence and cigarette consumption at each follow-up interview. If cytisine is as effective as varenicline, its lower cost and natural plant-based composition may make it an acceptable and affordable smoking cessation medication that could save millions of lives world-wide.
Cannabis use and non-cancer chronic pain – Authors' reply
Publisher: Elsevier BV
Date: 10-2018
A wastewater‐based assessment of the impact of a minimum unit price (MUP) on population alcohol consumption in the Northern Territory, Australia
Publisher: Wiley
Date: 20-07-2021
DOI: 10.1111/ADD.15631
Abstract: To test if there was a reduction in alcohol consumption in wastewater s les in the Northern Territory of Australia after the implementation of a minimum unit alcohol price policy (MUP) in October 2018. Between August 2016 and February 2020, wastewater s les were collected across 66 sites in the Northern Territory and all other states and territories in Australia. S les were collected every 2 months in capital cities and every 4 months in regional places during this period. Overall, 4917 s les were taken (2816 before MUP and 2101 after). The number of standard drinks per 1000 people per day in the respective catchment areas was estimated based on the concentration of an alcohol‐specific metabolite, ethyl sulphate in the s les (using the excretion factor of ethyl sulphate, the flow of wastewater entering the wastewater treatment plants and the population of each wastewater catchment). Results from a linear mixed model showed that there was a large drop in alcohol consumption immediately after the MUP in Northern Territory [estimated drop = 1231, 99% confidence interval (CI) = 830, 1633 38.75%]. There was no significant drop in all other states/territories except for Queensland, which showed a significant but much smaller drop (estimated drop: 310 99% CI = 114, 550). One year after the MUP, the drop narrowed to 520 (99% CI = 189, 851) and was no longer statistically significant in February 2020 (15 months after MUP estimated drop = 283, 99% CI = −114, 681). Per‐capita consumption of alcohol appears to have decreased substantially in the Northern Territory of Australia immediately after the implementation of a minimum unit price but consumption steadily recovered and almost returned to the pre‐MUP consumption level after 15 months.
Systematic review of prospective studies investigating remission from amphetamine, cannabis, cocaine or opioid dependence
Publisher: Elsevier BV
Date: 08-2010
DOI: 10.1016/J.ADDBEH.2010.03.019
Abstract: To review and summarize existing prospective studies reporting on remission from dependence upon hetamines, cannabis, cocaine or opioids. Systematic searches of the peer-reviewed literature were conducted to identify prospective studies reporting on remission from hetamines, cannabis, cocaine or opioid dependence. Searches were limited to publication between 1990 and 2009. Reference lists of review articles and important studies were searched to identify additional studies. Remission was defined as no longer meeting diagnostic criteria for drug dependence or abstinence from drug use follow-up periods of at least three years were investigated. The remission rate was estimated for each drug type, allowing pooling across studies with varying follow-up times. There were few studies examining the course of psychostimulant dependence that met inclusion criteria (one for hetamines and four for cocaine). There were ten studies of opioid and three for cannabis dependence. Definitions of remission varied and most did not clearly assess remission from dependence. Amphetamine dependence had the highest remission rate (0.4477 95%CI 0.3991, 0.4945), followed by opioid (0.2235 95%CI 0.2091, 0.2408) and cocaine dependence (0.1366 95%CI 0.1244, 0.1498). Conservative estimates of remission rates followed the same pattern with cannabis dependence (0.1734 95%CI 0.1430, 0.2078) followed by hetamine (0.1637 95%CI 0.1475, 0.1797), opioid (0.0917 95%CI 0.0842, 0.0979) and cocaine dependence (0.0532 95%CI 0.0502, 0.0597). The limited prospective evidence suggests that "remission" from dependence may occur relatively frequently but rates may differ across drugs. There is very little research on remission from drug dependence definitions used are often imprecise and inconsistent across studies and there remains considerable uncertainty about the longitudinal course of dependence upon these most commonly used illicit drugs.
Profiles of illicit drug use during annual key holiday and control periods in Australia: wastewater analysis in an urban, a semi-rural and a vacation area
Publisher: Wiley
Date: 05-12-2013
DOI: 10.1111/ADD.12006
Abstract: To examine changes in illicit drug consumption between peak holiday season (23 December-3 January) in Australia and a control period two months later in a coastal urban area, an inland semi-rural area and an island populated predominantly by vacationers during holidays. Analysis of representative daily composite wastewater s les collected from the inlet of the major wastewater treatment plant in each area. Three wastewater treatment plants. Wastewater treatment plants serviced approximately 350, 000 persons in the urban area, 120,000 in the semi-rural area and 1100-2400 on the island. Drug residues were analysed using liquid chromatography coupled to a tandem mass spectrometer. Per capita drug consumption was estimated. Changes in drug use were quantified using Hedges' g. During the holidays, cannabis consumption in the semi-rural area declined (g = -2.8) as did meth hetamine (-0.8), whereas cocaine (+1.5) and ecstasy (+1.6) use increased. In the urban area, consumption of all drugs increased during holidays (cannabis +1.6, cocaine +1.2, ecstasy +0.8 and meth hetamine +0.3). In the vacation area, meth hetamine (+0.7), ecstasy (+0.7) and cocaine (+1.1) use increased, but cannabis (-0.5) use decreased during holiday periods. While the peak holiday season in Australia is perceived as a period of increased drug use, this is not uniform across all drugs and areas. Substantial declines in drug use in the semi-rural area contrasted with substantial increases in urban and vacation areas. Per capita drug consumption in the vacation area was equivalent to that in the urban area, implying that these locations merit particular attention for drug use monitoring and harm minimisation measures.
National trends in the community prescribing of second-generation antipsychotic medications in Australian children and youth: the incomplete story
Publisher: SAGE Publications
Date: 29-07-2013
Abstract: The objective of this article is to examine national trends in prescribing second-generation antipsychotic (SGA) medications to Australian children and youth (0–24 years) and to report deficiencies in available data. We conducted a retrospective review of government data on all dispensed SGA prescriptions between 2002 and 2007. Scripts were converted to defined daily dose (DDD)/1000 population/day using census data. Trends in utilisation of dispensed SGAs were analysed by gender and age. The total amount of SGAs dispensed to children (0–14 years) remained stable over the five-year study period. In 2007, according to available data, total SGA medication dispensed to Australian children equated to fewer than three in 10,000 children receiving the equivalent of a standard adult dose of medication each day. In contrast to many other countries, the dispensed use of SGA medication in Australian children and youth has remained relatively stable. In our opinion, this is almost certainly because of limitations in data collection and accessibility. Given the safety concerns associated with SGAs prescribed to children and young people and the need to improve the quality use of medicines, it is essential that methods are developed in Australia to accurately capture prescribing of SGAs to Australian children and youth.
Benzodiazepine Use among Chronic Pain Patients Prescribed Opioids: Associations with Pain, Physical and Mental Health, and Health Service Utilization
Publisher: Oxford University Press (OUP)
Date: 02-2015
DOI: 10.1111/PME.12594
Abstract: Benzodiazepines (BZDs) are commonly used by chronic pain patients, despite limited evidence of any long-term benefits and concerns regarding adverse events and drug interactions, particularly in older patients. This article aims to: describe patterns of BZDs use the demographic, physical, and mental health correlates of BZD use and examine if negative health outcomes are associated with BZD use after controlling for confounders. A national s le of 1,220 chronic noncancer pain (CNCP) patients prescribed long-term opioids. We report on baseline data from a prospective cohort study comparing four groups based on their current BZD use patterns. General demographics, pain, mental and physical comorbidity, and health service utilization were examined. One-third (N = 398, 33%) of participants reported BZD use in the past month, and 17% (N = 212) reported daily BZD use. BZD use was associated with: 1) greater pain severity, pain interference with life, and lower feelings of self-efficacy with respect to their pain 2) being prescribed "higher-risk" (>200 mg oral morphine equivalent) doses of opioids 3) using antidepressant and/or antipsychotic medications 4) substance use (including more illicit and injection drug use, alcohol use disorder, and daily nicotine use) and 5) greater mental health comorbidity. After controlling for differences in demographic characteristics, physical and mental health, substance use, and opioid dose, BZD use was independently associated with greater past-month use of emergency health care such as ambulance or accident and emergency services. CNCP patients using BZDs daily represent a high-risk group with multiple comorbid mental health conditions and higher rates of emergency health care use. The high prevalence of BZD use is inconsistent with guidelines for the management of CNCP or chronic mental health conditions.
The neurobiology of overeating
Publisher: EMBO
Date: 17-08-2012
Abstract: Is overeating a neurological disorder like drug or alcohol addiction? Recent advances in neuroscience suggest it might be, which could have profound consequences for the treatment of obese people and public health policies to address the growing epidemic of obesity.
A renewed call for action on alcohol policy
Publisher: Wiley
Date: 08-04-2010
Overdose among heroin users in Sydney, Australia: I. Prevalence and correlates of non-fatal overdose
Publisher: Wiley
Date: 03-1996
Is there a role for contact tracing in preventing HIV transmission among injecting drug users?
Publisher: Wiley
Date: 07-1996
Management of impulse control disorders in Parkinson's disease
Publisher: Cambridge University Press (CUP)
Date: 04-07-2016
DOI: 10.1017/S104161021600096X
Abstract: Impulse control disorders (ICDs) have become a widely recognized non-motor complication of Parkinson's disease (PD) in patients taking dopamine replacement therapy (DRT). There are no current evidence-based recommendations for their treatment, other than reducing their dopaminergic medication. This study reviews the current literature of the treatment of ICDs including pharmacological treatments, deep brain stimulation, and psychotherapeutic interventions. Dopamine agonist withdrawal is the most common and effective treatment, but may lead to an aversive withdrawal syndrome or motor symptom degeneration in some in iduals. There is insufficient evidence for all other pharmacological treatments in treating ICDs in PD, including amantadine, serotonin selective reuptake inhibitors, antipsychotics, anticonvulsants, and opioid antagonists (e.g. naltrexone). Large randomized control trials need to be performed before these drugs can be routinely used for the treatment of ICDs in PD. Deep brain stimulation remains equivocal because ICD symptoms resolve in some patients after surgery but may appear de novo in others. Cognitive behavioral therapy has been shown to improve ICD symptoms in the only published study, although further research is urgently needed. Further research will allow for the development of evidence-based guidelines for the management of ICDs in PD.
Decreased heroin availability in Sydney in early 2001
Publisher: Wiley
Date: 19-12-2002
DOI: 10.1046/J.1360-0443.2003.00266.X
Abstract: To examine the veracity of reports of a substantial decrease in the availability of heroin in Sydney in January 2001. Cross-sectional survey. Sydney, Australia. Forty-one injecting drug users (IDUs) and 10 key informants (KIs). Almost all IDUs (93%) reported that heroin was harder to obtain at the time of interview (mid-February 2001) than it was before Christmas 2000 and KIs concurred. IDUs (83%) and KIs (70%) also reported that the price of heroin had increased since Christmas, and that the purity of heroin had decreased (IDUs 73% KIs 80%). Almost all IDUs reported a reduction in their heroin use and a subsequent increase in other drug use, particularly cocaine, benzodiazepines and cannabis. Similar reports about IDUs came from nine of the 10 KIs. Over half the KIs reported an increase in both property and violent crime as a result of the heroin shortage. This crime was reportedly occurring mainly between heroin suppliers and/or IDUs. Reports from other Australian jurisdictions suggest that the shortage was not specific to Sydney. The reduction in the availability of heroin provides a unique opportunity to investigate the impact of supply reduction.
Addiction May Not Be a Compulsive Brain Disease, But It Is More Than Purposeful Medication of Untreated Psychiatric Disorders
Publisher: Informa UK Limited
Date: 04-2012
Monitoring temporal changes in use of two cathinones in a large urban catchment in Queensland, Australia
Publisher: Elsevier BV
Date: 03-2016
DOI: 10.1016/J.SCITOTENV.2015.12.038
Abstract: Wastewater analysis was used to examine prevalence and temporal trends in the use of two cathinones, methylone and mephedrone, in an urban population (>200,000 people) in South East Queensland, Australia. Wastewater s les were collected from the inlet of the sewage treatment plant that serviced the catchment from 2011 to 2013. Liquid chromatography coupled with tandem mass spectrometry was used to measure mephedrone and methylone in wastewater s le using direct injection mode. Mephedrone was not detected in any s les while methylone was detected in 45% of the s les. Daily mass loads of methylone were normalized to the population and used to evaluate methylone use in the catchment. Methylone mass loads peaked in 2012 but there was no clear temporal trend over the monitoring period. The prevalence of methylone use in the catchment was associated with the use of MDMA, the more popular analogue of methylone, as indicated by other complementary sources. Methylone use was stable in the study catchment during the monitoring period whereas mephedrone use has been declining after its peak in 2010. More research is needed on the pharmacokinetics of emerging illicit drugs to improve the applicability of wastewater analysis in monitoring their use in the population.
Prisoners and risk of injury after release
Publisher: Elsevier BV
Date: 2019
Changes in criminal activity after entering methadone maintenance
Publisher: Wiley
Date: 02-1992
DOI: 10.1111/J.1360-0443.1992.TB02699.X
Abstract: The impact of different approaches to methadone maintenance on the level of crime committed by heroin addicts was examined in a cohort of addicts entering methadone treatment. The cohort comprises three groups: 72 subjects (group 1) who were approved for treatment and referred to a long-term programme which tolerated continued illicit drug use in treatment 159 subjects (group 2) who were referred to an abstinence orientated programme from which clients who continued to use heroin were expelled and 84 subjects who were rejected as unsuitable or failed to complete the assessment process. Official records of convictions were used to calculate conviction rates in the pre- and post-assessment periods. Differences between groups in conviction rates for drug and property crimes were analysed using Poisson regression. Three variables--age, sex and age of first criminal conviction--were significant predictors of conviction rates and all analyses controlled for these variables. Most of the rejected subjects entered treatment during the study period and it was, therefore, not possible to interpret differences between treated and untreated subjects. Among those who entered treatment, property offence rates actually rose, due to a significant increase in conviction rates in group 2. Subjects in group 1 were retained significantly longer in treatment than those in group 2. Among those who remained in treatment less than 12 months, most offences occurred after leaving treatment. When conviction rates were adjusted for time spent in treatment, the differences between the clinics disappeared.(ABSTRACT TRUNCATED AT 250 WORDS)
Tobacco harm reduction in people with serious mental illnesses
Publisher: Elsevier BV
Date: 06-2015
Trends in methamphetamine residues in wastewater in metropolitan and regional cities in south-east Queensland, 2009-2015.
Publisher: AMPCo
Date: 03-2016
DOI: 10.5694/MJA15.01054
Clinical management of cannabis withdrawal
Publisher: Wiley
Date: 10-01-2022
DOI: 10.1111/ADD.15743
Abstract: Cannabis withdrawal is a well‐characterized phenomenon that occurs in approximately half of regular and dependent cannabis users after abrupt cessation or significant reductions in cannabis products that contain Δ 9 ‐tetrahydrocannabinol (THC). This review describes the diagnosis, prevalence, course and management of cannabis withdrawal and highlights opportunities for future clinical research. Narrative review of literature. Symptom onset typically occurs 24–48 hours after cessation and most symptoms generally peak at days 2–6, with some symptoms lasting up to 3 weeks or more in heavy cannabis users. The most common features of cannabis withdrawal are anxiety, irritability, anger or aggression, disturbed sleep/dreaming, depressed mood and loss of appetite. Less common physical symptoms include chills, headaches, physical tension, sweating and stomach pain. Despite limited empirical evidence, supportive counselling and psychoeducation are the first‐line approaches in the management of cannabis withdrawal. There are no medications currently approved specifically for medically assisted withdrawal (MAW). Medications have been used to manage short‐term symptoms (e.g. anxiety, sleep, nausea). A number of promising pharmacological agents have been examined in controlled trials, but these have been underpowered and positive findings not reliably replicated. Some (e.g. cannabis agonists) are used ‘off‐label’ in clinical practice. Inpatient admission for MAW may be clinically indicated for patients who have significant comorbid mental health disorders and polysubstance use to avoid severe complications. The clinical significance of cannabis withdrawal is that its symptoms may precipitate relapse to cannabis use. Complicated withdrawal may occur in people with concurrent mental health and polysubstance use.
The Association between Four Citation Metrics and Peer Rankings of Research Influence of Australian Researchers in Six Fields of Public Health
Publisher: Public Library of Science (PLoS)
Date: 06-04-2011
Traffic fatalities within US states that have legalized recreational cannabis sales and their neighbours
Publisher: Wiley
Date: 04-02-2019
DOI: 10.1111/ADD.14536
Abstract: A growing body of evidence suggests that cannabis impairs driving ability. We used mortality data to investigate whether the commercial sale of cannabis for recreational use affected traffic fatality rates both in states that legalized it and in neighbouring jurisdictions. Interrupted time-series of traffic fatality rates adjusted for seasonality and autocorrelation. Changes are reported as step and trend effects against a comparator of states that had not implemented medicinal or recreational cannabis during the study period (2009-16). Sensitivity analyses added a 6-month 'phase-in' to account for lags in production. Meta-analyses were used to derive pooled results. Three states that legalized recreational cannabis sales [Colorado (January 2014), Washington State (June 2014) and Oregon (October 2015] and nine neighbouring jurisdictions [Kansas, Nebraska, New Mexico, Oklahoma and Utah (Colorado neighbours) British Columbia and Oregon (Washington neighbours) and California and Nevada (Oregon neighbours)]. Monthly traffic fatalities rates per million residents using mortality data from CDC WONDER and RoadSafetyBC and census data. There was a pooled step increase of 1.08 traffic fatalities per million residents followed by a trend reduction of -0.06 per month (both P < 0.001), although with significant heterogeneity between sites (step: I The combination of step increases and trend reductions suggests that in the year following implementation of recreational cannabis sales, traffic fatalities temporarily increased by an average of one additional traffic fatality per million residents in both legalizing US states of Colorado, Washington and Oregon and in their neighbouring jurisdictions.
Trends in heroin and pharmaceutical opioid overdose deaths in Australia
Publisher: Elsevier BV
Date: 10-2017
DOI: 10.1016/J.DRUGALCDEP.2017.07.018
Abstract: There has been international concern over the rise in fatal pharmaceutical opioid overdose rates, driven by increased opioid analgesic prescribing. The current study aimed to examine trends in opioid overdose deaths by: 1) opioid type (heroin and pharmaceutical opioids) and 2) age, gender, and intent of the death assigned by the coroner. Analysis of data from the National Coronial Information System (NCIS) of opioid overdose deaths occurring between 2001 and 2012. Deaths occurred predominantly (98%) among Australians aged 15-74 years. Approximately two-thirds of the decedents (68%) were male. The heroin overdose death rate remains unchanged over the period these were more likely to occur among males. Pharmaceutical opioid overdose deaths increased during the study period (from 21.9 per million population in 2001-36.2), and in 2012 they occurred at 2.5 times the incident rate of heroin overdose deaths. Increases in pharmaceutical opioid deaths were largely driven by accidental overdoses. They were more likely to occur among males than females, and highest among Australians aged 45-54 years. Rates of fentanyl deaths in particular showed an increase over the study period (from a very small number at the beginning of the period) but in 2012 rates of morphine deaths were higher than those for oxycodone, fentanyl and tramadol. Given the increase in rates of pharmaceutical opioid overdose deaths, it is imperative to implement strategies to reduce pharmaceutical opioid-related mortality, including more restrictive prescribing practices and increasing access to treatment for opioid dependence.
Predicting vaping uptake, vaping frequency and ongoing vaping among daily smokers using longitudinal data from the International Tobacco Control (ITC) Four Country Surveys
Publisher: Wiley
Date: 21-01-2019
DOI: 10.1111/ADD.14537
Distribution of Major Health Risks: Findings from the Global Burden of Disease Study
Publisher: Public Library of Science (PLoS)
Date: 19-10-2004
CANNABIS ABUSE AND DEPENDENCE
Publisher: Elsevier
Date: 2008
Recreational MDMA use in Sydney: a profile of 'Ecstasy' users and their experiences with the drug
Publisher: Wiley
Date: 08-1992
DOI: 10.1111/J.1360-0443.1992.TB02003.X
Abstract: 'Ecstasy' (3,4-methylenedioxymeth hetamine or MDMA) is a recreational drug that is gaining popularity world wide. There is a paucity of research regarding the ways in which Ecstasy is used and the nature of its effects. A 'snowball' peer network technique was used to recruit 100 users who completed anonymous questionnaires. The research revealed that Ecstasy is primarily used by infrequent recreational drug users for 'fun' at dance parties and social gatherings. The primary reported effects of Ecstasy were a 'positive mood state' and feelings of intimacy and closeness to others. The secondary effects of Ecstasy were the stimulant effects of energy and activation, and the psychedelic effects of insight and perceptual and sensual enhancement. Ecstasy was reported to share the properties of both hetamines and hallucinogens in the nature of its side effects and residual effects which were no more severe than those of the latter two classes of drug. It appeared Ecstasy was not conductive to regular and frequent use, because tolerance was reported to develop to the positive effects of Ecstasy, while negative effects increased with use. Although few problems associated with the recreational use of Ecstasy have surfaced to date, animal research has shown it to be neurotoxic to serotonergic nerve terminals. Caution must be observed until further research can determine the level of hazard in humans.
Characteristics and circumstances of heroin and pharmaceutical opioid overdose deaths: Comparison across opioids.
Publisher: Elsevier BV
Date: 12-2019
DOI: 10.1016/J.DRUGALCDEP.2019.06.035
Abstract: Although much is known about the correlates of heroin overdose, less is known about pharmaceutical opioid (PO) overdose. This study aimed to examine correlates of opioid overdose deaths by opioid and compare correlates between opioids. Analysis of opioid overdose deaths in Australia between 2000-2015, extracted from the National Coronial Information System (NCIS). The NCIS is an online database of deaths reportable to the coroner, and contains coroner's findings, autopsy and toxicology reports. Deaths were categorized into mutually exclusive groups: 1) Heroin deaths and 2) PO deaths (excluding heroin). PO deaths were examined by in idual opioid. There were 10,795 opioid overdose deaths over the study period. Relative to deaths occurring in major cities, deaths in regional/remote areas had 15.2 (95 % CI: 11.5-20.2) times the risk of being attributed to pharmaceutical fentanyl than heroin. Relative to deaths among people without a recorded history of chronic pain, deaths among people with a recorded history of chronic pain had a 1.9-10.7-fold increased risk of the death being attributed to POs than heroin. Deaths among people with a recorded history of substance use problems where the opioid was injected prior to death had 7.2 and 1.7 times the risk of being attributed to methadone and pharmaceutical fentanyl (respectively) than heroin. Findings suggest the need to: educate PO consumers about the risks of overdose at the time of prescribing increase coverage and engagement in opioid dependence treatment (particularly in regional/remote areas) and increase uptake of take-home naloxone to reduce opioid overdose mortality.
Managing Suicide Risk in Experimental Treatments of Treatment-Resistant Depression
Publisher: Informa UK Limited
Date: 2013
Increasing cancer mortality among opioid‐dependent persons in Australia: a new public health challenge for a disadvantaged population
Publisher: Elsevier BV
Date: 06-2011
DOI: 10.1111/J.1753-6405.2011.00682.X
Abstract: To examine cancer mortality in a population-based cohort of opioid-dependent persons. New South Wales opioid substitution therapy (OST) program registrants from 1985 to 2005 (n=43,789) were probabilistically linked to the National Death Index. Crude and standardised mortality rates and standardised mortality ratios (SMRs) were calculated. The crude cancer mortality rate increased from 4 to 65 deaths per 100,000 person-years (p trend <0.001). Overall, OST registrants were 1.7 times more likely to die of cancer than the general population (SMR 95% CI 1.4-1.9). Site-specific SMRs were significantly elevated for lung cancer (3.6, 95% CI 2.8-4.6), liver cancer (6.9, 95% CI 4.3-10.5), and anogenital cancers (2.8, 95% CI 1.3-5.3), and significantly reduced for breast cancer (0.4, 95% CI 0.1-0.9). Cancer is an increasingly important cause of death among OST registrants as they live longer with their dependency. The site-specific excess deaths suggest the role of tobacco, alcohol, and infection with hepatitis C and human papillomavirus. The OST setting may be a useful setting for the delivery of programs aimed at detection of precursor lesions, reducing exposure to established carcinogens, and treatment for those with HCV infection. Such targeted steps are likely to reduce the future cancer burden in this population.
Views of Addiction Neuroscientists and Clinicians on the Clinical Impact of a ‘Brain Disease Model of Addiction’
Publisher: Springer Science and Business Media LLC
Date: 19-01-2013
Strategies to reduce drug-related harm: responding to the evidence base
Publisher: Elsevier BV
Date: 10-2019
A randomized clinical trial of a financial education intervention with nicotine replacement therapy (NRT ) for low socio‐economic status A ustralian smokers: a study protocol
Publisher: Wiley
Date: 18-01-2017
DOI: 10.1111/ADD.12669
Abstract: Reducing smoking prevalence among smokers from low socio-economic status (SES) is a preventative health priority. Financial stress (e.g. shortage of money or inability to pay bills) may be a major barrier to quitting smoking. This study evaluates the efficacy of a financial education and support programme coupled with pharmacotherapy at improving cessation rates at 8-month follow-up among Australian low SES smokers (people receiving a government pension or allowance). A two-group parallel block randomized (ratio 1 : 1) open-label clinical trial (RCT) with allocation concealment will be conducted. Allocation will be concealed to interviewers at data collection-points. The study will be conducted primarily by telephone with baseline, follow-up interviews and telephone-based support sessions. Nicotine replacement therapy (NRT) delivery will be mail-based. Daily smokers who are interested in quitting smoking and are currently in receipt of government benefits (n = 1046) will be recruited through study advertisements placed in newspapers, posters placed in government social assistance agencies and Quitline telephone-based cessation support services. After completion of a baseline computer-assisted telephone interview, participants will be allocated randomly to control or intervention group using a permuted block approach. Participants in both groups will receive 8 weeks of free combination NRT plus Quitline support. Participants in the intervention group will also receive four telephone-delivered financial education and support sessions. The primary outcome measure will be prolonged abstinence (at 8-month follow-up) assessed using Russell Standard criteria and biochemically verified (urine cotinine). This is the first intervention study to evaluate the potential of co-managing financial stress as a means of enhancing smokers' capacity to quit smoking. Such an intervention may provide a scalable intervention to help low SES smokers to quit.
Predictors of retention in a randomised trial of smoking cessation in low-socioeconomic status Australian smokers
Publisher: Elsevier BV
Date: 2017
DOI: 10.1016/J.ADDBEH.2016.07.019
Abstract: Little is known about the factors associated with retention in smoking cessation trials, especially for low-socioeconomic status (low-SES) smokers. This study examined the factors associated with retention of low-SES smokers in the Australian Financial Interventions for Smoking Cessation Among Low-Income Smokers (FISCALS) trial. A two-group parallel block randomised open-label trial with allocation concealment. Australia. The study was conducted primarily by telephone-based interviews with nicotine replacement therapy delivered via mail. 1047 low-SES smokers interested in quitting smoking were randomised. Participants completed computer assisted telephone interviews (CATIs) at baseline, 2-month and 8-month follow-up. Smoking-related, substance use, mental or physical health, general psychological constructs, sociodemographic and recruitment sources association with retention at 8-month follow-up were examined using binary logistic regression. 946 participants (90%) completed the 2-month follow-up interview and 880 participants (84%) completed the 8-month follow-up interview. Retention at 8-months was associated with higher motivation to quit (OR: 1.15 95% CI: 1.04, 1.27 p<0.01), more recent quit attempts (OR: 1.20 95% CI: 1.04, 1.40 p<0.05), increasing age (OR: 1.05 95% CI: 1.03, 1.07 p<0.01), and higher level of education (OR: 2.24 95% CI: 1.45, 3.46 p<0.01). Lower retention at 8-months occurred for those participants recruited from posters placed in Department of Human Service Centrelink Offices (OR: 0.56 95% CI: 0.35, 0.89, p<0.05) compared to participants recruited from Quitline services. No significant differences in retention were found for participants recruited via newspaper advertisements or word of mouth compared to Quitline services. No significant associations were found between health-related or behavioural factors and retention. In the context of high overall retention rates from disadvantaged smokers in a randomised trial, retention was greater in those smokers with higher motivation to quit, more recent quit attempts, increased age, higher level of education and for those recruited through Quitline or newspaper advertisements.
Pharmaceutical Opioid Use and Dependence among People Living with Chronic Pain: Associations Observed within the Pain and Opioids in Treatment (POINT) Cohort
Publisher: Oxford University Press (OUP)
Date: 09-2015
DOI: 10.1111/PME.12773
Abstract: There is increasing concern about the appropriateness of prescribing pharmaceutical opioids for chronic non-cancer pain (CNCP), given the risks of problematic use and dependence. This article examines pharmaceutical opioid dose and dependence and examines the correlates of each. Baseline data were obtained from a national s le of 1,424 people across Australia (median 58 years, 55% female and experiencing pain for a median of 10 years), who had been prescribed opioids for CNCP. Current opioid consumption was estimated in oral morphine equivalent (OME mg per day), and ICD-10 pharmaceutical opioid dependence was assessed using the Composite International Diagnostic Interview. Current opioid consumption varied widely: 8.8% were taking = 200 mg OME. Greater daily OME consumption was associated with higher odds of multiple physical and mental health issues, aberrant opioid use, problems associated with opioid medication and opioid dependence. A significant minority, 8.5%, met criteria for lifetime ICD-10 pharmaceutical opioid dependence and 4.7% met criteria for past year ICD-10 pharmaceutical opioid dependence. Multivariate analysis found past-year dependence was independently associated with being younger, exhibiting more aberrant behaviors and having a history of benzodiazepine dependence. In this population of people taking opioids for CNCP, consumption of higher doses was associated with increased risk of problematic behaviors, and was more likely among people with a complex profile of physical and mental health problems.
How is acceptance of the brain disease model of addiction related to Australians’ attitudes towards addicted individuals and treatments for addiction?
Publisher: Springer Science and Business Media LLC
Date: 12-2014
Grand challenges in global mental health
Publisher: Springer Science and Business Media LLC
Date: 07-2011
DOI: 10.1038/475027A
Commentary on Ort etal. (2014): What next to deliver on the promise of large scale sewage-based drug epidemiology?
Publisher: Wiley
Date: 08-07-2014
DOI: 10.1111/ADD.12651
Systematic review of interventions to improve prescribing
Publisher: SAGE Publications
Date: 03-2009
DOI: 10.1345/APH.1L488
Abstract: To update 2 comprehensive reviews of systematic reviews on prescribing interventions and identify the latest evidence about the effectiveness of the interventions. Systematic searches for English-language reports of experimental and quasi-experimental research were conducted in PubMed(1951–May 2007). EMBASE (1974–March 2008), International Pharmaceutical Abstracts (1970–March 2008), and 11 other bibliographic databases of medical, social science, and business research. Following an initial title screening process and after selecting 6 specific intervention categories (identified from the previous reviews) in community settings, 2 reviewers independently assessed abstracts and then full studies for relevance and quality and extracted relevant data using formal assessment and data extraction tools. Results were then methodically incorporated into the findings of the 2 earlier reviews of systematic reviews. Twenty-nine of 26,314 articles reviewed were assessed to be of relevant, high-quality research. Audit and feedback, together with educational outreach visits, were the focus of the majority of recent, high-quality research into prescribing interventions. These interventions were also the most effective in improving prescribing practice. A smaller number of studies included a patient-mediated intervention this intervention was not consistently effective. There is insufficient recent research into manual reminders to confidently update earlier reviews and there remains insufficient evidence to draw conclusions regarding the effectiveness of local consensus processes or multidisciplinary teams. Educational outreach as well as audit and feedback continue to dominate research into prescribing interventions. These 2 prescribing interventions also most consistently show positive results. Much less research is conducted into other types of interventions and there is still very little effort to systematically test why interventions do or do not work.
Trends and characteristics of accidental and intentional codeine overdose deaths in Australia
Publisher: AMPCo
Date: 10-2015
DOI: 10.5694/MJA15.00183
Abstract: To examine trends in codeine-related mortality rates in Australia, and the clinical and toxicological characteristics of codeine-related deaths. Analysis of prospectively collected data from the National Coronial Information System on deaths where codeine toxicity was determined to be an underlying or contributory cause of death. The study period was 2000-2013. Population-adjusted numbers (per million persons) of (1) codeine-related deaths, classified by intent (accidental or intentional) and (2) heroin- and Schedule 8 opioid-related deaths (as a comparator). The overall rate of codeine-related deaths increased from 3.5 per million in 2000 to 8.7 per million in 2009. Deaths attributed to accidental overdoses were more common (48.8%) than intentional deaths (34.7%), and their proportion increased during the study period. High rates of prior comorbid mental health (53.6%), substance use (36.1%) and chronic pain (35.8%) problems were recorded for these deaths. For every two Schedule 8 opioid-related deaths in 2009, there was one codeine-related death. Most codeine-related deaths (83.7%) were the result of multiple drug toxicity. Codeine-related deaths (with and without other drug toxicity) are increasing as the consumption of codeine-based products increases. Educational messages are needed to better inform the public about the potential harms of chronic codeine use, especially in the context of polypharmacy.
Compulsory detention, forced detoxification and enforced labour are not ethically acceptable or effective ways to treat addiction
Publisher: Wiley
Date: 08-05-2012
Ethical implications of research on craving
Publisher: Elsevier BV
Date: 02-2013
DOI: 10.1016/J.ADDBEH.2012.07.002
Abstract: Cravings, intense desires to experience the effects of a drug, are widely regarded as significant impediments to overcoming addiction, although their role in relapse may be overstated. Scientists and clinicians wish to better understand the neurobiological and cognitive basis of craving so that they may develop psychotherapeutic, pharmacological and other medical methods to reduce craving and thereby drug use. The conduct of such research raises significant ethical issues. When recruiting in iduals and conducting this research, scientists need to ensure that substance dependent participants have the capacity to provide free and uncoerced consent. This is especially the case in studies in which dependent participants are given their drug of addiction or provided with other inducements to participate (e.g. financial incentives) that may undermine their ability to fully consider the risks of participation. Treatments for addiction that seek to reduce cravings may also carry risks. This includes psychotherapeutic approaches, as well as pharmacological and medical treatments. Clinicians need to consider the risks and benefits of treatment and carefully communicate these to patients. The desire to reduce urges to use drugs should not be employed to justify potentially harmful and ineffective treatments. The safety and effectiveness of emerging treatments should be assessed by well conducted randomized controlled clinical trials.
How Did Youth Mental Health Make It Onto Australia’s 2011 Federal Policy Agenda?
Publisher: SAGE Publications
Date: 10-2016
Abstract: The 2011 Australian federal budget included a large investment in youth mental health and early intervention services. In this article, we focus on the critical role of agenda setting in the preceding 4 years to examine how and why these services were given such a high priority at this time. We undertook a systematic review of relevant literature, including parliamentary Hansard transcripts from the House of Representatives and Senate, the final reports of all available parliamentary committees, government policy documents, other pertinent documents held by the Commonwealth Department of Health and Aging, and media reports from five widely circulated Australian publications/news outlets. We used Kingdon’s multiple streams framework to structure analysis. We highlight three factors that were influential in getting youth mental health issues onto the policy agenda: (a) the strategic use of quantitative evidence to create a publicly visible “problem,” (b) the marshalling of the “public” to create pressure on government, and (c) the role of serendipity. Overall, we found the decision to prioritize youth mental health resulted from a combination of advocacy for a well-articulated policy solution by high-profile, influential policy entrepreneurs, and political pressure caused by an up swell of national support for mental health reform. Our findings highlight the socio-political factors that influence agenda setting and health policy formulation. They raise important ethical and strategic issues in utilizing research evidence to change policy.
Commentary on Burgard et al. (2019): Wastewater based estimates of the size of illicit markets for psychoactive drugs
Publisher: Wiley
Date: 19-07-2019
DOI: 10.1111/ADD.14716
Heroin addiction and the capacity for consent: a reply to charland
Publisher: Wiley
Date: 12-2003
Ethical issues raised by a ban on the sale of electronic nicotine devices
Publisher: Wiley
Date: 05-04-2015
DOI: 10.1111/ADD.12898
Abstract: Some countries have banned the sale of electronic nicotine delivery systems (ENDS). We analyse the ethical issues raised by this ban and various ways in which the sale of ENDS could be permitted. We examine the ban and alternative policies in terms of the degree to which they respect ethical principles of autonomy, beneficence, non-maleficence and justice, as follows. Respect for autonomy: prohibiting ENDS infringes on smokers' autonomy to use a less harmful nicotine product while inconsistently allowing in iduals to begin and continue smoking cigarettes. Non-maleficence: prohibition is supposed to prevent ENDS recruiting new smokers and discouraging smokers from quitting, but it has not prevented uptake of ENDS. It also perpetuates harm by preventing addicted smokers from using a less harmful nicotine product. Beneficence: ENDS could benefit addicted smokers by reducing their health risks if they use them to quit and do not engage in dual use. Distributive justice: lack of access to ENDS disadvantages smokers who want to reduce their health risks. Different national policies create inequalities in the availability of products to smokers internationally. We do not have to choose between a ban and an unregulated free market. We can ethically allow ENDS to be sold in ways that allow smokers to reduce the harms of smoking while minimizing the risks of deterring quitting and increasing smoking among youth.
MAPPING THE CONSEQUENCES OF AN UNANTICIPATED DRUG SUPPLY CHANGE OF UNCERTAIN ORIGINS: RESPONSE TO THE COMMENTARIES
Publisher: Wiley
Date: 14-06-2005
The Lower-Risk Cannabis Use Guidelines (LRCUG): A ready-made targeted prevention tool for cannabis in New Zealand
Publisher: Elsevier BV
Date: 11-2020
Defining problematic pharmaceutical opioid use among people prescribed opioids for chronic noncancer pain: Do different measures identify the same patients?
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 08-03-2016
DOI: 10.1097/J.PAIN.0000000000000548
Abstract: The International Classification of Diseases (ICD) and the Diagnostic and Statistical Manual (DSM) are routinely used in diagnosing illicit substance use disorders, but for people taking prescribed opioids they remain controversial. In pain medicine, the concept of “Addiction” is preferred with reduced emphasis on tolerance and withdrawal. This article examines the prevalence and characteristics of pharmaceutical opioid dependence/disorder according to ICD, DSM, and the pain medicine concept of “Addiction,” among chronic noncancer pain (CNCP) patients prescribed opioids. In the current study, we used data from a national s le of 1134 people prescribed opioids for CNCP. Past 12-month “Addiction” (based on Pain Medicine definition), DSM, and ICD dependence definitions were assessed using the Composite International Diagnostic Interview. Twenty-four percent of the cohort met the criteria for “Addiction,” 18% for DSM-5 use disorder and 19% for ICD-11 dependence. There was “substantial” concordance between “Addiction” and both DSM-5 use disorder and ICD-11 dependence, although concordance was much greater with ICD-11 dependence (kappa = 0.63 and 0.79, respectively). Participants meeting the criteria for “Addiction” only were older, less likely to engage in nonadherent behaviours, self-reported fewer problems or concerns with their medication, and had lower rates of psychological distress than those who also met the DSM-5 and ICD-11 criteria. The definition of “Addiction” captures a larger group of patients than other classification systems and includes people with fewer “risk” behaviours. Despite removal of tolerance and withdrawal for prescribed opioid use for DSM-5, we found that “Addiction” was more closely related to an ICD-11 diagnosis of pharmaceutical opioid dependence.
Correlates of electronic cigarette use in the general population and among smokers in Australia - Findings from a nationally representative survey.
Publisher: Elsevier BV
Date: 08-2019
DOI: 10.1016/J.ADDBEH.2019.02.012
Abstract: In Australia, sales of nicotine containing electronic cigarettes (also known as e-cigarette) are banned unless approved as a therapeutic good. The aims of this study were to estimate the prevalence of e-cigarette use and its correlates in Australia using a nationally representative survey. We analysed data from the largest drug use survey in Australia (the National Drug Strategy Household Survey [NDSHS] N = 22,354). We estimated that 227,000 Australians (1.2% of the population) were current e-cigarettes users, and 97,000 (0.5%) used them daily. In iduals who were male, younger, had higher level of psychological distress, and smoked were more likely to use electronic cigarettes. Among smokers, an intention to quit and reduction in smoking was associated with experimentation and daily use of e-cigarette, but not with occasional use. Recent quitting was associated with daily use. Overall, the prevalence of e-cigarette use was low in 2016 in Australia. Smoking status was the strongest correlates of e-cigarette use. Patterns of vaping were differentialy associated with an intention to quit smoking, smoking reduction and recent quitting. Some smokers may attempt to use e-cigarettes to cut-down their tobacco use, and those who vaped daily were mostly likely to be recent quitters.
Factor structure of psychopathy among methadone maintenance patients
Publisher: Guilford Publications
Date: 06-1998
DOI: 10.1521/PEDI.1998.12.2.162
Abstract: The proposed two-factor structure of the Psychopathy Checklist (Revised) was assessed by confirmatory factor analyses on a s le of 376 community and prison based methadones maintenance patients. Confirmatory factor analyses indicated that the two-factor model proposed by previous researchers did not fit well with the data from this population. Exploratory analyses extracted five interpretable factors, three psychological factors (glibness/manipulative, callousness, irresponsibility), and two behavioral factors (criminal behaviors, promiscuity), which accounted for 61% of the variance. The data provided support for the psychometric reliability of the PCL-R, as indicated by a Chronbach's alpha of 0.83, weighted kappas for concordance between raters ranging from 0.51 to 1.00, and 100% agreement on diagnoses of psychopathy between raters. The data indicate that a two-factor structure does not adequately capture the dimensions of psychopathy in this population. While the factors do fall into distinct psychological and behavioral dimensions, more than two general factors are required to describe the dimensions of psychopathy.
Can wastewater analysis be used as a tool to assess the burden of pain treatment within a population?
Publisher: Elsevier BV
Date: 09-2020
Age–period–cohort analysis of trends in tobacco smoking, cannabis use, and their co‐use in the Australian population
Publisher: Wiley
Date: 08-06-2022
DOI: 10.1111/ADD.15951
Abstract: The prevalence of tobacco smoking has declined in most high‐income countries, while cannabis use has been rising. Moreover, cannabis use has been found to have increased among cigarette smokers in recent years in jurisdictions where it has been either decriminalized or legalized. This study measured trends in cannabis, tobacco and the co‐use of cannabis and tobacco in Australia. Age–period–cohort analysis. Participants were n = 143 344 in iduals aged 18–80 years who participated in Australia's National Drug Strategy Household Surveys (NDSHS) between 2001 and 2019. Regular (weekly/more frequently): (1) tobacco smoking only, (2) cannabis use only and (3) the co‐use of cannabis and tobacco. Prevalence of only smoking tobacco decreased in all age groups ( P 0.001) and birth cohorts between 2001 and 2019, but the co‐use of cannabis and tobacco did not. Younger cohorts were much less likely to co‐use tobacco and cannabis ( P = 0.02). Period trends showed that both cannabis use only and the co‐use of cannabis and tobacco have increased since 2013. There has been a consistent decrease in exclusive tobacco smoking across age, period and birth cohorts between 2001 and 2019 in Australia, although there is a recent increasing period trend in cannabis use with or without tobacco. The non‐decreasing trend of co‐use may reflect the strong tobacco control policies introduced over the period and changing attitudes towards cannabis use in Australia.
Neuroscience research on the addictions: A prospectus for future ethical and policy analysis
Publisher: Elsevier BV
Date: 09-2004
Injecting and sexual risk-taking behaviour among regular amphetamine users
Publisher: Informa UK Limited
Date: 02-1995
Regional versus urban differences in teenage alcohol use: Does parental disapproval account for these differences?
Publisher: Wiley
Date: 08-04-2015
DOI: 10.1111/AJR.12177
Abstract: To investigate if parental disapproval of alcohol use accounts for differences in adolescent alcohol use across regional and urban communities. Secondary data analysis of grade-level stratified data from a random s le of schools. High schools in Victoria, Australia. A random s le of 10 273 adolescents from Grade 7 (mean age = 12.51 years), 9 (14.46 years) and 11 (16.42 years). The key independent variables were parental disapproval of adolescent alcohol use and regionality (regional/ urban), and the dependent variable was past 30 days alcohol use. After adjusting for potential confounders, adolescents in regional areas were more likely to use alcohol in the past 30 days (OR = 1.83, 1.44 and 1.37 for Grades 7, 9 and 11, respectively, P < 0.05), and their parents have a lower level of disapproval of their alcohol use (b = -0.12, -0.15 and -0.19 for Grades 7, 9 and 11, respectively, P < 0.001). Bootstrapping analyses suggested that 8.37%, 23.30% and 39.22% of the effect of regionality on adolescent alcohol use was mediated by parental disapproval of alcohol use for Grades 7, 9 and 11 participants respectively (P < 0.05). Adolescents in urban areas had a lower risk of alcohol use compared with their regional counterparts, and differences in parental disapproval of alcohol use contributed to this difference.
Clinical correlates and outcomes associated with pregabalin use among people prescribed opioids for chronic non‐cancer pain: A five‐year prospective cohort study
Publisher: Wiley
Date: 26-01-2021
DOI: 10.1111/BCP.14715
Abstract: Pregabalin has become widely used as an alternative to opioids in treating certain types of chronic non‐cancer pain, but few studies have examined its clinical efficacy outside trials. We address this gap by examining the utilization, correlates and clinical outcomes of pregabalin use among an Australian community‐based cohort of people prescribed opioids for chronic non‐cancer pain. Through a five‐year prospective cohort study ( n = 1514) we examined associations between pregabalin use and pain severity and interference, mental health, opioid dose and past month use of ambulance and emergency department services. We used fixed‐effects regression models to examine within‐participant differences, and random‐effects regression models to examine within‐ and between‐participant differences in clinical outcomes. In an analysis of cases with complete data over five‐years ( n = 896), the prevalence of pregabalin use ranged from 16% at cohort entry to 29% at 36‐ and 48‐months, and 46% reported pregabalin use at any time during the five years. Pregabalin use was associated with greater pain severity and interference and greater use of high‐risk opioid doses ( oral morphine equivalents/day). Pregabalin use was not associated with changes in mental health symptoms, ambulance or emergency department attendance in the fixed or random effects models. Pregabalin use was common, but for most people use was not associated with clinically meaningful improvements in pain or functioning.
Aldous Huxley's The Doors of Perception
Publisher: Wiley
Date: 02-11-2021
DOI: 10.1111/ADD.15713
The iCannTookit: a consensus‐based, flexible framework for measuring contemporary cannabis use
Publisher: Wiley
Date: 08-06-2022
DOI: 10.1111/ADD.15956
Estimating the proportion of prescription opioids that is consumed by people who inject drugs in Australia
Publisher: Wiley
Date: 25-07-2013
DOI: 10.1111/DAR.12066
Abstract: To estimate the contribution that people who inject drugs (PWID) make to population-level use of prescription opioids in Australia. Data on prescriptions of oxycodone, morphine and methadone tablets were obtained for New South Wales, Victoria, Tasmania and Queensland, and time series analyses used to characterise the trends from 2002 to 2010. Estimates of the number of PWID were combined with data on their levels, frequency and typical doses of morphine, methadone tablet (only prescribed in Australia for pain) and oxycodone from 2004 to 2010. Estimated consumption per 1000 PWID and per 1000 persons aged 20-69 years was contrasted and the proportion of total consumption accounted for by PWID estimated. Morphine prescribing declined oxycodone prescribing increased. PWID had far higher rates of prescription opioid consumption (defined daily doses per 1000) than the general population. Tasmania had highest use of prescribed opioids. PWID contribution to morphine consumption in Tasmania increased to 28% (range 22-37%) in 2010 elsewhere, PWID contribution was lower (midpoints of 2-12%, 2010). Methadone tablet use was less elevated compared with the general population. With the exception of Tasmania, PWID were estimated to consume less than 5% of oxycodone. PWID use prescription opioids at high levels and can account for a significant proportion of consumption. Increased oxycodone prescribing in Australia has not been driven by PWID. Opioid substitution therapy and other effective treatments need to be more available and attractive to PWID.
Patterns of tobacco smoking among illicit drug users in A ustralia 2001–2010
Publisher: Wiley
Date: 29-07-2014
DOI: 10.1111/DAR.12187
Abstract: This study aimed to investigate whether there were changes from 2001 to 2010 in the characteristics of young adults who used party drugs or other illicit drugs and to determine if the prevalence of tobacco smoking differed depending on the type of drugs used. We analysed confidentialised data from the 2001 and 2010 National Drug Strategy Household Surveys. We compared young adults (aged 18-29) who used party drugs to other drug users and non-users on demographic variables. We assessed relationships between (i) illicit drug use and smoking (ii) illicit drug use and smoking while controlling for social and demographic differences and (iii) illicit drug use and smoking after controlling for social and demographic variables along with cannabis and alcohol use. There was little difference between 2001 and 2010 in drug user characteristics and smoking. Party drug users were more educated and of higher socioeconomic status than illicit drug users and non-users. Party drug users and users of other illicit drugs were far more likely to smoke tobacco however, a large part of this relationship was explained by the higher rate of cannabis and alcohol use in these groups. Over the last decade, party drug users have been a relatively socially advantaged sub-population, yet smoking prevalence among these and other drug users has remained higher than among non-users. This might be explained by the common sequence of drug involvement in which people initiate smoking, then cannabis use and followed by other drugs.
Swedish snus for tobacco harm reduction – Authors' reply
Publisher: Elsevier BV
Date: 10-2007
Five Genetic Variants Associated with Prostate Cancer
Publisher: Massachusetts Medical Society
Date: 19-06-2008
DOI: 10.1056/NEJMC080680
Using quantitative wastewater analysis to measure daily usage of conventional and emerging illicit drugs at an annual music festival
Publisher: Wiley
Date: 19-06-2013
DOI: 10.1111/DAR.12061
Abstract: Wastewater analysis provides a non-intrusive way of measuring drug use within a population. We used this approach to determine daily use of conventional illicit drugs [cannabis, cocaine, meth hetamine and 3,4-methylenedioxymeth hetamine (MDMA)] and emerging illicit psychostimulants (benzylpiperazine, mephedrone and methylone) in two consecutive years (2010 and 2011) at an annual music festival. Daily composite wastewater s les, representative of the festival, were collected from the on-site wastewater treatment plant and analysed for drug metabolites. Data over 2 years were compared using Wilcoxon matched-pair test. Data from 2010 festival were compared with data collected at the same time from a nearby urban community using equivalent methods. Conventional illicit drugs were detected in all s les whereas emerging illicit psychostimulants were found only on specific days. The estimated per capita consumption of MDMA, cocaine and cannabis was similar between the two festival years. Statistically significant (P < 0.05 Z = -2.0-2.2) decreases were observed in use of meth hetamine and one emerging illicit psychostimulant (benzyl piperazine). Only consumption of MDMA was elevated at the festival compared with the nearby urban community. Rates of substance use at this festival remained relatively consistent over two monitoring years. Compared with the urban community, drug use among festival goers was only elevated for MDMA, confirming its popularity in music settings. Our study demonstrated that wastewater analysis can objectively capture changes in substance use at a music setting without raising major ethical issues. It would potentially allow effective assessments of drug prevention strategies in such settings in the future.
Establishing and Governing e-Mental Health Care in Australia: A Systematic Review of Challenges and A Call For Policy-Focussed Research
Publisher: JMIR Publications Inc.
Date: 13-01-2016
DOI: 10.2196/JMIR.4827
Alcohol, Tobacco, and Prescription Drugs: The Relationship With Illicit Drugs in the Treatment of Substance Users
Publisher: Informa UK Limited
Date: 07-06-2012
DOI: 10.3109/10826084.2012.663283
Abstract: Alcohol, tobacco, prescription drug, and illicit drug use frequently co-occur. This paper reviews the extent of this co-occurrence in both general population s les and clinical s les, and its impact on treatment outcome. We argue that the research base for understanding comorbidity among tobacco, alcohol, prescription, and illicit drugs needs to be broadened. We specifically advocate for: (1) more epidemiological studies of relationships among alcohol, tobacco, and other illicit drug use and (2) increased research on treatment options that address the problematic use of all of these drugs.
Mapping Community Concerns About Radical Extensions of Human Life Expectancy
Publisher: Informa UK Limited
Date: 14-12-2009
ASSESSING THE QUALITY OF DATA FOR ANALYSING THE SEX RATIO AT BIRTH IN VIET NAM
Publisher: Informa UK Limited
Date: 11-2010
Utilization of anti-Parkinson drugs in Australia: 1995-2009
Publisher: Wiley
Date: 15-02-2011
DOI: 10.1002/PDS.2114
Abstract: To examine trends in the prescribing of anti-Parkinsonian drugs (APD) in Australia from 1995 to 2009. We analyzed the Medicare Australia and Drug Utilisation Sub-Committee (DUSC) databases for prescription data for overall APD dispensed use from 1995. We were able to examine prescribing by gender, age, and type of prescriber between 2002 and 2009. Prescriptions were converted to defined daily doses (DDD)/1000 population/day using Australian Bureau of Statistics population data. Dispensed use of levodopa + carbidopa remained steady from 1995 to 2009 (0.76-0.82 DDD/1000 population/day) levodopa + benserazide use increased from 0.34 to 0.55 DDD/1000 population/day. Since 2005 dispensed use of levodopa + carbidopa + entacapone has steadily increased, from 0.03 to 0.10 DDD/1000 population/day. In July 2009 levodopa + carbidopa was the most widely used agent, followed by levodopa + benserazide, then benztropine. Cabergoline increased from 1999, peaked in 2006, and thereafter declined. APD use peaked in males and females aged 60-69 years. Age-adjusted utilization was slightly higher in males than females. The amount of levodopa dispensed has slowly increased with levodopa + benserazide increasing faster than levodopa + carbidopa. Use of cabergoline fell when pramipexole became available and the risk of ergot-related serosal adverse effects was more widely appreciated. Use of centrally acting anti-cholinergics decreased over a period of time when use of atypical anti-psychotic agents increased.
Scepticism and hope in a complex predicament: People with addictions deliberate about neuroscience
Publisher: Elsevier BV
Date: 06-2016
DOI: 10.1016/J.DRUGPO.2016.03.004
Abstract: According to the 'brain disease model of addiction', addiction is a chronic condition the symptoms of which reflect persistent changes in neural functioning produced by long-term drug use. Scholars have argued both for and against the validity and usefulness of this way of conceptualising addiction, which has been variously described as emancipatory and detrimental to addicted persons. In this paper we explore how people with addictions make sense of the brain disease concept and the extent to which they find it useful. We conducted 44 semi-structured interviews with persons in treatment for drug and alcohol addiction recruited through a variety of channels. Transcripts were analysed by combining a health identity approach with thematic analysis. We describe participants' understandings of how they became addicted and what role, if any, neurobiological conceptions play in their explanations. Our findings highlight the hopeful and sceptical viewpoints of addicted in iduals on the value of addiction neuroscience ideas and neurotechnologies. These viewpoints shed some light on the erse and ergent ways that people with addictions make sense of neurobiological ideas and technologies. It also describes when, and how, neurobiological explanations and the 'brain disease' model can be helpful to addicted persons. Some of the limitations of the brain disease model become apparent in the complex ways in which neurobiological explanations and labels are incorporated into lay understandings. In order to be more useful to addicted persons, neurobiological explanations should be provided as part of a more complex explanation of addiction and the brain than the BDMA offers, and should not be given a 'disease' label.
Refining the estimation of illicit drug consumptions from wastewater analysis: Co-analysis of prescription pharmaceuticals and uncertainty assessment
Publisher: Elsevier BV
Date: 10-2011
DOI: 10.1016/J.WATRES.2011.05.042
Abstract: Wastewater analysis is a promising monitoring tool to estimate illicit drug consumption at the community level. The advantage of this technique over traditional surveys and other surveillance methods has been emphasized in recent studies. However, there are methodological challenges that can affect reliability. The objectives of this study were to systematically reduce and assess uncertainties associated with s ling (through a stringent optimization of the s ling method) and the back calculation of per capita drug consumption (through a refined estimation of the number of people actively contributing to the wastewater in a given period). We applied continuous flow-proportional s ling to ensure the collection of representative raw wastewater s les. Residues of illicit drugs, opioids, prescription pharmaceuticals and one artificial sweetener were analyzed by liquid chromatography coupled with tandem mass spectrometry. A parameter estimating the number of people actively contributing to wastewater over a given period was calculated from the measured loads of prescription pharmaceuticals, their annual consumption and relative excretion data. For the calculation of substance loads in sewage, uncertainties were propagated considering five in idual components: s ling, chemical analysis, flow measurements, excretion rates and the number of people contributing to the wastewater. The daily consumption per 1000 inhabitants was estimated to be almost 1000 mg for cannabis and several hundred mg for cocaine, meth hetamine and ecstasy. With the best s ling practice and current chemical analysis, we calculated the remaining uncertainty to be in the range of 20-30% (relative standard deviation, RSD) for the estimation of consumed drug masses in the catchment RSDs for the per capita consumption were lower (14-24%), as one of the biggest uncertainty components (i.e. error in flow measurements) cancels out in the proposed method for the estimation of the number of people contributing to the daily wastewater volume. In this study, we provide methodological improvements that substantially enhance the reliability of the estimation method--a prerequisite for the application of this technique to meaningfully assess changes in drug consumption and the success of drug intervention strategies in future studies.
What does ‘acceptance’ mean? Public reflections on the idea that addiction is a brain disease
Publisher: Springer Science and Business Media LLC
Date: 07-10-2013
A comparison of trends in wastewater‐based data and traditional epidemiological indicators of stimulant consumption in three locations
Publisher: Wiley
Date: 29-11-2019
DOI: 10.1111/ADD.14852
Abstract: To compare long-term trends in wastewater data with other indicators of stimulant use in three locations and to test the reliability of estimates based on 1 week of s ling. Comparison of trends in quantities ('loads') of stimulants or their metabolites in wastewater with trends in other indicators of stimulant use (e.g. treatment, police, population survey data). Populations in Oslo (Norway), South-East Queensland (Australia) and Eindhoven (the Netherlands). Wastewater data were modelled for MDMA (3,4-methylenedioxymeth hetamine), benzoylecgonine (a metabolite of cocaine), hetamine and meth hetamine in Oslo benzoylecgonine in Eindhoven and meth hetamine in South-East Queensland. Choice of stimulants modelled in each region was primarily determined by availability of useable data. In Oslo, wastewater data, driving under the influence of drugs statistics and seizure data all suggested increasing MDMA use between 2009 and 2017. In South-East Queensland, there was an estimated 31.1% [95% confidence interval (CI) = 29.4-32.9%] annual increase in daily loads of meth hetamine in wastewater between 2009 and 2016, compared with a 14.1% (95% CI = 10.9-17.3%) annual increase in seizures. Some of the increase in wastewater can be explained by increased purity. In Eindhoven, there was no evidence of a change in cocaine consumption from wastewater, but a reduction was observed in numbers in treatment for cocaine use from 2012 to 2017. In approximately half the cases examined in Oslo, credible intervals around estimates of annual average loads from a regression model versus estimates based on a single week of s ling did not overlap. Long-term trends in loads of stimulants in wastewater appear to be broadly consistent with trends in other indicators of stimulant use in three locations. Wastewater data should be interpreted alongside epidemiological indicators and purity data. One week of wastewater s ling may not be sufficient for valid inference about drug consumption.
The global epidemiology and burden of opioid dependence: results from the global burden of disease 2010 study
Publisher: Wiley
Date: 24-04-2014
DOI: 10.1111/ADD.12551
Abstract: To estimate the prevalence and burden of disease attributable to opioid dependence globally, regionally and at country level. Multiple search strategies: (i) peer-reviewed literature searches (ii) systematic searches of online databases (iii) internet searches (iv) consultation and feedback from experts. Culling and data extraction followed protocols. DisMod-MR, the latest version of the generic disease modelling system, a Bayesian meta-regression tool, imputed prevalence by age, year and sex for 187 countries and 21 regions. Disability weight for opioid dependence was estimated through population surveys and multiplied by prevalence data to calculate the years of life lived with disability (YLDs). Opioid dependence premature mortality was computed as years of life lost (YLLs) and summed with YLDs to calculate disability-adjusted life years (DALYs). There were 15.5 million opioid-dependent people globally in 2010 [0.22%, 95% uncertainty interval (UI) = 0.20-0.25%]. Age-standardized prevalence was higher in males (0.30%, 95% UI = 0.27-0.35%) than females (0.14%, 95% UI = 0.12-0.16%), and peaked at 25-29 years. Prevalence was higher than the global pooled prevalence in Australasia (0.46%, 95% UI = 0.41-0.53%), western Europe (0.35%, 95% UI = 0.32-0.39) and North America (0.30%, 95% UI = 0.25-0.36). Opioid dependence was estimated to account for 9.2 million DALYs globally (0.37% of global DALYs) in 2010, a 73% increase on DALYs estimated in 1990. Regions with the highest opioid dependence DALY rates were North America (292.1 per 100,000), eastern Europe (288.4 per 100,000), Australasia (278.6 per 100,000) and southern sub-Saharan Africa (263.5 per 100,000). The contribution of YLLs to opioid dependence burden was particularly high in North America, eastern Europe and southern sub-Saharan Africa. Opioid dependence is a substantial contributor to the global disease burden its contribution to premature mortality (relative to prevalence) varies geographically, with North America, eastern Europe and southern sub-Saharan Africa most strongly affected.
Ethical Issues Raised by Proposals to Treat Addiction Using Deep Brain Stimulation
Publisher: Springer Science and Business Media LLC
Date: 02-09-2010
The Australian alcopops tax revisited
Publisher: Elsevier BV
Date: 04-2011
Cannabinoids and cancer: Causation, remediation, and palliation
Publisher: Elsevier BV
Date: 2005
Response to commentaries: Slowing down the rush to translation in personal genomics
Publisher: Wiley
Date: 20-11-2012
Psychological Distress is Associated with Tobacco Smoking and Quitting Behaviour in the Australian Population: Evidence from National Cross-Sectional Surveys
Publisher: SAGE Publications
Date: 02-2011
DOI: 10.3109/00048674.2010.534070
Abstract: Objective: To investigate the association between levels of psychological distress and smoking and quitting behaviours. Method: Data were from two large Australian national household surveys of in iduals over 20 years of age. Level of psychological distress was measured by the Kessler 10 scale. Tobacco smoking measures included current smoking status (never, former, current) ex-smokers’ time since quitting current smokers’ abstinent period in the last 12 months, cigarettes smoked per day, reasons for smoking, and self-report of factors that would motivate quitting and self-report of factors that motivated smokers to quit in the last 12 months. Multinomial logistic regression was used to assess the relationships between smoking behaviours and psychological distress, while controlling for socio-demographic factors. Results: Current smokers, especially those who smoke more cigarettes per day and those who report less success at quitting or reducing smoking, had higher levels of psychological distress. Ex-smokers were also more likely to experience psychological distress than those who never smoked, but the association weakened with more years since quitting. Current smokers with psychological distress were just as, or more likely, to report planning to quit as those without psychological distress. Smokers who did not plan to quit due to addiction, past failure at quitting, and using smoking for relaxation or to deal with stress were more likely to report psychological distress than those who did not report these reasons. Conclusions: Current smoking and unsuccessful quit attempts in the Australian community were strongly associated with symptoms of psychological distress. Quitting aspirations and influence from general public health interventions were not associated with the smokers’ level of psychological distress.
The International Cannabis Toolkit (iCannToolkit): a multidisciplinary expert consensus on minimum standards for measuring cannabis use
Publisher: Wiley
Date: 27-10-2021
DOI: 10.1111/ADD.15702
Abstract: The lack of an agreed international minimum approach to measuring cannabis use hinders the integration of multidisciplinary evidence on the psychosocial, neurocognitive, clinical and public health consequences of cannabis use. A group of 25 international expert cannabis researchers convened to discuss a multidisciplinary framework for minimum standards to measure cannabis use globally in erse settings. The expert‐based consensus agreed upon a three‐layered hierarchical framework. Each layer—universal measures, detailed self‐report and biological measures—reflected different research priorities and minimum standards, costs and ease of implementation. Additional work is needed to develop valid and precise assessments. Consistent use of the proposed framework across research, public health, clinical practice and medical settings would facilitate harmonisation of international evidence on cannabis consumption, related harms and approaches to their mitigation.
Commentary on Beard et al.: Using survey data to test the hypothesis that e‐cigarettes are a gateway to cigarette smoking in youth
Publisher: Wiley
Date: 17-05-2022
DOI: 10.1111/ADD.15945
Availability of substances for use in personal vaporisers on three online cryptomarkets.
Publisher: Elsevier BV
Date: 12-2020
What Have Been the Public Health Impacts of Cannabis Legalisation in the USA? A Review of Evidence on Adverse and Beneficial Effects
Publisher: Springer Science and Business Media LLC
Date: 22-11-2019
Food Addiction and Its Impact on Weight-Based Stigma and the Treatment of Obese Individuals in the U.S. and Australia
Publisher: MDPI AG
Date: 21-11-2014
DOI: 10.3390/NU6115312
Mortality among cocaine users: A systematic review of cohort studies
Publisher: Elsevier BV
Date: 2011
DOI: 10.1016/J.DRUGALCDEP.2010.07.026
Abstract: To conduct a systematic review of mortality among cohort studies of cocaine users. Three electronic databases were searched (EMBASE, Medline and PsychINFO) other online databases were searched using online libraries and repositories of reports and literature in the drug and alcohol field, with requested contributions from trained librarians and experts. Searches and extraction were undertaken using protocols and cross-checking of decisions by two authors. Additional data were requested from study investigators where studies did not report relevant data. 1911 articles and 2 reports were identified from searches, with data from another four studies located from review articles. Seven cohorts of "problem" or dependent cocaine users reported data that permitted mortality rates to be estimated. Crude mortality rates ranged from 0.53 (95% CI: 0.10-1.58) to 6.16 (95% CI: 5.21-7.11) per 100 PY. Standardised mortality ratios (SMRs) reported in four studies suggested that mortality was four to eight times higher among cocaine users than age and sex peers in the general population. There are limited data on the extent of elevated mortality among problematic or dependent cocaine users and it is unclear how generalisable the results of these studies may be to other populations of problematic cocaine users. Greater attention to both the method of recruitment, and the characteristics of cocaine users, would enhance our understanding of the mortality risks of problematic cocaine use.
Nuances in the ethical regulation of electronic nicotine delivery systems
Publisher: Wiley
Date: 12-06-2015
DOI: 10.1111/ADD.12984
Harm Minimization in a Prohibition Context—australia
Publisher: SAGE Publications
Date: 07-2002
Cannabis legalisation in Canada: a brief history, policy rationale, implementation, and evidence of early impacts
Publisher: The University of Queensland
Date: 2022
DOI: 10.14264/A494332
IS DEEP BRAIN STIMULATION FOR ADDICTION AN ACCEPTABLE CRIME CONTROL MEASURE?
Publisher: Wiley
Date: 06-06-2012
Patterns of antipsychotic medication use in Australia 2002-2007
Publisher: SAGE Publications
Date: 04-2010
DOI: 10.3109/00048670903489890
Abstract: Objective: Atypical antipsychotic medications that are primarily used to treat schizophrenia and bipolar disorder cost the Pharmaceutical Benefits Scheme (PBS) AUD$334.4m in 2007. There are indications that they have also been used outside the approved indications to treat behavioural disturbances in the elderly. The aim of the present study was therefore to examine (i) trends in prescribing of subsidized atypical antipsychotic drugs in the Australian population from 2002 to 2007 and (ii) gender and age differences in the utilization of these drugs. Methods: Government (Medicare Australia) data on numbers of prescriptions, quantity and doses for atypical and typical antipsychotics from 2002 to 2007 were analysed. Defined daily dose per 1000 population per day were estimated for age and sex groups using Australian Bureau of Statistics population data. Results: The proportion of prescribed antipsychotics that were atypical increased from 61% in 2002 to 77% in 2007. In male subjects, olanzapine was most often prescribed between the ages of 25 and 55 years. In female subjects, in contrast, the highest rates of prescribing were in those ≥75 years. Lower doses of these drugs were prescribed in older adults. Conclusions: Atypical antipsychotic drugs were most commonly used to treat schizophrenia in younger men and behavioural disturbances in older women with dementia. They appear to have been used outside of the approved indication for schizophrenia and bipolar disorder with significant financial costs to the PBS. Research into the reasons for their extensive use in elderly women is needed to inform more rational prescribing of these medicines.
Epidemiology of alcohol-related burden of disease among Indigenous Australians
Publisher: Elsevier BV
Date: 07-2010
DOI: 10.1111/J.1753-6405.2010.00553.X
Abstract: To compare the burden of alcohol-related harm and underlying factors of this harm, by age and sex, for Indigenous and general population Australians. Population attributable fractions are used to estimate the disability adjusted life years (DALYs) for alcohol-related disease and injury. The DALYs were converted to rates per 1,000 by age and sex for the Indigenous and general populations. Homicide and violence rates were much higher for Indigenous males: greatest population difference was for 30-44 years, Indigenous rate 8.9 times higher. Rates of suicide were also greater: the largest population difference was for 15-29 years, Indigenous rate 3.9 times higher. Similarly, for Indigenous females, homicide and violence rates were much higher: greatest population difference was for 30-44 years, Indigenous rate 18.1 times higher. Rates of suicide were also greater: the largest population difference was for 15-29 years, Indigenous rate 5.0 times higher. Alcohol consumption and associated harms are of great concern for Indigenous Australians across all ages. Violent alcohol-related harms have been highlighted as a major concern. To reduce the disproportionate burden of alcohol-related harm experienced by Indigenous Australians, targeted interventions should include the impact on families and communities and not just the in idual.
Forecasting future tobacco control policy: where to next?
Publisher: Elsevier BV
Date: 10-2010
DOI: 10.1111/J.1753-6405.2010.00588.X
Abstract: Effective tobacco control policies include price increases through taxes, restrictions on smoking in public and work places, adequately funded mass media c aigns, bans on advertising, health warnings on packages and cessation assistance. As these policies have been largely implemented in Australia, what next should the country do in tobacco control? Ninety-one Australian tobacco control stakeholders took part in a web-based survey about the future of tobacco control policies. The policy deemed most important in decreasing smoking was to increase excise and customs duty by 30%. Other policies receiving high support included: funding mass media c aigns through tax hypothecation introducing retail display bans plain packaging of tobacco products and banning smoking in outdoor dining areas. Reintroducing the sale of smokeless tobacco products received the least support. Countries that have largely implemented the provisions of the Framework Convention on Tobacco Control must maintain commitments to proven tobacco control measures, but also provide global leadership through the adoption of innovative policies. The release of the Australian 2009 National Preventative Health Taskforce's report presents an opportunity to translate these ideas into action.
Anticipating the anti-ageing pill. Lessons from the history of the oral contraceptive pill and hormone replacement therapy
Publisher: EMBO
Date: 16-01-2009
Methadone maintenance treatment
Publisher: BMJ
Date: 27-05-1995
DOI: 10.1136/BMJ.310.6991.1408
Abstract: Apart from eccentric exercises (EE), isometric exercises (ISO) might be a treatment option for Achilles tendinopathy. Shear wave elastography (SWE) provides information for diagnosis and for monitoring tissue elasticity, which is altered in symptomatic tendons. Isometric exercises will have a beneficial effect on patients' outcome scores. Based on SWE, insertional and midportion tendon parts will differ in their elastic properties according to current symptoms. Randomized clinical trial. Level 2. Group 1 (EE n = 20 12 males, 8 females mean age, 52 ± 8.98 years) and group 2 (EE + ISO n = 22 15 males, 7 females mean age, 47 ± 15.11 years) performed exercises for 3 months. Measurement points were before exercises were initiated as well as after 1 and 3 months using the Victorian Institute of Sports Assessment-Achilles (VISA-A) score, American Orthopaedic Foot & Ankle Society score, and SWE (insertion and midportion). Both groups improved significantly, but there were no significant interin idual differences (VISA-A Isometric exercises do not have additional benefit when combined with eccentric exercises, as assessed over a 3-month intervention period. SWE is able to distinguish between insertional and midportion tendon parts in a symptomatic and asymptomatic state. The present study shows no additional effect of ISO when added to baseline EE in treating Achilles tendinopathy. Different elastic properties of the insertional and midportion tendon have to be taken into consideration when rating a tendon as pathologic.
Translational hurdles with cannabis medicines
Publisher: Wiley
Date: 12-04-2020
DOI: 10.1002/PDS.4999
Efficacy of smokeless tobacco for smoking cessation: a systematic review and meta-analysis
Publisher: BMJ
Date: 02-0099
DOI: 10.1136/TOBACCOCONTROL-2021-057019
Abstract: Smoking remains prevalent in many countries despite rigorous tobacco control strategies. The use of Swedish snus, a type of low-nitrosamine smokeless tobacco, has been promoted as a tobacco harm reduction strategy. Three databases were searched for studies that assessed the effectiveness of snus in promoting smoking abstinence. A total of 28 studies were reviewed (5 randomised controlled trials (RCTs), 7 longitudinal and 16 cross-sectional studies). Separate meta-analyses were conducted by study type, pooling effect estimates where outcome measures and design were sufficiently comparable. Study details and quality assessment (Risk of Bias 2 for RCTs, Newcastle-Ottawa Scale for observational studies) are provided for each study. While the meta-analysis of RCTs did not show a significant association between snus use and smoking cessation (risk ratio (RR)=1.33, 95% CI 0.71 to 2.47 and RR=0.62, 95% CI 0.27 to 1.41), the results of the meta-analysis of longitudinal cohort studies (RR=1.38, 95% CI 1.05 to 1.82, p=0.022) and cross-sectional studies (OR=1.87, 95% CI 1.29 to 2.72, p=0.001) indicated that use of snus was associated with an increased likelihood of quitting or having quit smoking. There was significant heterogeneity in the cross-sectional studies, and leave-one-out analysis indicated that the longitudinal cohort results were driven by one study. Most studies examined were subject to an elevated risk of bias. There is weak evidence for the use of snus for smoking cessation. Better RCTs and longitudinal studies are needed meanwhile, existing cessation aids may be better placed than snus to promote abstinence.
Health service utilisation by people living with chronic non-cancer pain: Findings from the Pain and Opioids in Treatment (POINT) study
Publisher: CSIRO Publishing
Date: 2016
DOI: 10.1071/AH15047
Abstract: Objective The aims of the present study were to describe the use, and barriers to the use, of non-medication pain therapies and to identify the demographic and clinical correlates of different non-opioid pain treatments. Methods The study was performed on a cohort (n = 1514) of people prescribed pharmaceutical opioids for chronic non-cancer pain (CNCP). Participants reported lifetime and past month use of healthcare services, mental and physical health, pain characteristics, current oral morphine equivalent daily doses and financial and access barriers to healthcare services. Results Participants reported the use of non-opioid pain treatments, both before and after commencing opioid therapy. Services accessed most in the past month were complementary and alternative medicines (CAMs 41%), physiotherapy (16%) and medical and/or pain specialists (15%). Higher opioid dose was associated with increased financial and access barriers to non-opioid treatment. Multivariate analyses indicated being younger, female and having private health insurance were the factors most commonly associated with accessing non-opioid treatments. Conclusions Patients on long-term opioid therapy report using multiple types of pain treatments. High rates of CAM use are concerning given limited evidence of efficacy for some therapies and the low-income status of most people with CNCP. Financial and insurance barriers highlight the importance of considering how different types of treatments are paid for and subsidised. What is known about the topic? Given concerns regarding long-term efficacy, adverse side-effects and risk of misuse and dependence, prescribing guidelines recommend caution in prescribing pharmaceutical opioids in cases of CNCP, typically advising a multidisciplinary approach to treatment. There is a range of evidence supporting different (non-drug) treatment approaches for CNCP to reduce pain severity and increase functioning. However, little is known about the non-opioid treatments used among those with CNCP and the demographic and clinical characteristics that may be associated with the use of different types of treatments. Understanding the use of non-drug therapy among people with CNCP is crucial given the potential to improve pain control for these patients. What does this paper add? The present study found that a wide range of non-opioid treatments was accessed by the study s le, both before and after commencing opioids, indicating that in this s le opioids were not the sole strategy used for pain management. The most common treatment (other than opioids) was CAM, reported by two-fifths of the s le. Having private health insurance was associated with increased use of non-opioid treatments for pain, highlighting the importance of considering how treatments are paid for and potential financial barriers to effective treatments. What are the implications for practitioners? Patients’ beliefs and financial barriers may affect the uptake of different treatments. Many patients may be using complementary and alternative approaches with limited evidence to support their use, highlighting the need for clinicians to discuss with patients the range of prescribed and non-prescribed treatments they are accessing and to help them understand the benefits and risks of treatments that have not been tested sufficiently, or have inconsistent evidence, as to their efficacy in improving pain outcomes.
Public Views on Food Addiction and Obesity: Implications for Policy and Treatment
Publisher: Public Library of Science (PLoS)
Date: 25-09-2013
Stimulant and other substance use disorders in schizophrenia: Prevalence, correlates and impacts in a population sample
Publisher: SAGE Publications
Date: 12-05-2014
Abstract: Stimulants may worsen psychotic symptoms but there is limited evidence about the impact of stimulant abuse in people with schizophrenia. This study examined the prevalence and correlates of stimulant and other drug disorders in a population-based s le of people with schizophrenia, examining associations with frequent service use, physical health comorbidities and accommodation instability. New South Wales (NSW) hospital, community mental health and emergency department data were used to examine health service contact over 5 years in 13,624 people with a diagnosis of schizophrenia. Associations of stimulant disorders were examined with multinomial logistic regression, comparing people with no substance disorders to those with cannabis disorders, stimulant disorders or both. Of people with schizophrenia, 51% had substance disorders, including 14% with stimulant disorders. Stimulant disorders were more common in young adults and in urban areas, less common in migrants, and unrelated to initial social disadvantage. More than 80% of those with stimulant disorders also had cannabis disorders. Service use and harms were most common in this group, including frequent mental health admissions (59%), frequent emergency department presentations (52%), admissions with injury or self-harm (44%), infectious disease diagnoses (22%), multiple changes of residence (61%), movement to more disadvantaged locations (42%) and periods of homelessness (18%). People with stimulant disorders alone had higher rates of self-harm, infectious disease and non-mental health admissions than people with cannabis disorders alone. Stimulant disorders occur in people with schizophrenia and in first-episode psychosis at rates more than 10 times that of the broader population. Stimulant disorders are likely to worsen the burden of psychosis, and strategies are needed to engage and support the highly disadvantaged group of people with schizophrenia who have cannabis and stimulant disorders.
Patterns of drug use and risk-taking among injecting amphetamine and opioid drug users in Sydney, Australia
Publisher: Wiley
Date: 04-1993
DOI: 10.1111/J.1360-0443.1993.TB02057.X
Abstract: Data are presented on the patterns of drug use and HIV risk-taking of daily hetamine and opioid injectors among 1245 injecting drug users who were interviewed in Sydney in 1989. About one-third of the s le had injected hetamines during a typical month of injecting, and 12% were using hetamines on a daily basis. Daily hetamine injectors were younger, less well educated, and less likely to have engaged in drug treatment, but they were no more likely than daily opioid users to have shared injection equipment or to have engaged in other behaviour likely to transmit HIV. Although there seemed to be no special cause for concern about HIV risk-taking among hetamine injectors, there was nonetheless a high prevalence of sharing injecting equipment, with over half of daily hetamine and heroin injectors having shared in the past several months. In addition, approximately a third of hetamine injectors were injecting on a daily basis, a pattern of use which increases the risk of developing a severe dependence syndrome, and of experiencing an hetamine-induced psychosis.
Prevalence and correlates of the injection of methadone syrup in Sydney, Australia
Publisher: Elsevier BV
Date: 12-1996
DOI: 10.1016/S0376-8716(96)01309-9
Abstract: A s le of 312 heroin users was interviewed on their injection of methadone syrup. Methadone injecting was widespread, with 52% of subjects having injected methadone syrup, 29% in the preceding six months. Males and females were equally likely to report methadone injecting. Forty per cent of current methadone injectors reported weekly or more frequent methadone injecting over the preceding six months. A history of methadone injecting was associated with abscesses and infections in injection sites, having been diagnosed with a venous thrombosis and a history of heroin overdose. Current methadone injectors were in poorer general health, had more injection-related symptoms, higher levels of psychological distress, were more likely to have recently passed on used injecting equipment and to have recently committed criminal acts. Implications for the reduction in the prevalence of methadone injecting and associated harm are discussed.
Parental supply of alcohol and adolescent drinking: A multilevel analysis of nationally representative data
Publisher: Springer Science and Business Media LLC
Date: 09-06-2017
Attitudes towards a hypothetical ‘clean nicotine’ product and harm reduction among smokers
Publisher: Elsevier BV
Date: 02-2021
Mortality among clients of a state-wide opioid pharmacotherapy program over 20 years: Risk factors and lives saved
Publisher: Elsevier BV
Date: 11-2009
Experience of adjunctive cannabis use for chronic non-cancer pain: findings from the Pain and Opioids IN Treatment (POINT) study.
Publisher: Elsevier BV
Date: 02-2015
DOI: 10.1016/J.DRUGALCDEP.2014.11.031
Abstract: There is increasing debate about cannabis use for medical purposes, including for symptomatic treatment of chronic pain. We investigated patterns and correlates of cannabis use in a large community s le of people who had been prescribed opioids for chronic non-cancer pain. The POINT study included 1514 people in Australia who had been prescribed pharmaceutical opioids for chronic non-cancer pain. Data on cannabis use, ICD-10 cannabis use disorder and cannabis use for pain were collected. We explored associations between demographic, pain and other patient characteristics and cannabis use for pain. One in six (16%) had used cannabis for pain relief, 6% in the previous month. A quarter reported that they would use it for pain relief if they had access. Those using cannabis for pain on average were younger, reported greater pain severity, greater interference from and poorer coping with pain, and more days out of role in the past year. They had been prescribed opioids for longer, were on higher opioid doses, and were more likely to be non-adherent with their opioid use. Those using cannabis for pain had higher pain interference after controlling for reported pain severity. Almost half (43%) of the s le had ever used cannabis for recreational purposes, and 12% of the entire cohort met criteria for an ICD-10 cannabis use disorder. Cannabis use for pain relief purposes appears common among people living with chronic non-cancer pain, and users report greater pain relief in combination with opioids than when opioids are used alone.
Pilot randomized controlled study of dexamphetamine substitution for amphetamine dependence
Publisher: Wiley
Date: 09-2001
DOI: 10.1046/J.1360-0443.2001.96912898.X
Abstract: To test the feasibility of conducting a definitive randomized controlled trial of dex hetamine substitution for hetamine dependent people and provide preliminary data. An open, two-group pre-post randomized controlled trial. Forty-one long-term, dependent hetamine users seeking treatment. Twenty subjects were offered weekly counselling. Twenty-one subjects were, in addition, prescribed up to 60 mg dex hetamine daily. Immunoassay and mass spectrometric urinalysis techniques were used to identify the presence of hetamine and methyl hetamine in urine. The Opiate Treatment Index and Severity of Dependence Scale were used to collect pre- and post-self-report data. Subjects were screened using the Composite International Diagnostic Interview. Reduced street hetamine use and hetamine dependence was observed both in subjects prescribed dex hetamine and subjects receiving counselling only. Treatment subjects appeared more likely to attend counselling. A definitive randomized controlled trial of dex hetamine substitution using the techniques and instruments piloted in this study is feasible. Users appeared to be attracted and retained in substitution treatment. The intervention also appeared to be acceptable to clinicians.
Opioid agonist pharmacotherapy in New South Wales from 1985 to 2006: patient characteristics and patterns and predictors of treatment retention
Publisher: Wiley
Date: 13-07-2009
DOI: 10.1111/J.1360-0443.2009.02633.X
Abstract: The aims of this study were to: examine the number and characteristics of patients entering and re-entering opioid replacement treatment between 1985 and 2006, to examine select demographic and treatment correlates of leaving treatment between 1985 and 2000, and to compare retention rates in methadone and buprenorphine maintenance treatment from 2001 to 2006. A retrospective cohort study using register data from the Pharmaceutical Drugs of Addiction System. Opioid substitution treatment in New South Wales (NSW), Australia. A total of n = 42 690 in iduals prescribed opioid replacement treatment between 1985 and 2006 in NSW. Client characteristics over time, retention in days in first treatment episode, number of episodes of treatment and proportion switching medication. Overall, younger in iduals were significantly more likely to leave their first treatment episode than older in iduals. In 2001-06, after controlling for age, sex and first administration point, the hazard of leaving treatment was 1.9 times for those on buprenorphine relative to those on methadone. Retention in treatment varied somewhat across historical time, with those entering during 1995-2000 more likely to leave at an earlier stage than those who entered before that time. Retention in treatment appears to fluctuate in inverse proportion to the availability of heroin. In iduals in contemporary treatment are older users with a lengthy treatment history. This study has provided population-level evidence to suggest that retention in methadone and buprenorphine differ in routine clinical practice. Future work might investigate ways in which patient adherence and retention may be improved.
State-Level Prevalence and Associates of Opioid Dependence in the USA
Publisher: MDPI AG
Date: 23-03-2022
Abstract: Traditionally, opioid-related disease burden was primarily due to heroin use. However, increases in extra-medical (or non-medicinal use of prescription opioids NMPOs) use has precipitated the current overdose epidemic in North America. We aim to examine the state-level prevalence of heroin and NMPO dependence and their associations with opioid-related mortality and state-level socio-demographic profiles. Data were pooled from the 2005–2014 National Survey on Drug Use and Health (NSDUH). We examine opioid-related mortality from CDC WONDER (Cause of Death database) by the past year prevalence of DSM-IV heroin and NMPO dependence, by age and sex, and their associations with state-level socio-demographic characteristics from census data. State-level rates of heroin dependence were associated with opioid-related death rates in young and mid-aged adults, while rates of NMPO dependence were associated with opioid-related death rates across all ages. The prevalence of heroin dependence was positively associated with state-level GDP/capita and urbanity. State-level NMPO dependence prevalence was associated with higher unemployment, lower GDP/capita, and a lower high-school completion rate. The prevalence of heroin and NMPO dependence are associated with a broad range of geographical and socio-demographic groups. Taking a wider view of populations affected by the opioid epidemic, inclusive interventions for all are needed to reduce opioid-related disease burden.
A systematic review of research examining benzodiazepine-related mortality
Publisher: Wiley
Date: 05-01-2009
DOI: 10.1002/PDS.1694
Abstract: This paper will review literature examining the association of benzodiazepine use and mortality. An extensive literature review was undertaken to locate all English-language published articles that examine mortality risk associated with use of benzodiazepines from 1990 onwards. Six cohort studies meeting the criteria above were identified. The results were mixed. Three of the studies assessed elderly populations and did not find an increased risk of death associated with benzodiazepine use, whereas another study of the general population did find an increased risk, particularly for older age groups. A study of a middle aged population found that regular benzodiazepine use was associated with an increased mortality risk, and a study of 'drug misusers' found a significant relationship between regular use of non-prescribed benzodiazepines and fatal overdose. Three retrospective population-based registry studies were also identified. The first unveiled a high relative risk (RR) of death due to benzodiazepine poisoning versus other outcomes in patients 60 or older when compared to those under 60. A positive but non-significant association between benzodiazepine use and driver-responsible fatalities in on-road motor vehicle accidents was reported. Drug poisoning deaths in England showed benzodiazepines caused 3.8% of all deaths caused by poisoning from a single drug. On the basis of existing research there is limited data examining independent effects of illicit benzodiazepine use upon mortality. Future research is needed to carefully examine risks of use in accordance with doctors' prescriptions and extra-medical use.
Collecting real‐time data from substance users raises unique legal and ethical issues: reply to K untsche & L abhart
Publisher: Wiley
Date: 21-07-2014
DOI: 10.1111/ADD.12640
Perceived access to cannabis and ease of purchasing cannabis in retail stores in Canada immediately before and one year after legalization
Publisher: Informa UK Limited
Date: 14-02-2022
Alcohol advertisers may be using social media to encourage parents to drink during COVID ‐19
Publisher: AMPCo
Date: 18-07-2020
DOI: 10.5694/MJA2.50707
Wastewater-based monitoring could help guide responses to the USA opioid epidemic
Publisher: Springer Science and Business Media LLC
Date: 18-05-2023
Factors influencing women’s decisions to drink alcohol during pregnancy: findings of a qualitative study with implications for health communication
Publisher: Springer Science and Business Media LLC
Date: 24-07-2014
Alcohol tax reform: now is the time
Publisher: AMPCo
Date: 12-2011
DOI: 10.5694/MJA11.11191
New psychoactive substances: challenges for drug surveillance, control, and public health responses
Publisher: Elsevier BV
Date: 11-2019
Reducing the opioid overdose death toll in North America
Publisher: Public Library of Science (PLoS)
Date: 31-07-2018
Short-Term Effects of State Legalization on Adolescent Cannabis Use May Not Predict Any Longer-Term Effects
Publisher: American Public Health Association
Date: 09-2020
Fortnightly Review: Methadone maintenance treatment in opiate dependence: a review
Publisher: BMJ
Date: 15-10-1994
Abstract: Non healing wounds of the lower limb continue to be a significant issue for both practitioners and patients. Failure of gold-standard management demands a creative response. This article describes the development of a novel and intuitive strapping technique overlying the compression bandage that appears to have an influence in healing complex lower limb ulcers. A retrospective audit of 17 patients with 25 ulcers allows further analysis and discussion. The strapping technique uses cohesive inelastic compression bandaging narrow strips of bandages are layered in a fan distribution over the ulcer and oedema. This approach seems to offer an intuitive response to these complex wounds, allowing management to be tailored to the site of the ulcer and oedema. Tolerance for this less bulky compression therapy regime is excellent, thereby aiding healing and reducing all costs associated with non healing leg ulcers.
The Issue of Consent in Research that Administers Drugs of Addiction to Addicted Persons
Publisher: Informa UK Limited
Date: 29-10-2008
DOI: 10.1080/08989620802388689
Abstract: In addiction, impaired control over drug use raises questions about the capacity of addicted persons to consent to participate in research studies in which they are given their drug of addiction. We review the case for doing such research, and the arguments that addiction does, and does not, prevent addicted persons from consenting to such research. We argue for a more nuanced view that acknowledges that while in some situations addiction impairs decision-making capacity, it does not eliminate such capacity. We conclude with some suggestions for recruiting addicted subjects and designing experiments in ways to obtain free and informed consent.
Methadone maintenance and drug-related crime
Publisher: Elsevier BV
Date: 1997
DOI: 10.1016/S0899-3289(97)90003-1
Abstract: Using data from an evaluation of methadone maintenance treatment, this study investigated factors associated with continued involvement in crime during treatment, and in particular whether there appeared to be differences in effectiveness of treatment between different methadone clinics. The methodology was an observational study, in which 304 patients attending three low-intervention, private methadone clinics in Sydney were interviewed on three occasions over a twelve month period. Outcome measures were self-reported criminal activity and police department records of convictions. By self-report, crime dropped promptly and substantially on entry to treatment, to a level of acquisitive crime about one-eighth that reported during the last addiction period. Analysis of official records indicated that rates of acquisitive convictions were significantly lower in the in-treatment period compared to prior to entry to treatment, corroborating the changes suggested by self-report. Persisting involvement in crime in treatment was predicted by two factors: the cost of persisting use of illicit drugs, particularly cannabis, and ASPD symptom count. Treatment factors also were independently predictive of continued involvement in crime. By both self-report and official records, and adjusting for subject factors, treatment at one clinic was associated with greater involvement in crime. This clinic operated in a chaotic and poorly organized way. It is concluded that crime during methadone treatment is substantially lower than during street addiction, although the extent of reduction depends on the quality of treatment being delivered.
Prevalence, correlates and comorbidity of DSM-IV cannabis use and cannabis use disorders in Australia
Publisher: SAGE Publications
Date: 14-09-2012
Abstract: To report nationally representative findings on the prevalence, correlates, psychiatric comorbidity and treatment of DSM-IV Cannabis Use and Cannabis Use Disorders in Australia. The 2007 National Survey of Mental Health and Wellbeing was a nationally representative household survey of 8841 Australians (16–85 years) that assessed symptoms of the most prevalent DSM-IV mental disorders. Prevalence of lifetime and 12-month cannabis use was 18% and 6% prevalence of lifetime and 12-month cannabis use disorder was 6% and 1%. The conditional prevalence (proportion of ever users who met criteria for a disorder) of lifetime and 12-month cannabis use disorder was 32.2% and 14.3%. Current cannabis use disorders were more common in males (OR 2.0) and younger users (OR 4.6). Strong associations were observed between current cannabis use disorders and alcohol use disorders (OR 3.6) and current affective disorders (OR 3.0). Only 36.2% of those with current cannabis use disorders sought any treatment. The prevalence of cannabis use disorders in the Australian population is comparable with that in the USA. Current cannabis use disorders are highly concentrated in young Australians who have high levels of comorbidity. The low rates of treatment seeking warrant attention in treatment and prevention strategies.
Policy-based evidence on e-cigarette, or vaping product, use–associated lung injury
Publisher: Wiley
Date: 14-04-2020
DOI: 10.1111/DAR.13072
Substance use and the adolescent brain: A toxic combination?
Publisher: SAGE Publications
Date: 11-2007
Abstract: Early onset substance use has consistently been associated with increased risk for a range of adverse outcomes in late adolescence and early adulthood. However, the mechanisms that underlie this relationship are not fully understood. Recent advances in developmental neuro-science, together with emerging literature on early onset substance use, suggest that the adolescent brain may be more vulnerable to the effects of addictive substances because of the extensive neuromaturational processes that are occurring during this period. Such findings are suggestive of disrupted developmental trajectories in early onset users, although there is growing evidence that high-risk youths have premorbid neurobiological vulnerabilities. Prospective studies investigating neurobiological correlates and sequelae of early adolescent drug use are urgently required to inform appropriate public health responses.
A qualitative study of overweight and obese Australians' views of food addiction
Publisher: Elsevier BV
Date: 08-2017
DOI: 10.1016/J.APPET.2017.02.013
Abstract: The concept of food addiction is increasingly used in the academic literature and popular media to explain some forms of overweight and obesity. However, there is limited evidence on how this term is understood by and impacts overweight and obese in iduals. This qualitative study investigated the views of overweight and obese in iduals on food addiction, and its likely impact upon stigma, treatment-seeking, and support for public policies to reduce overeating. Semi-structured interviews were conducted with 23 overweight and obese in iduals (M
UK classification of cannabis: is a change needed and why?
Publisher: Elsevier BV
Date: 11-2007
Comments on hall et al.'s Australian national drug strategy monograph no. 25 'The health and psychological consequences of cannabis use'
Publisher: Wiley
Date: 06-1996
Non-medical prescription stimulant use to improve academic performance among Australian university students: prevalence and correlates of use
Publisher: Springer Science and Business Media LLC
Date: 19-11-2018
Opioid analgesic prescribing in Australia: a focus on gender and age
Publisher: Wiley
Date: 04-2015
DOI: 10.1002/PDS.3767
Abstract: The use of prescription opioid analgesics has been increasing over the last few decades in Australia. In particular, oxycodone and fentanyl have increased substantially. We examined the gender and age trends in the prescribing of subsidised opioid analgesics in the Australian population for non-palliative care indications. We analysed the Medicare Australia and Drug Utilisation Sub-Committee databases for prescription data from 2002 to 2009 in 10-year age groups and by gender. Prescriptions were converted to Defined Daily Doses (DDD)/1000/day using Australian Bureau of Statistics population data. Overall use increased progressively in 2002-2009 from 12.95 to 16.08 DDD/1000 population/day (average annual increase 3.4%). Codeine was the most widely used agent followed by tramadol then oxycodone. Dispensed use increased in those aged in their 20s and 30s to plateau between 30 and 59 years for the three most preferred analgesics. The peak use of higher dose formulations of oxycodone was seen in males from 40 years. The highest dose formulation of tramadol was preferred in those aged up to approximately 70 years. Reasons for increased use may include increased prevalence of people with cancer and use for acute pain. The overall benefit and risk in this escalation of opioid use are difficult to determine however, the increasing risk of tolerance, dependence, overdose and drug ersion suggests to clinicians and policy makers that this escalation may not be in the best interest of all Australians.
Road Safety Risks of Cannabis Use: Sales Need to Fund Research
Publisher: American Public Health Association
Date: 03-2020
The Use of Cannabinoids in Treating Dementia
Publisher: Springer Science and Business Media LLC
Date: 19-06-2017
DOI: 10.1007/S11910-017-0766-6
Abstract: To review and summarise the current evidence on the safety and efficacy of using cannabinoids to treat behavioural and neuropsychiatric symptoms of dementia. Two randomised controlled trials testing a synthetic form of tetrahydrocannabinol have shown that while well tolerated, there was no significant therapeutic effect, based on changes to scores on the neuropsychiatric inventory (NPI). Case reports and open label trials have indicated that there may be some therapeutic benefit of adding synthetic cannabinoids as an adjunctive therapy to reduce agitation, aberrant motor behaviour and nighttime behaviour. More well-controlled clinical trials in older populations with varying severity of dementia are needed to evaluate the effectiveness of cannabinoids in treating behaviour symptoms of dementia. We provide suggestions for designing such trials and evaluating possible adverse effects of cannabinoids on cognitive and neuropsychiatric functioning.
Sewage epidemiology and illicit drug research: The development of ethical research guidelines
Publisher: Elsevier BV
Date: 02-2014
DOI: 10.1016/J.SCITOTENV.2013.11.039
Abstract: To discuss the need to develop ethical guidelines for researchers using sewage epidemiology to monitor drug use in the general population and specific precincts, including prisons, schools and workplaces. Describe current applications of sewage epidemiology, identify potential ethical risks associated with this science, and identify key means by which these risks may be mitigated through proportionate ethical guidance that allows this science to be fully developed. A rapidly advancing field of research is sewage epidemiology (SE) - the analysis of wastewater s les to monitor illicit drug use and other substances. Typically this research involves low ethical risks because in idual participants cannot be identified and, consequently, review has been waived by human research ethics committees. In the absence of such oversight, ethical research guidelines are recommended for SE teams, peer reviewers and journal editors guidelines will assist them to mitigate any risks in general population studies and studies of prisons, schools and workplaces. Potential harms include the stigmatisation of participants and, in the prison setting, austere policy responses to SE data that impact negatively upon inmate-participants. The risk of harm can be managed through research planning, awareness of the socio-political context in which results will be interpreted (or, in the case of media, sensationalised) and careful relations with industry partners. Ethical guidelines should be developed in consultation with SE scholars and be periodically amended. They should include publication processes that safeguard scientific rigour and be promulgated through existing research governance structures. Guidelines will assist to promote an ethical research culture among SE teams and scholars involved in the publication process and this will work to protect the reputation of the field.
A longitudinal study of the bi-directional relationship between tobacco smoking and psychological distress in a community sample of young Australian women
Publisher: Cambridge University Press (CUP)
Date: 19-10-2011
DOI: 10.1017/S0033291711002261
Abstract: Tobacco smoking and poor mental health are both prevalent and detrimental health problems in young women. The temporal relationship between the two variables is unclear. We investigated the prospective bi-directional relationship between smoking and mental health over 13 years. Participants were a randomly selected community s le of 10 012 young women with no experience of pregnancy, aged 18–23 years at baseline (1996) from the Australian Longitudinal Study on Women's Health. Follow-up surveys over 13 years were completed in 2000, 2003, 2006 and 2009, allowing for five waves of data. Measures included self-reported smoking and mental health measured by the Mental Health Index from the 36-item short-form health questionnaire and the 10-item Center for Epidemiologic Studies Depression Scale. Sociodemographic control variables included marital status, education level and employment status. A strong cross-sectional dose–response relationship between smoking and poor mental health was found at each wave [odds ratio (OR) 1.41, 95% confidence intervals (CI) 1.17–1.70 to OR 2.27, 95% CI 1.82–2.81]. Longitudinal results showed that women who smoked had 1.21 (95% CI 1.06–1.39) to 1.62 (95% CI 1.24–2.11) times higher odds of having poor mental health at subsequent waves. Women with poor mental health had 1.12 (95% CI 1.17–1.20) to 2.11 (95% CI 1.68–2.65) times higher odds of smoking at subsequent waves. These results held after adjusting for mental health history and smoking history and sociodemographic factors. Correlation analysis and structural equation modelling results were consistent in showing that both directions of the relationship were statistically significant. The association between poor mental health and smoking in young women appeared to be bi-directional.
A longitudinal study of the association of adolescent polydrug use, alcohol use and high school non-completion
Publisher: Wiley
Date: 26-01-2015
DOI: 10.1111/ADD.12829
Global prevalence of heated tobacco product use, 2015–22: A systematic review and meta‐analysis
Publisher: Wiley
Date: 19-04-2023
DOI: 10.1111/ADD.16199
Abstract: Heated tobacco products (HTPs) are electronic devices that heat process tobacco to release an aerosol containing nicotine and other chemicals. Limited data exist on world‐wide HTP use prevalence. This meta‐analytic review estimated the prevalence of HTP use by country, World Health Organization (WHO) region, year, sex/gender and age. Five databases (Web of Science, Scopus, Embase, PubMed and PsycINFO) were searched between January 2015 and May 2022. Included studies reported the prevalence of HTP use in nationally representative s les post‐modern HTP device market entry (2015). A random‐effects meta‐analysis was used to estimate overall prevalence for life‐time, current and daily HTP use. Forty‐five studies ( n = 1 096 076) from 42 countries/areas from the European Region (EUR), Western Pacific Region (WPR), Region of the Americas (AMR) and African Region (AFR) met inclusion criteria. Estimated pooled prevalence for life‐time, current and daily HTP use was 4.87% [95% confidence interval (CI) = 4.16, 5.63], 1.53% (95% CI = 1.22, 1.87) and 0.79% (95% CI = 0.48, 1.18), respectively, across all years (2015–22). Life‐time HTP use prevalence significantly increased by 3.39% for WPR [0.52% (95% CI = 0.25, 0.88) in 2015 to 3.91% (95% CI = 2.30, 5.92) in 2019] and 5.58% for EUR [1.13% (95% CI = 0.59, 1.97) in 2016 to 6.98% (95% CI = 5.69, 8.39) in 2020]. Current HTP use increased by 10.45% for WPR [0.12% (95% CI = 0, 0.37) in 2015 to 10.57% (95% CI = 5.59, 16.88) in 2020] and 1.15% for EUR [0% (95% CI = 0, 0.35) in 2016 to 1.15% (95% CI = 0.87, 1.47) in 2020]. Meta‐regression revealed higher current HTP use in WPR [3.80% (95% CI = 2.88, 4.98)] compared with EUR [1.40% (95% CI = 1.09, 1.74)] and AMR [0.81% (95% CI = 0.46, 1.26)] and for males [3.45% (95% CI = 2.56, 4.47)] compared with females [1.82% (95% CI = 1.39, 2.29)]. Adolescents had higher life‐time HTP use prevalence [5.25% (95% CI = 4.36, 6.21) than adults [2.45% (95% CI = 0.79, 4.97)]. Most studies scored a low risk of s ling bias due to their nationally representative s ling. The prevalence of HTPs use increased in the EUR and WPR between 2015 and 2020, with nearly 5% of the included populations having ever tried HTP and 1.5% identifying as current users during the study period.
Medicalisation, smoking and e-cigarettes
Publisher: BMJ
Date: 30-11-2017
DOI: 10.1136/TOBACCOCONTROL-2016-053348
Abstract: There is debate in the tobacco control literature about the value of a medical model in reducing smoking-related harm. The variety of medical treatments for smoking cessation has increased, health professionals are encouraged to use them to assist smoking cessation and tobacco dependence is being described as a 'chronic disease'. Some critics suggest that the medicalisation of smoking undermines the tobacco industry's responsibility for the harms of smoking. Others worry that it will lead smokers to deny personal responsibility for cessation, create beliefs in 'magic bullets' for smoking cessation, or erode smokers' confidence in their ability to quit. We argue that the medicalisation of smoking will have limited impact due to the emphasis on population-based interventions in tobacco control, the ambiguous place of nicotine among other drugs and the modest efficacy of current pharmacotherapies. These factors, as well as lay understandings of smoking that emphasise willpower, personal choice and responsibility, have contributed to the limited success of medical approaches to smoking cessation. While the rapid uptake of e-cigarettes in some countries has provided an option for those who reject medical treatments for smoking cessation, current regulatory developments could limit the potential of e-cigarettes to provide non-therapeutic nicotine for those who currently smoke tobacco.
Psychiatric drug prescribing in elderly Australians: Time for action
Publisher: SAGE Publications
Date: 09-2011
The global epidemiology and burden of psychostimulant dependence: Findings from the Global Burden of Disease Study 2010
Publisher: Elsevier BV
Date: 04-2014
DOI: 10.1016/J.DRUGALCDEP.2013.12.025
Abstract: To estimate the global prevalence of cocaine and hetamine dependence and the burden of disease attributable to these disorders. An epidemiological model was developed using DisMod-MR, a Bayesian meta-regression tool, using epidemiological data (prevalence, incidence, remission and mortality) sourced from a multi-stage systematic review of data. Age, sex and region-specific prevalence was estimated for and multiplied by comorbidity-adjusted disability weightings to estimate years of life lost to disability (YLDs) from these disorders. Years of life lost (YLL) were estimated from cross-national vital registry data. Disability-adjusted life years (DALYs) were estimated by summing YLDs and YLLs in 21 regions, by sex and age, in 1990 and 2010. In 2010, there were an estimated 24.1 million psychostimulant dependent people: 6.9 million cocaine and 17.2 million hetamines, equating to a point prevalence of 0.10% (0.09-0.11%) for cocaine, and 0.25% (0.22-0.28%) for hetamines. There were 37.6 hetamine dependence DALYs (21.3-59.3) per 100,000 population in 2010 and 15.9 per 100,000 (9.3-25.0) cocaine dependence DALYs. There were clear differences between hetamines and cocaine in the geographic distribution of crude DALYs. Over half of hetamine dependence DALYs were in Asian regions (52%), whereas almost half of cocaine dependence DALYs were in the Americas (44%, with 23% in North America High Income). Dependence upon psychostimulants is a substantial contributor to global disease burden the contribution of cocaine and hetamines to this burden varies dramatically by geographic region. There is a need to scale up evidence-based interventions to reduce this burden.
Support for the psychosocial, disease and brain disease models of addiction: A survey of treatment providers' attitudes in Australia, the UK, and U.S.
Publisher: Elsevier BV
Date: 08-2020
Cannabis and stimulant disorders and readmission 2 years after first-episode psychosis.
Publisher: Royal College of Psychiatrists
Date: 06-2014
DOI: 10.1192/BJP.BP.113.135145
Abstract: Few studies have examined the impact of stimulant use on outcome in early psychosis. Ceasing substance use may lead to positive outcomes in psychosis. To examine whether baseline cannabis or stimulant disorders and ongoing drug use predict readmission within 2 years of a first psychosis admission. Predictors of readmission were examined with Cox regression in 7269 people aged 15–29 years with a first psychosis admission. Baseline cannabis and stimulant disorders did not predict readmission. A stimulant disorder diagnosis prior to index psychosis admission predicted readmission, but a prior cannabis disorder diagnosis did not. Ongoing problem drug use predicted readmission. The lowest rate of readmission occurred in people whose baseline drug problems were discontinued. Prior admissions with stimulant disorder may be a negative prognostic sign in first-episode psychosis. Drug use diagnoses at baseline may be a good prognostic sign if they are identified and controlled.
THE NEED FOR MORE EXPLANATORY HUMILITY IN ADDICTION NEUROBIOLOGY
Publisher: Wiley
Date: 08-04-2010
Reducing alcohol‐related violence and other harm in Australia
Publisher: AMPCo
Date: 02-2017
DOI: 10.5694/MJA16.01094
Assessing the public health impacts of legalizing recreational cannabis use in the USA
Publisher: Wiley
Date: 17-04-2015
DOI: 10.1002/CPT.110
Abstract: A major challenge in assessing the public health impact of legalizing cannabis use in Colorado and Washington State is the absence of any experience with legal cannabis markets. The Netherlands created a de facto legalized cannabis market for recreational use, but policy analysts disagree about how it has affected rates of cannabis use. Some US states have created de facto legal supply of cannabis for medical use. So far this policy does not appear to have increased cannabis use or cannabis-related harm. Given experience with more liberal alcohol policies, the legalization of recreational cannabis use is likely to increase use among current users. It is also likely that legalization will increase the number of new users among young adults but it remains uncertain how many may be recruited, within what time frame, among which groups within the population, and how many of these new users will become regular users.
Proposals to trial deep brain stimulation to treat addiction are premature
Publisher: Wiley
Date: 05-01-2011
Compulsory treatment of addiction in the patient's best interests: More rigorous evaluations are essential
Publisher: Wiley
Date: 06-03-2014
DOI: 10.1111/DAR.12122
Multiple genetic tests for susceptibility to smoking do not outperform simple family history
Publisher: Wiley
Date: 12-12-2008
DOI: 10.1111/J.1360-0443.2008.02392.X
Abstract: To evaluate the utility of using predictive genetic screening of the population for susceptibility to smoking. The results of meta-analyses of genetic association studies of smoking behaviour were used to create simulated data sets using Monte Carlo methods. The ability of the genetic tests to screen for smoking was assessed using receiver operator characteristic curve analysis. The result was compared to prediction using simple family history information. To identify the circumstances in which predictive genetic testing would potentially justify screening we simulated tests using larger numbers of alleles (10, 15 and 20) that varied in prevalence from 10 to 50% and in strength of association [relative risks (RRs) of 1.2-2.1]. A test based on the RRs and prevalence of five susceptibility alleles derived from meta-analyses of genetic association studies of smoking performed similarly to chance and no better than the prediction based on simple family history. Increasing the number of alleles from five to 20 improved the predictive ability of genetic screening only modestly when using genes with the effect sizes reported to date. This panel of genetic tests would be unsuitable for population screening. This situation is unlikely to be improved upon by screening based on more genetic tests. Given the similarity with associations found for other polygenic conditions, our results also suggest that using multiple genes to screen the general population for genetic susceptibility to polygenic disorders will be of limited utility.
Monitoring medication and illicit drug consumption in a prison by wastewater-based epidemiology: impact of COVID-19 restrictions
Publisher: Elsevier BV
Date: 10-2023
Drug-Induced Impulse Control Disorders: A Prospectus for Neuroethical Analysis
Publisher: Springer Science and Business Media LLC
Date: 07-05-2010
Anticipating possible policy uses of addiction neuroscience research
Publisher: Informa UK Limited
Date: 08-04-2013
Professional and personal attitudes of researchers in ageing towards life extension
Publisher: Springer Science and Business Media LLC
Date: 31-05-2009
DOI: 10.1007/S10522-008-9149-3
Abstract: It is often assumed that there is broad public support for strong life extension research (i.e. research aimed at the dramatic extension of human life beyond the current maximum), and that there would be a near universal interest in using any life extending technologies that this research may produce. In this paper we report the opinions of researchers in ageing on the controversial promise of life extension, and compare these views. This paper describes the professional attitudes, personal interest and concerns expressed by Australian and international researchers in ageing (n = 14) as expressed during semi-structured, in-depth interviews. Researchers held varying opinions about the possibility of significantly extending human life. Some saw a limit to the extension of human life, while others did not. Some felt that research into the fundamental ageing process was a priority others did not. Researchers tended to weigh up the potential risks and benefits of life extension with most expressing a personal interest in life extension that was contingent on the technology providing a good quality of life. Some participants were not interested in the prospect of life extension for personal reasons, because they felt the potential risks outweighed the potential benefits, or because life extension raised issues of justice and equity.
Refining the excretion factors of methadone and codeine for wastewater analysis - Combining data from pharmacokinetic and wastewater studies
Publisher: Elsevier BV
Date: 09-2016
DOI: 10.1016/J.ENVINT.2016.05.033
Abstract: Analysing drug residues in wastewater (wastewater analysis) to monitor the consumption of those drugs in the population has become a complementary method to epidemiological surveys. In this method, the excretion factor of a drug (or the percentage of drug metabolites excreted through urine) is a critical parameter for the back-estimation of the consumption of a drug. However, this parameter is usually derived from a small database of human pharmacokinetic studies. This is true for methadone and codeine, the two most commonly used opioids and also common substances of abuse. Therefore, we aimed to refine the current excretion factors used for estimating methadone and codeine by analysing published data from the literature on the excretion of methadone, its main metabolite, 2-ethylidene-1,5-dimethyl-3,3-diphenylpyrrolidine (EDDP), and codeine. Our review included both human drug pharmacokinetic studies and wastewater analysis studies. We found that while the commonly used excretion factor of methadone (~27.5%) was relatively accurate, the excretion factor of EDDP, a better biomarker for methadone consumption in sewer epidemiology, should be twice that of methadone (i.e. 55%) instead of the current equal or half values. For codeine, the excretion factor should be ~30% instead of 63.5% or 10% as previously used in wastewater analysis studies. Data from wastewater analysis studies could be used in this way to refine the excretion factors of the drugs of interest.
Community perceptions on the significant extension of life: An exploratory study among urban adults in Brisbane, Australia
Publisher: Elsevier BV
Date: 02-2009
DOI: 10.1016/J.SOCSCIMED.2008.11.002
Abstract: Some researchers in the field of ageing claim that significant extension of the human lifespan will be possible in the near future. While many of these researchers have assumed that the community will welcome this technology, there has been very little research on community attitudes to life extension. This paper presents the results of an in-depth qualitative study of community attitudes to life extension across age groups and religious boundaries. There were 57 in idual interviews, and 8 focus groups (totalling 72 focus group participants) conducted with community members in Brisbane, Australia. Community attitudes to life extension were more varied and complex than have been assumed by some biogerontologists and bioethicists. While some participants would welcome the opportunity to extend their lives others would not even entertain the possibility. This paper details these differences of opinion and reveals contrasting positions that reflect in idualism or social concern among community members. The findings also highlight the relationship between Christianity, in particular belief in an afterlife, and attitudes to life extension technology. Overall, the study raises questions about the relationship between interest in life extension, the medicalisation of ageing and the increasing acceptability of enhancement technologies that need to be addressed in more representative s les of the community.
User characteristics and effect profile of Butane Hash Oil: An extremely high-potency cannabis concentrate
Publisher: Elsevier BV
Date: 09-2017
DOI: 10.1016/J.DRUGALCDEP.2017.04.014
Abstract: Recent reports suggest an increase in use of extremely potent cannabis concentrates such as Butane Hash Oil (BHO) in some developed countries. The aims of this study were to examine the characteristics of BHO users and the effect profiles of BHO. Anonymous online survey in over 20 countries in 2014 and 2015. Participants aged 18 years or older were recruited through onward promotion and online social networks. The overall s le size was 181,870. In this s le, 46% (N=83,867) reported using some form of cannabis in the past year, and 3% reported BHO use (n=5922). Participants reported their use of 7 types of cannabis in the past 12 months, the source of their cannabis, reasons for use, use of other illegal substances, and lifetime diagnosis for depression, anxiety and psychosis. Participants were asked to rate subjective effects of BHO and high potency herbal cannabis. Participants who reported a lifetime diagnosis of depression (OR=1.15, p=0.003), anxiety (OR=1.72, p<0.001), and a larger number of substance use (OR=1.29, p<0.001) were more likely to use BHO than only using high potency herbal cannabis. BHO users also reported stronger negative effects and less positive effects when using BHO than high potency herbal cannabis (p<0.001) CONCLUSION: Mental health problems and other illicit drug use were associated with use of BHO. BHO was reported to have stronger negative and weaker positive effects than high potency herbal cannabis.
HIV risk behaviour and prevention in prison: a bleach programme for inmates in NSW
Publisher: Wiley
Date: 06-1999
Neuroscience in gambling policy and treatment: an interdisciplinary perspective
Publisher: Elsevier BV
Date: 06-2017
The public health implications of genetic research on addiction
Publisher: Cambridge University Press
Date: 09-08-2012
Community Attitudes to the Regulation of Life Extension
Publisher: Wiley
Date: 10-2007
Abstract: Technologies purported to extend human life are already being marketed widely, and are being used by community members, despite a lack of evidence on their efficacy or safety: in fact, the use of some putative anti-aging technologies (e.g., human growth hormone) is illegal. Existing regulation is proving to be ineffective, especially in the face of Internet sales. Further advances in the field of life extension are a distinct possibility, exacerbating the need for a policy response. This paper presents the preliminary results of a study of community attitudes to life extension, with a focus on attitudes to the control and availability of strong life-extending technologies.
Challenges in Reducing the Disease Burden of Tobacco Smoking
Publisher: Wiley
Date: 18-03-2009
The epidemiology of cannabis use and cannabis-related harm in Australia 1993-2007
Publisher: Wiley
Date: 06-05-2010
DOI: 10.1111/J.1360-0443.2010.02903.X
Abstract: To examine trends in patterns of cannabis use and related harm in the Australian population between 1993 and 2007. Analysis of prospectively collected data from: (1) the National Drug Strategy Household Survey (NDSHS) and Australian Secondary Student Alcohol and Drug Survey (ASSADS) (2) the National Hospital Morbidity Database (NHMD) and (3) the Alcohol and Other Drug Treatment Services National Minimum Dataset (AODTS-NMDS). Australians aged 14 years and over from the general population students aged 12-17 years public and private hospital in-patients public and private in-patients and out-patients attending for drug treatment. Prevalence of 12-month cannabis use among the general population and secondary students. Proportions in the general population by age group reporting: daily cannabis use difficulties in controlling cannabis use and heavy cannabis use on each occasion. Number of hospital and treatment presentations for cannabis-related problems. Prevalence of past-year cannabis use has declined in the Australian population since the late 1990s. Among those reporting past-year use, daily use is prevalent among 40-49-year-olds, while heavy patterns of use are prevalent among 14-19-year-olds. Hospital presentations for cannabis-related problems reflect similar trends. Past-year cannabis use has decreased among the 10-19-year age group, but those who are daily users in this age group report using large quantities of cannabis. Despite declines in the prevalence of cannabis use, continued public health c aigns warning of the harms associated with cannabis use are essential, aimed particularly at users who are already experiencing problems. The increasing demand for treatment for cannabis problems in Australia suggests the need for more accessible and more effective interventions for cannabis use disorders.
Heroin-assisted treatment: Has a controversial treatment come of age?
Publisher: Royal College of Psychiatrists
Date: 07-2015
DOI: 10.1192/BJP.BP.114.160986
Abstract: This editorial considers the findings of the systematic review of heroin-assisted treatment, with six different studies from six different countries, published in this issue. The meta-analysis focuses on supervised injected heroin and reports significant crime reduction and an overall cost-effectiveness of treatment. Despite this body of evidence, policy makers remain reluctant to develop this treatment further. The question remains, what else is required to convince policy makers of the value of such treatment for severe and refractory heroin dependence?
The Social Implications of Neurobiological Explanations of Resistible Compulsions
Publisher: Informa UK Limited
Date: 02-2007
A mathematical model of HIV transmission in NSW prisons
Publisher: Elsevier BV
Date: 05-1998
DOI: 10.1016/S0376-8716(98)00009-X
Abstract: A mathematical model was developed to estimate HIV incidence in NSW prisons. Data included: duration of imprisonment number of inmates using each needle lower and higher number of shared injections per IDU per week proportion of IDUs using bleach efficacy of bleach HIV prevalence and probability of infection. HIV prevalence in IDUs in prison was estimated to have risen from 0.8 to 6.7% (12.2%) over 180 weeks when using lower (and higher) values for frequency of shared injections. The estimated minimum (and maximum) number of IDU inmates, infected with HIV in NSW prisons was 38 (and 152) in 1993 according to the model. These figures require confirmation by seroincidence studies.
Persons and Personification
Publisher: Informa UK Limited
Date: 02-2007
A critical analysis of Australia’s ban on the sale of electronic nicotine delivery systems
Publisher: Springer Science and Business Media LLC
Date: 18-03-2019
A Systematic Review of Trends in US Attitudes toward Cannabis Legalization
Publisher: Informa UK Limited
Date: 18-04-2022
DOI: 10.1080/10826084.2022.2063893
Abstract: A systematic search was conducted for publications in PubMed, EMBASE, and PsycINFO up to October 2019. Six studies with a regionally or nationally representative adult US-based populations were included. A secondary analysis was conducted using data from the National Survey of Drug Use and Health. Hierarchical age-period-cohort analysis assessed the trends in perceived harmfulness and availability of cannabis between 1996 and 2018. Ecological comparisons were made between these perceptions and support for cannabis legalization over time. A steep growth in support for cannabis legalization began in the 1990s and continued to grow in a relatively linear manner. Most people developed more liberal views, with no evidence that changes within any one sociodemographic group was disproportionately responsible for the overall attitudinal change. Increases in the proportion of people who use cannabis, non-religious population and political liberalism may partially explain the increased support for legalization. The decline in perceived harmfulness of cannabis, as reflected in the media, may have contributed to the increased support for legalization. However, perceptions of the availability of cannabis remained stable despite significant relaxations in cannabis regulations. The US population has become more accepting of cannabis legalization. The attitudinal change is related to changes in the perceived risks and benefits of cannabis use, influenced by broader political and cultural changes over the study period.
The brain disease model of addiction: is it supported by the evidence and has it delivered on its promises?
Publisher: Elsevier BV
Date: 2015
Estimation of the proportion of population cannabis consumption in Australia that is accounted for by daily users using Monte Carlo Simulation
Publisher: Wiley
Date: 15-01-2020
DOI: 10.1111/ADD.14909
Abstract: To estimate the proportion of cannabis consumed in Australia by daily cannabis users. Monte Carlo simulation using parameters estimated from nationally representative and repeated cross-sectional household surveys in 2007, 2010, 2013 and 2016. Australia PARTICIPANTS: Adult s les (mean age = 49.9 55% females) from four National Drug Strategy Household Surveys (n = 92 243). Frequency of cannabis use (daily/weekly/about once a month/every few months/once or twice a year). The weighted estimated prevalence of users in each of these frequency levels was multiplied by population size to estimate the total number of users. Quantity of cannabis use was measured as number of joints consumed. The consumption of those who reported using bongs was converted into joints based on the bong to joint ratio estimated from the survey data. We estimated the proportion of cannabis consumed by daily users by Monte Carlo simulation using parameters estimated from the household surveys. We conducted 10 000 simulation trials, and in each trial we [1] simulated the number of users at each consumption level (stratum) based on estimated prevalence and population size[2], for each simulated in idual, we simulated the number of days of cannabis use in a year based on frequency data[3], for each consumption day, we simulated the quantity consumed [4] and lastly we calculated the total joints consumed at each consumption level and estimated the proportion of joints consumed by daily users out of the total consumption. The prevalence of past-year cannabis use increased from 8.9% [95% confidence interval (CI) = 8.5-9.4] in 2007 to 10.5% (95% CI = 10.0-11.1) in 2016, 16% of whom were daily users. Between 2007 and 2016, daily users accounted for between 81.6 and 85.7% of all cannabis consumed. Weekly users accounted for an additional 12.1-15.9%. Between 2007 and 2016, only one in six Australian cannabis users were daily users, but they accounted for more than 80% of the estimated cannabis consumed in Australia.
Public attitudes in A ustralia towards the claim that addiction is a (brain) disease
Publisher: Wiley
Date: 11-03-2014
DOI: 10.1111/DAR.12115
Abstract: We investigated the Australian public's understandings of addiction to alcohol and heroin and the factors predicting support for the idea that these types of addiction are 'diseases' and specifically 'brain diseases'. Data were collected as part of the 2012 Queensland Social Survey, a computer-assisted telephone interview of 1263 residents of Queensland, Australia. Participants were presented with scenarios of two addicted persons, one who was addicted to heroin and the other addicted to alcohol. Participants were asked a series of questions about different definitions and causes of addiction for both characters. Over half of the respondents thought that addiction is a disease (alcohol: 67%, heroin: 53%), but fewer (alcohol: 34%, heroin: 33%) believed that addiction is a brain disease. Belief that addiction has biological causes predicted agreement that addiction is a disease [alcohol: odds ratio (OR) = 3.05 (2.15-4.31), heroin: OR = 3.99 (2.82-5.65)] and a brain disease [alcohol: OR = 4.97 (3.42-7.22), heroin: OR = 14.12 (9.23-21.61)]. Women were more likely than men to agree that addiction is a disease [alcohol: OR = 1.79 (1.35-2.38), heroin: OR = 1.40 (1.09-1.81)] as were those 35 years of age and older [alcohol: OR = 2.25 (1.50-3.40), heroin: OR = 1.50 (1.01-2.24)]. There is more public support for the idea that addiction is a 'disease' than for the more specific claim that it is a 'brain disease'. Support for a biological aetiology of addiction predicted higher levels of agreement with both disease concepts.
From “our world” to the “real world”: Exploring the views and behaviour of policy-influential Australian public health researchers
Publisher: Elsevier BV
Date: 04-2011
DOI: 10.1016/J.SOCSCIMED.2011.02.004
Abstract: Research and researchers influence the genesis and development of public health policy in limited but essential ways. Surveys and interviews with 36 peer-nominated "highly influential" Australian public health researchers found they engaged in a breadth of strategies that included rigorous but targeted research design, multilateral collaboration, multiple methods of research dissemination and promotion (including tactical use of the media), and purposeful development of bridging relationships. Researchers' ability to understand the worlds of research, policy and the media and to speak their languages (or to work with others who fulfilled this role) was a key factor. Advocacy was seen as fundamental by some but was disparaged by others. Influential behaviours were guided by values and beliefs about the principles underlying traditional science and the contrasting ethos of contemporary research. This study may help researchers consider their own policy-related roles, strategies and relationships in the context of increasing calls for research that serves economic and/or social goals.
The implications of genetic research on alcohol dependence for prevention and treatment
Publisher: Cambridge University Press
Date: 09-08-2012
Smokeless tobacco products: Unrecognised regulatory and policy opportunities
Publisher: Wiley
Date: 03-2010
Brain disease model of addiction: misplaced priorities?
Publisher: Elsevier BV
Date: 10-2015
SCIENCE, SAFETY AND COSTS MAKE DEEP BRAIN STIMULATION FOR ADDICTION A LOW PRIORITY: A REPLY TO VORSPAN ET AL. (2011) AND KUHN ET AL. (2011)
Publisher: Wiley
Date: 12-07-2011
Transitions between routes of benzodiazepine administration among heroin users in Sydney
Publisher: Wiley
Date: 06-1997
Direct-to-Consumer Genome-Wide Scans: Astrologicogenomics or Simple Scams?
Publisher: Informa UK Limited
Date: 22-06-2009
Alcohol burden in low-income and middle-income countries
Publisher: Elsevier BV
Date: 11-2015
Can automated content analysis be used to assess and improve the use of evidence in mental health policy? A systematic review
Publisher: Springer Science and Business Media LLC
Date: 15-11-2018
The use of depot naltrexone under legal coercion: the case for caution
Publisher: Wiley
Date: 06-11-2008
A wastewater-based evaluation of the effectiveness of codeine control measures in Australia
Publisher: Wiley
Date: 29-11-2023
DOI: 10.1111/ADD.16083
Abstract: From 1 February 2018, codeine was rescheduled from an over‐the‐counter (OTC) to a prescription‐only medicine in Australia. We used wastewater‐based epidemiology to measure changes in population codeine consumption before and after rescheduling. We analysed 3703 wastewater s les from 48 wastewater treatment plants, taken between August 2016 and August 2019. Our s les represented 10.6 million people, 45% of the Australian population in state capitals and regional areas in each state or territory. Codeine concentrations were determined by liquid chromatography–tandem mass spectrometry and converted to per‐capita consumption estimates using the site daily wastewater volume, catchment populations and codeine excretion kinetics. Average per‐capita consumption of codeine decreased by 37% nationally immediately after the rescheduling in February 2018 [95% confidence interval (CI) = 35.3–39.4%] and substantially in all states between 24 and 51% (95% CI = 22.4–27.0% and 41.8–59.4%). The decrease was sustained at the lower level to August 2019. Locations with least pharmacy access decreased by 51% (95% CI = 41.7–61.7%), a greater decrease than 37% observed for those with greater pharmacy access (95% CI = 35.1–39.4%). Regional areas decreased by a smaller margin to cities (32 versus 38%, 95% CI = 30.2–34.1% versus 34.9–40.4%, respectively) from a base per‐capita usage approximately 40% higher than cities. Wastewater analysis shows that codeine consumption in Australia decreased by approximately 37% following its rescheduling as a prescription‐only medicine in 2018. Wastewater‐based epidemiology can be used to evaluate changes in population pharmaceutical consumption in responses to changes in drug scheduling.
Ethical Issues in Alcohol, other Drugs and Addiction‐Related Research
Publisher: Wiley
Date: 16-02-2010
How Will Information About the Genetic Risk of Mental Disorders Impact on Stigma?
Publisher: SAGE Publications
Date: 2008
DOI: 10.1080/00048670701827226
Abstract: Objectives: To suggest ways of testing hypotheses about the impact that information on genetic risk may have on the social stigma of mental disorders and to analyse the implications of these hypotheses for genetic screening for mental disorders. Method: Literature review and critical analysis and synthesis. Results: An optimistic view is that information on the genetic risk for mental disorders will reduce blame and social stigma experienced by in iduals living with mental disorder. A more pessimists view is that genetic risk information and the use of predictive genetic testing will lead to earlier stigmatization of those at risk of mental disorders. Research is identified that is needed to provide a better understanding of the implications of predictive genetic testing for the stigmatization of different mental health disorders. Conclusions: It is essential that research on the genetics of mental disorders is accompanied by social science research on the ways in which genetic findings influence the lives of those who are tested.
Miscommunication about the causes of the US outbreak of lung diseases in vapers by public health authorities and the media
Publisher: Wiley
Date: 2020
DOI: 10.1111/DAR.13024
Global burden of disease attributable to illicit drug use and dependence: findings from the Global Burden of Disease Study 2010.
Publisher: Elsevier BV
Date: 11-2013
Assessing the place of nicotine vaporisers in tobacco control
Publisher: BMJ
Date: 31-03-2016
Minimising the misuse of oxycodone and other pharmaceutical opioids in Australia
Publisher: AMPCo
Date: 09-2011
DOI: 10.5694/MJA11.10832
Adverse effects of cannabis
Publisher: Elsevier BV
Date: 11-1998
Reaching “An Audience That You Would Never Dream of Speaking To”: Influential Public Health Researchers' Views on the Role of News Media in Influencing Policy and Public Understanding
Publisher: Informa UK Limited
Date: 24-10-2013
DOI: 10.1080/10810730.2013.811327
Abstract: While governments and academic institutions urge researchers to engage with news media, traditional academic values of public disengagement have inhibited many from giving high priority to media activity. In this interview-based study, the authors report on the views about news media engagement and strategies used by 36 peer-voted leading Australian public health researchers in 6 fields. The authors consider their views about the role and importance of media in influencing policy, their reflections on effective or ineffective media communicators, and strategies used by these researchers about how to best retain their credibility and influence while engaging with the news media. A willingness and capacity to engage with the mass media was seen as an essential attribute of influential public health researchers.
Estimating treatment rates for mental disorders in Australia.
Publisher: CSIRO Publishing
Date: 2014
DOI: 10.1071/AH13142
Abstract: Objective To estimate the percentage of Australians with a mental disorder who received treatment for that disorder each year between 2006–07 and 2009–10. Methods We used: (1) epidemiological survey data to estimate the number of Australians with a mental disorder in any year (2) a combination of administrative data on people receiving mental health care from the Commonwealth and State and Territories and epidemiological data to estimate the number receiving treatment and (3) uncertainty modelling to estimate the effects of s ling error and assumptions on these estimates. Results The estimated population treatment rate for mental disorders in Australia increased from 37% in 2006–07 to 46% in 2009–10. The model estimate for 2006–07 (37%) was very similar to the estimated treatment rate in the 2007 National Survey of Mental Health and Wellbeing (35%), the only data available for external comparison. The uncertainty modelling suggested that the increased treatment rates over subsequent years could not be explained by s ling error or uncertainty in assumptions. Conclusions The introduction of the Commonwealth’s Better Access initiative in November 2006 has been the driver for the increased the proportion of Australians with mental disorders who received treatment for those disorders over the period from 2006–07 to 2009–10. What is known about the topic? Untreated mental disorders incur major economic costs and personal suffering. Governments need timely estimates of treatment rates to assess the effects of policy changes aimed at improving access to mental health services. What does this paper add? Drawing upon a combination of epidemiological and administrative data sources, the present study estimated that the population treatment rate for mental disorders in Australia increased significantly from 37% in 2006–07 to 46% in 2009–10. What are the implications for practitioners? Increased access to services is not sufficient to ensure good outcomes for those with mental disorders. It is also important to ensure that evidence-based treatment is provided to those Australians accessing these services.
The impact of the COVID‐19 pandemic on addictive disorders—an update
Publisher: Wiley
Date: 06-09-2022
DOI: 10.1111/ADD.16033
The implementation and public health impacts of cannabis legalization in Canada: a systematic review
Publisher: Wiley
Date: 28-06-2023
DOI: 10.1111/ADD.16274
Abstract: We provide a narrative summary of research on changes in cannabis arrests, cannabis products and prices, cannabis use and cannabis‐related harm since legalization. We systematically searched for research on the impacts of cannabis legalization in Canada in PubMed, Embase, Statistics Canada and government websites and Google Scholar, published between 2006 and 2021. Cannabis legalization in Canada has been followed by substantial reductions in cannabis‐related arrests and cannabis prices. It has also increased adults’ access to a erse range of cannabis products, including edibles and extracts. The prevalence of cannabis use among young adults has increased, but there have been no marked increases or decreases in use among high school students or changes in the prevalence of daily or near‐daily use. Legalization has been associated with increased adult hospital attendances for psychiatric distress and vomiting, unintentional ingestion of edible cannabis products by children and hospitalizations for cannabis use disorders in adults. There is conflicting evidence on whether cannabis‐impaired driving has increased since legalization. There is suggestive evidence that presentations to emergency departments with psychoses and cannabis use disorders may have increased since legalization. Legalization of cannabis in Canada appears to have reduced cannabis arrests and increased access to a variety of more potent cannabis products at lower prices. Since 2019, recent cannabis use in Canada has modestly increased among adults but not among adolescents. There is evidence of increased acute adverse effects of cannabis among adults and children.
Addiction, ethics and scientific freedom
Publisher: Wiley
Date: 17-06-2003
Commentary on Shi & Liang (2020): Has cannabis legalization increased acute cannabis‐related harms?
Publisher: Wiley
Date: 20-04-2020
DOI: 10.1111/ADD.15064
Estimating the number of regular and dependent methamphetamine users in australia, 2002-2014
Publisher: AMPCo
Date: 03-2016
DOI: 10.5694/MJA15.00671
Abstract: To estimate the number of regular and dependent meth hetamine users in Australia. Indirect prevalence estimates were made for each year from 2002-03 to 2013-14. We applied multiplier methods to data on treatment episodes for hetamines (eg, counselling, rehabilitation, detoxification) and hetamine-related hospitalisations to estimate the numbers of regular (at least monthly) and dependent meth hetamine users for each year. Dependent users comprised a subgroup of those who used the drug regularly, so that estimates of the sizes of these two populations were not additive. We estimated that during 2013-14 there were 268 000 regular meth hetamine users (95% CI, 187 000-385 000) and 160 000 dependent users (95% CI, 110 000-232 000) aged 15-54 years in Australia. This equated to population rates of 2.09% (95% CI, 1.45-3.00%) for regular and 1.24% (95% CI, 0.85-1.81%) for dependent use. The rate of dependent use had increased since 2009-10 (when the rate was estimated to be 0.74%), and was higher than the previous peak (1.22% in 2006-07). The highest rates were consistently among those aged 25-34 years, in whom the rate of dependent use during 2012-2013 was estimated to be 1.50% (95% CI, 1.05-2.22%). There had also been an increase in the rate of dependent use among those aged 15-24 years (in 2012-13 reaching 1.14% 95% CI, 0.80-1.69%). There have been increases over the past 12 years in the numbers of regular and dependent meth hetamine users in Australia. Our estimates suggest that the most recent numbers are the highest for this period, and that the increase has been most marked among young adults (those aged 15-34 years). There is an increasing need for health services to engage with people who have developed problems related to their meth hetamine use.
Alienation and Authenticity in Parkinson's Disease and Its Treatment
Publisher: Informa UK Limited
Date: 02-10-2014
Smoking and Finances: Baseline Characteristics of Low Income Daily Smokers in the FISCALS Cohort
Publisher: Springer Science and Business Media LLC
Date: 30-08-2017
The Neurobiology of food Addiction and Its Implications for Obesity Treatment and Policy
Publisher: Annual Reviews
Date: 17-07-2016
DOI: 10.1146/ANNUREV-NUTR-071715-050909
Abstract: There is a growing view that certain foods, particularly those high in refined sugars and fats, are addictive and that some forms of obesity can usefully be treated as a food addiction. This perspective is supported by a growing body of neuroscience research demonstrating that the chronic consumption of energy-dense foods causes changes in the brain's reward pathway that are central to the development and maintenance of drug addiction. Obese and overweight in iduals also display patterns of eating behavior that resemble the ways in which addicted in iduals consume drugs. We critically review the evidence that some forms of obesity or overeating could be considered a food addiction and argue that the use of food addiction as a diagnostic category is premature. We also examine some of the potential positive and negative clinical, social, and public policy implications of describing obesity as a food addiction that require further investigation.
The Pain and Opioids IN Treatment study
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 02-0212
Cannabinoids for the treatment of spasticity
Publisher: Wiley
Date: 25-01-2019
DOI: 10.1111/DMCN.14165
Abstract: This review summarizes studies that examined the effectiveness of cannabinoids in treating spasticity, with a focus on understanding the relevance of the existing evidence to paediatric populations. MEDLINE, Embase, PsycINFO, and the Cochrane Library were searched to identify studies that examined the use of cannabinoids in spasticity. We identified 32 studies in adult and paediatric populations. Results were summarized by condition, with adult and paediatric studies considered separately. There is evidence from randomized controlled clinical trials that cannabinoids are more effective than placebo in reducing symptoms of spasticity in adults with multiple sclerosis. Most positive effects were based on patient-rated rather than clinician-rated measures, were modest in size, and should be considered in the context of the narrow therapeutic index of cannabinoids for spasticity and adverse effects. There were comparatively few, and no large studies, of spasticity in conditions other than multiple sclerosis. Few studies have been conducted in paediatric populations. Paediatric studies of spasticity provide low quality evidence and are inadequate to inform clinical practice. Cannabinoids have modest efficacy in reducing muscle spasticity in adults with multiple sclerosis. There is limited evidence of efficacy for cannabinoid use in other conditions, particularly in paediatric populations. Studies in paediatric populations have been of low quality and are insufficient to inform clinical practice.
Pain, alcohol use disorders and risky patterns of drinking among people with chronic non-cancer pain receiving long-term opioid therapy
Publisher: Elsevier BV
Date: 05-2016
DOI: 10.1016/J.DRUGALCDEP.2016.02.048
Abstract: The utilisation of pharmaceutical opioids has increased internationally, and there is evidence of increasing risky alcohol consumption with ageing. This study examines the patterns and correlates of risky drinking among people with chronic non-cancer pain (CNCP) prescribed opioids, and the associations between alcohol consumption and pain. The Pain and Opioids IN Treatment cohort comprises 1514 people in Australia prescribed pharmaceutical opioids for CNCP. Participants reported lifetime, past year and past month alcohol use, as well as mental and physical health, other substance use, pain characteristics, and current opioid dose. Less than one-tenth of the s le were 'lifetime abstainers' (7%) 34% were 'former drinkers' 34% were 'non-risky drinkers' (i.e., past 12 month use ≤4 standard drinks) 16% were 'occasional risky drinkers' and 8% were 'regular risky drinkers' (i.e., ≥weekly use of >4 standard drinks). Males reported greater levels of alcohol use, and a third (33%) of the total s le reported a lifetime alcohol use disorder. Controlling for demographics, mental health, physical health and substance use disorder history, 'former drinkers' (cf. 'non-risky drinkers') reported higher pain severity and interference ratings, and lower pain coping. 'Occasional risky drinkers' and 'regular risky drinkers' (cf. 'non-risky drinkers') reported higher levels of pain interference. Among people with CNCP, those who abstained from alcohol or drank at risky levels reported poorer pain outcomes compared with moderate drinkers. Early identification and intervention for risky drinking among people is critical, particularly given the risks associated with co-administration of alcohol and opioids.
A critique of the Australian National Health and Medical Research Council CEO statement on electronic cigarettes
Publisher: Wiley
Date: 20-02-2023
DOI: 10.1111/ADD.16143
Abstract: This paper critically analyses a statement by Australia's National Health and Medical Research Council (NHMRC) on e‐cigarettes in May 2022 that will be used to guide national policy. We reviewed the evidence and the conclusions drawn in the NHMRC Statement. In our view, the Statement is not a balanced reflection of the benefits and risks of vaping because it exaggerates the risks of vaping and fails to compare them to the far greater risks of smoking it uncritically accepts evidence of harms from e‐cigarettes while adopting a highly sceptical attitude towards evidence of their benefits it incorrectly claims that the association between adolescent vaping and subsequent smoking is causal and it understates the evidence of the benefits of e‐cigarettes in assisting smokers to quit. The Statement dismisses the evidence that vaping is probably already having a positive net public health effect and misapplies the precautionary principle. Several sources of evidence supporting our assessment were published after the NHMRC Statement's publication and are also referenced. The NHMRC Statement on e‐cigarettes does not present a balanced assessment of the available scientific literature and fails to meet the standard expected of a leading national scientific body.
Familial alcohol supply, adolescent drinking and early alcohol onset in 45 low and middle income countries
Publisher: Elsevier BV
Date: 09-2018
DOI: 10.1016/J.ADDBEH.2018.04.014
Abstract: This study estimated the extent of familial alcohol supply in 45 low and middle income countries (LMIC), and examined the country-level effects of familial alcohol supply on adolescents' alcohol use. We used data from 45 LMICs that participated in the Global School-Based Student Health Survey (GSHS) between 2003 and 2013 (n = 139,840). The weighted prevalence of familial alcohol supply in each country was estimated. Multilevel binary and ordinal logistic regression analyses were used to examine the country-level effect of familial alcohol supply on early onset of alcohol use (first alcohol before 12), past 30-day alcohol use, lifetime drunkenness and alcohol-related social problems. There were large variations between LMICs in the prevalence of familial alcohol supply and pattern of adolescent alcohol use. The prevalence of familial supply ranged from 0.1% in Tajikistan to 23.8% in St Lucia. It was estimated that a one percentage change in prevalence of familial alcohol supply was associated with 10%, 12% and 12% change in the odds of lifetime drunkenness (OR = 1.10, 95% CI = [1.04, 1.16]), early onset of alcohol use (OR = 1.12, 95% CI = [1.07, 1.08]) and more frequent drinking in the past month (OR = 1.12, 95% CI = [1.04, 1.20]). There were large variations in the prevalence of familial alcohol supply and adolescent alcohol use among LMICs. Adolescents in countries with higher prevalence of familial alcohol supply were more likely to start using alcohol at an earlier age, to have used alcohol in the past 30 days and experience intoxication.
Public health implications of legalising the production and sale of cannabis for medicinal and recreational use
Publisher: Elsevier BV
Date: 10-2019
The persistence of the association between adolescent cannabis use and common mental disorders into young adulthood
Publisher: Wiley
Date: 18-10-2013
DOI: 10.1111/J.1360-0443.2012.04015.X
Abstract: Debate continues about whether the association between cannabis use in adolescence and common mental disorders is causal. Most reports have focused on associations in adolescence, with few studies extending into adulthood. We examine the association from adolescence until the age of 29 years in a representative prospective cohort of young Australians. Nine-wave, 15-year representative longitudinal cohort study, with six waves of data collection in adolescence (mean age 14.9-17.4 years) and three in young adulthood (mean age 20.7, 24.1 and 29.1 years). Participants were a cohort of 1943 recruited in secondary school and surveyed at each wave when possible from mid-teen age to their late 20s. Victoria, Australia. Psychiatric morbidity was assessed with the Revised Clinical Interview Schedule (CIS-R) at each adolescent wave, and as Composite International Diagnostic Interview (CIDI)-defined ICD-10 major depressive episode and anxiety disorder at 29 years. Frequency of cannabis use was measured in the past 6 months in adolescence. Cannabis use frequency in the last year and DSM-IV cannabis dependence were assessed at 29 years. Cross-sectional and prospective associations of these outcomes with cannabis use and dependence were estimated as odds ratios (OR), using multivariable logistic regression models, with the outcomes of interest, major depressive episode (MDE) and anxiety disorder (AD) at 29 years. There were no consistent associations between adolescent cannabis use and depression at age 29 years. Daily cannabis use was associated with anxiety disorder at 29 years [adjusted OR 2.5, 95% confidence interval (CI):< 1.2-5.2], as was cannabis dependence (adjusted OR 2.2, 95% CI: 1.1-4.4). Among weekly+ adolescent cannabis users, those who continued to use cannabis use daily at 29 years remained at significantly increased odds of anxiety disorder (adjusted OR 3.2, 95% CI: 1.1-9.2). Regular (particularly daily) adolescent cannabis use is associated consistently with anxiety, but not depressive disorder, in adolescence and late young adulthood, even among regular users who then cease using the drug. It is possible that early cannabis exposure causes enduring mental health risks in the general cannabis-using adolescent population.
A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease
Publisher: Elsevier BV
Date: 12-2012
Mobile Phones in Research and Treatment: Ethical Guidelines and Future Directions
Publisher: JMIR Publications Inc.
Date: 16-10-2015
DOI: 10.2196/MHEALTH.4538
How should policymakers regulate the tetrahydrocannabinol content of cannabis products in a legal market?
Publisher: Wiley
Date: 02-02-2023
DOI: 10.1111/ADD.16135
Abstract: An increased use of high‐potency cannabis products since cannabis legalization in the United States, Canada and elsewhere may increase cannabis‐related harm. Policymakers have good reasons for regulating more potent cannabis in ways that minimize harm, using approaches similar to those used to regulate alcohol namely, banning the sale of high‐potency cannabis, setting a cap on tetrahydrocannabinol (THC) content and imposing higher rates of taxes on more potent cannabis products. Given the difficulty that US policymakers have had in regulating cannabis extracts and edibles, governments that are planning to legalize cannabis need to put policies on extracts into enabling legislation and evaluate the impact of these policies on cannabis use and cannabis‐related harms.
Addiction, neuroscience and ethics
Publisher: Wiley
Date: 17-06-2003
Illicit Drugs: Patterns of Use, Dependence, and Contribution to Disease Burden in Developed Countries
Publisher: Elsevier
Date: 2017
Genetic screening for susceptibility to depression: can we and should we?
Publisher: SAGE Publications
Date: 2004
Delivering on the promise of human stem-cell research - What are the real barriers?
Publisher: EMBO
Date: 03-11-2006
Changes in patterns of youth multiple tobacco and/or e-cigarette product use in the US between 2014 and 2020: a multiple-group latent class analysis
Publisher: BMJ
Date: 06-06-2022
DOI: 10.1136/TOBACCOCONTROL-2022-057266
Abstract: Multiple tobacco and e-cigarette product (MTEP) use, the concurrent use of two or more different types of tobacco and/or e-cigarettes products, is common among young people in the US. Changes in patterns of MTEP use among US youth between 2014 and 2020 were identified and the determinants of MTEP use were examined. Four years of repeated cross-sectional data from the US National Youth Tobacco Survey of middle and high school students from grade 6 to 12 (N total =77 402). Multigroup latent class analysis (LCA) was applied to the data series to allow for simultaneous identification of MTEP use patterns between 2014 and 2020. Logistic regression was used to predict class membership on demographic and tobacco-related variables. Over the 7-year period, LCA identified three patterns: minimal/non-users (MNU: ~89.8%), mostly occasional e-cigarette and cigarette users (MOEC: ~9%) and polytobacco users (POLY: ~1.2%). From 2014 to 2020, MNU increased from 86.4% to 92% (p .05), while MOEC and POLY decreased from 11.2% to 7.9% and from 2.4% to 0.1%, respectively. The probability of regular e-cigarette use increased from 0 to 2.3% among MNU, 6% to 31.9% among MOEC and 29.6% to 67.6% among POLY (p .05). In binomial logistic regression, being male, in high school, non-heterosexual, living with someone who uses tobacco at home, having cognitive difficulties, having lower perceptions of tobacco’s danger and exposure to tobacco marketing were associated with greater odds of MOEC and POLY than MNU. There was an increase in regular e-cigarette use in all three classes, but a corresponding decrease in the proportion of MTEP use. Public health interventions to discourage uptake of e-cigarettes, such as tighter restrictions on marketing to minors, are warranted and there is a need to consider disparities in the determinants of MTEP use.
What is the prevalence and risk of cannabis use disorders among people who use cannabis? a systematic review and meta-analysis
Publisher: Elsevier BV
Date: 10-2020
Justice and Equity in Trials of Deep Brain Stimulation for the Treatment of Addiction and Overeating
Publisher: Informa UK Limited
Date: 04-2013
Testing for cannabis in the work‐place: a review of the evidence
Publisher: Wiley
Date: 05-02-2010
DOI: 10.1111/J.1360-0443.2009.02808.X
Abstract: Urinalysis testing in the work-place has been adopted widely by employers in the United States to deter employee drug use and promote 'drug-free' work-places. In other countries, such as Canada, testing is focused more narrowly on identifying employees whose drug use puts the safety of others at risk. We review 20 years of published literature on questions relevant to the objectives of work-place drug testing (WPDT), with a special emphasis on cannabis, the most commonly detected drug. We conclude (i) that the acute effects of smoking cannabis impair performance for a period of about 4 hours (ii) long-term heavy use of cannabis can impair cognitive ability, but it is not clear that heavy cannabis users represent a meaningful job safety risk unless using before work or on the job (iii) urine tests have poor validity and low sensitivity to detect employees who represent a safety risk (iv) drug testing is related to reductions in the prevalence of cannabis positive tests among employees, but this might not translate into fewer cannabis users and (v) urinalysis has not been shown to have a meaningful impact on job injury/accident rates. Urinalysis testing is not recommended as a diagnostic tool to identify employees who represent a job safety risk from cannabis use. Blood testing for active tetrahydrocannabinol (THC) can be considered by employers who wish to identify employees whose performance may be impaired by their cannabis use.
Challenges and opportunities in using wastewater analysis to measure drug use in a small prison facility
Publisher: Wiley
Date: 10-2016
DOI: 10.1111/DAR.12156
Abstract: Wastewater analysis (WWA) is intended to be a direct and objective method of measuring substance use in large urban populations. It has also been used to measure prison substance use in two previous studies. The application of WWA in this context has raised questions as to how best it might be used to measure illicit drug use in prisons, and whether it can also be used to measure prescription misuse. We applied WWA to a small regional prison to measure the use of 12 licit and illicit substances. We attempted to measure the non-medical use of methadone and buprenorphine and to compare our findings with the results of the prison's mandatory drug testing (MDT). Representative daily composite s les were collected for two periods of 12 consecutive days in May to July 2013 and analysed for 18 drug metabolites. Prescription data and MDT results were obtained from the prison and compared with the substance use estimates calculated from WWA data. Daily use of meth hetamine, methadone, buprenorphine and codeine was detected, while sporadic detection of ketamine and methylone was also observed. Overall buprenorphine misuse appeared to be greater than methadone misuse. Compared with MDT, WWA provides a more comprehensive picture of prison substance use. WWA also has the potential to measure the misuse of medically prescribed substances. However, a great deal of care must be exercised in quantifying the usage of any substance in small populations, such as in prisons.
How many more young Australians say that they would use cannabis if it were legal?
Publisher: Wiley
Date: 29-07-2020
DOI: 10.1111/DAR.13124
Cannabis use in sub‐Saharan Africa: A systematic review and meta‐analysis
Publisher: Wiley
Date: 07-03-2023
DOI: 10.1111/ADD.16170
Abstract: The most available data on the prevalence of cannabis use come from population surveys conducted in high‐income countries in North America, Oceania and Europe. Less is known about the prevalence of cannabis use in Africa. This systematic review aimed to summarize general population‐level cannabis use in sub‐Saharan Africa since 2010. A comprehensive search was conducted in PubMed, EMBASE, PsycINFO and AJOL databases in addition to Global Health Data Exchange and grey literature without language restriction. Search terms related to ‘substance’, ‘Substance‐Related Disorders’ and ‘Prevalence’ and ‘Africa South of the Sahara’ were used. Studies that reported cannabis use in the general population were selected, while studies from clinical populations and high‐risk groups were excluded. Prevalence data on cannabis use in the general population of adolescents (10–17 years) and adults (≥ 18 years) in sub‐Saharan Africa were extracted. The study included 53 studies for the quantitative meta‐analysis and included 13 239 participants. Among adolescents, the life‐time, 12‐month and 6‐month prevalence of cannabis use were 7.9% [95% confidence interval (CI) = 5.4–10.9%], 5.2% (95% CI = 1.7–10.3%) and 4.5% (95% CI = 3.3–5.8%), respectively. The corresponding life‐time, 12‐month and 6‐month prevalence of cannabis use among adults were 12.6% (95% CI = 6.1–21.2%), 2.2% (95% CI = 1.7–2.7%, with data only available from Tanzania and Uganda) and 4.7% (95% CI = 3.3–6.4%), respectively. The male‐to‐female life‐time cannabis use relative risk was 1.90 (95% CI = 1.25–2.98) among adolescents and 1.67 (CI = 0.63–4.39) among adults. Life‐time cannabis use prevalence in sub‐Saharan Africa appears to be approximately 12% for adults and just under 8% for adolescents.
Why don't smokers want help to quit? A qualitative study of smokers' attitudes towards assisted vs. unassisted quitting
Publisher: MDPI AG
Date: 10-06-2015
Does cannabis use increase the risk of death? Systematic review of epidemiological evidence on adverse effects of cannabis use
Publisher: Wiley
Date: 05-2010
DOI: 10.1111/J.1465-3362.2009.00149.X
Abstract: To conduct a comprehensive search of the peer-reviewed literature to assess risk of cannabis-related mortality. Systematic peer-reviewed literature searches were conducted in Medline, EMBASE and PsycINFO to identify data on mortality associated with cannabis use. Search strings for cannabis and mortality were used. Searches were limited to human subjects and the publication timeframe of January 1990 to January 2008. Reference lists of review articles and of specific studies deemed important by colleagues were searched to identify additional studies. A list of the selected articles was emailed to experts in the field asking for comment on completeness. There is insufficient evidence, particularly because of the low number of studies, to assess whether the all-cause mortality rate is elevated among cannabis users in the general population. Case-control studies suggest that some adverse health outcomes may be elevated among heavy cannabis users, namely, fatal motor vehicle accidents, and possibly respiratory and brain cancers. The evidence is as yet unclear as to whether regular cannabis use increases the risk of suicide. There is a need for long-term cohort studies that follow cannabis using in iduals into old age, when the likelihood of any detrimental effects of cannabis use are more likely to emerge among those who persist in using cannabis into middle age and older. Case-control studies of cannabis use and various causes of mortality are also needed.
The evidence base for registration and reimbursement of new pharmaceuticals in cancer treatment: Surrogate and real health outcomes
Publisher: Wiley
Date: 18-08-2006
The global burden of disease attributable to alcohol and drug use in 195 countries and territories, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016
Publisher: Elsevier BV
Date: 12-2018
A cautionary bibliometric tale of two cities
Publisher: Springer Science and Business Media LLC
Date: 12-01-2010
The Use of Cannabis and Cannabinoids in Treating Symptoms of Multiple Sclerosis: a Systematic Review of Reviews
Publisher: Springer Science and Business Media LLC
Date: 02-2018
DOI: 10.1007/S11910-018-0814-X
Abstract: Pharmaceutical cannabinoids such as nabiximols, nabilone and dronabinol, and plant-based cannabinoids have been investigated for their therapeutic potential in treating multiple sclerosis (MS) symptoms. This review of reviews aimed to synthesise findings from high quality systematic reviews that examined the safety and effectiveness of cannabinoids in multiple sclerosis. We examined the outcomes of disability and disability progression, pain, spasticity, bladder function, tremor/ataxia, quality of life and adverse effects. We identified 11 eligible systematic reviews providing data from 32 studies, including 10 moderate to high quality RCTs. Five reviews concluded that there was sufficient evidence that cannabinoids may be effective for symptoms of pain and/or spasticity in MS. Few reviews reported conclusions for other symptoms. Recent high quality reviews find cannabinoids may have modest effects in MS for pain or spasticity. Future research should include studies with non-cannabinoid comparators this is an important gap in the evidence.
Prescribing databases can be used to monitor trends in opioid analgesic prescribing in Australia
Publisher: Elsevier BV
Date: 04-2013
Abstract: There has been increased use of prescription opioid analgesics in Australia in the past 20 years with increasing evidence of related problems. A number of data sources collect information about the dispensed prescribing for opioid medications, but little is known about the extent to which these data sources agree on levels of opioid prescribing. In Queensland, all opioid prescriptions (S8 prescriptions) dispensed by community pharmacies must be submitted to the Drugs of Dependence Unit (DDU). This potentially comprises a 'gold standard' against which other data sources may be judged. There are two national data sources: the Pharmaceutical Benefits Schedule (PBS) for all medications subsidised by government and an annual national survey of representative pharmacies, which assesses non-subsidised opioid prescribing. We examined the agreement between these data sources. The three data sources provided consistent estimates of use over time. The correlations between different data sources were high for most opioid analgesics. There was a substantial (60%) increase in the dispensed use of opioid analgesics and a 180% increase in the dispensed use of oxycodone over the period 2002-2009. Tramadol was the most used opioid-like medication. Since 2002 different data sources reveal similar trends, namely a substantial increase in the prescribing of opioid medications. With few exceptions, the conclusions derived from using any of these data sources were similar. Improved access to PBS data for relevant stakeholders could provide an efficient and cost-effective way to monitor use of prescription opioid analgesics.
Effect of cannabis use in people with chronic non-cancer pain prescribed opioids: findings from a 4-year prospective cohort study
Publisher: Elsevier BV
Date: 07-2018
Mood and Anxiety Symptoms in Persons Taking Prescription Opioids: A Systematic Review with Meta-Analyses of Longitudinal Studies
Publisher: Oxford University Press (OUP)
Date: 15-02-2022
DOI: 10.1093/PM/PNAC029
Abstract: To review evidence from longitudinal studies on the association between prescription opioid use and common mood and anxiety symptoms. We conducted a systematic review and meta-analysis according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We searched PubMed, Embase, and PsycINFO for search terms related to opioids AND (depression OR bipolar OR anxiety OR post-traumatic stress disorder [PTSD]). Findings were summarized narratively, and random-effects meta-analyses were used to pool effect sizes. We identified 10,290 records and found 10 articles that met our inclusion criteria. Incidence studies showed that people who used prescription opioids had an elevated risk of any mood outcome (adjusted effect size [aES] = 1.80 [95% confidence interval = 1.40–2.30]) and of an anxiety outcome (aES = 1.40 [1.20–1.80]) compared with those who did not use prescription opioids. Associations with depression were small and not significant after adjustment for potential confounders (aES = 1.18 [0.98–1.41]). However, some studies reported an increased risk of depressive symptoms after increased (aES = 1.58 [1.30–1.93]) or prolonged opioid use (aES = 1.49 [1.19–1.86]). Mental health should be considered when opioids are prescribed because some patients could be vulnerable to adverse mental health outcomes.
MAKING SPACE FOR CANNABIS POLICY EXPERIMENTS
Publisher: Wiley
Date: 12-05-2011
A provisional evaluation of Australia's medical cannabis program
Publisher: Elsevier BV
Date: 12-2023
Alcohol industry and government revenue derived from underage drinking by Australian adolescents 2005
Publisher: Elsevier BV
Date: 2009
DOI: 10.1016/J.ADDBEH.2008.09.006
Abstract: The purpose of this study was to estimate the revenue gained from consumption of alcohol by adolescents for each beverage type for the year 2005. Secondary analysis of self-reported alcohol use in the 2005 Australian Secondary School Surveys Alcohol and Drug Use. Australia. Over 506,000 adolescents aged between 12 and 17 years (29% of all Australian adolescents) consumed approximately 175.69 million standard drinks in 2005. The total revenue generated by the consumption of these beverages was estimated to be $218 million, of which the government received approximately $107 million or 49% in taxation revenue. Total revenue per underage drinker is estimated at $430.84 with revenue increasing with age. Males tend to spend more on spirits and beer while females spend more on pre-mixed spirits. Females aged 12-15 years spend around $121 per year (or 50% of total expenditure) on pre-mixed spirits compared to females aged 16-17 years old that spend around $257 per year (or 62% of total expenditure) on pre-mixed spirits. The Australian government and the alcohol industry receive substantial financial benefit from the sale of alcoholic beverages to under age drinkers.
Cannabis use and mental health: risks and benefits
Publisher: Springer Science and Business Media LLC
Date: 02-2019
Does parental monitoring and disapproval explain variations in alcohol use among adolescents from different countries of birth?
Publisher: Wiley
Date: 24-05-2016
DOI: 10.1111/DAR.12413
Abstract: This study investigated the extent to which parental monitoring and parental disapproval of alcohol use account for the association between country of birth and adolescent alcohol use. The s le consisted of 10 273 adolescents from grades 7 (Mean age = 12.5 years), 9 (14.5 years) and 11 (16.4 years) in Victoria, Australia. Participants completed a questionnaire during class time. Mediation analyses were performed to examine the extent to which parental monitoring and parental disapproval of alcohol use accounted for variations in past 30 day alcohol use between Australian-born and immigrant adolescents. Alcohol use in the past 30 days ranged from 8.0% to 44.4% for participants from different countries/regions of birth. Those born in Asia (odds ratio 0.20-0.51, P < 0.05) and Africa (odds ratio 0.45, P < 0.01) were much less likely to have consumed alcohol compared to those born in Australia. Adolescents from these two regions (except for Western Asia) reported higher levels of parental monitoring and parental disapproval of alcohol use (P < 0.05). Higher levels of parental monitoring and parental disapproval of alcohol use partially mediated the association between birth place and alcohol use (P < 0.05). There were large variations in alcohol use between Australian-born and immigrant adolescents from different countries/regions. Adolescents from Asia or Africa were much less likely to consume alcohol, and this protective effect was partially accounted for by parental monitoring and disapproval of alcohol use.[Chan GCK, Kelly AB, Connor JP, Hall WD, Young RM, Williams JW. Does parental monitoring and disapproval explain variations in alcohol use among adolescents from different countries of birth? Drug Alcohol Rev 2016 :741-749].
Psychological morbidity and route of administration among amphetamine users in Sydney, Australia
Publisher: Wiley
Date: 1996
Non‐medical use of pharmaceutical opioids with and without other illicit substances in Australia: Prevalence and correlates
Publisher: Wiley
Date: 16-01-2019
DOI: 10.1111/DAR.12893
Abstract: To estimate the prevalence of non-medical use of pharmaceutical opioids and examine the socio-demographic, psychological, health and behavioural correlates and type of opioids used. Data from the Australian National Drug Strategy Household Survey 2016 was used. The s le consisted of. 23 448 participants aged over 14 years (54% female). The key measure was opioid use status in the past year. Based on participants' responses to questions about their substance use in the past 12 months, they were grouped into four opioid use status: (i) No illicit substance use (ISU) and no non-medical use of pharmaceutical opioids (NMUPO) (ii) ISU but no NMUPO (iii) NMUPO but no ISU and (iv) NMUPO and ISU. The prevalence non-medical pharmaceutical opioid use was 3.56%. Two-thirds of them engaged in NMUPO but no ISU one-third engaged in NMUPO and ISU. Younger people were more likely to use pharmaceutical opioids in addition to other illicit drugs, while older people were more likely to only use pharmaceutical opioids. Alcohol risk and daily smoking were associated with using pharmaceutical opioids and other illicit drugs, but not with pharmaceutical opioids only. Those who reported only using pharmaceutical opioids were more likely to use over-the-counter codeine products. Over 700 000 Australian used pharmaceutical opioids for non-medical purpose. Among users, two-thirds used only opioids and one-third used opioids in addition to other illicit drugs. Profile of these two types of users were substantially different. Future prevention efforts targeting different type of opioids users may need to be optimised based on their profiles.
Alpha 1 antitrypsin phenotypes and alcoholic pancreatitis.
Publisher: BMJ
Date: 08-1991
DOI: 10.1136/GUT.32.8.945
Abstract: Altered frequencies of alpha 1 antitrypsin phenotypes have been reported in patients with chronic pancreatitis, suggesting a possible genetic basis for in idual susceptibility to this disease. Alpha 1 antitrypsin phenotypes, with particular regard to alcoholic pancreatitis, were studied. Patients with alcoholic pancreatitis were compared with alcoholic control subjects with no history of pancreatic disease. Serum alpha 1 antitrypsin concentrations were raised in pancreatitis patients s led within one month of an acute attack of pancreatitis, but otherwise values were similar to those of control subjects. There were no significant differences in alpha 1 antitrypsin phenotypes between alcoholics with pancreatitis and alcoholic control subjects. This study of alpha 1 antitrypsin phenotypes provides no evidence of an inherited susceptibility to alcoholic pancreatitis.
The increasing global health priority of substance use in young people
Publisher: Elsevier BV
Date: 03-2016
Preventing drug misuse by young people: we need to do more than ‘just say no’
Publisher: Wiley
Date: 25-04-2002
What is the hype on #MedicinalCannabis in the United States? A content analysis of medicinal cannabis tweets
Publisher: Wiley
Date: 21-02-2023
DOI: 10.1111/DAR.13618
Abstract: Medicinal cannabis is now legal in 44 US jurisdictions. Between 2020 and 2021 alone, four US jurisdictions legalised medicinal cannabis. The aim of this study is to identify themes in medicinal cannabis tweets from US jurisdictions with different legal statuses of cannabis from January to June 2021. A total of 25,099 historical tweets from 51 US jurisdictions were collected using Python. Content analysis was performed on a random s le of tweets accounting for the population size of each US jurisdictions ( n = 750). Results were presented separately by tweets posted from jurisdictions where all cannabis use (non‐medicinal and medicinal) is ‘fully legalised’, ‘illegal’ and legal for ‘medical‐only’ use. Four themes were identified: ‘Policy’, ‘Therapeutic value’, ‘Sales and industry opportunities’ and ‘Adverse effects’. Most of the tweets were posted by the public. The most common theme was related to ‘Policy’ (32.5%–61.5% of the tweets). Tweets on ‘Therapeutic value’ were prevalent in all jurisdictions and accounted for 23.8%–32.1% of the tweets. Sales and promotional activities were prominent even in illegal jurisdictions (12.1%–26.5% of the tweets). Fewer than 10% of tweets were about intoxication and withdrawal symptoms. This study has explored if content themes of medicinal cannabis tweets differed by cannabis legal status. Most tweets were pro‐cannabis and they were related to policy, therapeutic value, and sales and industry opportunities. Tweets on unsubstantiated health claims, adverse effects and crime warrants continued surveillance as these conversations could allow us to estimate cannabis‐related harms to inform health surveillance.
Cohort protocol paper: The Pain and Opioids In Treatment (POINT) study
Publisher: Springer Science and Business Media LLC
Date: 20-03-2014
Longitudinal patterns of amphetamine use from adolescence to adulthood: A latent class analysis of a 20-year prospective study of Australians
Publisher: Elsevier BV
Date: 2019
DOI: 10.1016/J.DRUGALCDEP.2018.08.042
Abstract: To examine the longitudinal patterns of hetamine use over twenty years from adolescence to the mid-thirties and identify adolescent antecedents of future problematic patterns of use. Ten-wave longitudinal study following participants from age 15 to age 35 in Victoria, Australia. Participants (N = 1755 47% males) first enrolled in the Victoria Adolescent Health Cohort Study in 1992. Outcome: Self-reported frequency of hetamine use. Gender, depression and anxiety, peer alcohol and tobacco use self-reported alcohol, tobacco and cannabis use, self-reported adolescent antisocial behavior. Three different longitudinal patterns were identified: Non-user (83.7%) Occasional user (14.5%) Regular user (1.8%). Among the two user patterns, hetamine use was commonly initiated in late teenage years or early 20s, peaked at mid-20s, and declined substantially by mid-30s. Participants who used cannabis and had smoking peers during adolescence were at significantly more likely to become an occasional or regular user (p < .05). Regular cannabis use and peer tobacco use during adolescence were the two strongest predictors of a longitudinal pattern of regular hetamine use in the mid-30s. This suggests that prevention programs could be implemented around or before mid-adolescence and interventions to reduce hetamine harms focus on high-risk in iduals in their 20s when hetamine use was at its peak.
Should Australia reconsider its ban on the sale of electronic nicotine delivery systems?
Publisher: Elsevier BV
Date: 08-2014
An analysis of policy success and failure in formal evaluations of Australia's national mental health strategy (1992-2012)
Publisher: Springer Science and Business Media LLC
Date: 30-05-2017
Public Understandings of Addiction: Where do Neurobiological Explanations Fit?
Publisher: Springer Science and Business Media LLC
Date: 15-02-2013
Indirect evidence of the contribution of prenatal sex selection practices to the high sex ratio at birth in Vietnam
Publisher: Springer Science and Business Media LLC
Date: 22-06-2011
Predictors of injecting and injecting risk-taking behaviour among methadone maintenance clients
Publisher: Wiley
Date: 03-1994
DOI: 10.1111/J.1360-0443.1994.TB00897.X
Abstract: A s le of 222 methadone maintenance clients were interviewed regarding current injecting and needle risk-taking in order to ascertain factors associated with these behaviours. Just over half (55%) of subjects had injected in the month preceding interview. Current injecting was associated with being female, having a regular sexual partner who was a current injecting drug user, polydrug use and higher levels of global psychopathology. Approximately 15% of subjects had shared needles in the month preceding interview, predominantly with one other person. Needle sharing was associated with having a regular sexual partner who was a current injecting drug user, current criminality and injecting at places other than home. Needle-sharing episodes in the study period were considered safe by practically all sharers. The implications of these findings are discussed.
Ethical and policy issues in the translation of genetic and neuroscience research on addiction
Publisher: Elsevier
Date: 2007
A latent class analysis of patterns of tobacco and cannabis use in Australia and their health‐related correlates
Publisher: Wiley
Date: 13-02-2023
DOI: 10.1111/DAR.13614
Abstract: The shifting landscape in Australia's tobacco and cannabis policies and emerging new products and modes of administration may increase experimentation and the risks of addiction to these drugs. We analysed cross‐sectional data from the 2019 National Drug Strategy and Household Survey ( n = 22,015) of Australians aged 14 and above. Latent class analysis was used to identify distinct groups based on types of tobacco and cannabis products used. The socio‐demographic, health‐rated correlates and past‐year substance use of each latent class was examined. A four‐class solution was identified: co‐use of tobacco and cannabis (2.4%), cannabis‐only (5.5%), tobacco‐only (8.0%) and non‐user (84.0%). Males (odds ratio [OR] range 1.5–2.9), younger age (OR range 2.4–8.4), moderate to high psychological distress (OR range 1.3–3.0), using illicit substances in the last year (OR range 1.41–22.87) and high risk of alcohol use disorder (OR range 2.0–21.7) were more likely to be in the tobacco/cannabis use classes than non‐users. Within the co‐use class, 78.4% mixed tobacco with cannabis and 89.4% had used alcohol with cannabis at least once. Approximately 16% of respondents used tobacco or cannabis, or both substances, and no major distinct subgroups were identified by the use of different product types. Mental health issues and the poly‐substance use were more common in the class who were co‐users of cannabis and tobacco. Existing policies need to minimise cannabis and tobacco‐related harms to reduce the societal burden associated with both substances.
All‐cause and cause‐specific mortality in individuals with an alcohol‐related emergency or hospital inpatient presentation: A retrospective data linkage cohort study
Publisher: Wiley
Date: 16-05-2023
DOI: 10.1111/ADD.16218
Abstract: Alcohol consumption is a leading risk factor for premature mortality globally, but there are limited studies of broader cohorts of people presenting with alcohol‐related problems outside of alcohol treatment services. We used linked health administrative data to estimate all‐cause and cause‐specific mortality among in iduals who had an alcohol‐related hospital inpatient or emergency department presentation. Observational study using data from the Data linkage Alcohol Cohort Study (DACS), a state‐wide retrospective cohort of in iduals with an alcohol‐related hospital inpatient or emergency department presentation. Hospital inpatient or emergency department presentation in New South Wales, Australia, between 2005 and 2014. Participants comprised 188 770 in iduals aged 12 and above, 66% males, median age 39 years at index presentation. All‐cause mortality was estimated up to 2015 and cause‐specific mortality (by those attributable to alcohol and by specific cause of death groups) up to 2013 due to data availability. Age‐specific and age–sex‐specific crude mortality rates (CMRs) were estimated, and standardized mortality ratios (SMRs) were calculated using sex and age‐specific deaths rates from the NSW population. There were 188 770 in iduals in the cohort (1 079 249 person‐years of observation) 27 855 deaths were recorded (14.8% of the cohort), with a CMR of 25.8 [95% confidence interval (CI) = 25.5, 26.1] per 1000 person‐years and SMR of 6.2 (95% CI = 5.4, 7.2). Mortality in the cohort was consistently higher than the general population in all adult age groups and in both sexes. The greatest excess mortality was from mental and behavioural disorders due to alcohol use (SMR = 46.7, 95% CI = 41.4, 52.7), liver cirrhosis (SMR = 39.0, 95% CI = 35.5, 42.9), viral hepatitis (SMR = 29.4, 95% CI = 24.6, 35.2), pancreatic diseases (SMR = 23.8, 95% CI = 17.9, 31.5) and liver cancer (SMR = 18.3, 95% CI = 14.8, 22.5). There were distinct differences between the sexes in causes of excess mortality (all causes fully attributable to alcohol female versus male risk ratio = 2.5 (95% CI = 2.0, 3.1). In New South Wales, Australia, people who came in contact with an emergency department or hospital for an alcohol‐related presentation between 2005 and 2014 were at higher risk of mortality than the general New South Wales population during the same period.
Measuring spatial and temporal trends of nicotine and alcohol consumption in Australia using wastewater-based epidemiology.
Publisher: Wiley
Date: 26-02-2018
DOI: 10.1111/ADD.14157
Abstract: Tobacco and alcohol consumption remain priority public health issues world-wide. As participation in population-based surveys has fallen, it is increasingly challenging to estimate accurately the prevalence of alcohol and tobacco use. Wastewater-based epidemiology (WBE) is an alternative approach for estimating substance use at the population level that does not rely upon survey participation. This study examined spatio-temporal patterns in nicotine (a proxy for tobacco) and alcohol consumption in the Australian population via WBE. Daily wastewater s les (n = 164) were collected at 18 selected wastewater treatment plants across Australia, covering approximately 45% of the total population. Nicotine and alcohol metabolites in the s les were measured using liquid chromatography-tandem mass spectrometry. Daily consumption of nicotine and alcohol and its associated uncertainty were computed using Monte Carlo simulations. Nation-wide daily average and weekly consumption of these two substances were extrapolated using ordinary least squares and mixed-effect models. Nicotine and alcohol consumption was observed in all communities. Consumption of these substances in rural towns was three to four times higher than in urban communities. The spatial consumption pattern of these substances was consistent across the monitoring periods in 2014-15. Nicotine metabolites significantly reduced by 14-25% (P = 0.001-0.008) (2014-15) in some catchments. Alcohol consumption remained constant over the studied periods. Strong weekly consumption patterns were observed for alcohol but not nicotine. Nation-wide, the daily average consumption per person (aged 15-79 years) was estimated at approximately 2.5 cigarettes and 1.3-2.0 standard drinks (weekday-weekend) of alcohol. These estimates were close to the sale figure and apparent consumption, respectively. Wastewater-based epidemiology is a feasible method for objectively evaluating the geographic, temporal and weekly profiles of nicotine and alcohol consumption in different communities nationally.
Gateway or common liability? A systematic review and meta‐analysis of studies of adolescent e‐cigarette use and future smoking initiation
Publisher: Wiley
Date: 05-10-2021
DOI: 10.1111/ADD.15246
Is the socioeconomic gap in childhood exposure to secondhand smoke widening or narrowing?
Publisher: BMJ
Date: 30-03-2012
DOI: 10.1136/TOBACCOCONTROL-2011-050297
Abstract: The social gradient in smoking contributes substantially to the health gap between the rich and poor. Passive smoking by children is associated with increased risk of more severe asthma, respiratory diseases and infections, middle ear disease and Sudden Infant Death Syndrome. This study examined trends in the social gradient of children's exposure to secondhand smoke in Australian households between 2001 and 2010. Series of cross-sectional national household surveys. Between 2001 and 2010, the proportion of Australian households containing a child aged under 15 years and a smoker declined by 22%. However, there was no change in the most disadvantaged households, with half of these households still containing at least one smoker in 2010. There was a social gradient in outdoor smoking in all survey years but the prevalence of outdoor-only smoking increased in all socioeconomic groups by around 50% between 2001 and 2010. The presence of a child aged 5 years or younger in the household increased the chances that smokers only smoked outdoors. Children's exposure to indoor smoking in households that contain a smoker is declining in all socioeconomic groups but the social class differentials in such exposure remain. The proportion of children who live with a smoker declined in all social groups except the most disadvantaged households, with half of these households still containing a smoker in 2010. More needs to be done to reduce secondhand smoke exposure of children in socially disadvantaged households.
‘Occasional’ and ‘social’ smokers: potential target groups for smoking cessation campaigns?
Publisher: Elsevier BV
Date: 12-2006
DOI: 10.1111/J.1467-842X.2006.TB00784.X
Abstract: To describe the characteristics of self-described 'occasional' and 'social' Australian smokers. Analysis of a national cross-sectional survey of smoking patterns, conducted in Australia in 2004. Australian adults in 2004 who responded to a survey question about self-described smoking status. Demographic characteristics, patterns of alcohol and tobacco use, smoking cessation attempts in the past year, and interest in cessation. Smokers who described themselves as 'occasional' and 'social' smokers comprised 29% of all smokers. A significant proportion of occasional and social smokers had been daily smokers, but the majority either believed that they had 'already quit' or had no intention of quitting smoking. Self-ascribed occasional and social smokers potentially represent an important target group for cessation. These types of smokers may be more resistant to public health messages regarding cessation because they do not view their smoking behaviour as presenting a high risk.
Alcohol use disorders
Publisher: Elsevier BV
Date: 03-2016
Implementation of Task-Based Learning for Non-English Students: A Practice in Malikussaleh University
Publisher: Emerald Publishing Limited
Date: 04-05-2018
Agreement between definitions of pharmaceutical opioid use disorders and dependence in people taking opioids for chronic non-cancer pain (POINT): a cohort study
Publisher: Elsevier BV
Date: 04-2015
Ethical Guidelines for Genetic Research on Alcohol Addiction and Its Applications
Publisher: Project MUSE
Date: 2018
Abstract: Research on the genomic correlates to addiction raises ethical issues in a number of different domains. In this paper, we evaluate the status of genetic research on alcohol dependence as background to addressing the ethical issues raised in conducting research on addiction and the application of that research to the formulation of public policies. We conclude that genetic testing is not yet ready for use in the prediction of alcohol dependence liability. Pharmacogenetic testing for responses to treatments may have more clinical utility, although additional research is required to demonstrate utility and cost-effectiveness. Genetic research on addiction raises potential risks for participants that must be clearly communicated to participants, including limitations on the ability of researchers to protect their privacy. Responsible communication of research findings is essential to prevent common misunderstandings about the role of genetics in addiction liability, to prevent its premature or inappropriate use, and to reduce discrimination and stigmatization experienced by addicted in iduals. More research is needed to determine the impact of genetic explanations on addicted in iduals, treatment-seeking behavior, and on public attitudes towards addicted persons. Importantly, genetic research on addiction must not be at the expense of investments in social, behavioral, and psychological research on addiction.
Anticipating the use of life extension technologies
Publisher: EMBO
Date: 16-04-2010
Should doctors prescribe cannabinoids?
Publisher: BMJ
Date: 23-04-2014
DOI: 10.1136/BMJ.G2737
Risk factors for indicators of opioid-related harms amongst people living with chronic non-cancer pain: Findings from a 5-year prospective cohort study
Publisher: Elsevier BV
Date: 11-2020
Prevalence and correlates of DSM-IV alcohol abuse and dependence in Australia: Findings of the 2007 National Survey of Mental Health and Wellbeing
Publisher: Wiley
Date: 12-08-2010
DOI: 10.1111/J.1360-0443.2010.03096.X
Abstract: To report nationally representative data on the prevalence and correlates (including psychiatric comorbidity and treatment) of DSM-IV alcohol abuse and dependence in Australian adults. The 2007 National Survey of Mental Health and Wellbeing (NSMHWB). Australian nationally representative household survey. 8841 Australian adults (16-85 years). Interview schedule that assessed symptoms of the most prevalent DSM-IV mental disorders in the life-time and the past 12 months. Prevalence of life-time and 12-month disorders was 18.3% and 2.9% for alcohol abuse and 3.9% and 1.4% for alcohol dependence. Current alcohol abuse and dependence was significantly more common in males and younger adults. There were significant associations between current alcohol use and other drug use disorders (OR 18.2) and between anxiety disorders and alcohol use disorders (OR 2.6). Only 22.4% of those with alcohol use disorders were treated for their alcohol disorder. Alcohol use disorders are highly prevalent, especially among young adult males. Comorbidity between anxiety and other drug use disorders is common and remains a significant challenge for the delivery of effective health-care services and treatment. The low rate of effective interventions for alcohol problems is a significant public health concern.
Ethical and policy issues in using vaccines to treat and prevent cocaine and nicotine dependence
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 05-2011
Avoiding the Premature Introduction of Psychedelic Medicines in Alzheimer’s Disease and Related Disorders
Publisher: Informa UK Limited
Date: 03-04-2023
Back-projection estimates of the number of dependent heroin users in Australia
Publisher: Wiley
Date: 03-2001
DOI: 10.1046/J.1360-0443.2001.9634337.X
Abstract: To plan an appropriate response to heroin use in Australia, good estimates are needed of the numbers of dependent heroin users, the group who are most in need of treatment, most at risk of fatal opioid overdose and most at risk of contracting and transmitting blood-borne viruses. Back-projection methods were used to estimate the numbers of people starting dependent heroin injecting in Australia between 1960 and 1997. Separate analyses were based on national opioid overdose deaths and numbers of new entrants to methadone treatment in New South Wales (NSW). Estimates of the rates at which dependent heroin users cease heroin use, commence methadone treatment or die from opioid overdoses were estimated from external data sources. Back-projection estimates derived from opioid overdose deaths indicated that there were 104 000 (lower limit of 72 000 and upper limit of 157 000) people who were heroin dependent in Australia between 1960 and 1997. Of these it was estimated that 67 000 (39 000-120 000) were still heroin dependent at the end of 1997. Back-projection estimates based on numbers of new entrants to methadone treatment in NSW indicated that there were 108 000 (82 000-141 000) heroin-dependent people in Australia between 1960 and 1997, of whom 71 000 (47 000-109 000) were estimated to be heroin dependent at the end of 1997. Both analyses indicated that the number of heroin-dependent people in Australia has increased substantially from the early 1970s onwards. Back-projection estimates based on analyses of treatment entries and opioid overdose deaths provide an additional method for estimating the numbers of heroin-dependent people in the population. The addition of these methods to existing methods, using different data sources and statistical methods, should improve consensus estimates of the numbers of heroin-dependent people.
Has Marijuana Legalization Increased Marijuana Use Among US Youth?
Publisher: American Medical Association (AMA)
Date: 02-2017
Prescription Drug Utilization Following Patient Co-Payment Changes in Australia
Publisher: Wiley
Date: 11-1996
DOI: 10.1002/(SICI)1099-1557(199611)5:6<385::AID-PDS246>3.0.CO;2-8
A first pass, using pre‐history and contemporary history, at understanding why Australia and England have such different policies towards electronic nicotine delivery systems, 1970s–c. 2018
Publisher: Wiley
Date: 19-01-2021
DOI: 10.1111/ADD.15391
Abstract: The United Kingdom and Australia have developed highly ergent policy responses to electronic nicotine delivery systems (ENDS). To understand the historical origins of these differences, we describe the history of tobacco control in each country and the key roles played in setting ENDS policy in its early stages by public health regulations and policy networks, anti‐smoking organizations, ‘vaper’ activist networks and advocates of harm reduction policies towards injecting drug use. We analysed key government reports, policy statements from public health bodies and non‐government organizations (e.g. cancer councils and medical organizations) on ENDS submissions to an Australian parliamentary inquiry media coverage of policy debates in medical journals and the history of tobacco control policy in Australia and England. Key discourses about ENDS were identified for each country. These were compared across countries during a multi‐day face‐to‐face meeting, where consensus was reached on the key commonalities and ergences in historical approaches to nicotine policy. This paper focuses on England, as different policy responses were apparent in constituent countries of the United Kingdom, and Scotland in particular. Policymakers in Australia and England differ markedly in the priority that they have given to using ENDS to promote smoking cessation or restricting smokers’ access to prevent uptake among young people. In understanding the origins of these ergent responses, we identified the following key differences between the two countries’ approaches to nicotine regulation: an influential scientific network that favoured nicotine harm reduction in the United Kingdom and the absence of such a network in Australia the success of different types of health activism both in England and in Europe in opposing more restrictive policies and the greater influence on policy in England of the field of illicit drug harm reduction. An understanding of the different policy responses to electronic nicotine delivery systems (ENDS) in England and Australia requires an appreciation of how actors within the different policy structures, scientific networks and activist organizations in each country and region have interpreted the evidence and the priority that policymakers have given to the competing goals of preventing adolescent uptake and encouraging smokers to use ENDS to quit smoking.
Quantification of physical illness in psychiatric research in the elderly
Publisher: Wiley
Date: 05-1990
Overdose among heroin users in Sydney, Australia: II. Responses to overdose
Publisher: Wiley
Date: 03-1996
Framing tobacco dependence as a brain disease
Publisher: Oxford University Press (OUP)
Date: 21-01-2017
DOI: 10.1093/NTR/NTX006
Abstract: Like other forms of drug dependence, tobacco dependence is increasingly being described as a "chronic brain disease." The potential consequences of this medical labelling have been examined in relation to other addictions, but the implications for tobacco control have been neglected. Some have posited that biomedical conceptions of addiction will reduce stigma and increase uptake of efficacious treatments. Others have countered that it could increase stigma, reduce treatment seeking, and deter unassisted quitting. We explored how smokers respond to the labelling of smoking as a brain disease. Semi-structured interviews with 29 Australian smokers recruited using purposive s ling. Thematic analysis was used to analyze the results. Most participants questioned the accuracy of the brain disease label as applied to smoking. They believed that smoking was not a chronic disease because they perceived smoking to be an in idual's choice. In addition, many believed that this label would increase the stigma that they already felt and, did not want to adopt a "sick role" in relation to their smoking. Describing smoking as a brain disease is more likely to alienate smokers than to engage them in quitting. The application of overly medical labels of smoking are inconsistent with smokers own conceptualizations of their smoking, and may have unintended consequences if they are widely disseminated in healthcare settings or antismoking c aigns. The participants in this project believed that biomedical labels of smoking as a "brain disease" or a "chronic disease" were discordant their existing understandings of their smoking. Explanations of addiction that downplay or ignore the role of choice and autonomy risk being perceived as irrelevant by smokers, and could lead to suspicion of health professionals or an unwillingness to seek treatment.
The genetics of nicotine addiction liability: ethical and social policy implications
Publisher: Wiley
Date: 09-01-2008
DOI: 10.1111/J.1360-0443.2007.02070.X
Abstract: To assess the promise and risks of technological applications of genetic research on liability to develop nicotine dependence. We reviewed (i) the evidence on the genetics of nicotine dependence (ii) the technical feasibility of using genetic information to reduce smoking uptake and increase cessation and (iii) policy and ethical issues raised by the uses of genetic information on addiction liability. (i) Despite evidence from twin studies that genes contribute to addiction susceptibility, research to date has not identified commonly occurring alleles that are strongly predictive of developing nicotine addiction. Nicotine addiction is likely to involve multiple alleles of small effect that interact with each other and with the environment. (ii) Population screening for susceptibility alleles is unlikely to be effective or cost-effective. Tailoring of smoking cessation treatments with genetic information is more plausible but results to date have been disappointing. Population health strategies such as increased taxation and reduced opportunities to smoke are more efficient in reducing cigarette smoking. Tobacco harm reduction policies applied to populations may also play a role in reducing tobacco-related harm. (iii) Future uses of genomic information on addiction risk will need to assess the risks of medicalising addiction (e.g. pessimism about capacity to quit) and community concerns about genetic privacy. Nicotine genomics is a very new and underdeveloped field. On the evidence to date, its advocates would be wise to avoid extravagant claims about its preventive applications.
The use of asthma and allergy medicines is associated with exposure to smoking
Publisher: Springer Science and Business Media LLC
Date: 20-04-2023
Is There Evidence of ‘Hardening’ Among Australian Smokers Between 1997 and 2007? Analyses of the Australian National Surveys of Mental Health and Well-Being
Publisher: SAGE Publications
Date: 12-2010
DOI: 10.3109/00048674.2010.520116
Abstract: Objectives: To use data from the 1997 and 2007 National Surveys of Mental Health and Well-Being (NSMHWB) to assess whether Australian smokers in 2007 have higher rates of mental distress and social disadvantage than smokers in 1997. Method: We compared symptoms of mental distress and social disadvantage in Australian smokers in the 1997 and 2007 National Surveys of Mental Health and Well-Being (N = 10 373 in 1997 and N = 8135 in 2007). Both surveys used multistage probability s les of Australians living in private dwellings. Participants were classified into smokers and non-smokers (which included former and never smokers). We used the Kessler 10 (K10) symptom score to classify smokers into three levels of psychological distress (low, medium or high) and socioeconomic disadvantage was measured using an area-based index of relative disadvantage converted into quintiles. We used logistic regressions to: (i) examine associations between smoking status (smoker/non-smoker) and psychological distress and socioeconomic disadvantage in 1997 and 2007 surveys and (ii) to test whether the prevalence of psychological distress and social disadvantage among smokers increased between 1997 and 2007. Results: Psychological distress and social disadvantage were more common among smokers than non-smokers in both surveys but there was no evidence that the prevalence of psychological distress or social disadvantage was more common among smokers in 2007 than in 1997. Conclusion: We find no evidence that the declining smoking prevalence in Australia (over the last decade) has been accompanied by a ‘hardening’ of continuing smokers in terms of rates of mental disorders and socioeconomic disadvantage.
Monitoring substance use in prisons: Assessing the potential value of wastewater analysis
Publisher: Elsevier BV
Date: 09-2014
DOI: 10.1016/J.SCIJUS.2014.06.006
Abstract: Prison substance use is a major concern for prison authorities and the wider community. Australia has responded to this problem by implementing the National Corrections Drug Strategy. Across Australia, the true extent of prison substance use cannot be determined. As a result, the effectiveness of the interventions employed as part of this strategy cannot be properly assessed. This has important implications for the allocation of corrective services resources and future policy development. This article explores the benefits and limitations, as well as the ethical and practical issues in using wastewater analysis (WWA) to measure levels of substance use in prisons. It reports results from the first application of WWA to an Australian prison, which supports the use of WWA in this context. Given the increasing concern for prescription misuse in prisons, we also highlight the novel use of WWA to measure the extent of prescription misuse by prisoners. The article concludes that as a result of its objectivity, sensitivity and cost-effectiveness, the use of WWA in prisons warrants further consideration in Australia.
Evidence for cannabis and cannabinoids for epilepsy: a systematic review of controlled and observational evidence
Publisher: BMJ
Date: 06-03-2018
Abstract: Review evidence for cannabinoids as adjunctive treatments for treatment-resistant epilepsy. Systematic search of Medline, Embase and PsycINFO was conducted in October 2017. Outcomes were: 50%+ seizure reduction, complete seizure freedom improved quality of life (QoL). Tolerability/safety were assessed by study withdrawals, adverse events (AEs) and serious adverse events (SAEs). Analyses were conducted in Stata V.15.0. 36 studies were identified: 6 randomised controlled trials (RCTs), 30 observational studies. Mean age of participants was 16.1 years (range 0.5–55 years). Cannabidiol (CBD) 20 mg/kg/day was more effective than placebo at reducing seizure frequency by 50%+(relative risk (RR) 1.74, 95% CI 1.24 to 2.43, 2 RCTs, 291 patients, low Grades of Recommendation, Assessment, Development and Evaluation (GRADE) rating). The number needed to treat for one person using CBD to experience 50%+ seizure reduction was 8 (95% CI 6 to 17). CBD was more effective than placebo at achieving complete seizure freedom (RR 6.17, 95% CI 1.50 to 25.32, 3 RCTs, 306 patients, low GRADE rating), and improving QoL (RR 1.73, 95% CI 1.33 to 2.26), however increased risk of AEs (RR 1.24, 95% CI 1.13 to 1.36) and SAEs (RR 2.55, 95% CI 1.48 to 4.38). Pooled across 17 observational studies, 48.5% (95% CI 39.0% to 58.1%) of patients reported 50%+ reductions in seizures in 14 observational studies 8.5% (95% CI 3.8% to 14.5%) were seizure-free. Twelve observational studies reported improved QoL (55.8%, 95% CI 40.5 to 70.6) 50.6% (95% CI 31.7 to 69.4) AEs and 2.2% (95% CI 0 to 7.9) SAEs. Pharmaceutical-grade CBD as adjuvant treatment in paediatric-onset drug-resistant epilepsy may reduce seizure frequency. Existing RCT evidence is mostly in paediatric s les with rare and severe epilepsy syndromes RCTs examining other syndromes and cannabinoids are needed. CRD42017055412.
Cocaine, MDMA and methamphetamine residues in wastewater: Consumption trends (2009–2015) in South East Queensland, Australia
Publisher: Elsevier BV
Date: 10-2016
DOI: 10.1016/J.SCITOTENV.2016.05.181
Abstract: Wastewater analysis, or wastewater-based epidemiology, has become a common tool to monitor trends of illicit drug consumption around the world. In this study, we examined trends in cocaine, 3,4-methylenedioxymeth hetamine (MDMA) and meth hetamine consumption by measuring their residues in wastewater from two wastewater treatment plants in Australia (specifically, an urban and a rural catchment, both in South East Queensland) between 2009 and 2015. With direct injection of the s les, target analytes were identified and quantified using liquid chromatography-mass spectrometry. Cocaine and MDMA residues and metabolites were mainly quantifiable in the urban catchment while meth hetamine residues were consistently detected in both urban and rural catchments. There was no consistent trend in the population normalised mass loads observed for cocaine and MDMA at the urban site between 2009 and 2015. In contrast, there was a five-fold increase in meth hetamine consumption over this period in this catchment. For meth hetamine consumption, the rural area showed a very similar trend as the urban catchment starting at a lower baseline. The observed increase in per capita loads of meth hetamine via wastewater analysis over the past six years in South East Queensland provides objective evidence for increased meth hetamine consumption in the Australian population while the use of other illicit stimulants remained relatively stable.
A prospectus for ethical analysis of ageing individuals' responsibility to prevent cognitive decline
Publisher: Wiley
Date: 04-10-2017
DOI: 10.1111/BIOE.12387
Abstract: As the world's population ages, governments and non-governmental organizations in developed countries are promoting healthy cognitive ageing to reduce the rate of age-related cognitive decline and sustain economic productivity in an ageing workforce. Recommendations from the Productivity Commission (Australia), Dementia Australia, Government Office for Science (UK), Presidential Commission for the Study of Bioethical Issues (USA), Institute of Medicine (USA), among others, are encouraging older adults to engage in mental, physical, and social activities. These lifestyle recommendations for healthy cognitive ageing are timely and well supported by scientific evidence but they make implicit normative judgments about the responsibility of ageing in iduals to prevent cognitive decline. Ethical tensions arise when this in idual responsibility collides with social and personal realities of ageing populations. First, we contextualize the priority given to healthy cognitive ageing within the current brain-based medical and social discourses. Second, we explore the in idual responsibility by examining the economic considerations, medical evidence and in idual interests that relate to the priority given to healthy cognitive ageing. Third, we identify three key ethical challenges for policymakers seeking to implement lifestyle recommendations as an effective population-level approach to healthy cognitive ageing. The result is a prospectus for future in-depth analysis of ethical tensions that arise from current policy discussions of healthy cognitive ageing.
Socio‐economic differentials in cannabis use trends in Australia
Publisher: Wiley
Date: 14-09-2017
DOI: 10.1111/ADD.14010
Abstract: To test if the degree of change in cannabis use between 2001 and 2013 differed according to socio-economic status. Repeated cross-sectional household surveys that were nationally representative. Australia. Adult s les from the 2001 and 2013 National Drug Strategy Household Surveys (n = 23 642 in 2001 and n = 21 353 in 2013), the largest nationally representative survey on drug use in Australia. Frequency of cannabis use coded as daily use, weekly use, less than weekly use and non-current use socio-economic status (SES) as measured by personal income and educational level. There were significant differences in changes to levels of cannabis use between SES groups. Among participants who completed high school, the probability of daily use decreased from 0.014 to 0.009 (P < 0.001), and the probability of weekly use decreased from 0.025 to 0.017 (P < 0.001). These probabilities remained stable for participants who did not complete high school. The probability of weekly cannabis use decreased from 0.032 to 0.023 among participants with middle level income (P = 0.004), and from 0.021 to 0.013 among those with high income (P = 0.005). There were no significant changes in these probabilities among those with low income (0.026 in 2001 and 0.032 in 2013 P = 0.203). The decline in cannabis use in Australia from 2001 to 2013 occurred largely among higher socio-economic status groups. For people with lower income and/or lower education, rates of frequent cannabis use remained unchanged.
A qualitative study of smokers' views on brain-based explanations of tobacco dependence
Publisher: Elsevier BV
Date: 03-2016
DOI: 10.1016/J.DRUGPO.2015.12.011
Abstract: The role the brain plays in the creation and maintenance of tobacco dependence has become increasingly prominent in explanations of smoking that are presented to the public. The potential for brain-based explanations of smoking to influence smokers' understandings of their addiction, their sense of self-efficacy, and perhaps even their treatment preferences, has been raised by some working in the addiction field. However, little empirical evidence exists in this area. This paper reports on semi-structured interviews with 29 daily smokers. Participants were shown a brief presentation about the neuroscience of nicotine dependence. They were then queried about their awareness of the role of the brain in smoking, and the consequences of this knowledge for their understandings of smoking and their treatment preferences. Our results indicated that many participants displayed some awareness of the link between the brain and addiction. While there was a ersity of ideas about the potential impacts of neuroscience knowledge about smoking, there was an overall tendency to maintain pre-existing treatment preferences, and to assert in idual responsibility for smoking. Emergent themes that arose were the brain as a special organ, the discourse of the "other" smoker, and the distinction between physical and psychological facets of addiction. While brain-based explanations of smoking are unlikely to revolutionise lay understandings of smoking, neuroscience information should be presented in a way that does not negate people's sense of agency and self-efficacy in relation to quitting smoking.
Heroin use in New South Wales, Australia, 1996-2000: 5 year monitoring of trends in price, purity, availability and use from the Illicit Drug Reporting System (IDRS)
Publisher: Wiley
Date: 02-2002
DOI: 10.1046/J.1360-0443.2002.00032.X
Abstract: To document trends in the price, purity, availability and use of heroin in New South Wales detected by the Illicit Drug Reporting System (IDRS) between 1996 and 2000, and to demonstrate the utility of the IDRS in identifying such trends. The IDRS compares information derived from interviews with injecting drug users, key informants who work in the illicit drugs field, and key indicator data on illicit drug trends. New South Wales, Australia. The price of heroin approximately halved over this period, from a median of A$400 per gram in 1996 to A$220 per gram in 2000. While the price of heroin fell dramatically over the study period, the purity of police seizures of the drug was high across all years, ranging between 62% and 71%. In all years heroin was considered easy to obtain by both heroin users who purchased the drug, and by key informants from the law enforcement and health fields. Concurrent with the large fall in heroin prices, there appeared to have been an increase in the number of heroin users. Between 1997 and 1998 there was a sharp increase in the injecting use of cocaine by heroin users in NSW, a pattern that has persisted. Regular and formal monitoring of illicit drug trends provides timely data in a systematic way to inform health and law enforcement policies towards current and emerging illicit drug problems.
Increased barbiturate deaths: an unintended consequence of increased publicity for methods of do‐it‐yourself euthanasia?
Publisher: Wiley
Date: 11-08-2021
DOI: 10.1111/ADD.15573
Researchers’ perspectives on scientific and ethical issues with transcranial direct current stimulation: An international survey
Publisher: Springer Science and Business Media LLC
Date: 12-06-2015
DOI: 10.1038/SREP10618
Abstract: In the last decade, an increasing number of studies have suggested that transcranial direct current stimulation (tDCS) may enhance brain function in healthy in iduals and ameliorate cognitive and other symptoms in patients suffering from various medical conditions. This, along with its presumed safety, simplicity and affordability, has generated great enthusiasm amongst researchers, clinicians, patient populations and the public (including a growing “do-it-yourself” community). However, discussion about the effectiveness and ethics of tDCS thus far has been confined to small groups of tDCS researchers and bioethicists. We conducted an international online survey targeting the opinions of researchers using tDCS who were asked to rate the technique’s efficacy in different contexts. We also surveyed opinions about ethical concerns, self-enhancement and public availability. 265 complete responses were received and analyzed statistically and thematically. Our results emphasize the potential uses of tDCS in clinical and research contexts, but also highlight a number of emerging methodological and safety concerns, ethical challenges and the need for improved communication between researchers and bioethicists with regard to regulation of the device. Neither the media reputation of tDCS as a “miracle device” nor concerns expressed in recent neuroethical publications were entirely borne out in expert opinion.
Analysis of socio-political and health practices influencing sex ratio at birth in Viet Nam
Publisher: Informa UK Limited
Date: 2008
Ethical issues in using a cocaine vaccine to treat and prevent cocaine abuse and dependence
Publisher: BMJ
Date: 08-2004
Abstract: A "cocaine vaccine" is a promising immunotherapeutic approach to treating cocaine dependence which induces the immune system to form antibodies that prevent cocaine from crossing the blood brain barrier to act on receptor sites in the brain. Studies in rats show that cocaine antibodies block cocaine from reaching the brain and prevent the reinstatement of cocaine self administration. A successful phase 1 trial of a human cocaine vaccine has been reported. The most promising application of a cocaine vaccine is to prevent relapse to dependence in abstinent users who voluntarily enter treatment. Any use of a vaccine to treat cocaine addicts under legal coercion raises major ethical issues. If this is done at all, it should be carefully trialled first, and only after considerable clinical experience has been obtained in using the vaccine to treat voluntary patients. There will need to be an informed community debate about what role, if any, a cocaine vaccine may have as a way of preventing cocaine addiction in children and adolescents.
Beyond the Right to Injectable Heroin
Publisher: Informa UK Limited
Date: 10-02-2010
Accurate identification of opioid overdose deaths using coronial data
Publisher: Elsevier BV
Date: 06-2018
DOI: 10.1016/J.FORSCIINT.2018.03.032
Abstract: Defining drug-related mortality is complex as these deaths can include a wide range of diseases and circumstances. This paper outlines a method to identify deaths that are directly due to fatal opioid toxicity (i.e. overdose), utilising coronial data. The National Coronial Information System (NCIS), an online coronial database containing information on all deaths that are reported to a coroner in Australia, is used to develop methods to more accurately identify opioid overdose deaths. The NCIS contains demographic information, Medical Cause of Death, and associated documentation on toxicology, clinical and police investigations. Identifying overdose deaths using the coroner determined Medical Cause of Death provided greater capture, and specificity, of opioid overdose deaths. Distinguishing morphine from heroin-related deaths presented challenges, requiring analysis of clinical and investigative information in addition to toxicology results. One-quarter of the deaths attributed to morphine were recorded to heroin as a result of further investigation. There was also some underestimation of codeine-related deaths. Access to clinical and investigative information also yields important information in relation to comorbid conditions among these decedents, such as history of chronic pain, substance use issues and mental health problems. Reliance on toxicology results alone leads to an underestimate of heroin-related deaths. Differentiating between heroin and pharmaceutical opioid (e.g. morphine) overdose deaths has important public health and policy implications, particularly in relation to prescribing practices and development of a strategic response. Understanding comorbidities among these decedents is also important in efforts to reduce preventable causes of death such as opioid overdose.
Polysubstance Use in Cannabis Users Referred for Treatment: Drug Use Profiles, Psychiatric Comorbidity and Cannabis-Related Beliefs
Publisher: Frontiers Media SA
Date: 2013
Cannabis and cannabinoids for the treatment of people with chronic noncancer pain conditions: a systematic review and meta-analysis of controlled and observational studies
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 25-05-2018
DOI: 10.1097/J.PAIN.0000000000001293
Abstract: This review examines evidence for the effectiveness of cannabinoids in chronic noncancer pain (CNCP) and addresses gaps in the literature by: considering differences in outcomes based on cannabinoid type and specific CNCP condition including all study designs and following IMMPACT guidelines. MEDLINE, Embase, PsycINFO, CENTRAL, and clinicaltrials.gov were searched in July 2017. Analyses were conducted using Revman 5.3 and Stata 15.0. A total of 91 publications containing 104 studies were eligible (n = 9958 participants), including 47 randomised controlled trials (RCTs) and 57 observational studies. Forty-eight studies examined neuropathic pain, 7 studies examined fibromyalgia, 1 rheumatoid arthritis, and 48 other CNCP (13 multiple sclerosis–related pain, 6 visceral pain, and 29 s les with mixed or undefined CNCP). Across RCTs, pooled event rates (PERs) for 30% reduction in pain were 29.0% (cannabinoids) vs 25.9% (placebo) significant effect for cannabinoids was found number needed to treat to benefit was 24 (95% confidence interval [CI] 15-61) for 50% reduction in pain, PERs were 18.2% vs 14.4% no significant difference was observed. Pooled change in pain intensity (standardised mean difference: −0.14, 95% CI −0.20 to −0.08) was equivalent to a 3 mm reduction on a 100 mm visual analogue scale greater than placebo groups. In RCTs, PERs for all-cause adverse events were 81.2% vs 66.2% number needed to treat to harm: 6 (95% CI 5-8). There were no significant impacts on physical or emotional functioning, and low-quality evidence of improved sleep and patient global impression of change. Evidence for effectiveness of cannabinoids in CNCP is limited. Effects suggest that number needed to treat to benefit is high, and number needed to treat to harm is low, with limited impact on other domains. It seems unlikely that cannabinoids are highly effective medicines for CNCP.
Drug use and drug dependence
Publisher: Cambridge University Press
Date: 18-09-2008
Ensuring access to safe, effective, and affordable cannabis‐based medicines
Publisher: Wiley
Date: 03-03-2020
DOI: 10.1111/BCP.14242
How do we define the policy impact of public health research? A systematic review
Publisher: Springer Science and Business Media LLC
Date: 02-10-2017
Avoiding Selective Ethical Objections to Nudges
Publisher: Informa UK Limited
Date: 02-2012
Stimulant use disorders in people with psychosis: A meta-analysis of rate and factors affecting variation
Publisher: SAGE Publications
Date: 17-12-2015
Abstract: Stimulant abuse and dependence often complicate the care of people with psychotic disorders. This study systematically reviews the prevalence estimates reported for stimulant abuse and dependence in people with psychotic disorders, and examines personal, clinical, regional and methodological factors which explain variation in these rates. PsychINFO, EMBASE and MEDLINE (1946–2013) were searched systematically for studies reporting on stimulant drug use disorders in representative s les of people with psychotic disorders. Random effects models estimated the pooled rate of a stimulant use disorder, defined to include stimulant abuse and stimulant dependence. Study characteristics associated with heterogeneity in rates of stimulant use disorder were examined by subgroup analyses for categorical variables, by meta-regression for continuous independent variables and by multiple meta-regression. Sixty-four studies provided 68 estimates of lifetime or recent stimulant use disorders in 22,500 people with psychosis. The pooled rate of stimulant use disorder was 8.9% (95% CI 7.4%, 10.5%). Higher rates of stimulant use disorders were reported in studies of affective psychosis, studies from inpatient settings, studies from the USA and Australia, and studies with higher rates of cannabis disorder in multiple meta-regression analysis these factors explained 68% of between-study variance. Rates of stimulant use disorder were stable over time, and unrelated to age, sex, stage of psychosis, type of stimulant drug or study methodology factors. Reported rates of stimulant use disorder in people with psychosis are much higher than in the general population but vary widely and are associated with regional, service setting and clinical differences between studies. It is likely that stimulants contribute to the overall burden of psychosis, and that social and environmental factors combine with drug and illness-related factors to influence stimulant use in psychosis.
An overview of diversion strategies for Australian drug-related offenders
Publisher: Wiley
Date: 09-2001
Do Neurobiological Understandings of Smoking Influence Quitting Self-Efficacy or Treatment Intentions?
Publisher: Oxford University Press (OUP)
Date: 22-06-2018
DOI: 10.1093/NTR/NTX144
Abstract: Addiction is increasingly defined as a "brain disease" caused by changes to neurochemistry. While nicotine addiction has historically been excluded in the brain disease model of addiction (BDMA), it is beginning to be labeled a chronic brain disease. We investigated whether Australian smokers endorse brain-based explanations of smoking, and whether these beliefs are associated with quitting self-efficacy or treatment intentions. Cross-sectional study of Australian smokers (N = 1538) who completed a survey measuring their agreement with statements on the brain's role in smoking. Logistic regressions tested associations between these items and socio-demographic variables, quitting self-efficacy and intention to use cessation medications. The majority (57.9%) agreed that smoking changed brain chemistry and 34.4% agreed that smoking was a brain disease. Younger participants and those with more education were more likely to endorse brain-based understandings of smoking. Participants who agreed smoking changed brain chemistry were more likely to report an intention to use cessation medicines (OR 1.5, 95% CI = 1.0-2.2) as were those who agreed that smoking was a brain disease (OR 1.5, 95% CI = 1.1-2.1). Self-efficacy did not differ between those who agreed and disagreed that smoking changed brain chemistry. However, those who agreed that smoking was a brain disease had higher self-efficacy than those who disagreed (OR 1.7, 95% CI = 1.3-2.3). A neurobiological view of smoking does not dominate public understandings of smoking in Australia. Endorsement of neurobiological explanations of smoking were associated with increased intention to use cessation aids, but were not associated with reduced self-efficacy. Explaining tobacco dependence in neurobiological terms is unlikely to induce feelings of fatalism in relation to smoking cessation. Those who endorse biomedical explanations of smoking may be more open to using cessation pharmacotherapies. Describing smoking in terms of alterations in brain chemistry may be more acceptable to smokers than labeling smoking a "brain disease" or "brain disorder."
Global statistics on alcohol, tobacco and illicit drug use: 2017 status report
Publisher: Wiley
Date: 04-06-2018
DOI: 10.1111/ADD.14234
Abstract: This review provides an up-to-date curated source of information on alcohol, tobacco and illicit drug use and their associated mortality and burden of disease. Limitations in the data are also discussed, including how these can be addressed in the future. Online data sources were identified through expert review. Data were obtained mainly from the World Health Organization, United Nations Office on Drugs and Crime and Institute for Health Metrics and Evaluation. In 2015, the estimated prevalence among the adult population was 18.4% for heavy episodic alcohol use (in the past 30 days) 15.2% for daily tobacco smoking and 3.8, 0.77, 0.37 and 0.35% for past-year cannabis, hetamine, opioid and cocaine use, respectively. European regions had the highest prevalence of heavy episodic alcohol use and daily tobacco use. The age-standardized prevalence of alcohol dependence was 843.2 per 100 000 people for cannabis, opioids, hetamines and cocaine dependence it was 259.3, 220.4, 86.0 and 52.5 per 100 000 people, respectively. High-income North America region had among the highest rates of cannabis, opioid and cocaine dependence. Attributable disability-adjusted life-years (DALYs) were highest for tobacco smoking (170.9 million DALYs), followed by alcohol (85.0 million) and illicit drugs (27.8 million). Substance-attributable mortality rates were highest for tobacco smoking (110.7 deaths per 100 000 people), followed by alcohol and illicit drugs (33.0 and 6.9 deaths per 100 000 people, respectively). Attributable age-standardized mortality rates and DALYs for alcohol and illicit drugs were highest in eastern Europe attributable age-standardized tobacco mortality rates and DALYs were highest in Oceania. In 2015 alcohol use and tobacco smoking use between them cost the human population more than a quarter of a billion disability-adjusted life years, with illicit drugs costing further tens of millions. Europeans suffered proportionately more, but in absolute terms the mortality rate was greatest in low- and middle-income countries with large populations and where the quality of data was more limited. Better standardized and rigorous methods for data collection, collation and reporting are needed to assess more accurately the geographical and temporal trends in substance use and its disease burden.
Assessing the place of neurobiological explanations in accounts of a family member's addiction
Publisher: Wiley
Date: 31-08-2015
DOI: 10.1111/DAR.12318
Abstract: The brain disease model of addiction posits that addiction is a persistent form of neural dysfunction produced by chronic drug use, which makes it difficult for addicted persons to become and remain abstinent. As part of an anticipatory policy analysis of addiction neuroscience, we engaged family members of addicted in iduals to assess their views on the place and utility of brain-based accounts of addiction. Fifteen in-depth qualitative interviews were conducted and used to develop a quantitative online survey that was completed by 55 family members. This article reports responses on what addiction is and how it is caused and responses to explanations of the brain disease model of addiction. Participants gave multiple reasons for their family members developing an addiction and there was no single dominant belief about the best way to describe addiction. Participants emphasised the importance of both scientific and non-scientific perspectives on addiction by providing multifactorial explanations of their family members' addictions. Most family members acknowledged that repeated drug use can cause changes to the brain, but they varied in their reactions to labelling addiction a 'brain disease'. They believed that understanding addiction, and how it is caused, could help them support their addicted relative. Participants' beliefs about neurobiological information and the brain disease model of addiction appeared to be driven by empathetic, utilitarian considerations rather than rationalist ones. We discuss the importance of providing information about the nature and causes of addiction. [Meurk C, Fraser D, Weier M, Lucke J, Carter A, Hall W. Assessing the place of neurobiological explanations in accounts of a family member's addiction. Drug Alcohol Rev 2016 :461-469].
An analysis of policy levers used to implement mental health reform in Australia 1992-2012
Publisher: Springer Science and Business Media LLC
Date: 06-2015
Debunking Alarmist Objections to the Pharmacological Prevention of PTSD
Publisher: Informa UK Limited
Date: 14-09-2007
Effects of seascape connectivity on reserve performance along exposed coastlines
Publisher: Wiley
Date: 18-12-2018
DOI: 10.1111/COBI.13237
Abstract: Seascape connectivity (landscape connectivity in the sea) can modify reserve performance in low-energy marine ecosystems (e.g., coral reefs, mangroves, and seagrass), but it is not clear whether similar spatial linkages also shape reserve effectiveness on high-energy, exposed coastlines. We used the surf zones of ocean beaches in eastern Australia as a model system to test how seascape connectivity and reserve attributes combine to shape conservation outcomes. Spatial patterns in fish assemblages were measured using baited remote underwater video stations in 12 marine reserves and 15 fished beaches across 2000 km of exposed coastline. Reserve performance was shaped by both the characteristics of reserves and the spatial properties of the coastal seascapes in which reserves were embedded. Number of fish species and abundance of harvested fishes were highest in surf-zone reserves that encompassed >1.5 km of the surf zone were located < 100 m to rocky headlands and included pocket beaches in a heterogeneous seascape. Conservation outcomes for exposed coastlines may, therefore, be enhanced by prioritizing sufficiently large areas of seascapes that are strongly linked to abutting complementary habitats. Our findings have broader implications for coastal conservation planning. Empirical data to describe how the ecological features of high-energy shorelines influence conservation outcomes are lacking, and we suggest that seascape connectivity may have similar ecological effects on reserve performance on both sheltered and exposed coastlines.
Trend in alcohol use in Australia over 13 years: has there been a trend reversal?
Publisher: Springer Science and Business Media LLC
Date: 10-10-2016
Defined daily doses (DDD) do not accurately reflect opioid doses used in contemporary chronic pain treatment
Publisher: Wiley
Date: 19-01-2017
DOI: 10.1002/PDS.4168
Abstract: To assess how well the defined daily dose (DDD) metric reflects opioid utilisation among chronic non-cancer pain patients. Descriptive, cross-sectional study, utilising a 7-day medication diary. Community-based treatment settings, Australia. A s le of 1101 people prescribed opioids for chronic non-cancer pain. Opioid dose data was collected via a self-completed 7-day medication diary capturing names, strengths and doses of each medication taken in the past week. Median daily dose was calculated for each opioid. Comparisons were made to the World Health Organization's (WHO) DDD metric. WHO DDDs ranged from 0.6 to 7.1 times the median opioid doses used by the s le. For transdermal fentanyl and oral hydromorphone, the median dose was comparable with the DDD. The DDD for methadone was 0.6 times lower than the median doses used by this s le of chronic pain patients. In contrast, the DDD for oxycodone and transdermal buprenorphine, the most commonly used strong opioids for chronic pain in Australia, was two to seven times higher than actual doses used. For many opioids, there are key differences between the actual doses used in clinical practice and the WHO's DDDs. The interpretation of opioid utilisation studies using population-level DDDs may be limited, and a recalibration of the DDD for many opioids or the reporting of opioid utilisation in oral morphine equivalent doses is recommended. Copyright © 2017 John Wiley & Sons, Ltd.
Treatment rates for alcohol use disorders: a systematic review and meta‐analysis
Publisher: Wiley
Date: 12-01-2021
DOI: 10.1111/ADD.15357
Abstract: To estimate the treatment rate for alcohol use disorders (AUDs) in the general adult population. Treatment rates were also considered in relation to economic differences. Systematic review and meta‐analysis. We searched PubMed, EMBASE, PsycINFO and CINAHL databases to identify studies that reported treatment rates for alcohol use disorders in the general population. Independent reviewers screened the articles based on predefined inclusion criteria. Data were extracted using a standardized data extraction form. We conducted quality assessments of the included studies. The overall treatment rates were estimated from studies that reported any treatment for AUDs from healthcare or informal non‐healthcare settings (any treatment). We estimated the separate treatment rates for each diagnostic category as reported in the primary studies: AUD as a single disorder, alcohol abuse and alcohol dependence. Data were pooled using a random‐effect model. Thirty‐two articles were included to estimate the treatment rates (percentage treated among the total number of people with AUDs). The pooled estimate of people with AUDs who received any treatment were 14.3% (95% CI: 9.3–20.3%) for alcohol abuse, 16.5% (95% CI: 12–21.5%) for alcohol dependence and 17.3% (95% CI: 12.8–22.3%) for AUD. A subgroup analysis by World Bank economic classification of countries found that the treatment rate for AUD was 9.3% (95% CI: 4.0–15.7%) in low and lower‐middle‐income countries. Globally, approximately one in six people with AUDs receives treatment. Treatment rates for AUDs are generally low, with even lower rates in low and lower‐middle‐income countries.
Harm reduction policies for tobacco users
Publisher: Elsevier BV
Date: 03-2010
DOI: 10.1016/J.DRUGPO.2009.10.008
Abstract: Tobacco harm reduction is a controversial policy due to the experience with filtered and 'light' cigarettes and concerns that the tobacco industry will use reduced harm products to undermine tobacco control strategies. The most promising harm reduction products are high dose pharmaceutical nicotine preparations and low nitrosamine smokeless tobacco, such as Swedish snus. However, despite widespread availability, existing pharmaceutical nicotine preparations have not been taken up by smokers as an alternative to smoking. In Sweden, increased snus use was associated with decreased cigarette smoking and mortality from tobacco-related disease. We suggest a graduated series of policies to explore of the public health costs and benefits of encouraging smokers to switch to these less harmful nicotine products.
Do not let the ideal be the enemy of good enough regulation
Publisher: Wiley
Date: 23-04-2023
DOI: 10.1111/ADD.16201
[Commentary] THE POTENTIAL ROLE OF SNUS IN TOBACCO HARM REDUCTION
Publisher: Wiley
Date: 03-08-2009
Identifying Trustworthy Experts: How Do Policymakers Find and Assess Public Health Researchers Worth Consulting or Collaborating With?
Publisher: Public Library of Science (PLoS)
Date: 05-03-2012
Thresholds for safer alcohol use might need lowering
Publisher: Elsevier BV
Date: 04-2018
Crystalline methamphetamine use and methamphetamine-related harms in Australia
Publisher: Wiley
Date: 11-06-2017
DOI: 10.1111/DAR.12426
Abstract: Concerns about crystal meth hetamine use and harm have increased in multiple countries. This paper describes how changes in the availability and use of crystal meth hetamine have impacted on meth hetamine-related harms in Australia. Data on meth hetamine use were obtained from population-level surveys, health service data and surveys of drug use among sentinel groups of ecstasy users and people who inject drugs. Data were obtained on seizures, arrests, clandestine laboratory detections, hospital separations, mental health unit admissions, drug telephone helpline calls and drug treatment episodes. Segmented linear regression models were fitted to identify changes in these series using log-transformed data where appropriate. The availability of crystal meth hetamine has increased as evidenced by increased laboratory detections, domestic seizures and purity of the seized drug. Population surveys do not report an increase in the number of people who used at least once in the past year. However, more users report using crystal meth hetamine rather than lower-purity powder meth hetamine and more regular use. Indicators of meth hetamine-related harms have increased in parallel with this change. Amphetamine-related helpline calls, drug treatment, arrests and hospital admissions for hetamine disorders and psychosis all peaked in the mid-2000s, declined for several years and have increased steeply since 2010. The increased availability and use of crystal meth hetamine have been associated with increased regular use and harms. Treatment is required for those experiencing problems and the capacity of health services to provide care needs to be enhanced.[Degenhardt L, Sara G, Connor JP, McKetin R, Roxburgh A, Dobbins T, Farrell M, Burns L, Hall WD. Crystalline meth hetamine use and meth hetamine-related harms in Australia. Drug Alcohol Rev 2017 :160-170].
Substance Use Terminology
Publisher: American Medical Association (AMA)
Date: 21-02-2017
Adverse adult consequences of different alcohol use patterns in adolescence: an integrative analysis of data to age 30 years from four Australasian cohorts
Publisher: Wiley
Date: 19-06-2018
DOI: 10.1111/ADD.14263
Abstract: Studies have linked adolescent alcohol use with adverse consequences in adulthood, yet it is unclear how strong the associations are and to what extent they may be due to confounding. Our aim was to estimate the strength of association between different patterns of adolescent drinking and longer-term psychosocial harms taking into account in idual, family and peer factors. Participant-level data were integrated from four long-running longitudinal studies: Australian Temperament Project, Christchurch Health and Development Study, Mater Hospital and University of Queensland Study of Pregnancy and Victorian Adolescent Health Cohort Study. Australia and New Zealand. Participants were assessed on multiple occasions between ages 13 and 30 years (from 1991 to 2012). Number of participants varied (up to n = 9453) by analysis. Three patterns of alcohol use (frequent, heavy episodic and problem drinking) were assessed prior to age 17. Thirty outcomes were assessed to age 30 spanning substance use and related problems, antisocial behaviour, sexual risk-taking, accidents, socio-economic functioning, mental health and partner relationships. After covariate adjustment, weekly drinking prior to age 17 was associated with a two- to threefold increase in the odds of binge drinking [odds ratio (OR) = 2.14 95% confidence interval (CI) = 1.57-2.90], drink driving (OR = 2.78 95% CI = 1.84-4.19), alcohol-related problems (OR = 3.04 95% CI = 1.90-4.84) and alcohol dependence (OR = 3.30 95% CI = 1.69-6.47) in adulthood. Frequency of drinking accounted for a greater proportion of the rate of most adverse outcomes than the other measures of alcohol use. Associations between frequent, heavy episodic and problem drinking in adolescence and most non-alcohol outcomes were largely explained by shared risk factors for adolescent alcohol use and poor psychosocial functioning. Frequency of adolescent drinking predicts substance use problems in adulthood as much as, and possibly more than, heavy episodic and problem drinking independent of in idual, family and peer predictors of those outcomes.
Assessment of Swedish snus for tobacco harm reduction: an epidemiological modelling study
Publisher: Elsevier BV
Date: 06-2007
Compulsive use of dopamine replacement therapy: a model for stimulant drug addiction?
Publisher: Wiley
Date: 27-07-2012
DOI: 10.1111/J.1360-0443.2011.03511.X
Abstract: The compulsive use of dopamine replacement therapy (DRT) or dopamine dysregulation syndrome (DDS) is one of the behavioural disturbances reported in some patients with Parkinson's disease (PD) and other disorders who are receiving DRT. We draw this phenomenon to the attention of the addiction field as a topic deserving of more systematic study. We outline: the clinical features, epidemiology and clinical correlates of the disorder the unresolved issues in its definition and diagnosis and its potential relevance to neurobiological models of psychostimulant addiction. We argue that compulsive DRT use may provide a useful model for drug addiction, while advancing our understanding of the neurobiology of addiction and improving the management of PD patients with the disorder.
Public policy and the prevention of substance-use disorders
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 05-2002
Technical, Ethical and Social Issues in the Bioprediction of Addiction Liability and Treatment Response
Publisher: Elsevier
Date: 2012
Rural and Urban Differences in Adolescent Alcohol Use, Alcohol Supply, and Parental Drinking
Publisher: Wiley
Date: 08-10-2016
DOI: 10.1111/JRH.12151
Abstract: Alcohol use is more prevalent in rural than urban areas in adult populations. Few studies have focused on adolescent drinking. This study investigated if adolescents in regional and rural areas of Australia were more likely to drink alcohol and if there were differences in parental drinking and alcohol supply across regions. A subs le from the National Drug Strategy Household Survey 2013, the largest nationally representative household survey on drug use in Australia, was used for this study. Participants who were aged 12-17 (N = 1,159) and participants who indicated they were parents or guardians of a dependent child (N = 7,059) were included in the analyses. Key measures were adolescent and parental alcohol use, parental supply of alcohol, and drinking location. Compared to those living in major cities, adolescents from inner regional and rural areas were at 85% and 121% higher odds, respectively, of obtaining their first alcohol from parents, and at 131% and 287% higher odds of currently obtaining their alcohol from their parents. Those from rural areas were at 126% higher odds of drinking in the past 12 months. Parents from inner regional and rural areas were at 45% and 63% higher odds, respectively, of heavy drinking at 27% and 52% higher odds of weekly drinking and at 26% and 37% higher odds of drinking at home. Adolescents from rural areas were at higher risk of alcohol use. Parents in rural areas were more likely to use alcohol in ways that encourage adolescent drinking.
Trajectories of adolescent alcohol and cannabis use into young adulthood
Publisher: Wiley
Date: 12-03-2007
DOI: 10.1111/J.1360-0443.2006.01728.X
Abstract: Both alcohol and cannabis use carry health risks. Both are commonly initiated in adolescence. To date little research has described trajectories of adolescent cannabis or alcohol use or compared their respective consequences in young adulthood. The design was a 10-year eight-wave cohort study of a state-wide community s le of 1943 Victorians initially aged 14-15 years. Moderate- and high-risk alcohol use was defined according to total weekly alcohol consumption. Moderate- and high-risk cannabis use were defined as weekly and daily use, respectively. Around 90% of young adults used either alcohol or cannabis. Although an association existed between alcohol and cannabis use, there was a tendency for heavy users to use one substance predominantly at any one time. Weekly or more frequent cannabis use in the absence of moderate-risk alcohol use in teenagers predicted a sevenfold higher rate of daily cannabis use in young adults but only a twofold increase in high-risk alcohol use. Conversely, moderate-risk adolescent alcohol use in the absence of weekly cannabis predicted an approximately threefold increased rate of both high-risk drinking and daily cannabis use in young adulthood. Selective heavy cannabis use in both adolescence and young adulthood was associated with greater illicit substance use and poorer social outcomes in young adulthood than selective alcohol use. Heavier teenage cannabis users tend to continue selectively with cannabis use. Considering their poor young adult outcomes, regular adolescent cannabis users appear to be on a problematic trajectory.
An Ethical Reevaluation: Where Are the Voices of Those With Anorexia Nervosa and Their Families?
Publisher: Informa UK Limited
Date: 02-10-2015
Lessons from the public health responses to the US outbreak of vaping-related lung injury
Publisher: Wiley
Date: 30-05-2021
DOI: 10.1111/ADD.15108
The use of paracetamol (acetaminophen) among a community sample of people with chronic non-cancer pain prescribed opioids
Publisher: Hindawi Limited
Date: 13-08-2015
DOI: 10.1111/IJCP.12716
Abstract: The regular use of simple analgesics in addition to opioids such as paracetamol (or acetaminophen) is recommended for persistent pain to enhance analgesia. Few studies have examined the frequency and doses of paracetamol among people with chronic non-cancer pain including use above the recommended maximum daily dose. To assess (i) the prevalence of paracetamol use among people with chronic non-cancer pain prescribed opioids, (ii) assess the prevalence of paracetamol use above the recommended maximum daily dose and (iii) assess correlates of people who used paracetamol above the recommended maximum daily dose including: age, gender, income, education, pain severity and interference, use of paracetamol/opioid combination analgesics, total opioid dose, depression, anxiety, pain self-efficacy or comorbid substance use, among people prescribed opioids for chronic non-cancer pain. This study draws on baseline data collected for the Pain and Opioids IN Treatment (POINT) study and utilises data from 962 interviews and medication diaries. The POINT study is national prospective cohort of people with chronic non-cancer pain prescribed opioids. Participants were recruited from randomly selected pharmacies across Australia. Sixty-three per cent of the participants had used paracetamol in the past week (95% CI = 59.7-65.8). Among the paracetamol users 22% (95% CI = 19.3-24.6) had used paracetamol/opioid combination analgesics and 4.8% (95% CI = 3.6-6.3) had used paracetamol above the recommended maximum daily dose (i.e. > 4000 mg/day). Following binomial logistic regression (χ(2) = 25.98, df = 10, p = 0.004), people who had taken above the recommended maximum daily dose were less likely to have low income (AOR = 0.52, 95% CI = 0.27-0.99), more likely to use paracetamol/opioid combination analgesics (AOR = 2.01, 95% CI = 1.02-3.98) and more likely to take a higher opioid dose (AOR = 1.00, 95% CI = 1.00-1.01). The majority of people with chronic non-cancer pain prescribed opioids report using paracetamol appropriately. High income, use of paracetamol/opioid combination analgesics and higher opioid dose were independently associated with paracetamol use above the recommended maximum daily dose.
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View Funded ActivityLinkage Infrastructure, Equipment And Facilities - Grant ID: LE110100032
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View Funded ActivityLinkage Infrastructure, Equipment And Facilities - Grant ID: LE140100129
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