ORCID Profile
0000-0002-8769-1785
Current Organisations
Northern Ontario School of Medicine
,
Canadian Addiction Treatment Centres
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Publisher: Wiley
Date: 2015
Publisher: Informa UK Limited
Date: 15-03-2013
Publisher: Informa UK Limited
Date: 2005
DOI: 10.1081/JA-200042287
Publisher: S. Karger AG
Date: 2014
DOI: 10.1159/000360697
Abstract: Considerable recent attention has focused on how harmful or problematic cannabis use is defined and understood in the literature and put to use in clinical practice. The aim of the current study is to review conceptual and measurement shortcomings in the identification of problematic cannabis use, drawing on the WHO ASSIST instrument for specific ex les. Three issues with the current approach are debated and discussed: (1) the identification of problematic cannabis use disproportionately relies on measures of the frequency of cannabis consumption rather than the harms experienced (2) the quantity consumed on a typical day is not considered when assessing problematic use, and (3) screening tools for problematic use employ a ‘one-size-fits-all approach' and fail to reflect on the drug use context (networks and environment). Our commentary tackles each issue, with a review of relevant literature coupled with analyses of two Canadian data sources - a representative s le of the Canadian adult population and a smaller s le of adult, regular, long-term cannabis users from four Canadian cities - to further articulate each point. This article concludes with a discussion of appropriate treatment interventions and approaches to reduce cannabis-related harms, and offers suggested changes to improve the measurement of problematic cannabis use.
Publisher: Informa UK Limited
Date: 23-06-2011
Publisher: Wiley
Date: 05-2010
Publisher: Springer Science and Business Media LLC
Date: 26-10-2015
Publisher: Elsevier BV
Date: 07-2012
DOI: 10.1016/J.DRUGPO.2011.11.004
Abstract: Needle and syringe programmes (NSPs) have been established as effective harm reduction initiatives to reduce injection drug use (IDU)-related risk behaviours, including sharing needles. On May 31, 2008, Victoria, BC's only fixed site NSP was shut down due to community and political pressure. This study examines and compares IDU trends in Victoria with those in Vancouver, BC, a city which has not experienced any similar disruption of IDU-related public health measures. Quantitative and qualitative data were collected by interviewer-administered questionnaires conducted with injection drug users (n=579) in Victoria and Vancouver between late 2007 and late 2010. Needle sharing increased in Victoria from under 10% in early 2008 to 20% in late 2010, whilst rates remained relatively low in Vancouver. Participants in Victoria were significantly more likely to share needles than participants in Vancouver. Qualitative data collected in Victoria highlight the difficulty participants have experienced obtaining clean needles since the NSP closed. Recent injection of crack cocaine was independently associated with needle sharing. The closure of Victoria's fixed site NSP has likely resulted in increased engagement in high-risk behaviours, specifically needle sharing. Our findings highlight the contribution of NSPs as an essential public health measure.
Publisher: Informa UK Limited
Date: 03-2013
DOI: 10.1080/13691058.2012.754054
Abstract: Research shows that sexual minorities are at greater risk for illicit substance use and related harm than their heterosexual counterparts. This study examines a group of active drug users to assess whether sexual identity predicts increased risk of substance use and harm from ecstasy, ketamine, alcohol, marijuana, cocaine and crack. Structured interviews were conducted with participants aged 15 years and older in Vancouver and Victoria, BC, Canada, during 2008-2012. Harm was measured with the World Health Organization's AUDIT and ASSIST tools. Regression analysis controlling for age, gender, education, housing and employment revealed lesbian, gay or bisexual in iduals were significantly more likely to have used ecstasy, ketamine and alcohol in the past 30 days compared to heterosexual participants. Inadequate housing increased the likelihood of crack use among both lesbian, gay and bisexuals and heterosexuals, but with considerably higher odds for the lesbian, gay and bisexual group. Lesbian, gay and bisexual participants reported less alcohol harm but greater ecstasy and ketamine harm, the latter two categorised by the ASSIST as hetamine and hallucinogen harms. Results suggest encouraging harm reduction among sexual minority, high-risk drug users, emphasising ecstasy and ketamine. The impact of stable housing on drug use should also be considered.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 11-2015
No related grants have been discovered for David C. Marsh.