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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.
Policy and Administration | Public Policy | Causes and Prevention of Crime | Combinatorics and Discrete Mathematics (excl. Physical Combinatorics) | Economic Models And Forecasting | Public Sector Economics | Criminology | Public Policy | Sociology | Sociology and Social Studies of Science and Technology
Public Services Policy Advice and Analysis | Law Enforcement | Economic issues not elsewhere classified | Expanding Knowledge through Studies of Human Society | Substance Abuse | Substance abuse | Crime Prevention |
Publisher: Wiley
Date: 07-2010
DOI: 10.1111/J.1465-3362.2009.00155.X
Abstract: Researchers are often frustrated by their inability to influence policy. We describe models of policy-making to provide new insights and a more realistic assessment of research impacts on policy. We describe five prominent models of policy-making and illustrate them with ex les from the alcohol and drugs field, before drawing lessons for researchers. Policy-making is a complex and messy process, with different models describing different elements. We start with the incrementalist model, which highlights small amendments to policy, as occurs in school-based drug education. A technical/rational approach then outlines the key steps in a policy process from identification of problems and their causes, through to examination and choice of response options, and subsequent implementation and evaluation. There is a clear role for research, as we illustrate with the introduction of new medications, but this model largely ignores the dominant political aspects of policy-making. Such political aspects include the influence of interest groups, and we describe models about power and pressure groups, as well as advocacy coalitions, and the challenges they pose for researchers. These are illustrated with reference to the alcohol industry, and interest group conflicts in establishing a Medically Supervised Injecting Centre. Finally, we describe the multiple streams framework, which alerts researchers to 'windows of opportunity', and we show how these were effectively exploited in policy for cannabis law reform in Western Australia. Understanding models of policy-making can help researchers maximise the uptake of their work and advance evidence-informed policy.
Publisher: Wiley
Date: 09-2008
DOI: 10.1080/09595230802093752
Abstract: Determining prevalence estimates of illicit or stigmatized behaviours is problematic, due to under-reporting and difficulties in s ling adequately populations most at risk of engaging in such behaviours. This has led to the development of indirect prevalence estimation techniques such as multiplier methods, capture-recapture, multivariate indicator methods and back-calculation. This study reports on the development of a treatment multiplier to estimate the number of clients estimated to seek treatment through publicly funded services annually. This study uses a multiplier method of indirect prevalence estimation, using the number of clients receiving publicly funded treatment as the benchmark population. Data for the multiplier were collected through a drug and alcohol telephone information and referral helpline. Participants are callers seeking assistance for their own alcohol use. Results indicate that up to 40 200 in iduals (95% confidence interval: 34 900, 47 000) may seek treatment at these agencies annually. This estimate represents a 300% increase in current publicly funded treatment provision. This method was cost-effective and resulted in estimates similar to those obtained through a population-based survey. This method can be adapted easily to areas with a complete registry of clients receiving publicly funded alcohol or drug treatment services and a helpline service with adequate geographic coverage.
Publisher: Elsevier BV
Date: 09-2004
Publisher: Elsevier BV
Date: 07-2023
Publisher: Wiley
Date: 16-08-2013
DOI: 10.1111/J.1465-3362.2012.00497.X
Abstract: Policy should be informed by the people it directly affects however, the voices of people who use illicit drugs have been marginalised from drug policy debate. In Australia, the majority of survey data regarding attitudes to drug policy are collected at the population level and the opinions of people who inject drugs remain underexplored. This study aimed to investigate how people who inject drugs perceive drug policy in Australia and whether these opinions differ from those of the broader general population. Drug-related policy questions were drawn from the National Drug Strategy Household Survey (NDSHS) and added to the 2011 Illicit Drug Reporting System (IDRS) Survey (n = 868). The results were analysed for the full IDRS s le and by recent drug use. IDRS responses were compared with the general population using the 2010 NDSHS. There was a high level of support among IDRS participants for measures to reduce the problems associated with heroin, but heterogeneity in levels of support for legalisation and penalties for sale/supply across different drug types. Differences between the opinions of the IDRS s le and the NDSHS s le were identified regarding support for harm reduction, treatment, legalisation and penalties for sale/supply. These findings provide a springboard for further investigation of the attitudes of people who use illicit drugs towards drug policy in Australia, and challenge us to conceptualise how the opinions of this community should be solicited, heard and balanced in drug policy processes.
Publisher: SAGE Publications
Date: 29-01-2015
Abstract: This study sought to assess the impact of the pre-sentence Magistrates Early Referral Into Treatment (MERIT) ersion program in New South Wales, Australia on offending in the 12 months following exposure to the intervention. The comparative design involved an experimental group of 1017 defendants who exited the MERIT program in 2008 and a comparison group of 1017 offenders identified as drug misusers following completion of a Corrective Services’ risk and needs assessment and sentencing in a non-MERIT New South Wales Local Court during this period. Both groups were selected from a larger pool of cases ( N = 3319) that were found to be significantly different on a number of key variables. Propensity score matching was used to deal with this non-equivalence. The outcome measures were: the rate, volume and seriousness of known re-offending. Reci ism risk factors were also examined for MERIT participants. There was no association between exposure to MERIT and reduced rates of reconviction at 12 months and group status did not make a significant contribution to the prediction of reconviction, when controlling for the influence of penalties imposed. The MERIT group had committed a larger number of offences during this period (including when adjustments were made for time at reduced risk due to imprisonment), but there were no differences in relation to changes in offence seriousness. Among MERIT participants, the factor with the largest effect on risk of reci ism was offence type. Completing the program had a significant protective effect against reci ism, while the number of prior court convictions increased this risk. These findings shed light on possible reforms to MERIT aimed at maximising the program’s crime prevention impact.
Publisher: Wiley
Date: 18-03-2014
DOI: 10.1111/DAR.12134
Abstract: The news media is an important source of information regarding new developments in medicine and public health interventions. Previous research has indicated that in many cases, reporting on new treatments can be inaccurate or sensationalist. This paper presents analysis of Australian print media reporting on two treatment options for heroin dependence (naltrexone and methadone). The aim of this study was to quantitatively compare the volume and content of Australian print media reporting on these two treatments, one of which had a long history of use in Australia, and the other which was comparatively newer. The study constituted a quantitative content analysis of a s le of 859 Australian newspaper articles, published over a 10-year period (1997-2007). Each article paragraph was coded for positive outcomes/benefits of treatment, as well as negative outcomes associated with treatment. The analysis revealed that during this period, the Australian print media was significantly more likely to report the potential positive outcomes of naltrexone treatment, compared with the negative outcomes. In contrast, reporting on methadone focused more on the negative outcomes and side effects. The relative frequency by which the benefits of naltrexone were mentioned in this s le of news content is somewhat at odds with the extant efficacy and effectiveness research evidence. The findings suggest that reporting on these treatments in the Australian print media has not been balanced. This type of reporting has potential implications for public attitudes, as well as policy decisions.
Publisher: Wiley
Date: 17-04-2023
DOI: 10.1111/ADD.16192
Abstract: Restrictive late‐night alcohol policies are aimed at reducing alcohol‐related violence but, to date, no evaluations of their impact on family and domestic violence have been conducted. This study aimed to measure whether modifying the drinking environment and restricting on‐site trading hours affected reported rates of family and domestic violence. This study used a non‐equivalent control group design with two treatment sites and two matched control sites with pre‐ and postintervention data on rates of family and domestic violence assaults within local catchment areas of four late‐night entertainment precincts in New South Wales, Australia, covering a population of 27 309 people. Participants comprised monthly counts of police‐recorded incidents of domestic violence assaults from January 2001 to December 2019. Two variations of restrictive late‐night interventions were used: restricted entry to late‐night venues after 1:30 a.m., trading ceasing at 3:30 a.m. and other restrictions on alcohol service (Newcastle) and restricted entry to late‐night venues after 1 a.m. and a range of restrictions on alcohol service (Hamilton). The comparators were no restrictions on late‐night trading or modifications of the drinking environment (Wollongong and Maitland). Measurements involved the rate, type and timing of reported family and domestic violence assaults. Reported rates of domestic violence assaults fell at both intervention sites, while reported domestic violence assaults increased over time in the control sites. The protective effects in Newcastle were robust and statistically significant across three main models. The relative reduction associated with the intervention in Newcastle was 29% (incidence rate ratio = 0.71, 95% confidence interval: 0.60–0.83) and an estimated 204 assaults were prevented across the duration of the study. The protective effects found in Hamilton were not consistently supported across the three main models. Increases to late‐night alcohol restrictions may reduce rates of domestic violence.
Publisher: Wiley
Date: 2012
Publisher: Emerald
Date: 07-12-2015
Abstract: – This paper starts from the familiar premise of evidence-based policy, and examines the active role that researchers play in policy development processes. The interactive nature of much research translation immediately suggests the need to consider the dynamic way in which problems come to be understood, which is explored in this paper. Furthermore, the integration of research knowledge with the knowledges of “ordinary” citizens is a key challenge. The paper aims to discuss these issues. – This paper represents a synthesis of recent studies conducted by the author and her colleagues along with other drug policy literature. – The interactive and dialogic processes that researchers engage with, whether as knowledge brokers or participants in elite policy development forums, have implications for how policy problems (and solutions) come to be constituted. Four perspectives and theoretical approaches are briefly outlined: research design policy processes problematization and critical social sciences analyses. These offer different ways of seeing, understanding and analyzing the relationship between problems, policy solutions and the policy processes. Yet all have lessons for the ways in which research evidence and researchers constitute policy. This needs to sit alongside the role of other drug policy stakeholders – notably the “ordinary” citizen. It is argued that the elite role of research can be tempered with engagement of ordinary citizens. While it can be challenging to reconcile general public views about drugs with the evidence-base, deliberative democracy approaches may hold some promise. – This paper draws together a number of central themes for drug policy processes research: where the evidence-based policy paradigm intersects with participatory democracy how problems are constituted and the privileged role of research and researchers.
Publisher: Informa UK Limited
Date: 17-10-2015
Publisher: The Sax Institute
Date: 2011
DOI: 10.1071/NB10062
Publisher: Wiley
Date: 04-02-2021
DOI: 10.1111/ADD.15418
Publisher: Informa UK Limited
Date: 28-09-2011
Publisher: Elsevier BV
Date: 07-2010
DOI: 10.1016/J.DRUGPO.2009.11.002
Abstract: The application of regulatory theory to the problem of illicit drugs has generally been thought about only in terms of 'command and control'. The international treaties governing global illicit drug control and the use of law enforcement to dissuade and punish offenders have been primary strategies. In this paper I explore the application of other aspects of regulatory theory to illicit drugs-primarily self-regulation and market regulation. There has been an overreliance on strategies from the top of the regulatory pyramid. Two other regulatory strategies--self-regulation and market regulation--can be applied to illicit drugs. Self-regulation, driven by the proactive support of consumer groups may reduce drug-related harms. Market strategies such as pill-testing can change consumer preferences and encourage alternate seller behaviour. Regulatory theory is also concerned with partnerships between the state and third parties: strategies in these areas include partnerships between police and pharmacies regarding sale of potential precursor chemicals. Regulatory theory and practice is a rich and well-developed field in the social sciences. I argue that governments should consider the full array of regulatory strategies. Using regulatory theory provides a rationale and justification to strategies that are currently at the whim of politics, such as funding for user groups. The greater application of regulatory approaches may produce more flexible and structured illicit drug policies.
Publisher: Elsevier BV
Date: 08-2019
DOI: 10.1016/J.SAPHARM.2018.10.024
Abstract: Increases in opioid use and related harms such as mortality are occurring in many high income countries. Community pharmacists are often in contact with patients at risk of opioid-related harm and represent an ideal point for intervention. Best practice in monitoring opioid-related outcomes involves assessing analgesia, pain functioning, mood, risks and harms associated with opioid use. Community pharmacists are well-placed to undertake these tasks. Our pilot study will test the implementation of a computer-facilitated screening and brief intervention (SBI). The SBI will support pharmacist identification of opioid-related problems and provide capacity for brief intervention including verbal reinforcement of tailored information sheets, supply of naloxone and referral back to the opioid prescriber. The SBI utilises software that embeds study procedures into dispensing workflow and assesses opioid outcomes with domains aligned with a widely accepted clinical framework. We will recruit and train 75 pharmacists from 25 pharmacies to deliver the Routine Opioid Outcome Monitoring (ROOM) SBI. Pharmacists will complete the SBI with up to 500 patients in total (20 per pharmacy). Data will be collected on pharmacists' knowledge and confidence through pre- and post-intervention online surveys. Data on feasibility, acceptability and implementation outcomes, including naloxone supply, will also be collected. Our study will examine changes in pharmacists' knowledge and confidence to deliver the SBI. Through the implementation pilot, we will establish the feasibility and acceptability of a pharmacist SBI that aims to improve monitoring and clinical management of patients who are prescribed opioids.
Publisher: Elsevier BV
Date: 2020
DOI: 10.1016/J.DRUGALCDEP.2019.107737
Abstract: The legalization and regulation of currently illicit drugs has come to the forefront of drug policy debates in recent years, particularly in the context of cannabis legalization and the opioid crisis in North America. However, sufficient granularity on the various aspects of a legally regulated drug supply is missing from these debates. Further, the voices and opinions of people who use drugs have generally been absent from drug law reform deliberations. This study aimed to examine the views of people who use drugs and who are deeply impacted by drug policies to understand the perceived impacts and role of government under a legalized-regulated market. Four focus groups were held with people who use drugs in Sydney, Australia. Most participants supported various models of legalization, although the perspectives on these models were erse. Overriding these views was skepticism over the government's role in regulating a legal market, as well as concern for the personal agency of people who use drugs under a medically regulated drug supply model. Some participants discussed potential harms (e.g. increases in use and initiation), but emphasized the benefits (e.g. increases in quality and safety) from legal reform. While there was support for legal models of drug supply regulation, findings have major implications in terms of how governments and medical systems may perpetuate the oppression of people who use drugs through regulation, and urge future drug policy deliberations to include broader perspectives from the affected community.
Publisher: SAGE Publications
Date: 2002
Publisher: Wiley
Date: 28-09-2021
DOI: 10.1111/DAR.13176
Publisher: Elsevier BV
Date: 07-2019
DOI: 10.1016/J.JSAT.2019.04.004
Abstract: Remission from alcohol problems in the absence of treatment is common, yet there are wide ranging estimates of the extent to which this occurs, depending on method. A systematic review of the literature on untreated remission from alcohol problems was conducted to analyse the ways different definitions and study designs impact on estimates of untreated remission from alcohol problems, and to explore the implications for treatment planning. 2103 texts were identified through systematic searches of databases (Medline, PsycINFO, EMBASE) and other searches. Peer-reviewed journal articles published since 1975 which provided numeric estimates of untreated remission from alcohol problems were included. A narrative synthesis was undertaken. 124 estimates of untreated remission from alcohol problems were extracted from 27 studies. Three different s ling methods were identified: taking an 'alcohol problems s le' (method 1) which estimated the proportion of people with alcohol problems who remit without treatment taking an 'untreated s le' (method 2) which estimated the proportion of untreated people who enter remission and taking a 'remitted s le' (method 3) which estimated the proportion of people in remission who have not received treatment. In addition to this s ling ersity, the definitions of an alcohol problem, definitions of remission, and definitions of treatment varied between studies. The combination of the methods and definitional issues impacted on estimates of untreated remission from alcohol problems. Estimates derived from the 'alcohol problems s le' (method 1) and 'untreated s le' (method 2) are the most appropriate for treatment planners. How a treatment planner defines what treatment is, what remission is, and how an alcohol problem is defined all matter for these estimates.
Publisher: Wiley
Date: 04-2019
DOI: 10.1111/DAR.12919
Abstract: Drug consumptions rooms (DCR) and supervised injecting facilities (SIF) are expanding internationally. Previous reviews have not systematically addressed evaluation methodologies. Results from systematic searches of scientific databases in English until June 2017 were coded for paper type, country and year of publication. For evaluation papers, study outcome, methodology/study design and main indicators of DCR/SIF 'exposure' were recorded. Two hundred and nineteen eligible peer-reviewed papers were published since 1999: the majority from Canada (n = 117 papers), Europe (n = 36) and Australia (n = 32). Fifty-six papers reported evaluation outcomes. Ecological study designs (n = 10) were used to assess the impact on overdose, public nuisance and crime modelling techniques (n = 6) estimated impact on blood-borne diseases, overdose deaths and costs. Papers using in idual-level data included four prospective cohorts (n = 28), cross-sectional surveys (n = 7) and service records (n = 5). In idual-level data were used to assess safer injecting practice, uptake into health and social services and all the other above outcomes except for impact on crime and costs. Four different indicators of DCR/SIF attendance were used to measure service 'exposure'. Research around DCRs/SIFs has used ecological, modelling, cross-sectional and cohort study designs. Further research could involve systematic inclusion of a control group of people who are eligible but do not access SIFs, validation of self-reported proportion of injections at SIFs or a stepped-wedge or a cluster trial comparing localities. Methodologies appropriate for DCR/SIF evaluation have been established and can be readily replicated from the existing literature. Research on operational aspects, implementation and transferability is also warranted.
Publisher: Informa UK Limited
Date: 30-09-2014
Publisher: Wiley
Date: 10-2021
DOI: 10.1111/ADD.15243
Abstract: During the past decade, ‘alcohol's harm to others’ (AHTO) has emerged as an international approach to studying alcohol problems and informing policy. The AHTO approach seeks to increase political will for alcohol policy by mapping, measuring and often costing harms beyond the person who drinks (e.g. family members, co‐workers). In this paper we consider the implications of a ‘harm to others’ approach for illicit drugs. We ask whether it could and should be used as a policy tool, given the high risks of further stigmatizing people who use drugs. We consider the ways in which the concept and measurement of ‘harm to others’ may be either productive or potentially harmful, depending on the extent to which the AHTO is replicated for illicit drugs. Shifting the language may assist: the term ‘harm from others’ appears to carry less risk of stigma. In addition, all harms inclusive of drug supply and drug consumption need to be included if a full picture of harms that accrue to other people from illicit drugs is to be achieved.
Publisher: Informa UK Limited
Date: 07-05-2015
Publisher: Elsevier BV
Date: 11-2016
DOI: 10.1016/J.DRUGALCDEP.2016.09.008
Abstract: In Vietnam, two dominant approaches for heroin treatment are center-based compulsory rehabilitation (CCT), funded by the Vietnamese government and community-based voluntary methadone maintenance treatment (MMT), funded primarily by international donors. Recent reduction in international funding requires more efficient allocation of government funding for public health programs. A cost-effectiveness analysis comparing two approaches provides a useful source of evidence to inform the government about funding reallocation. The study was a combined retrospective and prospective, non-randomized cohort comparison over three years of CCT and MMT in Vietnam, conducted between 2012 and 2014, involving 208 CCT participants and 384 MMT participants with heroin dependence. The primary end-point was drug-free days over three years. Total costs, including both program and participant personal costs were measured and cost-effectiveness compared. Mixed effects regression analyses were used to analyze effectiveness data and non-parametric bootstrapping method was used to compare cost-effectiveness. Over three years, MMT costed on average VND85.73 million (US$4108) less than CCT (95% CI: -VND76.88 million, -VND94.59 million). On average, a MMT participant had 344.20 more drug-free days compared to a CCT participant (p<0.001). The incremental cost-effectiveness ratio for MMT was -VND0.25 million (US$11.99) (95% CI: -VND0.34 million, -VND0.19 million) per drug-free day suggesting MMT is the more cost effective alternative. Compared to CCT, MMT is both less expensive and more effective in achieving drug-free days. If the government of Vietnam invests in MMT instead of CCT, it is potentially a cost-saving strategy for reducing illicit drug use among heroin dependent in iduals.
Publisher: Elsevier BV
Date: 08-2010
DOI: 10.1111/J.1753-6405.2010.00573.X
Abstract: This study aimed to investigate which categories of medication are most commonly implicated in overdose, to compare this information with prescription data and to explore how the medications used in overdoses are typically acquired. A 12-month audit (11/2003-10/2004) of all medication overdose presentations to an inner-Melbourne ED was conducted and the medications compared to published population-based prescription data. Interviews were conducted with 31 patients who attended the ED following a medication overdose and typical stories regarding the acquisition of medications reported. The same broad categories of medications identified in earlier studies were found to contribute to the majority of overdoses in this study, namely benzodiazepines, antidepressants, analgesics and antipsychotics. Two benzodiazepine medications, diazepam and alprazolam, appeared to be over-represented in the overdose data relative to their population rates of prescription. Patient interviews revealed three main reasons for the original acquisition of the medications used in overdose: treatment purposes (77%) recreational use (16%) and overdose (7%). The most common source of medications (68%) used in overdose was prescription by the patient's usual doctor. The high representation of benzodiazepines among medications used in overdose is of ongoing concern. The time of medication prescription and dispensing may be an ideal opportunity for overdose prevention, through judicious prescribing, consideration of treatment alternatives, patient education and encouraging the safe disposal of unused medications.
Publisher: Informa UK Limited
Date: 03-2007
DOI: 10.1080/09595230601184653
Abstract: Given the very positive and extensive research evidence demonstrating efficacy and effectiveness of contingency management, it is important that Australia explore whether contingency management has a role to play in our own treatment context. Qualitative interviews were conducted with 30 experienced alcohol and drug practitioners, service managers and policy-makers in Victoria. Interviewees were selected to represent the range of drug treatment services types and included rural representation. A semi-structured interview schedule, covering their perceptions and practices of contingency management was used. All interviews were transcribed verbatim and analysed using N2 qualitative data analysis program. The majority of key informants were positively inclined toward contingency management, notwithstanding some concerns about the philosophical underpinnings. Concerns were raised in relation to the use of monetary rewards. Ex les of the use of contingency management provided by key informants demonstrated an over-inclusive definition: all the ex les did not adhere to the key principles of contingency management. This may create problems if a structured contingency management were to be introduced in Australia. Contingency management is an important adjunctive treatment intervention and its use in Australia has the potential to enhance treatment outcomes. No unmanageable barriers were identified in this study.
Publisher: SAGE Publications
Date: 05-04-2016
Abstract: This article provides an historical and descriptive account of the introduction and development of the use of drug detection dogs as a tool for street-level illicit drugs policing in one Australian jurisdiction, NSW. Within this account, the legal and political context in which drug detection dogs emerged and gained prominence is described. The introduction of drug detection dogs was contingent on the political imperatives at work throughout the 1990s in NSW, and the increased salience of both policing and illicit drugs issues at this time. In documenting the emergence of the use of drug detection dogs from the early 2000s, and the associated legal challenges and rapid legislative responses, the role of third sector organisations and the media in generating debate is notable. Debates concerning the dogs’ effectiveness emerged in the mid- to late-2000s, giving rise to anomalies between policy and evidence. The more recent legislative developments and public and political debate about drug detection dogs from 2012 to 2014 can be seen in light of this history. By taking a different view which situates decisions and events in their historical and political context, we begin to see the dynamic processes and contingency involved in the development and implementation of particular illicit drugs policing policies over time. As debate about drug detection dogs continues to play out, generating new insights into drugs policing policy processes is imperative.
Publisher: Wiley
Date: 09-2002
DOI: 10.1080/0959523021000002723
Abstract: The substance abuse field has been slow to embrace research into the impact of the therapeutic relationship on treatment outcome. Limited previous research has demonstrated that therapist factors such as unconditional regard and empathy are associated strongly with treatment outcome. This study examined the relationships between client perception of the therapist and client characteristics client response to out-patient relapse prevention treatment and client outcome 3 months following treatment for alcohol dependence. One hundred and sixty-one male clients of a 3-week relapse prevention programme participated in the research, completing questionnaires assessing their perception of therapist regard, empathy, congruence, attractiveness, expertness and trustworthiness. Treatment outcome was measured at the conclusion of treatment, and 3 months post-treatment. Clients who were more anxious and those with poorer cognitive functioning appeared to perceive therapists as showing less unconditional regard, empathy and congruence. Self-efficacy and coping skills acquisition measured at the end of treatment correlated significantly with clients' perceptions of the therapist as empathic, congruent and displaying high regard for them. Treatment outcome at 3 months was associated significantly with degree of perceived therapist expertness and empathy. These relationships held when cognitive functioning and skills acquisition were controlled for. Self-efficacy moderated the relationships between regard and empathy and outcome, but not perceived therapist expertness. A lower than desirable follow-up rate limits the generalizability of the findings. The quality of the therapeutic relationship as perceived by clients appears to be associated with client characteristics, response to treatment and treatment outcome.
Publisher: Wiley
Date: 22-09-2022
DOI: 10.1111/ADD.15681
Abstract: The configuration of alcohol and other drug treatment service systems has been influenced by the uptake of market mechanisms for treatment funding and purchasing. This study measured the impact of market mechanisms for funding and purchasing alcohol and drug treatment services on client outcomes. An observational cross‐sectional study, employing multi‐level analysis: episodes of care data, nested within person‐level data, nested within treatment site and nested within organization. One hundred and seventy‐eight alcohol and other drug treatment service sites in Australia. Client outcome variables were length of stay and successful treatment completion. Predictor variables were competitive tendering, number of funding contracts, recurrent funding, the ratio of episodes to staff, type of professions, years of clinical experience, staff turnover and type of provider (government non‐government). Analyses controlled for drug type, type of treatment received and client characteristics. There were no significant associations between the procurement and contracting variables and length of stay [incidence rate ratios (IRRs) ranged between 1.01 and 1.07, all P 0.05 Bayes factors (BF) 0.03], and inconclusive results for treatment completion [odds ratios (ORs) ranged between 1.04 and 1.15, all P 0.05, BF = 0.51–0.63]. Having an alcohol and other drug (AOD) work‐force relative to an ‘other’ work‐force (IRR = 0.79, P = 0.021) and lower case‐loads (IRR = 0.99, P = 0.047) may be associated with longer stay in treatment. Receiving services from a government compared to non‐government provider may also be associated with less treatment completion (OR = 0.34, P = 0.023, BF = 2.14). There appears to be no association between client outcomes and procurement and funding contract arrangements for alcohol and drug treatment services.
Publisher: Wiley
Date: 17-04-2018
DOI: 10.1111/ADD.14197
Abstract: The prevailing 'evidence-based policy' paradigm emphasizes a technical-rational relationship between alcohol and drug research evidence and subsequent policy action. However, policy process theories do not start with this premise, and hence provide an opportunity to consider anew the ways in which evidence, research and other types of knowledge impact upon policy. This paper presents a case study, the police deployment of drug detection dogs, to highlight how two prominent policy theories [the Advocacy Coalition Framework (ACF) and the Multiple Streams (MS) approach] explicate the relationship between evidence and policy. The two theories were interrogated with reference to their descriptions and framings of evidence, research and other types of knowledge. The case study methodology was employed to extract data concerned with evidence and other types of knowledge from a previous detailed historical account and analysis of drug detection dogs in one Australian state (New South Wales). Different types of knowledge employed across the case study were identified and coded, and then analysed with reference to each theory. A detailed analysis of one key 'evidence event' within the case study was also undertaken. Five types of knowledge were apparent in the case study: quantitative program data practitioner knowledge legal knowledge academic research and lay knowledge. The ACF highlights how these various types of knowledge are only influential inasmuch as they provide the opportunity to alter the beliefs of decision-makers. The MS highlights how multiple types of knowledge may or may not form part of the strategy of policy entrepreneurs to forge the confluence of problems, solutions and politics. Neither the Advocacy Coalition Framework nor the Multiple Streams approach presents an uncomplicated linear relationship between evidence and policy action, nor do they preference any one type of knowledge. The implications for research and practice include the contestation of evidence through beliefs (Advocacy Coalition Framework), the importance of venues for debate (Advocacy Coalition Framework), the way in which data and indicators are transformed into problem specification (Multiple Streams) and the importance of the policy ('alternatives') stream (Multiple Streams).
Publisher: SAGE Publications
Date: 05-04-2016
Abstract: This article provides an historical and descriptive account of the introduction and development of the use of drug detection dogs as a tool for street-level illicit drugs policing in one Australian jurisdiction, NSW. Within this account, the legal and political context in which drug detection dogs emerged and gained prominence is described. The introduction of drug detection dogs was contingent on the political imperatives at work throughout the 1990s in NSW, and the increased salience of both policing and illicit drugs issues at this time. In documenting the emergence of the use of drug detection dogs from the early 2000s, and the associated legal challenges and rapid legislative responses, the role of third sector organisations and the media in generating debate is notable. Debates concerning the dogs’ effectiveness emerged in the mid- to late-2000s, giving rise to anomalies between policy and evidence. The more recent legislative developments and public and political debate about drug detection dogs from 2012 to 2014 can be seen in light of this history. By taking a different view which situates decisions and events in their historical and political context, we begin to see the dynamic processes and contingency involved in the development and implementation of particular illicit drugs policing policies over time. As debate about drug detection dogs continues to play out, generating new insights into drugs policing policy processes is imperative.
Publisher: Wiley
Date: 22-10-2019
DOI: 10.1111/DAR.12871
Publisher: Springer Science and Business Media LLC
Date: 31-03-2007
DOI: 10.1007/S10729-007-9012-0
Abstract: A five-state compartment model of trends in illicit drug use in Australia is parameterized using data from multiple sources. The model reproduces historical prevalence and supports what-if analyses under the assumption that past trajectories of drug escalation and desistance persist. For fixed initiation, the system has a unique stable equilibrium. The chief qualitative finding is that even though some users escalate rapidly, regular injection drug use still adjusts to changes in incidence with considerable inertia and delay. This has important policy implications, e.g., concerning the timing of reductions in drug-related social cost generated by interventions that reduce the social cost per injection user versus those that cut drug initiation.
Publisher: Elsevier BV
Date: 2013
DOI: 10.1016/J.DRUGPO.2013.07.002
Abstract: National drug policies are often regarded as inconsequential, rhetorical documents, however this belies the subtlety with which such documents generate discourse and produce (and re-produce) policy issues over time. Critically analysing the ways in which policy language constructs and represents policy problems is important as these discursive constructions have implications for how we are invoked to think about (and justify) possible policy responses. Taking the case of Australia's National Drug Strategies, this paper used an approach informed by critical discourse analysis theory and aspects of Bacchi's (2009) 'What's the Problem Represented to be' framework to critically explore how drug policy problems are constructed and represented through the language of drug policy documents over time. Our analysis demonstrated shifts in the ways that drugs have been 'problematised' in Australia's National Drug Strategies. Central to these evolving constructions was the increasing reliance on evidence as a way of 'knowing the problem'. Furthermore, by analysing the stated aims of the policies, this case demonstrates how constructing drug problems in terms of 'drug-related harms' or alternately 'drug use' can affect what is perceived to be an appropriate set of policy responses. The gradual shift to constructing drug use as the policy problem altered the concept of harm minimisation and influenced the development of the concepts of demand- and harm-reduction over time. These findings have implications for how we understand policy development, and challenge us to critically consider how the construction and representation of drug problems serve to justify what are perceived to be acceptable responses to policy problems. These constructions are produced subtly, and become embedded slowly over decades of policy development. National drug policies should not merely be taken at face value appreciation of the construction and representation of drug problems, and of how these 'problematisations' are produced, is essential.
Publisher: Elsevier BV
Date: 05-2022
DOI: 10.1016/J.DRUGPO.2022.103653
Abstract: The ability to fairly and justly distinguish between drug possession for personal use and drug possession for supply is a central feature of drug laws across the globe. Whether such distinctions pertain to decriminalisation of simple possession, or to the penalties associated with drug offences, such differentiation remains a core problem for policymakers. In this commentary, taking 91 different jurisdictions into consideration, we identify five different approaches to distinguishing personal use from supply: four of these involved quantification of an amount of drug (whether in weight or number of doses). The other approach relied on case-by-case judgement. Drawing upon survey data of drug use from nine countries, we provide an ex le of how the quantity bears little resemblance to drug use patterns, and does not take heterogeneity of drug use into account. While the non-quantified approach can lead to discriminatory and racialised policing, all of the quantification approaches also pose problems, largely concerned with arbitrary amounts. There appears to be no perfect way to differentiate possession for personal use from intentions to supply. This commentary opens up a number of important policy-relevant research questions given this central feature of drug policy design.
Publisher: Elsevier BV
Date: 05-1992
DOI: 10.1016/0028-3932(92)90090-9
Abstract: Small s les of alcohol-dependent subjects who showed no clinical signs of Wernicke-Korsakoff syndrome were compared with nonalcohol-dependent controls on two animal memory tests which are performed poorly by human amnesics. Compared to the control subjects, the alcohol-dependent subjects' performance was impaired on a version of the delayed matching to s le task. On concurrent discrimination learning the overall group difference just failed to reach significance. The results are interpreted as suggesting that behavioural impairment may occur in alcohol-dependent subjects who are not clinically amnesic, and that the impairment is similar in type to that observed in cases of severe Wernicke-Korsakoff syndrome.
Publisher: Wiley
Date: 23-10-2003
DOI: 10.1046/J.1360-0443.2003.00529.X
Abstract: The present study aimed to compare the efficacy of levo-alpha-acetylmethadol (LAAM) and methadone, as measured by retention in treatment and heroin use, in a randomized trial conducted under naturalistic conditions. This study is the first randomized trial comparing LAAM with methadone in the primary care setting. Participants were recruited through 29 medical practitioners working in specialist and generalist settings in Australia. Existing methadone maintenance patients, aged 18 years and over and able to give informed consent, were randomized to receive either LAAM or methadone. A total of 93 patients participated. After being trained in the use of LAAM, existing methadone prescribers were then able to determine an in idually tailored treatment regimen for each patient. The trial was an open-label study. Methadone and LAAM dosing was supervised through local community pharmacies. Participation in ancillary services (e.g. counselling) was optional for all patients. The treatment period for the trial was 12 months. Baseline, 3-, 6- and 12-month interviews were conducted. Outcome measures were retention in treatment, self-reported heroin use and serious adverse events. There were no significant differences between LAAM and methadone on retention in treatment, nor heroin use. There was a trend for LAAM patients to have lower heroin use than methadone patients. Of the seven serious adverse events in the LAAM group, three were not drug-related. There were two dosing errors. This study demonstrates (a) the efficacy of LAAM as a treatment for heroin dependence, and (b) the capacity for LAAM to be effectively delivered in primary care settings by trained general practitioners and pharmacists. The next challenge is to resolve outstanding safety concerns with LAAM.
Publisher: Elsevier BV
Date: 04-2018
DOI: 10.1016/J.JSAT.2018.01.011
Abstract: In Vietnam, like many countries in East and Southeast Asia, the government has invested heavily in center-based compulsory treatment (CCT) as the mainstay demand reduction strategy for illicit drug use. This approach has been criticised on human rights grounds. Meanwhile, community-based voluntary methadone maintenance treatment (MMT) has been implemented for nearly a decade with promising results. To date, there have been no comparative Vietnamese studies of these approaches. The study, involving 208 CCT participants and 384 MMT participants with heroin dependence, was a combined retrospective and prospective observational study conducted over three years between 2012 and 2014 (with data at five time-points). The primary outcome was: self-report heroin use (confirmed by urinalysis). The four secondary outcomes were: illegal behaviours, overdose, blood-borne virus (BBV) risk behaviours, and monthly drug expenditure. Mixed effects regression analyses, which took into account baseline differences between the groups, were used to analyse the data. This study is registered with ClinicalTrials.gov, number NCT03071315. The study found MMT was more strongly associated with four outcome measures compared to CCT (reduction in heroin use (β = 3.39, SE = 0.31, p < .0001) (equivalent to an odds ratio of 29.67 (95% CI 21.76-40.45)), reduction in illegal behaviours (β = 0.94, SE = 0.39, p < .0001), (equivalent to an odds ratio of 2.56 (95% CI 1.79-3.78)), reduction in BBV risk behaviours (β = 1.08, SE = 0.17, p < .0001), (equivalent to an odds ratio of 2.94 (95% CI 2.48-3.49)), and reduction in monthly drug spending (β = -VND1,515,200 (equivalent to US$72.00), SE = VND452,900, p < .0001)). The analyses did not support the hypothesis that MMT was associated with better outcomes pertaining to overdose (β = -0.27, SE = 0.30, p = .62), probably due to the infrequency of these self-reported events. Our observational study suggests that MMT is associated with greater reductions in heroin use, BBV risk behaviours, drug-related illegal behaviours, and monthly drug spending compared with CCT. In the context that the CCT approach has been criticized for human rights violations, this study provides evidence to support the scale up of MMT and the transition of CCT to voluntary community based treatment.
Publisher: Springer Science and Business Media LLC
Date: 11-01-2017
Publisher: Wiley
Date: 11-2013
DOI: 10.1111/DAR.12064
Publisher: Informa UK Limited
Date: 06-05-2013
Publisher: Wiley
Date: 29-01-2019
DOI: 10.1111/DAR.12900
Publisher: Informa UK Limited
Date: 05-2011
Publisher: Informa UK Limited
Date: 02-2001
DOI: 10.1076/CLIN.15.1.69.1910
Abstract: This study examined the joint factor structure of the WAIS-R and WMS-R in a s le of 289 participants (mostly males) with alcohol dependency. In a confirmatory phase we contrasted a range of factor models derived from previous analyses of the Wechsler scales. The best fitting model incorporated five factors representing Verbal Comprehension, Perceptual Organization, Attention-Concentration, Verbal Memory, and Visual Memory, with reassignment of factor loadings for two subtests. The invariance of the measurement model was then examined comparing data from a large s le of healthy participants (J. R. Carstairs & E. A. Shores, 1999). The results indicated that the number of factors was invariant across s les, and four of the factors satisfied the criterion of partial measurement invariance.
Publisher: AMPCo
Date: 03-2016
DOI: 10.5694/MJA15.01372
Publisher: Informa UK Limited
Date: 27-01-2014
Publisher: Bristol University Press
Date: 11-2013
Abstract: The mantra of evidence-based policy (EBP) suggests that endeavours to implement evidencebased policing will produce better outcomes. However there is dissonance between the rhetoric of EBP and the actuality of policing policy. This disjuncture is critically analysed using the case study of illicit drugs policing. The dissonance may be ameliorated by taking into account the policing context, and lessons from the extant evidence-based medicine, research translation and policy processes literature. Furthermore a developmental pathway notion suggests that it is only once research is fully embedded within the policy culture that critical reflections on the role of evidence become possible.
Publisher: Wiley
Date: 07-2015
DOI: 10.1111/DAR.12291
Publisher: SAGE Publications
Date: 04-2002
DOI: 10.1046/J.1440-1614.2002.01012.X
Abstract: Objective: This article examines the use of naltrexone in the treatment of heroin dependence. The relationship between naltrexone and depression as well as risk of overdose is examined. Method: The existing literature is reviewed along with recent interim data from clinical trials underway in Victoria. Results: Naltrexone is a recent addition to treatment for heroin dependence in Australia. The relationship between depression and naltrexone has been examined in previous literature. Underlying rates of depression in heroin users are high and treatment may resolve or exacerbate depression. Research to date demonstrates that the addition of naltrexone does not necessarily increase depression in patients. The risk of non-fatal heroin overdose is significantly elevated after naltrexone treatment as a result of reduced tolerance. Data from clinical trials underway in Victoria demonstrate a significantly elevated rate of non-fatal overdose in naltrexone patients compared to those in substitution maintenance treatment. The mortality rate subsequent to naltrexone treatment appears to be equivalent to or greater than that for untreated heroin users. Further research is required. Conclusions: Clinicians need to carefully monitor depression in patients, and warn patients of the risks of reduced tolerance to opiates following naltrexone treatment. Agonist treatments such as methadone, LAAM and buprenorphine carry much less risk of overdose.
Publisher: Wiley
Date: 25-05-2012
DOI: 10.1111/J.1465-3362.2012.00472.X
Abstract: Australian pharmacotherapy maintenance programs incur costs to patients. These dispensing fees represent a financial burden to patients and are inconsistent with Australian health-care principles. No previous work has examined the current costs nor the future predicted costs if government subsidised dispensing fees. A system dynamics model, which simulated the flow of patients into and out of methadone maintenance treatment, was developed. Costs were imputed from existing research data. The approach enabled simulation of possible behavioural responses to a fee subsidy (such as higher retention) and new estimates of costs were derived under such scenarios. Current modelled costs (AUS$11.73m per month) were largely borne by state/territory government (43%), with patients bearing one-third (33%) of the total costs and the Commonwealth one-quarter (24%). Assuming no behavioural changes associated with fee subsidies, the cost of subsidising the dispensing fees of Australian methadone patients would be $3.9m per month. If retention were improved as a result of fee subsidy, treatment numbers would increase and the model estimates an additional cost of $0.8m per month. If this was coupled with greater numbers entering treatment, the costs would increase by a further $0.4m per month. In total, full fee subsidy with modelled behavioural changes would increase per annum government expenditure by $81.8m to $175.8m. If government provided dispensing fee relief for methadone maintenance patients, it would be a costly exercise. However, these additional costs are offset by the social and health gains achieved from the methadone maintenance program.
Publisher: Springer Science and Business Media LLC
Date: 2005
DOI: 10.2165/00019053-200523010-00007
Abstract: Buprenorphine offers an alternative to methadone in the treatment of heroin dependence, and has the advantage of allowing alternate-day dosing. This study is the first to examine the cost effectiveness of buprenorphine as maintenance treatment for heroin dependence in a primary care setting using economic and clinical data collected within a randomised trial. The study was a randomised, open-label, 12-month trial of 139 heroin-dependent patients in a community setting receiving in idualised treatment regimens of buprenorphine or methadone. Those who were currently on a methadone program (n = 57 continuing therapy subgroup) were analysed separately from new treatment recipients (n = 82 initial therapy subgroup). The study took a broad societal perspective and included health, crime and personal costs. Data on resource use and outcomes were a combination of clinical records and self report at interview. The main outcomes were incremental cost per additional day free of heroin use and per QALY. An analysis of uncertainty calculated the likelihood of net benefits for a range of acceptable money values of outcomes. All costs were in 1999 Australian dollars (DollarA). The estimated mean number of heroin-free days did not differ significantly between those randomised to methadone (225 [95% CI 91, 266]), or buprenorphine (222 [95% CI 194, 250]) over the year of the trial. Buprenorphine was associated with an average 0.03 greater QALYs over 52 weeks (not significant). The total cost was DollarA 17,736 (95% CI -DollarA 2981, DollarA 38,364) with methadone and DollarA 11,916 (95% CI DollarA 7697, DollarA 16,135) with buprenorphine costs excluding crime were DollarA 4513 (95% CI DollarA 3495, DollarA 5531) and DollarA 5651 (95% CI DollarA 4202, DollarA 7100). With additional heroin-free days as the outcome, and crime costs included buprenorphine has a lower cost but less heroin-free days. If crime costs are excluded buprenorphine has a higher cost and worse outcome than methadone. With additional QALYs as the outcome, the cost effectiveness of buprenorphine is DollarA 39,404 if crime is excluded, but buprenorphine is dominant if crime is included. The trial found no significant differences in costs or outcomes between methadone and buprenorphine maintenance in this particular setting. Although some of the results suggest that methadone may have a cost advantage, it is difficult to infer from the trial data that offering buprenorphine as an alternative would have a significant effect on total costs or outcomes. The point estimates of costs and outcomes suggest that buprenorphine may have an advantage in those initiating therapy. The confidence intervals were wide, however, and the likelihood of net benefits from substituting one treatment for another was close to 50%.
Publisher: Wiley
Date: 02-2020
DOI: 10.1111/DAR.13027
Publisher: Wiley
Date: 20-06-2018
DOI: 10.1111/DAR.12576
Abstract: This study aimed to determine design features of a drug-checking service that would be feasible, attractive and likely to be used by Australian festival and nightlife attendees. Web survey of 851 Australians reporting use of psychostimulants and/or hallucinogens and attendance at licensed venues past midnight and/or festivals in the past year (70% male median age 23 years). A drug-checking service located at festivals or clubs would be used by 94% a fixed-site service external to such events by 85%. Most (80%) were willing to wait an hour for their result. Almost all (94%) would not use a service if there was a possibility of arrest, and a majority (64%) would not use a service that did not provide in idual feedback of results. Drug-checking results were only slightly more attractive if they provided comprehensive quantitative results compared with qualitative results of key ingredients. Most (93%) were willing to pay up to $5, and 68% up to $10, per test. One-third (33%) reported willingness to donate a whole dose for testing: they were more likely to be male, younger, less experienced, use drugs more frequently and attend venues/festivals less frequently. In this s le, festival- or club-based drug-checking services with low wait times and low cost appear broadly attractive under conditions of legal amnesty and in idualised feedback. Quantitative analysis of ecstasy pills requiring surrender of a whole pill may appeal to a minority in Australia where pills are more expensive than elsewhere. [Barratt MJ, Bruno R, Ezard N, Ritter A. Pill testing or drug checking in Australia: Acceptability of service design features. Drug Alcohol Rev 2017 :000-000].
Publisher: Elsevier BV
Date: 09-2010
DOI: 10.1016/J.DRUGPO.2009.12.001
Abstract: One outcome measure of law enforcement effectiveness is the reduction in drug consumption which occurs as a result of law enforcement interventions. A theoretical relationship between drug consumption and retail price has promoted the use of retail price as a surrogate measure for consumption. In the current article, retail price is examined as a potential outcome measure for the effectiveness of law enforcement. The predictions regarding the relationship between law enforcement intensity and price are only partially supported by research. Explanations for the disconnect between the drug law enforcement activity and retail price include: rapid adaptation by market players, enforcement sw ing, assumptions of rational actors, short-run versus long-run effects, structure of the illicit market, simultaneous changes that affect price in perverse ways, the role of violence in markets, and data limitations. Researchers who use retail price as an outcome measure need to take into account the complex relationship between drug law enforcement interventions and the retail price of illicit drugs. Viable outcome measures which can be used as complements to retail price are worth investigation.
Publisher: Wiley
Date: 2016
DOI: 10.1111/DAR.12334
Publisher: BMJ
Date: 28-06-2010
Abstract: Medication overdose accounts for >80% of hospital presentations for self-harm. Previous research has identified typical characteristics of medication overdose cases however, these cases have not been well differentiated from other similar presentations, namely (1) illicit drug overdose and (2) self-harm by means other than overdose. A 12-month audit of medication overdose cases (both intentional and unintentional) attending the emergency department (ED) of a major metropolitan public hospital in Melbourne, Australia was conducted. Comparison was made with patients attending for illicit drug overdose or for self-harm by means other than overdose. Medication overdose cases (n=453) showed a broadly comparable profile with those found in earlier studies (predominantly female gender, aged in their 30s and referred for psychosocial assessment). A similar though not identical profile was noted for self-harm cases (n=545). In contrast, patients attending for illicit drug overdose (n=409) could be characterised as male, in their 20s and not referred for psychosocial assessment. Illicit drug overdose cases were more likely than either the medication overdose or self-harm cases to be triaged in the most urgent category (19.3, 3.8 and 3.9% respectively), suggesting a high level of acuity in this group. However, the illicit drug overdose group on average spent less time in the ED than medication overdose patients, and were less likely to require hospital admission. On both demographic and treatment variables, patients attending the ED following a medication overdose more closely resemble those attending for self-harm by means other than overdose than those attending for illicit drug overdose.
Publisher: Wiley
Date: 23-10-2014
DOI: 10.1111/ADD.12740
Abstract: Meth hetamine-related harms in Victoria have increased recently in the context of stable or declining use prevalence. We determine how changes in price and purity of meth hetamine compared to other drugs such as heroin may, in part, explain these ergent patterns. Detailed meth hetamine and heroin purchase price data from 2152 participant interviews from the Melbourne Injecting Drug User cohort study were used to generate drug price series for the period January 2009-June 2013. Data on drug purity from 8818 seizures made within Victoria were used to generate drug purity series during the same period. Purity-adjusted price data for meth hetamine and heroin were obtained for the period 2009-13 by combining the two data sets. While the average purity of heroin seizures remained consistent and low, the average purity of powder and of crystal meth hetamine seizures increased from 12% [95% confidence interval (CI) = 10-14%] to 37% (95% CI = 20-54%) and 21% (95% CI = 18-23%) to 64% (95% CI = 60-68%), respectively. Crystal meth hetamine purity was bimodal, with observations generally less than 20% or greater than 70%. The average unadjusted price per gram for heroin decreased from $374 (95% CI = $367-381) to $294 (95% CI = $280-308), powder meth hetamine did not change significantly from $252 (95% CI = $233-271), and crystal meth hetamine increased substantially from $464 (95% CI = $416-511) in 2009 to $795 (95% CI = $737-853) in 2011. This increase was offset by an even greater increase in purity, meaning the average purity-adjusted price per gram declined. Furthermore, pure prices of both meth hetamine forms were similar, whereas their unadjusted prices were not. The pure price of heroin fluctuated with no ongoing trends. Decreases in meth hetamine purity-adjusted price along with the bimodality of crystal meth hetamine purity may account for some of the recent increase in meth hetamine-related harm. For a given amount spent, meth hetamine purchase power has increased and the presence of extreme purity variations may challenge in iduals' control of consumption.
Publisher: Elsevier BV
Date: 05-2016
Publisher: Wiley
Date: 2011
Publisher: Springer Science and Business Media LLC
Date: 13-04-2016
Publisher: Elsevier BV
Date: 2013
DOI: 10.1016/J.DRUGPO.2012.02.005
Abstract: Assessing the extent to which drug research influences and impacts upon policy decision-making needs to go beyond bibliometric analysis of academic citations. Policy makers do not necessarily access the academic literature, and policy processes are largely iterative and rely on interactions and relationships. Furthermore, media representation of research contributes to public opinion and can influence policy uptake. In this context, assessing research influence involves examining the extent to which a research project is taken up in policy documents, used within policy processes, and disseminated via the media. This three component approach is demonstrated using a case ex le of two ongoing illicit drug monitoring systems: the Illicit Drug Reporting System (IDRS) and the Ecstasy and related Drugs Reporting System (EDRS). Systematic searches for reference to the IDRS and/or EDRS within policy documents, across multiple policy processes (such as parliamentary inquiries) and in the media, in conjunction with analysis of the types of mentions in these three sources, enables an analysis of policy influence. The context for the research is also described as the foundation for the approach. The application of the three component approach to the case study demonstrates a practical and systematic retrospective approach to measure drug research influence. For ex le, the ways in which the IDRS and EDRS were mentioned in policy documents demonstrated research utilisation. Policy processes were inclusive of IDRS and EDRS findings, while the media analysis revealed only a small contribution in the context of wider media reporting. Consistent with theories of policy processes, assessing the extent of research influence requires a systematic analysis of policy documents and processes. Development of such analyses and associated methods will better equip researchers to evaluate the impact of research.
Publisher: Informa UK Limited
Date: 25-03-2023
Publisher: Elsevier BV
Date: 09-2014
DOI: 10.1016/J.DRUGPO.2014.02.003
Abstract: Analysis of how policy processes happen in real-world, contemporary settings is important for generating new and timely learning which can inform other drug policy issues. This paper describes and analyses the process leading to the successful establishment of Australia's first peer-administered naloxone program. Within a case study design, qualitative data were collected using semi-structured interviews with key in iduals associated with the initiative (n=9), and a collaborative approach to data analysis was undertaken. Central to policy development in this case was the formation of a committee structure to provide expert guidance and support. The collective, collaborative and relational features of this group are consistent with governing by network. The analysis demonstrates that the Committee served more than a merely consultative role. We posit that the Committee constituted the policy process of stakeholder engagement, communication strategy, program development, and implementation planning, which led to the enactment of the naloxone program. We describe and analyse the roles of actors involved, the goodwill and volunteerism which characterised the group's processes, the way the Committee was used as a strategic legitimising mechanism, the strategic framings used to garner support, emergent tensions and the evolving nature of the Committee. This case demonstrates how policy change can occur in the absence of strong political imperatives or ideological contestation, and the ways in which a collective process was used to achieve successful outcomes.
Publisher: Springer Science and Business Media LLC
Date: 15-08-2008
Publisher: SAGE Publications
Date: 14-10-2015
Abstract: Social network analysis (SNA) conducted on criminal networks can identify key players and shed light on important patterns of connectivity. This information can be used to develop interventions to dismantle or disrupt criminal networks. Drawing upon the network capital construct, this study demonstrates that integrating centrality measures (such as degree or betweenness centrality) with other in idual attributes related to functional roles and access to tangible and intangible resources will enhance efforts to identify critical actors. Using a drug trafficking network that operated in Australia in the 1990s, we identify actors who are key to the network by virtue of their position in the network, their attributes, and combinations of these factors. Implications for law enforcement practice are discussed.
Publisher: Wiley
Date: 09-2004
Publisher: Elsevier BV
Date: 2011
Publisher: Informa UK Limited
Date: 27-04-2015
Publisher: Wiley
Date: 27-11-2020
DOI: 10.1111/DAR.13018
Abstract: There was an exceptional drug policy debate in Australia over the summer of 2018-2019 regarding the availability of drug checking (pill-testing) services at festivals. Drug checking is not a new intervention and has been available across Europe for many years. This paper aimed to analyse the nature of the policy debate. Data were sourced from public domain sites online, TV and radio media, alongside documentation of advocacy actions. Analysis of the contents of the public debate was conducted through the theoretical lens of Science and Technology Studies, notably the work of Stengers. The narratives identified in favour of pill-testing focussed on the evidence available to date, the importance of informed choice and accessing a population to provide information and education. The arguments against pill-testing included the belief that there is no such thing as safe drug use, the false sense of security that pill-testing would engender and that the evidence to date is equivocal. Both those for and against pill-testing shared the same goal-saving lives. However, the beliefs and values underpinning this goal differed. As the heat increased over summer, the debate became more polarised, but shedding little light. Drug policy debate, which becomes polarised, and remains focussed on matters of fact, rather than matters of concern, seems unlikely to result in productive resolutions. A more 'civilised' mode of debate that situates knowledge, engages values, is conducted with humility and encourages hesitation (following Stengers) may be more productive.
Publisher: Public Library of Science (PLoS)
Date: 22-04-2014
Publisher: Springer Science and Business Media LLC
Date: 05-04-2014
Publisher: Wiley
Date: 15-07-2014
DOI: 10.1111/DAR.12167
Abstract: Legal thresholds for drug trafficking, over which possession of an illicit drug is deemed 'trafficking' as opposed to 'personal use', are employed in all Australian states and territories excepting Queensland. In this paper, we explore the extent to which people who regularly inject drugs understand such laws. Participants from the seven affected states/territories in the 2012 Illicit Drug Reporting System (n = 823) were asked about their legal knowledge of trafficking thresholds: whether, if arrested, quantity possessed would affect legal action taken and the quantities of heroin, meth hetamine, cocaine and cannabis that would constitute an offence of supply. Data were compared against the actual laws to identify the accuracy of knowledge by drug type and state, and sociodemographics, use and purchasing patterns related to knowledge. Most Illicit Drug Reporting System participants (77%) correctly said that quantity possessed would affect charge received. However, only 55.8% nominated any specific quantity that would constitute an offence of supply, and of those 22.6% nominated a wrong quantity, namely a quantity that was larger than the actual quantity for supply (this varied by state and drug). People who regularly inject drugs have significant gaps in knowledge about Australian legal thresholds for drug trafficking, particularly regarding the actual threshold quantities. This suggests that there may be a need to improve education for this population. Necessity for accurate knowledge would also be lessened by better design of Australian drug trafficking laws.
Publisher: Informa UK Limited
Date: 18-01-2013
Publisher: Wiley
Date: 04-04-2023
DOI: 10.1111/DAR.13652
Publisher: Informa UK Limited
Date: 06-11-2016
Publisher: Wiley
Date: 03-2021
DOI: 10.1111/DAR.13257
Abstract: While treatment is an effective way to resolve alcohol problems, many people resolve their alcohol problems in the absence of treatment. Just how many do so is not known and may vary based on the definition of treatment. Various estimates of untreated alcohol problem resolution were calculated in this study, and the differences between people who resolve their alcohol problems with or without treatment were explored in relation to sociodemographic variables, levels of alcohol consumption in the past 12 months and lifetime alcohol problem severity. A cross‐sectional online survey was administered to 719 people who had resolved an alcohol problem in Australia. Convenience s ling was used through a recruitment strategy targeted towards the general population via Facebook. Almost half (49.8%) of all people who resolved their alcohol problem did so in the absence of alcohol treatment, whether specialist alcohol treatment, mutual‐aid services or digital support services. When accessing mental health treatment is included under the scope of ‘treatment’, this estimate dropped to 12.8%. The estimated odds of having accessed treatment increased with age and lifetime alcohol problem severity. Other sociodemographic variables, or levels of alcohol consumption in the past 12 months, were not significantly associated with treatment status. It might be beneficial to expand the scope of ‘treatment’ to include mental health services and focus on the development of cost‐effective and less intrusive standalone activities, which can expedite and support alcohol problem resolution for those who choose not to access specialist treatment.
Publisher: Elsevier BV
Date: 02-2019
DOI: 10.1016/J.DRUGPO.2018.12.006
Abstract: In Australia and elsewhere, the impacts of drug prohibition have sparked a critical dialogue about the state of current drug laws. While a range of 'experts' have offered their opinion and participation in these deliberations, the voices of the affected community have largely been excluded. This study aimed to gather the opinions and preferences of people who use drugs about the current or alternative models of drug laws, in addition to how they think drug laws could be changed Author Conflict of Interest Declaration. In March 2018, four focus groups (n = 37) were conducted with people who were in receipt of social welfare services in Sydney, Australia, where participants were encouraged to share their views about the current drug laws, drug law reform options, and important messages to politicians. Several themes were identified through a thematic analysis. Models of drug law reform were often understood and expressed in language and constructs different to those commonly used by researchers. Opinions were erse and there was no consensus on a preferred model, although discussions flowed around decriminalisation, legalisation, and a medical rescription model the latter being the preferred approach. Participants shared pessimistic views of the drug laws ever changing, and argued that public opinion would need to adjust for reform to succeed. Furthermore, they argued that the views of the affected community are vital to any drug law reform c aign. Participants affinity towards a medical rescription approach to drug regulation was an unexpected finding. This study serves as an important ex le of the opinions and experiential knowledge of the affected community and this knowledge could be solicited alongside other forms of 'expertise' in drug law reform c aigns.
Publisher: Elsevier BV
Date: 11-2022
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 09-2006
Publisher: Wiley
Date: 26-11-2021
DOI: 10.1111/ADD.15288
Abstract: Recovery from alcohol problems in the absence of treatment or mutual‐aid is very common, but under‐researched. This study explores the lives of people who had resolved their alcohol problems without treatment, seeking to situate experiences of recovery in social contexts and broader life narratives. The in‐depth qualitative interviews were aided by a life‐history methodology that invited participants to account retrospectively for their lives. A narrative analysis was undertaken. Two major cities (Sydney and Melbourne) in Australia. People who had resolved an alcohol problem in the absence of treatment ( n = 12) were recruited from the general community using convenience s ling. Eligible participants had received ‘minimal treatment’ for an alcohol use disorder: fewer than three sessions in an outpatient treatment programme or nine sessions with mutual‐aid groups (e.g. Alcoholics Anonymous), or having accessed mental health treatment for problems other than drinking at least 2 years prior or 1 year after having resolved an alcohol problem. Participants were considered to have had an alcohol use disorder if they reported two or more symptoms (DSM‐V) within a 1‐year period prior to the past year, using questions endorsed by the National Institute on Alcohol Abuse and Alcoholism (NIAAA). People were considered to have resolved their alcohol use disorder by responding to the recruitment message calling for people who "used to have an alcohol problem but no longer do". The Alcohol Use Disorders Identification Test (AUDIT‐C) was used to understand participant’s drinking behaviours in the past 12 months. Four different narratives were identified in the analysis. In the emancipation narrative, identity development and major changes across the life‐curve were associated with separating oneself from an oppressive circumstance. In discovery narratives, art culture and other consciousness‐expanding experiences were sources of identity development, but sometimes a barrier to alcohol recovery. In mastery narratives, life events were understood as failures or successes, and recovery was positioned as an in idual journey accomplished through increased problem awareness. Finally, in coping narratives, changes were understood as a series of continuous struggles, and recovery was made sense of through diagnostic discourses. People who resolve an alcohol use disorder in the absence of treatment or mutual‐aid appear to explain their recovery in terms of at least four different life narratives: emancipation, discovery, mastery or coping. Social contexts and cultures outside the treatment setting, and the various identities and narratives they provide, shape change processes.
Publisher: Elsevier BV
Date: 05-2012
DOI: 10.1016/J.DRUGALCDEP.2011.09.028
Abstract: The illicit drug trade is the largest in value among global illicit commodities, at some $320 billion US dollars, according to the UN World Drug Report. Endeavours to control such a large illicit market would be enhanced by improved understanding of the economics of the trade. However, due to its illicit nature many aspects of the illicit drug market are largely unknown. This study explored one economic aspect of illicit drug dealing, profitability, with the aim of developing a better picture of the financial gains from illicit drug dealing. Data were obtained from judges sentencing remarks, key informants from law enforcement, and other published reports which detail the prices paid for meth hetamine in Australia. The financial margins attained from non-crystal meth hetamine dealing in Australia were calculated by examining the best fit for the relationship between prices and quantities: in this case a power law. If it is assumed that a single deal is ided ("cut") between 4 times and 20 times before selling to the next customer, the mark-ups can range from 24% to 59%. The mark-ups appear low compared with those found in US research, but similar to those found in UK research. To our knowledge, this is the first attempt to analyse profitability of meth hetamine dealing in Australia. The findings of this study will help in understanding the motivations and decisions of drug dealers, and potentially assist drug law enforcement agencies to design better strategies to dismantle supply chain linkages which generate excessive profits.
Publisher: Wiley
Date: 04-1992
DOI: 10.1080/09595239200185641
Abstract: The present paper aims to explore issues related to men within the context of seeking help for substance abuse. The male gender role is in conflict with help-seeking behaviour and with the fundamental principles of therapy, i.e. introspection, emotional expressivity and acknowledgement of difficulties. This creates a paradox for the male seeking psychological treatment and, it will be argued, particularly for the male substance abuser. It is argued that interventions which address the gender role and challenge men's perceptions of themselves are critical variables in the outcome of therapy, i.e. enabling them to make the necessary changes in order to promote psychological well-being. An examination of the male gender role in relation to intrapsychic issues and family systems will be followed by a brief discussion of therapeutic interventions. Some of the difficulties and issues confronted by workers who work with male substance abusers will be explored.
Publisher: Informa UK Limited
Date: 2008
Publisher: Wiley
Date: 09-2006
Publisher: Wiley
Date: 11-2006
DOI: 10.1080/09595230600944529
Abstract: Harm reduction is both a policy approach and used to describe a specific set of interventions. These interventions aim to reduce the harms associated with drug use. Employing a strict definition of harm reduction, evidence for the efficacy and effectiveness of alcohol, tobacco and illicit drug harm reduction interventions were reviewed. Systematic searches of the published literature were undertaken. Studies were included if they provided evaluation data (pre-post, or control group comparisons). More than 650 articles were included in the review. The majority of the literature concerned illicit drugs. For alcohol, harm reduction interventions to reduce road trauma are well-founded in evidence. Otherwise, there is limited research to support the efficacy and effectiveness of other alcohol harm reduction interventions. For tobacco, the area is controversial but promising new products that reduce the harms associated with smoking are being developed. In the area of illicit drugs there is solid efficacy, effectiveness and economic data to support needle syringe programmes and outreach programmes. There is limited published evidence to date for other harm reduction interventions such as non-injecting routes of administration, brief interventions and emerging positive evidence for supervised injecting facilities. There is sufficient evidence to support the wide-spread adoption of harm reduction interventions and to use harm reduction as an overarching policy approach in relation to illicit drugs. The same cannot be concluded for alcohol or tobacco. Research at a broad policy level is required, especially in light of the failure by many policy makers to adopt cost-effective harm reduction interventions.
Publisher: Wiley
Date: 21-06-2021
DOI: 10.1111/ADD.15605
Publisher: Elsevier BV
Date: 07-2015
DOI: 10.1016/J.DRUGPO.2015.04.006
Abstract: The notion of 'recovery' as an overarching approach to drug policy remains controversial. This cross-national analysis considers how the problem of drugs was constructed and represented in two key reports on the place of 'recovery' in drug policy, critically examining how the problem of drugs (and the people who use them) are constituted in recovery discourse, and how these problematisations are shaped and disseminated. Bacchi's poststructuralist approach is applied to two documents (one in Britain and one in Australia) to analyse how the 'problem of drugs' and the people who use them are constituted: as problematic users, constraining alternative understandings of the shifting nature of drug use as responsibilised in iduals (in Britain) and as patients (in Australia) as worthy of citizenship in the context of treatment and recovery, silencing the assumption of unworthiness and the loss of rights for those who continue to use drugs in 'problematic' ways. The position of the organisations which produced the reports is considered, with the authority of both organisations resting on their status as independent, apolitical bodies providing 'evidence-based' advice. There is a need to carefully weigh up the desirable and undesirable political effects of these constructions. The meaning of 'recovery' and how it could be realised in policy and practice is still being negotiated. By comparatively analysing how the problem of drugs was produced in 'recovery' discourse in two jurisdictions, at two specific points in the policy debate, we are reminded that ways of thinking about 'problems' reflect specific contexts, and how we are invoked to think about policy responses will be dependent upon these conditions. As 'recovery' continues to evolve, opening up spaces to discuss its contested meanings and effects will be an ongoing endeavour.
Publisher: Wiley
Date: 07-2010
Publisher: Informa UK Limited
Date: 19-06-2020
Publisher: Wiley
Date: 06-05-2004
Publisher: Informa UK Limited
Date: 30-01-2013
Publisher: Bristol University Press
Date: 11-2017
DOI: 10.1332/174426416X14683497019265
Abstract: This paper critically analyses the introduction of drug detection dogs as a tool for policing of illicit drugs in New South Wales, Australia. Using Kingdon’s ‘multiple streams’ heuristic as a lens for analysis, we identify how the issue of drugs policing became prominent on the policy agenda, and the conditions under which the alternative of drug detection dogs for illicit drugs policing came to be endorsed by decision makers. By applying Kingdon’s heuristic, we also consider how this approach may be used to illuminate the limitations of the evidence-based policy paradigm in the context of policing policy.
Publisher: Wiley
Date: 24-04-2017
DOI: 10.1111/DAR.12553
Abstract: Cannabis use rates in Australia have declined since 2001. No research to date has examined possible reasons, despite evident policy interest in understanding such a positive public health outcome. In a 'first pass' examination, five possible reasons are explored: (i) attitudinal shifts regarding the acceptability of cannabis use (ii) regulatory or policy changes (iii) supply/market changes (iv) changes in other drug use that may operate as substitutes or complements to cannabis and (v) socio-cultural factors. Secondary analyses from three publically available national surveys (the National Drug Strategy Household Survey 2001 to 2013, the Illicit Drug Reporting System 2004 to 2013 and the Illicit Drug Data Report 2002 to 2013) were used to explore the five reasons. It appears that all five explanations are reasonable and have preliminary evidence to indicate they are worth pursuing empirically. Attitudes have not softened towards cannabis in Australia, and regulatory changes appear to have tightened. Perceived purity may have declined, and with stable prices, this suggests an increase in purity-adjusted price that would also be consistent with decreased use. The significant declines in tobacco and alcohol use in Australia, which operate as complements to cannabis, also plausibly account for the significant decrease. This work suggests future directions for cannabis research in Australia. New multi-disciplinary research that has the potential to explore multiple hypotheses simultaneously is required. [Ritter A, Sotade O. Explaining the declining rates of past year cannabis use in Australia: A first pass. Drug Alcohol Rev 2017 :000-000].
Publisher: Wiley
Date: 09-12-2021
DOI: 10.1111/ADD.15755
Abstract: Many nations have provisions for involuntary treatment of alcohol dependence where the person is at serious risk of harm to themselves. To date, there has been little thorough evaluation of its effectiveness. This study aimed to determine if there were differences between involuntary and voluntary treatment for alcohol dependence on subsequent emergency and hospital care. A retrospective cohort design using linked routinely collected administrative data on health‐care utilization. Hospital and community‐based alcohol treatment, New South Wales, Australia. A total of 231 patients who were involuntarily treated for alcohol dependence and 231 matched controls who received treatment as usual within the period May 2012 to April 2018. Involuntary treatment comprised a 28‐day mandated hospital admission which included supervised withdrawal, comprehensive assessment, rehabilitation and support followed by voluntary aftercare support for up to 6 months. Treatment as usual comprised three not mutually exclusive forms of intensive voluntary alcohol treatment: withdrawal management, rehabilitation and pharmacotherapies for alcohol dependence. Outcome measures: changes in the number of emergency department (ED) visits and number of unplanned hospital admissions 12 months before and 12 months after completion of index treatment. Both groups showed a reduction in ED visits (incidence rate ratio (IRR) = 0.56, 95% credible intervals (CrI) = 0.39–0.78) and unplanned hospital admissions (IRR = 0.49, 95% CrI = 0.37–0.65). There was no statistically significant difference between the two groups (IRR = 0.77, 95% CrI = 0.58–1.03 for ED visits and IRR = 0.79, 95% CrI = 0.62–1.01 for hospital admissions). The Bayes factors were 0.925 and 0.936 for ED visits and unplanned hospital admissions, respectively, interpreted as weak evidence in support of the null hypothesis of no difference between the interventions. Involuntary treatment of alcohol dependence was associated with reduced health service utilization in the year following treatment, and the outcomes did not differ from those of a matched control group.
Publisher: Wiley
Date: 09-12-2017
DOI: 10.1111/ADD.13611
Publisher: No publisher found
Date: 2014
Publisher: Wiley
Date: 09-2016
DOI: 10.1111/DAR.12429
Publisher: Wiley
Date: 08-2022
DOI: 10.1111/DAR.13518
Abstract: There have been many changes to cannabis laws across the globe, some dramatic but more often incremental. This study explored the experiences after an incremental cannabis law reform in the Australian Capital Territory, Australia. Semi‐structured interviews ( n = 30) were conducted in March and April 2021, 14 months after the introduction of cannabis law reform, with people aged 18 and over who had grown and/or consumed cannabis in the previous 12 months. Participants were asked about recent and past cannabis use, growing cannabis and changes to their practices after the introduction of the legislation. Incremental cannabis law change resulted in regulatory grey areas. How people interpreted and navigated such grey areas were connected to their relative privileges, circumstances and histories. Those who were highly policed were more likely to experience the grey areas negatively. Those who were not highly policed found the grey areas confusing or ‘half‐arse’ (insufficiently executed), but mostly experienced the new laws positively through new cannabis cultivation or perceived reduction in stigma and fear of arrest. Those with self‐identified privilege were unconcerned with grey areas of the legislation. Incremental policy change can result in grey areas that require some navigation. Vulnerable populations appear less likely to experience the full benefits of such incremental drug law reform. It is vital to attend to the inequities that can arise from incremental law reform so that positive experiences are shared across the population regardless of relative privilege.
Publisher: Wiley
Date: 08-03-2023
DOI: 10.1111/DAR.13639
Publisher: Elsevier BV
Date: 12-2004
DOI: 10.1016/J.JSAT.2004.08.003
Abstract: This study evaluated the additional effectiveness of a 12-week manualized group counseling program over a structured naltrexone treatment program. The randomized controlled trial, the first of its kind in Australia, was conducted at Turning Point Alcohol and Drug Centre, Melbourne, Australia. Ninety-seven participants received a 50 mg dose of naltrexone daily and were randomized to either the experimental (n = 52) or control (n = 45) conditions. The experimental group received a structured group counseling program, which used a cognitive-behavioral relapse prevention approach. Using intention-to-treat analyses, there was only one statistically significant difference between the groups, with the control group reporting a significantly higher level of physical functioning at Week 6. All participants improved significantly in their level of heroin use and in psychosocial functioning between Baseline and Weeks 6, 12, and 24. It is not possible to conclude from these results whether or not group counseling provides additional benefit to naltrexone treatment.
Publisher: Elsevier BV
Date: 07-2014
DOI: 10.1016/J.DRUGPO.2014.03.005
Abstract: Policy choices for illicit drugs such as cannabis entail consideration of competing factors such as in idual health, societal views about pleasure, and criminal justice impacts. Society must weigh up these factors in determining the preferred cannabis policy although often cast as a contest between legalisation of cannabis or full prohibition the actual policy choices are not so black and white. This study assessed societal preferences for different cannabis policies and multiple consequences. A discrete choice experiment (DCE) quantified value-based preferences for alternative cannabis policies described by the five key attributes legal status, health harms, criminal justice service costs, rates of cannabis use and purchase location. An online survey was conducted on a population s le of 1020 Australians. The analytical model was based on stated choices for Policy A, B or Current Policy. The results revealed a strong general preference for either civil penalties or legalisation compared to cannabis cautioning (Current Policy) and a strong dislike of criminalising possession and use of cannabis. Results also demonstrate difference in preferences among those with different demographics and beliefs. Understanding these nuances help to quantify the range of preferences held within the population and can be used to inform policy. This is the first known DCE survey applied to the area of illicit drugs policy. It demonstrates the public hold disparate views on the most appropriate status for cannabis offences and they are able to make trade-offs between policy choices and outcomes in complex areas of social policy.
Publisher: Informa UK Limited
Date: 23-04-2013
Publisher: Wiley
Date: 07-2005
DOI: 10.1080/09595230500263939
Abstract: The development of policies in relation to unsupervised doses of methadone (take-away doses) should be based upon the best available evidence. There are both risks and benefits associated with take-away doses. This study aimed to explore the relationship between take-away policies and one measure of harm: methadone injection rates. Six different states in Australia were compared in relation to their methadone take-away policy and rates of methadone injection within their population of injecting drug users. At a simplistic level, those states with restrictive and less flexible take-away policies tended to have the lowest reported prevalence of methadone injection. However, this does not fully explain variability in methadone injecting. There were also considerable differences between those states with similar take-away policies. Variables which appear to impact upon methadone injecting rates include: take-away policies, drug preference, drug availability, treatment availability and degree of treatment penetration. Consideration of the benefits, rather than merely the harms, of various take-away policy options may provide an evidence-based platform for take-away policy development.
Publisher: Wiley
Date: 12-07-2022
DOI: 10.1111/DAR.13352
Abstract: Pill testing is regarded as a controversial harm reduction intervention and provides an ideal case study for examining how policy change comes about. Two Australian jurisdictions were analysed to explore factors that may account for policy change by comparing the ACT which allowed a pill testing trial, and NSW where pill testing has not been permitted. The analysis was conducted using the Advocacy Coalition Framework (ACF). Data sources were first coded to establish the subsystem actors beliefs and advocacy coalitions then coded using a deductive approach and classified against core dimensions of the ACF. An inductive approach was then applied to generate and link themes in the data. A dominant and minority coalition was identified in each jurisdictions' policy subsystem. The results show how in the ACT a dominant ‘harm reduction’ coalition shifted their secondary beliefs and introduced a pill testing policy. Whereas in NSW, a shift in both the secondary and policy core beliefs of the dominant ‘law enforcement’ coalition was required, something which rarely occurs according to the ACF. The analysis supports the ACF's assertion that advocacy coalitions will respond to pressures for change by restricting change to secondary beliefs, while keeping policy core beliefs intact. It also demonstrates that secondary and policy core beliefs matter in the context of minority and dominant coalitions. Further research is needed to explore whether a minority coalition's strategic re‐framing of an issue to align with the policy core beliefs of their opponents would have more success than advocating from their own belief paradigm.
Publisher: Wiley
Date: 25-01-2023
DOI: 10.1111/DAR.13599
Abstract: Most studies of alcohol policy have focussed on the role of industry. However, little is known about the evidence base used in alcohol policymaking or policymakers' actions in the field. Here, we mapped the different evidence types used in a case study to construct a classification framework of the evidence types used in alcohol policymaking. Using a case study from the state‐level in Australia, we used content analysis to delineate the evidence types cited across six phases of a policymaking process. We then grouped these types into a higher‐level classification framework. We used descriptive statistics to study how the different evidence types were used in the policymaking process. Thirty‐one evidence types were identified in the case study, across four classes of knowledge: person knowledge, shared knowledge, studied knowledge and practice knowledge. The participating public preferenced studied knowledge. Policymakers preferenced practice knowledge over all other types of knowledge. The classification framework expands on models of evidence and knowledge used across public health, by mapping new evidence types and proposing an inductive method of classification. The policymakers' preferences found here are in line with theories regarding the alcohol industry's influence on policymaking. The classification framework piloted here can provide a useful tool to examine the evidence base used in decision‐making. Further study of evidence types used in policymaking processes can help inform research translation and advocacy efforts to produce healthier alcohol policies.
Publisher: Elsevier BV
Date: 09-2014
DOI: 10.1016/J.DRUGPO.2014.03.002
Abstract: Legal thresholds are used in many parts of the world to define the quantity of illicit drugs over which possession is deemed "trafficking" as opposed to "possession for personal use". There is limited knowledge about why or how such laws were developed. In this study we analyse the policy processes underpinning the introduction and expansion of the drug trafficking legal threshold system in New South Wales (NSW), Australia. A critical legal and historical analysis was undertaken sourcing data from legislation, Parliamentary Hansard debates, government inquiries, police reports and research. A timeline of policy developments was constructed from 1970 until 2013 outlining key steps including threshold introduction (1970), expansion (1985), and wholesale revision (1988). We then critically analysed the drivers of each step and the roles played by formal policy actors, public opinion, research/data and the drug trafficking problem. We find evidence that while justified as a necessary tool for effective law enforcement of drug trafficking, their introduction largely preceded overt police calls for reform or actual increases in drug trafficking. Moreover, while the expansion from one to four thresholds had the intent of differentiating small from large scale traffickers, the quantities employed were based on government assumptions which led to "manifest problems" and the revision in 1988 of over 100 different quantities. Despite the revisions, there has remained no further formal review and new quantities for "legal highs" continue to be added based on assumption and an uncertain evidence-base. The development of legal thresholds for drug trafficking in NSW has been arbitrary and messy. That the arbitrariness persists from 1970 until the present day makes it hard to conclude the thresholds have been well designed. Our narrative provides a platform for future policy reform.
Publisher: Wiley
Date: 11-09-2023
DOI: 10.1111/ADD.16038
Abstract: While many studies have examined outcome measurement as part of clinical trials and routine outcome collection at the person‐level in alcohol and other drug (AOD) treatment services, there has been limited attention to measures required to assess performance at the service‐level. In Australia, non‐government services are primarily funded by government using public funds however, there is no standardized approach to performance measurement. This study sought to establish a finite list of performance measures that represented consensus between funders, treatment providers and service‐users. A three‐round Delphi process was undertaken with (i) funders of treatment ( n = 10), (ii) treatment providers ( n = 10) and (iii) treatment service‐users ( n = 10). Participants were asked to rate a range of measures on a 10‐point Likert scale on how important they were to be included in contracts with funders. Measures with a median score 7 and agreement among participants above 70% were the criteria for inclusion in the final set of measures. Qualitative data in the form of text responses provided by participants for their ratings in rounds 1 and 2 were also analysed. Participants rated 93 measures in round 1, which reduced to 78 measures in round 2 and 32 measures in round 3. Fifteen service‐level measures and two system‐level measures met criteria for inclusion in the final set of performance measures. The final set of measures cover a range of measurement types: outcomes ( n = 5), access ( n = 3), structural ( n = 3), experience ( n = 2), input ( n = 2), process ( n = 1) and output ( n = 1). In Australia, performance measures for alcohol and other drug treatment services that represent a consensus among service‐users, providers and funders focus upon demonstrating accountability for public funds, improving services and communicating key measures of success to future service‐users and the broader community.
Publisher: Elsevier BV
Date: 05-2016
Publisher: Elsevier BV
Date: 12-2022
DOI: 10.1016/J.DRUGPO.2022.103903
Abstract: While there is widespread agreement as to the importance of increasing participation in drug policy design, drug policy literature contains limited reflection on the practices that may support inclusion and collaboration amongst policy actors, particularly when disagreement and difference are an intrinsic part of participation. Drawing on qualitative interviews and ethnographic fieldwork with actors engaged in an Australian illicit drug policy reform c aign, this paper examines how particular modes of personal connection mattered in establishing and maintaining working relationships between a range of differently situated actors. Through engagement with this case study, we argue that modes of personal connection marked by qualities such as being frank engaged not forcing consensus enacting respect listening in order to understand and acting in ways that respected the obligations and limits that came with people's roles while also recognising one another as more than those roles, were particularly important qualities that supported connection across difference. Such personal connections seem to have been even more important for the engagement of people representing more marginal positionalities. Arguing that personal connection is already an element of both inclusion and exclusion in drug policy creation, we suggest that policy actors interested in contributing to a more erse and rigorous policy participation space attend to how people connect, with whom, and with what space for disagreement, while also taking seriously the labour of such connection across difference.
Start Date: 2014
End Date: 07-2016
Amount: $105,000.00
Funder: Australian Research Council
View Funded ActivityStart Date: 08-2020
End Date: 08-2023
Amount: $300,515.00
Funder: Australian Research Council
View Funded ActivityStart Date: 2012
End Date: 06-2016
Amount: $109,000.00
Funder: Australian Research Council
View Funded ActivityStart Date: 2020
End Date: 12-2022
Amount: $300,134.00
Funder: Australian Research Council
View Funded ActivityStart Date: 2008
End Date: 12-2010
Amount: $238,579.00
Funder: Australian Research Council
View Funded ActivityStart Date: 03-2015
End Date: 03-2017
Amount: $114,500.00
Funder: Australian Research Council
View Funded Activity