ORCID Profile
0000-0002-1886-0733
Current Organisation
La Trobe University - Melbourne Campus
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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.
Sociology | Sociology and Social Studies of Science and Technology | Social Change | Health Policy | Public Health and Health Services not elsewhere classified | Family and Household Studies | Policy and Administration
Social Structure and Health | Expanding Knowledge through Studies of Human Society | Substance Abuse |
Publisher: Wiley
Date: 03-10-2022
DOI: 10.1111/DAR.13386
Abstract: ‘Drinking occasions’ are commonly used to capture quantities of alcohol consumed. Yet this standardised terminology brings with it numerous assumptions and epistemological limitations. We suggest that social changes brought on by COVID‐19 restrictions have influenced routines, patterns of time use and drinking practices, highlighting the need to re‐examine how we conceptualise drinking and ‘drinking occasions’ in alcohol research. This analysis draws on data gathered from 59 qualitative interviews conducted during the second half of 2020 with Australian drinkers aged 18 and over. The interviews explored how COVID‐19 restrictions impacted daily practices and alcohol consumption patterns. Participants spoke about their work, study and social routines changing, which influenced the times, timing and contexts of their drinking practices. We separated these shifts into four overarching themes: shifting of structures shaping drinking the permeability of drinking boundaries the extension of drinking occasions and new contexts for drinking. COVID‐19 restrictions have led to shifts in the temporal boundaries and contexts that would otherwise shape people's drinking, meaning drinking practices may be less bound by structures, norms, settings and rituals. The drinking occasions concept, although a simple tool for measuring how much people drink, has not been able to capture these complex developments. This is a timely consideration given that COVID‐19 may have enduring effects on people's lifestyles, work and drinking practices. It may be useful to examine drinking as practice, rather than just an occasion, in order to better contextualise epidemiological studies going forward.
Publisher: Wiley
Date: 12-10-2021
DOI: 10.1111/DAR.13188
Publisher: Elsevier BV
Date: 11-2015
Publisher: Informa UK Limited
Date: 15-07-2021
Publisher: Elsevier BV
Date: 07-2008
DOI: 10.1016/J.DRUGPO.2008.05.001
Abstract: Evidence of harms associated with temazepam gel capsule injecting among injecting drug users in Australia led to its withdrawal from manufacture in Australia. Subsequently, diphenhydramine gel capsule injecting was identified among a subset of ethnic Vietnamese injecting drug users. Observational fieldwork around an active street-based illicit drug marketplace together with targeted purposive s ling enabled 66 ethnic Vietnamese injecting drug users to be recruited for in-depth interview. Data revealed that the injection of gel capsules increases exposure to non-viral infections. Analysis of participant interviews show how participants have established their own ways of reducing these harms including thinning the drug solution by jacking regularly during injection. Controversially, femoral vein administration of diphenhydramine-heroin cocktails was also seen as a harm reduction strategy by participants. Health education c aigns to address the potentially negative consequences of gel capsule groin injection will not be successful unless health workers and policy makers work with drug users and incorporate local understandings and meanings of risk in health promotion activities.
Publisher: Wiley
Date: 11-2020
DOI: 10.1111/DAR.13061
Publisher: Springer Science and Business Media LLC
Date: 03-05-2017
Publisher: Elsevier BV
Date: 02-2008
DOI: 10.1016/J.DRUGALCDEP.2008.08.016
Abstract: The prevalences and correlates of non-viral injecting-related injuries and diseases (IRIDs) in Australian injecting drug users (IDUs) remain unknown. A cross-sectional survey of IDUs was conducted in six sites across Australia's eastern states to investigate IRID experience among Australian IDU. Correlates of IRIDs were explored using logistic and negative binomial regression analyses. 393 IDUs were recruited. Lifetime experience of non-serious IRIDs was common (e.g., 'dirty hit' 68%) potentially serious and serious IRIDs were less commonly experienced (e.g., abscess 16% gangrene <1%). Factors independently associated with potentially serious or serious IRIDs in the previous 12 months were: injecting in sites other than arms (Adjusted Odds Ratio 3.0, 95% confidence interval 1.7-5.4), injecting non-powder drug forms (5.0, 2.2-11.2), unstable accommodation (2.0, 1.1-3.5), being aged 25 years or older (4.3, 1.7-10.6) and not always washing hands before injection (9.3, 2.1-41.8). Factors independently associated with multiple IRIDs in the preceding 12 months were using three or more injecting sites (Adjusted Incidence Rate Ratio 1.5, 95% CI 1.1-2.0), injecting in sites other than arms (1.7, 1.3-2.2), using non-powder drug forms (1.9, 1.4-2.5), injecting daily or more often (1.7, 1.3-2.2), current pharmacotherapy experience (1.5, 1.1-1.9), and not always washing hands before injecting (1.9, 1.2-2.9). Some IRIDs are widespread among Australian IDUs. Observed associations, particularly the protective effect of handwashing, have useful public health implications.
Publisher: Wiley
Date: 05-2018
DOI: 10.1111/DAR.12812
Abstract: Take-home naloxone (THN) programs commenced in Australia in 2012 in the Australian Capital Territory and programs now operate in five Australian jurisdictions. The purpose of this paper is to record the progress of THN programs in Australia, to provide a resource for others wanting to start THN projects, and provide a tool for policy makers and others considering expansion of THN programs in this country and elsewhere. Key stakeholders with principal responsibility for identified THN programs operating in Australia provided descriptions of program development, implementation and characteristics. Short summaries of known THN programs from each jurisdiction are provided along with a table detailing program characteristics and outcomes. Data collected across current Australian THN programs suggest that to date over 2500 Australians at risk of overdose have been trained and provided naloxone. Evaluation data from four programs recorded 146 overdose reversals involving naloxone that was given by THN participants. Peer drug user groups currently play a central role in the development, delivery and scale-up of THN in Australia. Health professionals who work with people who use illicit opioids are increasingly taking part as alcohol and other drug-related health agencies have recognised the opportunity for THN provision through interactions with their clients. Australia has made rapid progress in removing regulatory barriers to naloxone since the initiation of the first THN program in 2012. However, logistical and economic barriers remain and further work is needed to expand access to this life-saving medication.
Publisher: Elsevier BV
Date: 07-2019
DOI: 10.1016/J.DRUGPO.2019.03.020
Abstract: Opioid overdose is a significant public health issue among people who use pharmaceutical opioids and/or heroin. One response to reducing overdose deaths is to expand public access to naloxone. The Australian Therapeutic Goods Administration down-scheduled naloxone from prescription only (S4) to pharmacist only over-the-counter (OTC, schedule 3) in February 2016. There is little research examining pharmacists' perspectives or experiences of this change. Thirty-seven semi-structured interviews with Australian community pharmacists were conducted in 2016-2017 to investigate pharmacists' attitudes to and experiences of OTC naloxone. Transcripts were thematically analysed, guided by a broad interest in facilitators and barriers to OTC supply. Around half of the pharmacists were aware of the down-scheduling and only two had provided OTC naloxone. Core barriers to pharmacist provision of OTC naloxone included limited understanding of opioid overdose, confusion about the role and responsibilities of pharmacists in providing OTC naloxone, concerns about business, stigma related to people who inject drugs (PWID) and system-level challenges. Pharmacy provision of OTC naloxone offers an important opportunity to reduce overdose mortality. Our study suggests this opportunity is yet to be realised and highlights several in idual- and structural-level impediments hindering the expansion of public access to naloxone via community pharmacies. There is a need to develop strategies to improve pharmacists' knowledge of OTC naloxone and opioid overdose as well as to address other logistical and cultural barriers that limit naloxone provision in pharmacy settings. These need to be addressed at the in idual level (training) as well as the system level (information, regulation and supply).
Publisher: Wiley
Date: 02-2019
Abstract: 'Take-home naloxone' refers to a life-saving intervention in which a drug (naloxone) is made available to nonmedically trained people for administration to other people experiencing an opioid overdose. In Australia, it has not been taken up as widely as would be expected, given its life-saving potential. We consider the actions of take-home naloxone, focusing on how care relations shape its uses and effects. Mobilising Science and Technology Studies insights, we suggest that the uses and effects of naloxone are co-produced within social relations and, therefore, this initiative 'affords' multiple outcomes. We argue that these affordances are shaped by a politics of care, and that these politics relate to uptake. We analyse two complementary case studies, drawn from an interview-based project, in which opioid consumers discussed take-home naloxone and its uses. Our analysis maps the ways take-home naloxone can afford (i) a regime of care within an intimate partnership (allowing a terminally ill man to more safely consume opioids) and (ii) a political process of care (in which a consumer takes care of others treated with the medication by administering it 'gently'). We conclude by exploring the political affordances of a politics of care approach for the uptake of take-home naloxone.
Publisher: Informa UK Limited
Date: 30-03-2016
Publisher: SAGE Publications
Date: 22-06-2019
Abstract: Commentators suggest the social media platform, Twitter, might afford challenges to hegemonic knowledge by providing voice to those outside traditional media and by enabling vigorous public discussion and contestation of dominant ideas and concepts. In this article, we ask whether such affordances might be reshaping the culturally charged concept of addiction and, in turn, its accompanying abject and maligned subject, the ‘addict’. To explore this question, we examine Twitter messages about addiction posted by celebrities. These people are among the most highly followed Twitter account holders, meaning their Twitter messages can reach millions of people. Our analysis examines how specific addiction problems, and their solutions, are being constituted through the tweeting practices of celebrities. We also consider the unintentional effects these messages produce. Finally, we examine the ways in which these messages are discussed and contested by the audiences of the celebrities. We find celebrity Twitter activity re-enacts familiar realities of addiction, realities that collapse drug use with harm and addiction, addiction with pathology and death. Abstinence is posed as the only effective and genuine response, and the contradictions in simultaneously in idualizing action against addiction and condemning stigmatization are ignored. Despite the ‘revolutionary’ potential of Twitter posited by advocates and some scholars, when it comes to addiction, it seems, the global, uncensored, ‘free’ communication on Twitter serves largely to validate and perpetuate dominant addiction concepts and the stigma and discrimination these concepts evoke.
Publisher: Elsevier BV
Date: 04-2009
DOI: 10.1016/J.DRUGALCDEP.2008.12.002
Abstract: The process of drug injection may give rise to vascular and soft tissue injuries and infections. The social and physical environments in which drugs are injected play a significant role in these and other morbidities. Supervised injecting facilities (SIFs) seek to address such issues associated with public injecting drug use. Estimate lifetime prevalence of injecting-related problems, injury and disease and explore the socio-demographic and behavioral characteristics associated with the more serious complications. Self-report data from 9552 injecting drug users (IDUs) registering to use the Sydney Medically Supervised Injecting Centre (MSIC). Lifetime history of either injecting-related problems (IRP) or injecting-related injury and disease (IRID) was reported by 29% of the 9552 IDUs 26% (n=2469) reported ever experiencing IRP and 10% (n=972) reported IRID. Prevalence of IRP included difficulties finding a vein (18%), prominent scarring or bruising (14%) and swelling of hands or feet (7%). Prevalence of IRID included abscesses or skin infection (6%), thrombosis (4%), septicaemia (2%) and endocarditis (1%). Females, those who mainly injected drugs other than heroin, and those who reported a history of drug treatment, drug overdose, and/or sex work, were more likely to report lifetime IRID. Frequency and duration of injecting, recent public injecting, and sharing of needles and/or syringes were also independently associated with IRID. IRPs and IRIDs were common. Findings support the imperative for education and prevention activities to reduce the severity and burden of these preventable injecting outcomes. Through provision of hygienic environments and advice on venous access, safer injecting techniques and wound care, SIFs have the potential to address a number of risk factors for IRID.
Publisher: Elsevier BV
Date: 05-2013
DOI: 10.1016/J.DRUGPO.2013.03.003
Abstract: Over the last decade in Australia, meth hetamine has come to be seen as a significant issue for drug research, policy and practice. Concerns have been expressed over its potency, the increasing prevalence of its use and its potential for producing greater levels, and more severe forms, of harm compared to hetamine or other drugs. In this article, we critically examine some of the ways in which meth hetamine and its effects are produced and reproduced within and through Australian public discourse, focusing in particular on the associations made between meth hetamine and psychosis. We show how public discourse enacts meth hetamine as an anterior, stable, singular and definite object routinely linked to the severe psychological 'harm' of psychosis. We contrast the enactment of meth hetamine within public discourse with how meth hetamine is enacted by consumers of the drug. In their accounts, consumers perform different meth hetamine objects and offer different interpretations of the relationships of these objects to psychological problems and of the ontological nature (i.e. relating to what is real, what is, what exists) of these problems. In examining public discourse and consumer accounts, we challenge conventional ontological understandings of meth hetamine as anterior, singular, stable and definite, and of its psychological effects as indicative of pathology. In line with recent critical social research on drugs, we draw on social studies of science and technology that focus on the performativity of scientific knowledge and material practices. We suggest that recognising the ontological contingency, and therefore the multiplicity, of meth hetamine offers a critical counterpoint to conventional research, policy and practice accounts of meth hetamine and its psychological effects.
Publisher: Wiley
Date: 22-02-2018
DOI: 10.1111/DAR.12680
Abstract: Take-home naloxone (THN) programs have been operating in Australia since 2012 in a variety of settings. We examine whether THN programs were effective in increasing knowledge about opioid overdose and appropriate responses in program participants. Data were obtained from pre- and post-training questionnaires administered as part of the early evaluations of THN naloxone programs operated in Sydney (n = 67), Melbourne (n = 280), Perth (n = 153) and Canberra (n = 183). Pooled data from comparable items, analysed in the domains specified in previously-developed evaluation scales, were compared using repeated-measures analysis of variance and random effects logistic regression. Results pre- and post-training were compared as well as results across sites. High levels of knowledge about overdose risks and signs and appropriate actions to take were observed at baseline and this generally improved over time. No substantial differences were identified across cities. Knowledge also increased with participant age but the improvements over time were similar in each age group. There were small differences by participant gender with knowledge generally higher among females. THN programs are effective in improving knowledge related to overdose response. Major improvements in knowledge were limited to overdose recognition and effect of naloxone suggesting that education may best be focused on overdose signs and the use of naloxone among populations accessed through these programs. A focus on younger people also appears warranted. Further work is needed to understand the impact of training and knowledge on actual behaviours around overdose events.
Publisher: SAGE Publications
Date: 03-2016
Abstract: Persons, substances, bodies, consumption: an ever widening process of “addicting” is underway in Western societies. In this article, we turn our attention to the production of addiction on the microblogging social media platform, Twitter, as an important emerging site in which the addicting of contemporary societies is also occurring. Our analysis explores two questions. First, we investigate the ways in which addiction is enacted via Twitter. How is addiction being made on Twitter? Second, we ask how the technology of Twitter itself is shaping meaning: how do the technological “affordances” of Twitter help constitute the kinds of addiction being materialized? While we find a multiplicity of meanings in the 140-character messages, we also find a pattern: a tendency toward extremes—addiction riven between pain and pleasure. In addition, we find significant areas of commonality between approaches and notable silences around alternatives to common understandings of addiction. We argue that the constraints on communication imposed by Twitter technology afford a “shorthand” of addiction that is both revealing and productive. Illuminated is the importance of addiction as a piece of cultural shorthand that draws on and simultaneously reproduces simplistic, reductive addiction objects. In concluding, we consider what these realities of addiction being enacted through Twitter can tell us about contemporary conditions of possibility for drug use in society and for in idual subjectivities and experiences.
Publisher: Elsevier BV
Date: 07-2018
DOI: 10.1016/J.CORTEX.2018.03.003
Abstract: Phantom limbs are the phenomenal persistence of postural and sensorimotor features of an utated limb. Although immaterial, their characteristics can be modulated by the presence of physical matter. For instance, the phantom may disappear when its phenomenal space is invaded by objects ("obstacle shunning"). Alternatively, "obstacle tolerance" occurs when the phantom is not limited by the law of impenetrability and co-exists with physical objects. Here we examined the link between this under-investigated aspect of phantom limbs and apparent motion perception. The illusion of apparent motion of human limbs involves the perception that a limb moves through or around an object, depending on the stimulus onset asynchrony (SOA) for the two images. Participants included 12 unilateral lower limb utees matched for obstacle shunning (n = 6) and obstacle tolerance (n = 6) experiences, and 14 non- utees. Using multilevel linear models, we replicated robust biases for short perceived trajectories for short SOA (moving through the object), and long trajectories (circumventing the object) for long SOAs in both groups. Importantly, however, utees with obstacle shunning perceived leg stimuli to predominantly move through the object, whereas utees with obstacle tolerance perceived leg stimuli to predominantly move around the object. That is, in people who experience obstacle shunning, apparent motion perception of lower limbs was not constrained to the laws of impenetrability (as the phantom disappears when invaded by objects), and legs can therefore move through physical objects. Amputees who experience obstacle tolerance, however, had stronger solidity constraints for lower limb apparent motion, perhaps because they must avoid co-location of the phantom with physical objects. Phantom limb experience does, therefore, appear to be modulated by intuitive physics, but not in the same way for everyone. This may have important implications for limb experience post- utation (e.g., improving prosthesis embodiment when limb representation is constrained by the same limits as an intact limb).
Publisher: Informa UK Limited
Date: 11-04-2011
Publisher: Informa UK Limited
Date: 2009
Publisher: Wiley
Date: 07-12-2022
DOI: 10.1111/DAR.13415
Abstract: The COVID-19 pandemic and associated social restrictions have profoundly shaped the routines, practices and space-times of alcohol and other drug (AOD) consumption. As a part of these transformations, video conferencing services (e.g. Zoom, Whereby) have emerged as popular mediums for socialising and AOD consumption. In this article, we adopt a more-than-human theoretical framework to explore how these online contexts re-shape experiences of AOD consumption. Data were gathered using a case-study approach, guided by principles of digital ethnography. We 'staged' the online gatherings of three established friendship clusters of adults in Melbourne, Australia, and drew on a discussion guide to elicit accounts of past online AOD encounters during the COVID-19 pandemic. Our thematic analysis was sensitised to the dynamic composition of these encounters and the kinds of relations, practices and affects they enabled and constrained. Composed via video conferencing services, AOD consumption afforded distinct pleasures, including enhanced sociality, excitement and momentary reprieves from isolation. Importantly, these effects were not uniform or stable. Participants also navigated various constraints of online AOD consumption while establishing for themselves what substances and associated practices 'fit' within these novel encounters. Our study conveys the importance of digitally-mediated AOD consumption as a site of socialising and pleasure. In so doing, it demonstrates the ways in which AOD consumption was drawn on in the everyday negotiation of health and wellbeing under lockdown conditions. We call for research and policy approaches that are sensitive to the affirmative potentials of digitally=mediated AOD encounters.
Publisher: Wiley
Date: 03-2022
DOI: 10.1111/DAR.13457
Publisher: Cambridge University Press
Date: 05-09-2011
Publisher: Elsevier BV
Date: 10-2008
DOI: 10.1016/J.DRUGPO.2007.09.004
Abstract: Pleasure and its pursuit provide the key explanatory frame in this ethnographic analysis of temazepam injection among a set of drug injectors who enthusiastically embrace high-risk practices. The foregrounding of pleasure challenges key assumptions of harm reduction: namely, the 'rational' subject and the privileging of health as a universal good. In this paper I problematise the concepts of pleasure and conventional understandings of rationality. Interrogating these concepts through the actions and accounts of temazepam injectors, I argue that the model of the subject implicit in harm reduction does not sufficiently account for their everyday social practices. The paper draws on ethnographic research among heroin user/sellers of Vietnamese ethnicity in a local Australian heroin marketplace. Temazepam was used in combination with heroin to enhance the experience of intoxication. Intense intoxication was desired for the pleasurable bodily sensations and emotional feelings it produced. The transgressive and dangerous nature of the practice added to its pleasure. Injection of temazepam capsules was also one of the practices constituting as well as expressing central social and cultural processes of heroin use in this particular social field. Despite embodied awareness of the harms associated with temazepam injection, these people were prepared to sacrifice 'health' for the pleasures they perceived to be afforded by injecting the gel capsules. My ethnographic analysis suggests that if harm reduction is to respond to high-risk practices such as these, then attention needs to be paid to the pleasures people derive from their practices, and to the social and cultural values these constitute and express.
Publisher: Wiley
Date: 02-2022
DOI: 10.1111/J.1360-0443.2008.02339.X
Abstract: To examine the effects of a series of injecting drug users' (IDU) characteristics and drug use behaviours upon the self-reported oral health of a s le of IDU. Cross-sectional survey. Melbourne, Australia. A total of 285 IDU recruited through needle and syringe programmes, snowballing and outreach across six sites. Structured survey that collected information on current drug use patterns, self-reported blood-borne virus status and general health factors, including open-ended questions on past-year dental health problems. Sixty-eight per cent of the s le reported dental problems that were commonly severe and caused dental pain. Despite these reported problems, almost half the s le had not visited the dentist in the 12 months prior to the survey. Participants who were older, and reported homelessness, not eating every day and more common injection of hetamines rather than heroin in the previous month, were more likely to report having a past-year dental problem. Dental problems in IDUs are common but few receive treatment. Further, those using hetamines, with poor housing, hygiene and poor nutrition, are most at risk. Programmes designed to improve the oral health of IDU need to be developed and implemented in a manner amenable to the varying social circumstances of this marginalized group in the community.
Publisher: Informa UK Limited
Date: 09-12-2014
Publisher: Elsevier BV
Date: 06-2008
DOI: 10.1111/J.1753-6405.2008.00232.X
Abstract: To report on the response rate achieved in a survey of medical practitioners and discuss the reasons for it. An on-line (internet-based) survey of all 609 registered pharmacotherapy prescribers in Victoria and Queensland invitations to participate were sent by mail in late April 2007, and one reminder letter in late May 2007. Six hundred and nine invitation letters were mailed, nine were returned to sender, and 52 questionnaires completed, making the overall response rate 52/600 = 8.7%. The response rate in Queensland was 13.2% (16/121), and in Victoria 7.5% (36/479). Despite utilising sound techniques, our response rate was much lower than those achieved in recent Australian paper-based surveys of medical practitioners. It is possible that the issue being addressed (injecting-related injuries and diseases) was not of high priority for many invitees, leading to reduced response. On-line surveys are not yet an effective method of collecting data from Australian medical practitioners researchers should continue to use paper questionnaires for maximum response.
Publisher: Wiley
Date: 09-2001
Publisher: Elsevier BV
Date: 06-2017
DOI: 10.1016/J.DRUGPO.2017.05.049
Abstract: It is widely accepted that alcohol and other drug consumption is profoundly gendered. Just where this gendering is occurring, however, remains the subject of debate. We contend that one important and overlooked site where the gendering of substance consumption and addiction is taking place is through AOD research itself: in particular, through the addiction screening and diagnostic tools designed to measure and track substance consumption and problems within populations. These tools establish key criteria and set numerical threshold scores for the identification of problems. In many of these tools, separate threshold scores for women and men are established or recommended. Drawing on Karen Barad's concept of post-humanist performativity, in this article we examine the ways in which gender itself is being materialised by these apparatuses of measurement. We focus primarily on the Drug Use Disorders Identification Test (DUDIT) tool as an exemplar of gendering processes that operate across addiction tools more broadly. We consider gendering processes operating through tools questions themselves and we also examine the quantification and legitimation processes used in establishing gender difference and the implications these have for women. We find tools rely on and reproduce narrow and marginalising assumptions about women as essentially fragile and vulnerable and simultaneously reinforce normative expectations that women sacrifice pleasure. The seemingly objective and neutral quantification processes operating in tools naturalise gender as they enact it.
Publisher: Elsevier BV
Date: 09-2018
DOI: 10.1016/J.DRUGPO.2018.06.004
Abstract: Opioid overdose deaths are increasing in Australia and around the world. Despite this, measures aimed at reducing these deaths such as safe injecting facilities and take-home naloxone continue to face obstacles to uptake. The reasons for this are manifold, but a key contributor is public discourse on opioid consumption and overdose. In this article we explore this public discourse using Judith Butler's work on 'grievable lives'. The article analyses mainstream newspaper coverage of opioid overdose in Australia to map key articulations of overdose and to consider how public understandings of overdose are shaped. It then goes on to consider ways these understandings might be reshaped, looking at what have been called overdose 'anti-memorials' and a new website Livesofsubstance.org. In concluding we argue that until the lives of opioid consumers come to be considered grievable, the measures known to reduce overdose deaths may struggle to find public support.
Publisher: Wiley
Date: 09-2001
DOI: 10.1046/J.1360-0443.2001.969131911.X
Abstract: To examine injecting drug user (IDU) motivations as research participants. Convenience s ling facilitated by recruitment notices distributed through needle and syringe programmes (NSPs), and snowballing within peer networks. NSPs in six suburbs throughout the Melbourne metropolitan area. One hundred and fifty-four current IDUs. The mean age was 28 years, 62% were male, and 80% nominated heroin as preferred drug. Interviewer-administered survey including questions about socio-demographics, drug use and main reasons for participating in research. IDU research participation reasons were consistent with motivational themes such as economic gain (46%), expression of citizenship (38%), altruism (19%), personal satisfaction (17%), drug user activism (16%) and seeking information or assistance (5%). Most respondents (58%) cited reasons where the primary beneficiaries of participation were other in iduals or groups (citizenship, altruism, drug user activism) or both self and others. IDU motivations for research involvement appear to be multi-dimensional, rarely motivated by economic gain alone, and not necessarily defined by direct benefits or gains to themselves. These findings are relevant to the question of IDU research payment ethics.
Publisher: SAGE Publications
Date: 04-08-2017
Publisher: Wiley
Date: 09-2022
DOI: 10.1111/DAR.13517
Publisher: Informa UK Limited
Date: 17-09-2020
Publisher: Elsevier BV
Date: 12-2015
DOI: 10.1016/J.DRUGPO.2015.08.016
Abstract: Human practices of all kinds - substance use, gambling, sex, even eating - are increasingly being reframed through the language of addiction. This 'addicting' of contemporary society is achieved, in part, through the screening and diagnostic tools intended to identify and measure addiction. These tools are a key element in the expert knowledge-making through which realities of addiction emerge. Promoted as objective and accurate, the tools are given legitimacy through application of scientific validation techniques. In this article, we critically examine the operations of these validation techniques as applied to substance addiction tools. Framed by feminist and other scholarship that decentres the epistemological guarantees of objectivity and validity, we structure our analysis using Ian Hacking's (1999) concepts of 'refuting' (showing a thesis to be false) and 'unmasking' (undermining a thesis). Under 'refuting', we consider the methodological validation processes on their own terms, identifying contradictory claims, weak findings and inconsistent application of methodological standards. Under 'unmasking', we critically analyse validation as a concept in itself. Here we identify two fundamental problems: symptom learning and feedback effects and circularity and assumptions of independence and objectivity. Our analysis also highlights the extra-theoretical functions and effects of the tools. Both on their own terms and when subjected to more searching analysis, then, the validity claims the tools make fail to hold up to scrutiny. In concluding, we consider some of the effects of the processes we identify. Not only do these tools make certainty where there is none, we contend, they actively participate in the creation of social objects and social groups, and in shaping affected in iduals and their opportunities. In unpacking in detail the legitimacy of the tools, our aim is to open up for further scrutiny the processes by which they go about making (rather than merely reflecting) the disease of addiction.
Publisher: Informa UK Limited
Date: 22-02-2022
Publisher: Informa UK Limited
Date: 27-02-2019
Publisher: Informa UK Limited
Date: 12-07-2018
Publisher: SAGE Publications
Date: 12-06-2020
Abstract: Opioid overdose deaths are a major health issue in Australia and around the world. Programmes to provide opioid consumers with ‘take-home’ naloxone to reverse overdose exist internationally, but uptake by mainstream health services and consumers remains inconsistent. Researchers have identified a range of important educational, training and logistical impediments to take-home naloxone uptake and distribution, yet they have focused less on the social dynamics that can enhance or limit access, such as stigma. In this article, we also explore impediments to uptake, drawing on qualitative interview data gathered for an Australian research project on take-home naloxone. Mobilising a performative approach to stigma, we argue that overdose and prevention are shaped by the social dynamics of stigma and, as such, responsibility for dealing with overdose, as with take-home naloxone, should also be considered social (i.e. shared among peers, the public, communities and governments). Our interview data illuminate the various ways in which addiction stigma limits the possibilities and capacities of take-home naloxone and overdose prevention. First, we focus on how stigma may impede professional information provision about take-home naloxone by limiting the extent to which it is presented as a matter of interest for all opioid consumers, not just those who consume opioids illicitly. Second, we explore how stigma may limit the scale-up and expansion of programmes and access points. From here, we focus on how stigma co-constitutes the politics of overdose and prevention, rendering take-home naloxone ill-suited to many social settings of overdose. In closing, we point out that stigma is not just a post hoc impediment to access to and use of take-home naloxone but is central to opioid overdose production itself, and to effective prevention. While take-home naloxone is an excellent life-saving initiative, uncritically valorising it may ert attention from broader goals, such as the de-stigmatisation of drug consumption through decriminalisation, and other ambitious attempts to reduce overdose.
Publisher: Journal of Artificial Societies and Social Simulation
Date: 2016
DOI: 10.18564/JASSS.3069
Publisher: Informa UK Limited
Date: 08-06-2016
Publisher: Informa UK Limited
Date: 18-05-2022
Publisher: BMJ
Date: 13-10-2019
DOI: 10.1136/OEMED-2019-105849
Abstract: We aim to quantitatively synthesise available epidemiological evidence on the prevalence rates of workplace violence (WPV) by patients and visitors against healthcare workers. We systematically searched PubMed, Embase and Web of Science from their inception to October 2018, as well as the reference lists of all included studies. Two authors independently assessed studies for inclusion. Data were double-extracted and discrepancies were resolved by discussion. The overall percentage of healthcare worker encounters resulting in the experience of WPV was estimated using random-effects meta-analysis. The heterogeneity was assessed using the I 2 statistic. Differences by study-level characteristics were estimated using subgroup analysis and meta-regression. We included 253 eligible studies (with a total of 331 544 participants). Of these participants, 61.9% (95% CI 56.1% to 67.6%) reported exposure to any form of WPV, 42.5% (95% CI 38.9% to 46.0%) reported exposure to non-physical violence, and 24.4% (95% CI 22.4% to 26.4%) reported experiencing physical violence in the past year. Verbal abuse (57.6% 95% CI 51.8% to 63.4%) was the most common form of non-physical violence, followed by threats (33.2% 95% CI 27.5% to 38.9%) and sexual harassment (12.4% 95% CI 10.6% to 14.2%). The proportion of WPV exposure differed greatly across countries, study location, practice settings, work schedules and occupation. In this systematic review, the prevalence of WPV against healthcare workers is high, especially in Asian and North American countries, psychiatric and emergency department settings, and among nurses and physicians. There is a need for governments, policymakers and health institutions to take actions to address WPV towards healthcare professionals globally.
Publisher: Elsevier BV
Date: 11-2021
Publisher: Elsevier BV
Date: 09-2010
DOI: 10.1016/J.DRUGPO.2010.03.001
Abstract: The dominant Australian approaches to understanding illicit drug marketplaces are surveillance and criminological research. These approaches rely on the elementary neoclassical economic model of the market which focuses primarily on supply and demand. In this paper, we draw on anthropological and sociological research to develop an alternative framework for understanding Australian illicit drug marketplaces that emphasises their constituent processes. The paper draws on two years of ethnographic research among heroin user/sellers of Vietnamese ethnicity in an Australian heroin marketplace. Trade and barter were key modes of exchange in this marketplace. We identified active negotiation and bargaining over price on the basis of social relationships, with dealers and customers actively working to develop and maintain such ties. Dealers set price collectively and this was shaped by moral and cultural elements such as notions of a 'fair' price. Social processes and relations as well as shared cultural expectations helped to generate trust and maintain order in the marketplace. Our ethnographic research suggests that the dominant Australian approaches to the study of illicit drug markets, with their reliance on the elementary neoclassical economic market model, ignore the social processes and social relations through which such sites are made and remade. Nor do they adequately capture the complex character of the subjects who act within these sites. If we are to expand our understanding of illicit drug markets and marketplaces in Australia, we must look beyond the conceptions offered by surveillance and criminological approaches.
Publisher: Wiley
Date: 05-2018
DOI: 10.1111/DAR.12700
Publisher: Informa UK Limited
Date: 11-10-2021
Publisher: Elsevier BV
Date: 08-2019
DOI: 10.1016/J.SAPHARM.2019.03.003
Abstract: and Aims: Opioid overdose can be reversed with timely administration of naloxone. In Australia, naloxone was rescheduled from prescription only (S4) to pharmacist only over-the-counter (OTC, S3) in February 2016, increasing access for the general public. A key barrier to naloxone supply by pharmacists is a lack of knowledge, highlighting the role of pharmacist education. Community pharmacists' education, experience, and training preferences related to naloxone provision, overdose, and substance use disorder were examined. Online survey data from a national s le of Australian pharmacists on their educational preferences regarding naloxone and overdose prevention, and prior training on substance use disorder (n = 595) was analyzed using bivariate and multivariate regression analysis. Data from qualitative semi-structured telephone interviews with pharmacists about OTC naloxone provision (n = 21) was analyzed using thematic analysis. Most pharmacists (81%, n = 479) were willing to be trained in opioid overdose prevention, with greater willingness to attend training associated with younger age, being female, fewer years of practice, not having attended previous education on substance use disorder, and higher confidence in issues relating to substance use disorder. Qualitative interviews confirmed community pharmacists' willingness to attend training but analysis revealed low awareness, knowledge, and confidence about naloxone and preventing opioid overdose. Most pharmacists preferred online training or webinars. Most community pharmacists in Australia are willing to attend training on providing naloxone and preventing opioid overdose. There are opportunities to develop and expand the online presence of training, guidelines, and education materials to facilitate the expanded supply of OTC naloxone.
Publisher: Elsevier BV
Date: 08-2009
DOI: 10.1111/J.1753-6405.2009.00407.X
Abstract: We estimated the cost to the public health system of treating Injecting-Related Injuries and Diseases (IRIDs) in the three most populous states in Australia in the 12 months over 2005/06. We conducted a cost of illness analysis from the perspective of the public health system. Costs of treating IRIDs in the community were estimated from health service utilisation surveys of injecting drug users and physicians (yielding data on Government subsidised physician visits, medicines prescribed and emergency department presentations). Data on admitted hospitalisations in public hospitals due to IRIDs were extracted from State Government databases. Appropriate costs were attached to all Government-borne services and prescriptions to estimate the total cost to the public health system of treating IRIDs in 2005/06 in Queensland, NSW and Victoria. Our estimate of the cost to the public health system of treating IRIDs in Queensland, NSW and Victoria in 2005/06 was $20 million. IRIDs are an under-recognised harm resulting from injecting drug use, but the economic burden of IRIDs in Australia are non-negligible. Research is needed to identify cost effective programs to reduce the clinical and economic burden caused by IRIDs, particularly to reduce hospitalisations due to IRIDs. General practitioners, clinicians and other health workers need to be alert to IRIDs in their injecting drug user clients to prevent progression to more serious disease and consequent elevation of the associated economic costs.
Publisher: Oxford University Press (OUP)
Date: 30-10-2010
DOI: 10.1093/BJC/AZP065
Start Date: 03-2021
End Date: 09-2024
Amount: $232,688.00
Funder: Australian Research Council
View Funded ActivityStart Date: 2017
End Date: 06-2020
Amount: $502,000.00
Funder: Australian Research Council
View Funded ActivityStart Date: 07-2020
End Date: 03-2024
Amount: $236,657.00
Funder: Australian Research Council
View Funded ActivityStart Date: 05-2021
End Date: 05-2024
Amount: $502,501.00
Funder: Australian Research Council
View Funded Activity