ORCID Profile
0000-0002-4902-7293
Current Organisation
Monash University
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Publisher: MDPI AG
Date: 12-01-2017
Publisher: International Journal of Alcohol and Drug Research
Date: 04-10-2017
Abstract: Curtis, A., Coomber, K., Droste, N., Hyder, S., Mayshak, R., Lam, T., Gilmore, W., Chikritzhs, T., & Miller, P. (2017). Consumption plans for the rest of the night among Australian nightlife patrons. The International Journal Of Alcohol And Drug Research, 6(1), 19-25. doi:0.7895/ijadr.v6i1.243Aims: This study investigates associations between blood alcohol content (BAC), gender, location, time of night, and intention to consume more alcohol, energy drinks, and illicit drugs following a street intercept interview.Design: Interviews were conducted from December 2011 to July 2012.Setting: Interviews were conducted in nightlife areas of Sydney, Melbourne, Perth, Wollongong, and Geelong, between 8 p.m. to 5 a.m.Participants: Data from 4,203 participants are utilized in the current paper.Measures: Participants were asked demographic questions, as well as questions about their intentions for the rest of the night (further alcohol, drug, and energy drink use), and completed a breathalyzer test.Findings: Over 70% of the nightlife patrons intended to consume more alcohol, and this was more likely for males, regional patrons, and those with a BAC of over 0.08 g/100 ml. Overall, intention to use drugs was consistent across BAC, location, and time of night, though males were significantly more likely than females to intend to consume drugs.Conclusions: Given the risky behaviors of the most intoxicated group out drinking late at night, interventions that target latenight drinking, high levels of intoxication, and high-risk drinkers are indicated.
Publisher: Wiley
Date: 28-07-2023
DOI: 10.1111/DAR.13724
Abstract: Engaging people with lived experience of alcohol and other drug use as peer researchers in qualitative research is becoming more common. However, there are differing opinions on how to best engage and support peer researchers. Through this case study the researchers aimed to illustrate the potential benefits of a peer/academic researcher dual‐interview approach as a qualitative method in research. In the study, a peer researcher who had lived experience of alcohol and other drug use collaborated with an academic researcher who had qualitative expertise. Semi‐structured interviews ( N = 22) were undertaken with men and women with lived experience of alcohol and other drug harms ( n = 14) and healthcare staff ( n = 8) from alcohol and other drug, and broader healthcare services. The research team contend that in a dual‐interview approach, rather than peer/academic researchers being binary opposites, there exists a continuum along which peer and academic researchers travel back and forth that supports recognition of similarities and differences and deepens mutual respect. Engaging peer researchers also represents an opportunity for meaningful capability building, with the ultimate and important goal of having peer researchers drive their own research agendas, and move from supporting to leading alcohol and other drug‐related research.
Publisher: Wiley
Date: 28-08-2020
DOI: 10.1002/HPJA.378
Abstract: Underage drinkers most commonly source alcohol from older peers. However, few studies have examined older peers’ supply‐related beliefs and motivations. A s le of 270 risky drinkers aged 18‐19 years were interviewed in Australia where the legal purchase age is 18. They were asked about their provision to underage friends, awareness of secondary supply legislation (intended to prohibit such supply) and 24 psycho‐legal beliefs around supply. Half (49%) provided alcohol to a 16‐ to 17‐year‐old friend to drink at a party they were both attending at least twice a year. Three‐quarters reported provision was okay so long as the recipient(s) were in a safe environment, and 46% reported “everyone gives alcohol to teenagers if they are in a safe environment.” There was significantly higher agreement that “my friends would think I was mean if I did not give alcohol to a friend under the age of 18” (37%), compared to “my friends would think I was uncool if I did not give alcohol to a friend under the age of 18” (26%). Two thirds (69%) felt more responsible for an underage friend's safety if they provided the alcohol. A multivariate logistic regression revealed supply was more likely if the supplier: was aged 18 compared to 19 (95% CI OR: 1.57, 4.84), male (1.06, 3.27), of a higher SES quintile (1.08, 1.80) and believed alcohol supply to minors was morally acceptable (1.01, 1.33) and normal (1.04, 1.38). Knowledge of regulatory strategies (68%) designed to prevent supply to minors, and their perceived deterrent value did not significantly impact supply. Supply of alcohol to underage peers was perceived as morally and socially acceptable in a group of 18‐ to 19‐year‐old risky drinkers. Opportunities include harm reduction initiatives that prioritise caring responsibilities towards friends, as opposed to relying on external enforcement measures alone.
Publisher: Royal College of General Practitioners
Date: 28-04-2021
Abstract: Alcohol is a major source of harm in Australia that disproportionately affects low-income communities. Alcohol brief interventions (ABIs) combine an assessment of a person’s alcohol use with advice to reduce health risks. Despite their effectiveness, ABIs are not routinely performed by clinicians. This article presents a protocol for a feasibility trial of pragmatic implementation strategies and a new set of resources to support clinicians to complete ABIs in Australian general practices. To explore the facilitators and barriers to increasing the uptake of ABIs in primary care, including acceptability, reach, adoption, fidelity, and sustainability. A mixed-methods evaluation of the uptake of ABIs in general practice clinics serving low-income communities in Melbourne, Australia. The approach is informed by the Consolidated Framework for Implementation Research (CFIR) and Normalisation Process Theory (NPT). The implementation strategies and resources will be trialled in five general practices over 12 months. The primary outcome will be change in the proportion of adult patients with a complete alcohol history in their electronic medical records. Baseline data collection includes a practice survey to describe practice routines for ABIs and de-identified patient medical record data on completed alcohol histories (repeated at 3, 6, 9, and 12-months post-intervention). Survey and interview data will also be collected from clinicians, patients, and primary health network staff to assess acceptability and feasibility of the intervention. The study will explore how the implementation strategies and resources can improve alcohol screening and management among low-income patients in general practice.
Publisher: Wiley
Date: 25-04-2018
DOI: 10.1111/DAR.12552
Abstract: The current study aimed to examine the association between patron demographics and substance use, and experiences of verbal and physical aggressive incidents within the last 3 months among patrons of night-time entertainment precincts (NEP) in Australia. Patron interviews (n = 4216) were conducted around licensed venues in the NEPs of five Australian cities. Seven correlates of verbal and physical aggressive incidents were examined: gender, age, occupation, blood alcohol concentration, pre-drinking, energy drink use and illicit drug use in the current session. A total of 7.5% and 8.2% of respondents reported involvement in a verbally and physically aggressive incident in the past 3 months, respectively. Multivariate logistic regression models indicated men and people <25 years old were significantly more likely to report both verbal and physical aggressive incidents. A significant occupation effect showed lower levels of both verbal and physical aggression in managers rofessionals compared with non-office workers. The likelihood of being involved in a verbally aggressive incident significantly increased with energy drink consumption, while the likelihood of being involved in a physically aggressive incident significantly increased with blood alcohol concentration, energy drink consumption and illicit drug use. This study highlights the different correlates of verbal and physical aggression within NEPs, suggesting they should be viewed as distinct types of violence, rather than points on a continuum. Major modifiable correlates with verbal and physical aggression included intoxication, energy drink consumption, and illicit drug use, suggesting the need for further interventions and policy development to address these key issues. [Hyder S, Coomber K, Pennay A, Droste N, Curtis A, Mayshak R, Lam T, Gilmore W, Chikritzhs T, Miller PG. Correlates of verbal and physical aggression among patrons of licensed venues in Australia. Drug Alcohol Rev 2018 :6-13].
Publisher: Wiley
Date: 21-02-2022
DOI: 10.1111/ADD.15832
Abstract: The current phase of the North American ‘opioid crisis’ is characterised by illicit fentanyl use however, the presence of illicit fentanyl in Australia is unknown. This study aimed to monitor unintentional fentanyl consumption in Australia. Rapid urine drug screens (UDS) paired with surveys conducted within supervised injecting facilities (SIFs) and confirmatory laboratory testing. Sydney and Melbourne, Australia. Clients who used heroin within the past 2 days ( n = 911 tests, 2017–2021). Participants were demographically similar to the overall client base (median age 43, 72% male). UDS were conducted using BTNX Rapid Response fentanyl urine strip tests with cross‐reactivity to numerous fentanyl analogues. Positive urine s les were analysed using liquid chromatography coupled with tandem mass spectrometry. Surveys covered past 3 day drug use and lifetime report of fentanyl in heroin. Two percent of participants reported intentional use of fentanyl, mostly through fentanyl patches. Of the 911 rapid UDS conducted, 17 (1.9%) yielded positive results. Eight of these (all from Melbourne) were not explained by survey‐reported fentanyl use in the past 3 days. Of these 8 unexplained positives, confirmatory laboratory analysis was conducted on 6, with 4 deemed to be false positives, and 2 confirmed for the presence of fentanyl. This represents the first confirmation of unintended use of fentanyl type substances in this population. There is limited evidence of unintentional fentanyl use among people in Sydney and Melbourne, Australia who regularly inject heroin, suggesting that, currently, there is very little illicit fentanyl in Australian drug markets accessed by supervised injecting facilities attendees. This study demonstrates the feasibility of quick onsite testing to cost‐effectively screen large s les for fentanyl however, the high false positive rate emphasises the need for confirmation of positive tests through advanced analytical techniques.
Publisher: Wiley
Date: 18-09-2021
DOI: 10.1111/ADD.15653
Abstract: Pharmaceutical opioids are a significant contributor to the global ‘opioid crisis’, yet few studies have comprehensively distinguished between opioid types. We measured whether a range of common pharmaceutical opioids varied in their contribution to the rates and characteristics of harm in a population‐wide indicator of non‐fatal overdose. Retrospective observational study of emergency department (ED) patient care records in the Victorian Emergency Minimum Data set (VEMD), July 2009 to June 2019. Victoria, Australia. ED presentations for non‐fatal overdose related to pharmaceutical opioid use ( n = 5403), where the specific pharmaceutical opioid was documented. We compared harms across the nine in idual pharmaceutical opioids most commonly sold, and considered where multiple opioids contributed to the overdose. We calculated supply‐adjusted rates of ED presentations using Poisson regression and used multinomial logistic regression to compare demographic and clinical characteristics of presentations among nine distinct pharmaceutical opioids and a 10th category where multiple opioids were documented for the presentation. There were wide differences, up to 27‐fold, between supply‐adjusted rates of overdose. When considering presentations with sole opioids, the highest supply‐adjusted overdose rates [per 100 000 oral morphine equivalents (OME) 95% confidence interval (CI)] were for codeine (OME = 0.078, 95% CI = 0.073–0.08) and oxycodone (OME =0.029, 95% CI = 0.027–0.030) and the lowest were for tapentadol (OME = 0.004, 95% CI = 0.003–0.006) and fentanyl (OME = 0.003, 95% CI = 0.002–0.004). These rates appeared related to availability rather than opioid potency. Most (62%) poisonings involved females. Codeine, oxycodone and tramadol were associated with younger presentations (respectively, 59.5%, 41.7% and 49.8% of presentations were 12‐34 years old), and intentional self‐harm (respectively 65.2%, 50.6%, and 52.8% of presentations). Relative to morphine, fentanyl [ 0.32 relative risk ratio (RRR)] and methadone ( 0.58 RRR) presentations were less likely to be coded as self‐harm. Relative to morphine–buprenorphine, codeine, oxycodone and tramadol presentations were significantly more likely to be associated with the less urgent triage categories (respectively 2.18, 1.80, 1.52, 1.65 RRR). In Victoria, Australia, rates and characteristics of emergency department presentations for pharmaceutical opioids show distinct variations by opioid type.
Publisher: Wiley
Date: 02-12-2019
DOI: 10.1111/ADD.14784
Abstract: To characterize the trajectory in the years leading up to 2018 in pharmaceutical opioid and heroin morbidity in Victoria, Australia, and to assess the effect on that trajectory of reformulation of oxycodone to a form that could not be easily snorted or injected. Interrupted time-series analyses of population-level data before versus after reformulation of oxycodone, stratified by sex. Victoria, Australia. The population of Victoria aged 12+ years. Ambulance patient care and emergency department (ED) records were examined using both fixed-code and free-text fields, with each record manually cleaned and checked by trained coders. These were used to derive the output variables providing an index of harm: rates of opioid-related ambulance attendances and ED attendances for pharmaceutical opioids and heroin. The input variable was pre- versus post-oxycodone reformulation. There were 30 045 opioid-related ambulance attendances from January 2012 to October 2018 (54% heroin-related), and 10 113 ED attendances from July 2008 to June 2018 (39% heroin-related). There was an increase in the rate (events per 100 000 people per year) of all opioid ED attendances from 2008 to 2018 [increase = 0.063 95% confidence interval (CI) = 0.049, 0.078]. Pharmaceutical opioid ED attendances decreased from 2014 onwards (slope change = -0.083 95% CI = -0.108, -0.059). Heroin-related ED attendances increased from 2014 to 2018 11 324 heroin-related ambulance attendances and 1980 ED attendances were observed from April 2014 to June 2018, compared with the respective estimates of 8176, and 1661 had the pre-April 2014 trend continued (ambulance slope change = 0.296, 95% CI = 0.104, 0.489 ED slope change = 0.026, 95% CI = 0.005, 0.046). The inflection point of 2014 coincided with the re-formulation of oxycodone. In Victoria, Australia, there appears to have been a trend starting around mid-2014 of increasing heroin-related harm, and a flattening of the increase or a decrease of harms relating to pharmaceutical opioids. These changes may, in part, reflect reformulation of oxycodone to reduce the extent to which it can be injected or snorted.
Publisher: Wiley
Date: 09-03-2023
DOI: 10.1111/DAR.13638
Abstract: Minimum unit price (MUP) policies establish a retail floor price below which alcohol may not be sold, and have been shown to reduce harmful alcohol use. We aimed to collect retail price data to estimate the proportion of alcohol products that would potentially be impacted by a MUP policy in Western Australia. We purposively s led the four largest off‐premises alcohol retail chains, a further random s le of other off‐premise alcohol outlets ( n = 16) and on‐premise inner‐city outlets ( n = 11). Using website data from May to June 2021, we estimated the proportion of products across four beverage categories priced ≤A$1.30, ≤A$1.50 and ≤A$1.75 per standard drink (10 g alcohol). Of 27,797 off‐premise products identified, 5.7% were available at ≤$1.30 per standard drink, 7.6% at ≤$1.50 and 10.4% at ≤$1.75. The proportion of products available at ≤$1.30 per standard drink varied by beverage category: 7.8% wine, 2.9% beer and cider, .1% spirits, 0.0% ready‐to‐drink spirits. Cask‐packaged wines represented only 1.9% of off‐premise wine products and 98.9% of this cask wine was priced ≤$1.30 per standard drink. No on‐premise products were priced ≤$1.75 per standard drink. A comprehensive survey of alcohol prices in Western Australia found only a small proportion of products would potentially be affected by a MUP of $1.30 to $1.75 per standard drink. A MUP policy has potential to target the small proportion of alcohol products available at very low prices (i.e., off‐premise cask wine), with negligible impact on other off‐premise beverage categories, and no impact on on‐premises products.
Publisher: Royal College of General Practitioners
Date: 06-06-2023
Abstract: Background: Brief interventions (BIs) are effective for reducing harmful alcohol consumption, but their use in primary care is less frequent than clinically indicated. The REducing AlCohol-related Harm (REACH) Project aimed to increase the delivery of BIs in primary care. Aim: The aim of this paper is to assess the effectiveness of the REACH program in increasing alcohol BIs in general practice and explore the implementation factors that improve or reduce uptake by clinicians. Design and Setting: This paper reports on a sequential, explanatory mixed-methods study of the implementation of the REACH project in six general practice clinics serving low-income communities in Melbourne, Australia. Method: We conducted time-series analyses using routinely-collected patient records and semi-structured interviews, guided by the Consolidated Framework for Implementation Research. Results: The six intervention sites significantly increased their rate of recorded alcohol status (56.7% to 60.4%), whereas there was no significant change in the non-intervention practices (344 sites, 55.2% to 56.4%). Conclusion: REACH resources were seen as useful and acceptable by clinicians and staff. National policies that support the involvement of primary care in alcohol harm reduction helped promote ongoing intervention sustainability.
Publisher: American Academy of Sleep Medicine (AASM)
Date: 15-09-2018
DOI: 10.5664/JCSM.7330
Publisher: Oxford University Press (OUP)
Date: 27-08-2014
Abstract: A significant proportion of adolescents who attend celebratory events often engage in substantial alcohol and other drug use. We examined patterns, influences and impacts of drug consumption at an end of schooling life celebration. Seventeen- to 18-year-old Australians who intended to attend (n = 541) and who attended the celebration (n = 405), respectively, completed pre- and post-event surveys. Males consumed 18.44 and females 13.24 Australian standard drinks on an average day during the school leavers' event. Compared with their last social event, there was greater alcohol (P < 0.0005) and ecstasy use (P < 0.046 for Day 1 and P < 0.008 on Day 3). However, the number of drinks consumed per hour appeared to be similar across contexts. Most (87%) experienced at least one negative outcome attributed to alcohol and other drug use. Safety strategies were frequently used and appeared to be protective against some of the most common harms (hangover, vomiting, black out and unprotected sex). The use of alcohol and other drugs at this celebratory event appears to be reflective of the greater than usual number of drinking hours that are available to participants. The use of safety strategies can be successful in mitigating some of the most common drug-related harms.
Publisher: Informa UK Limited
Date: 25-01-2017
Publisher: SAGE Publications
Date: 11-07-2017
Abstract: Our understanding of patient pathways through specialist Alcohol and Other Drug treatment and broader health/welfare systems in Australia remains limited. This study examines how treatment outcomes are influenced by continuity in specialist Alcohol and Other Drug treatment, engagement with community services and mutual aid, and explores differences between clients who present with a primary alcohol problem relative to those presenting with a primary drug issue. In a prospective, multi-site treatment outcome study, 796 clients from 21 Alcohol and Other Drug services in Victoria and Western Australia completed a baseline interview between January 2012 and January 2013. A total of 555 (70%) completed a follow-up assessment of subsequent service use and Alcohol and Other Drug use outcomes 12-months later. Just over half of the participants (52.0%) showed reliable reductions in use of, or abstinence from, their primary drug of concern. This was highest among clients with meth/ hetamine (66%) as their primary drug of concern and lowest among clients with alcohol as their primary drug of concern (47%), with 31% achieving abstinence from all drugs of concern. Continuity of specialist Alcohol and Other Drug care was associated with higher rates of abstinence than fragmented Alcohol and Other Drug care. Different predictors of treatment success emerged for clients with a primary drug problem as compared to those with a primary alcohol problem mutual aid attendance (odds ratio = 2.5) and community service engagement (odds ratio = 2.0) for clients with alcohol as the primary drug of concern, and completion of the index treatment (odds ratio = 2.8) and continuity in Alcohol and Other Drug care (odds ratio = 1.8) when drugs were the primary drugs of concern. This is the first multi-site Australian study to include treatment outcomes for alcohol and cannabis users, who represent 70% of treatment seekers in Alcohol and Other Drug services. Results suggest a substantial proportion of clients respond positively to treatment, but that clients with alcohol as their primary drug problem may require different treatment pathways, compared to those with illicit drug issues, to maximise outcomes.
Publisher: Elsevier BV
Date: 02-2018
Publisher: Elsevier BV
Date: 04-2015
Abstract: To explore the impacts of existing policies on young Australian risky drinkers' access to alcohol and to gauge their support for proposed alcohol measures. The 16-19 year old participants were recruited from three Australian states using non-random convenience s ling, for either a face-to-face or online quantitative survey (N=958). The s le was deliberately selected to represent drinkers whose consumption placed them in the riskiest drinking 20-25% of their age bracket. Half (49%) the s le who were younger than the Australian legal purchase age reported it was 'easy' to buy alcohol from bottle stores, and 75% of those who had tried to purchase alcohol, said it was 'easy' the last time they tried. Half of those under 18, who had attempted to enter a licensed venue, reported they did not have their identification checked last time they gained access. Ninety per cent of all respondents drank within a private location at their last risky drinking session. Sixty-five per cent supported 'increasing the price of [alcohol by 20¢] a standard drink if the extra 20¢ was used to support prevention and treatment of alcohol problems'. Age- or intoxication-based restrictions to alcohol were commonly bypassed. Point-of-sale alcohol controls require improvement to prevent under age access. Given that a significant proportion of drinking occasions for those under 18 were in private premises, prevention strategies need to target these locations. There were erse levels of support for strategies to reduce harm, including potential community backing for an evidence-based proposed price policy.
Publisher: Springer Science and Business Media LLC
Date: 16-01-2018
Publisher: Springer Science and Business Media LLC
Date: 13-06-2018
Publisher: Informa UK Limited
Date: 04-12-2018
Publisher: Wiley
Date: 28-09-2022
DOI: 10.1111/DAR.13551
Abstract: There are a range of models and structures that determine features of alcohol and other drug treatment. Despite some structures being long‐established, less is known about how specific aspects of service delivery impact treatment‐seeking for people who use alcohol and other drugs. This Australian qualitative study explored both people with lived experience of problematic alcohol and other drug use, and health care staff's experiences of service delivery. Thirty‐nine semi‐structured interviews with people with lived experience and staff from either alcohol and other drug specialist, or broader health‐care services, explored experiences of service delivery processes and procedures. Transcripts were thematically analysed and guided by a broad interest in barriers to treatment‐seeking. Within alcohol and other drug specialist services (i) time spent on wait lists and (ii) poor implementation of assessment processes were identified barriers to treatment‐seeking and engagement. Within broader health‐care services (i) organisational expectations around behaviour and engagement (ii) alcohol and other drugs viewed as separate to service role and (iii) limited opportunities to informally engage were identified barriers to treatment‐seeking. Results suggest opportunities to engage and undertake needs‐based care planning are yet to be fully realised, particularly at the intake and assessment stages of alcohol and other drug service delivery with frequent reassessment resulting in people repeatedly recounting traumatic experiences, often to different people, only to be placed back on wait lists with no support. Within broader health‐care services aspects of service delivery may perpetuate stigma that places such people outside the purview of health care.
Publisher: Informa UK Limited
Date: 25-05-2016
DOI: 10.3109/10826084.2016.1168443
Abstract: Pre-drinking has been linked to subsequent heavy drinking and the engagement in multiple risky behaviors. The present study examined a group of adolescents who recently had a "big night out" to determine whether there were differences in their pre-drinking behavior based on age, gender, geographic location, and social setting. Participants (n = 351, aged 16-19) representing the heaviest 20-25% of drinkers in their age group were recruited using nonrandom s ling from metropolitan (Melbourne, Sydney, Perth) or regional (Bunbury) locations across Australia and administered a survey by a trained interviewer. Almost half the s le pre-drank (n = 149), most commonly at a friend's house. Those aged 18-19 were more likely to pre-drink, and did so at higher quantities compared to their younger counterparts. Males and females reported similar pre-drinking duration, quantity and amount spent on alcohol. Compared to those in cities, regional participants consumed greater quantities over longer periods of time. Two-thirds of participants consumed alcohol in excess of national guidelines during their pre-drinking session. These participants were more likely to nominate price as a motivation to pre-drink and were less likely to report that someone else provided them alcohol. This study sheds light on the pre-drinking habits of a population of young risky drinkers, and highlights the need for policy makers to address this form of drinking to reduce alcohol-related harm among young people.
Publisher: Elsevier BV
Date: 06-2018
Abstract: We investigated young people's exposure to alcohol advertising, their intentions to consume and purchase alcohol products following the viewing of advertisements, and whether they perceived the actors in the advertisements as being under the age of 25 years. Face-to-face interviews were completed with 351 risky drinking 16-19-year-old Australians, with a sub-s le (n=68) responding to a range of alcohol advertisements in an in-depth interview. Participants were exposed to alcohol advertisements from an average of seven specific contexts in the past 12 months, with younger adolescents more likely to recall TV and outdoor billboards (n=351). Positive perception of advertisements was associated with increased intention to use and to purchase advertised products (n=68). A liqueur advertisement actor was perceived by 94% as being under 25 years-old, and almost 30% thought the advertisement was marketed at people younger than 18 years of age. Young people's perceptions of alcohol advertising are not necessarily in line with expert/industry assessment products are sometimes marketed in a way that is highly appealing to young people. Greater appeal was associated with increased intention to consume and to purchase products. Implications for public health: These results indicate deficiencies in the effectiveness of current advertising codes in regard to protecting the health and wellbeing of adolescents.
Publisher: Informa UK Limited
Date: 12-12-2017
Publisher: Wiley
Date: 31-08-2021
DOI: 10.1111/DAR.13150
Publisher: Wiley
Date: 07-07-2020
DOI: 10.1111/DAR.13118
Publisher: Elsevier BV
Date: 08-2020
Publisher: Wiley
Date: 09-07-2018
DOI: 10.1111/DAR.12841
Abstract: Prescribed psychotropic medications contribute to overdose mortality among people with alcohol and other drug (AOD) disorders. We report on prescribed psychotropic medication use among AOD treatment service attendees, focusing on sedative drugs. Prospective multi-site naturalistic outcome study in residential and outpatient AOD treatment facilities in Victoria and Western Australia. A convenience s le of 480 people (57% male mean age 36.1) entering treatment were surveyed, of whom 313 (65%) were followed up by telephone interview after a median of 377 days. Participants' prescribed psychotropic medication use was ascertained by self-report at baseline and follow-up. At baseline, 41% of participants reported prescribed sedative medication (benzodiazepine, zopiclone or zolpidem) use within the past month, including prescriptions to treat withdrawal symptoms. At follow-up, the cohort reported a reduced rate of past month prescribed sedative use (23% P 0.99 for change from baseline). At baseline, 40% of participants were prescribed an antidepressant and 13% an antipsychotic medication, which remained similar at follow-up (45% and 13%, respectively). The high level of prescribed sedative drug use reported by people receiving AOD treatment is a serious public health concern given the increasing incidence of drug overdose deaths in Australia.
Publisher: Wiley
Date: 28-06-2022
DOI: 10.1111/DAR.13336
Abstract: The extant Alcohol's Harms to Others (AHTO) literature is largely comprised of reports from victims. We investigated AHTO from perpetrators' perspectives, including how harms were associated with in idual characteristics, and alcohol quantities consumed during the perpetration incident. Participants ( N = 2932) were 14–19 years old, recruited primarily through social media and screened as risky drinkers. They completed face‐to‐face ( n = 594) or self‐administered ( n = 2338) surveys. They self‐reported whether during their last risky drinking session (LRDS) they had perpetrated any verbal abuse, physical abuse or property damage. A multinomial logistic regression examined whether nine factors were associated with perpetrating zero, one or 2+ categories of AHTO. Eleven percent ( n = 323) reported perpetrating at least one form of AHTO (7.5% verbal, 1.9% physical and 4.6% property). Perpetration of AHTO at LRDS was uniquely associated with: younger age, male gender, experiences of childhood physical punishment, greater perpetration incident‐specific drinking, concurrent illicit drug use, and less frequent use of safety strategies while drinking in the past 12 months. Controlling for the other variables, an increase of six Australian standard drinks (60 g of alcohol) increased the odds of perpetration by 15% [95% confidence interval (CI) adjusted odds ratio (AOR) 1.08, 1.23], and an increase of 15 Australian standard drinks increased the odds by 42% (95% CI AOR 1.20, 1.69). In idual characteristics, larger quantities of alcohol consumed, and a disinclination to practice harm reduction lified risk of AHTO perpetration. This has implications for health promotion and risk prevention/reduction strategies.
Publisher: Wiley
Date: 26-06-2020
DOI: 10.1002/HPJA.264
Abstract: Adolescents under the legal purchase age primarily source their alcohol through social networks. This study assessed the provision context from the perspective of both underage recipients and their suppliers who were older peers and siblings. Interviewer-administered surveys were conducted with 590 risky-drinking (50 g alcohol per session, at least monthly) adolescents. Participants of legal purchase age (18- to 19-year-olds n = 269) reported their provision to 16- to 17-year-olds under eight scenarios. Those aged 14-17 (n = 321) reported receipt of alcohol under the same scenarios plus two parental supply contexts. Purchase-age participants reported supply: to an underage friend (67%), an acquaintance (44%) or a sibling (16%) to drink at the same party to a friend (43%) or sibling (20%) to take to another party (20%) and to a stranger near a bottle shop (5%). Supply to a friend at the same party was more likely if money was exchanged (60% vs 40% P < 0.001). Almost all (98%) 14- to 17-year-olds reported receiving alcohol from an adult (including 36% from a parent for consumption away from the parent), with a similar pattern of receipt scenarios as those reported by the 18- to 19-year-olds. Provision of alcohol was more frequent with a friend than a sibling or stranger, in close environmental proximity, and if money was exchanged. SO WHAT?: As supply may be sensitive to monetary considerations, the incidence of underage receipt may be affected by community-wide pricing measures. Traditional alcohol availability regulations should be supplemented by strategies relating to the social nature of supply and demand.
Publisher: Wiley
Date: 07-2014
DOI: 10.1111/DAR.12145
Abstract: There is little research describing how intoxication levels change throughout the night in entertainment districts. This research aims to describe levels of alcohol intoxication across multiple Australian metropolitan and regional nightlife districts. This study was conducted in the night-time entertainment districts of three metropolitan cities (Sydney, Melbourne and Perth) and two regional cities (Wollongong and Geelong) in Australia. Data collection occurred approximately fortnightly in each city on a Friday or Saturday night between 8 pm and 5 am. Brief structured interviews (3-10 min) and breathalyser tests were undertaken in busy thoroughfares over six months. Of the 7037 in iduals approached to participate in the study, 6998 [61.8% male, mean age 24.89 years (standard deviation 6.37 range 18-73)] agreed to be interviewed. There was a linear increase in blood alcohol concentration (BAC) levels throughout the night. Post hoc testing revealed significantly more highly intoxicated participants (i.e. BAC above 0.10 mg of alcohol per 100 mL of blood) after midnight (P < 0.05). The overall mean BAC was 0.06 mg/100 mL. Men were more intoxicated than women earlier in the night, but gender differences disappeared by 3 am. There was no age differences in intoxication earlier in the night, but after midnight, patrons over the age of 21 showed increasing BAC levels. There is a consistent trend across the cities of high to very high levels of intoxication later in the night, with trends after midnight being significantly different to those before.
Publisher: BMJ
Date: 04-2022
DOI: 10.1136/BMJOPEN-2021-060151
Abstract: Each year, an estimated two million Australians commence opioids, with 50 000 developing longer-term (persistent) opioid use. An estimated 3%–10% of opioid-naïve patients prescribed opioids following surgery develop persistent opioid use. This study will compare rates of persistent opioid use between two commonly used postoperative opioids, oxycodone and tapentadol, to understand if initial postoperative opioid type is important in determining longer-term outcomes. A retrospective data linkage study that analyses administrative data from hospital and community pharmacies. Data will be obtained from at least four pharmacies that service large hospitals with comparable supplies of oxycodone and tapentadol. The study will include at least 6000 patients who have been dispensed a supply of oxycodone or tapentadol to take home following their discharge from a surgical ward. The primary outcome measure will be persistent opioid use at 3 months postdischarge for opioid naïve people who receive either immediate release tapentadol or immediate release oxycodone. Hierarchical logistic regression models will be used to predict persistent opioid use, controlling for covariates including comorbidities. Ethics approval has been obtained through the Monash University Human Research Ethics Committee (29977). We will present project findings in a peer-reviewed journal article, in accordance with the REporting of studies Conducted using Observational Routinely-collected health Data statement.
Publisher: Oxford University Press (OUP)
Date: 13-08-2016
Abstract: To conduct a systematic review of studies exploring the relationship between exposure to Internet-based alcohol-related content and alcohol use among young people. Searches of electronic databases and reference lists of relevant articles were conducted to retrieve studies of relevance up until December 2015. Full texts of the studies that met the inclusion criteria were read, appraised for quality using the Kmet forms and guidelines, and included in this review. Fifteen relevant studies were identified. The included studies were a mix of cross-sectional, longitudinal, experimental and qualitative studies conducted in the USA, the UK, Australia and New Zealand. The age range of the participants involved in these studies was 12-25 years. Included studies employed a variety of study designs and a range of different exposure variables and outcome measures. Studies demonstrated significant associations between exposure to Internet-based alcohol-related content and intentions to drink and positive attitudes towards alcohol drinking among young people. Exposure to alcohol-related content on the Internet might predispose young people to patterns of alcohol use by promoting alcohol as a natural and vital part of life. However, the research exploring the influence of this novel form of advertising on young people's alcohol use is emergent, and comprised primarily of cross-sectional studies. To evaluate the direction of the association between exposure to online alcohol-related content and alcohol use, we call for further research based on longitudinal designs. From 15 relevant studies identified, this review reports significant associations between exposure to Internet-based alcohol-related content and intentions to drink and positive attitudes towards alcohol drinking among young people, with different influences found at different stages of alcohol use.
Publisher: Wiley
Date: 13-01-2020
DOI: 10.1111/ADD.14896
Publisher: Wiley
Date: 07-12-2017
DOI: 10.1111/DAR.12639
Abstract: Breathalyser estimate of blood alcohol concentration (BAC) is widely used as an objective intoxication measure, but is not always practical in nightlife contexts. This study uses in situ data collected in nightlife environments to explore how four measures of intoxication are related so as to inform the development of a more practical and reliable method of differentiating intoxication for people working in the night-time economy. Nightlife patron interviews were conducted in five Australian cities. Participants completed demographic questions and were asked about current session (past 12 h) alcohol use, and four different measures of intoxication were assessed: BAC, participant's self-reported intoxication (0-10), interviewer rating of the participant's intoxication (0-10) and interviewer-rated number of the participants' of physical signs of intoxication. A total of 7028 patrons were surveyed and n = 5273 included in analysis. Mean age was 23.9 years (SD = 6.36) 61.5% were male. There was a significant difference in occurrence of all observable intoxication symptoms across differing levels of BAC (P < 0.001). All visible symptoms became more common as intoxication increased, except for talking very quickly/talkative and giggly symptoms. As BAC levels increase, the extent of the disagreement between self-rated and interviewer-rated intoxication measures widens. Exhibiting four or more visible intoxication symptoms emerged as a reliable method for observers to identify intoxicated patrons. As BAC increases, people become worse at estimating their own intoxication, but sober observers remain relatively accurate. Findings provide support for efforts to strengthen and enforce responsible service of alcohol.
Publisher: Wiley
Date: 30-01-2023
DOI: 10.1111/ANAE.15970
Publisher: Wiley
Date: 04-01-2021
DOI: 10.1111/ADD.15365
Abstract: In Australia, oxycodone has been associated with increasing rates of harm over time, despite reduced use, reformulation to a t er‐resistant form and in contrast to most prescription opioids. We explored characteristics of oxycodone‐related ambulance attendances to understand whether presentation characteristics could explain increasing oxycodone harm. Retrospective study of coded ambulance patient care records related to extramedical oxycodone use, January 2013 to September 2018. Victoria, Australia. A total of 2788 oxycodone‐related ambulance attendances. Primary outcomes were temporal changes in characteristics of oxycodone presentations over time (from 2013 to 2018) and following reformulation. Covariates include demographic characteristics, presentation severity, mental health, substance use and poisoning intent. Average age was 41.3 (± 16.4) years with females comprising 56.4% of attendances ( n = 2788). The proportion of females in oxycodone‐related attendances increased over time [an average increase in the odds ratios of 5% per year (OR) = 1.05, 95% confidence interval (CI) = 1.01–1.10]. Other temporal trends included a reduced likelihood of naloxone administration (OR = 0.92, 95% CI = 0.85–1.00), heroin involvement (OR = 0.81, 95% CI = 0.66–0.99), comorbid mental health symptoms (OR = 0.87, 95% CI = 0.82–0.92) and unknown intent poisoning (OR = 0.91, 95% CI = 0.85–0.96) and a greater risk of alcohol involvement (OR = 1.06, 95% CI = 1.01–1.11), non‐opioid extramedical pharmaceutical use (OR = 1.05, 95% CI = 1.01–1.10), comorbid suicidal thoughts or behaviours (OR = 1.10, 95% CI = 1.05–1.15) and past history of psychiatric issues (OR = 1.22, 95% CI = 1.16–1.27). Interrupted time–series analysis showed that reformulation was associated with an immediate effect on sex, severity, accidental poisoning and unknown intent poisoning, although these were not sustained over time. Alcohol involvement in the attendance (OR = 1.43, 95% CI = 1.17–1.74, i.e. an average increase in the odds of 43% per year), Glasgow Coma Scale (OR = 1.28, 95%CI 1.04 – 1.57), a previous history of psychiatric issues (OR = 0.80, 95% CI = 0.70–0.92, i.e. an average decrease in the odds of 20% per year, heroin involvement (OR = 0.22, 95% CI = 0.05 – 0.98) and illicit drug use (OR = 0.45, 95% CI = 0.23 – 0.87) showed statistically significant relative changes following the reformulation. The characteristics of oxycodone presentations in Australian ambulances attendances appear to be changing over time, including more female presentations increasing alcohol use, extramedical use of non‐opioid pharmaceuticals and suicidal thoughts or behaviours and decreasing heroin and illicit drug involvement.
Publisher: Informa UK Limited
Date: 21-04-2017
Publisher: Elsevier BV
Date: 02-2017
Abstract: Despite declines in Australian alcohol consumption, youth alcohol related harms remain prevalent. These alcohol-related consequences appear to be driven by a subset of risky drinkers who engage in 'high intensity' drinking episodes and are underrepresented in national health surveys. This project aims to investigate high risk drinking practices and alcohol-related harms amongst young people not otherwise recorded in existing data. A community s le of the heaviest drinking 20-25% 16-19 year olds were surveyed across three Australian states (n=958 80% metropolitan). We examined the context of their last risky drinking session through online and face-to-face surveys. Males consumed a mean of 17 and females 14 standard drinks, and 86% experienced at least one alcohol-related consequence during this session. More than a quarter of the face-to-face s le had Alcohol Use Disorders Identification Test (AUDIT) scores indicative of alcohol dependence. Indications of dependence were 2.3 times more likely among those who felt uncomfortable about seeking alcohol treatment, and less likely if harm reduction strategies were frequently used while drinking. It is clear this underrepresented population experiences substantial acute and potentially chronic consequences. Within the context of increasing alcohol-related harms among young Australians, the understanding of this group's drinking habits should be prioritised.
Publisher: Wiley
Date: 19-12-2022
DOI: 10.1111/ANAE.15933
Abstract: Opioid harm can vary by opioid type. This observational study examined the effect of opioid type (oxycodone vs. tapentadol) on rates of persistent postoperative opioid use (‘persistence’). We linked hospital and community pharmacy data for surgical patients who were dispensed discharge opioids between 1 January 2016 and 30 September 2021. Patients were grouped by opioid experience (‘opioid‐naive’ having received no opioids in the 3 months before discharge) and formulation of discharge opioid (immediate release only or modified release ± immediate release). Mixed‐effects logistic regression models predicted persistence (continued use of any opioid at 90 days after discharge), controlling for key persistence risk factors. Of the 122,836 patients, 2.31% opioid‐naive and 27.24% opioid‐experienced patients met the criteria for persistence. For opioid‐naive patients receiving immediate release opioids, there was no significant effect of opioid type. Tapentadol modified release was associated with significantly lower odds of persistence compared with oxycodone modified release, OR (95%CI) 0.81 (0.69–0.94) for opioid‐naive patients and 0.81 (0.71–0.93) for opioid‐experienced patients. Among patients who underwent orthopaedic surgery (n = 19,832), regardless of opioid experience or opioid formulation, the odds of persistence were significantly lower for those who received tapentadol compared with oxycodone. This was one of the largest and most extensive studies of persistent postoperative opioid use, and the first that specifically examined persistence with tapentadol. There appeared to be lower odds of persistence for tapentadol compared with oxycodone among key subgroups, including patients prescribed modified release opioids and those undergoing orthopaedic surgery.
Publisher: Wiley
Date: 08-02-2023
DOI: 10.1111/ANAE.15979
No related grants have been discovered for Tina Lam.