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Lloyd Z, Colledge-Frisby S, Taylor N, Livingston M, Jauncey M, Roxburgh A. Changes in Australians' attitudes towards supervised injecting facilities. Drug Alcohol Rev 2024. [PMID: 39222486 DOI: 10.1111/dar.13937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Revised: 07/29/2024] [Accepted: 08/01/2024] [Indexed: 09/04/2024]
Abstract
INTRODUCTION Supervised injecting facilities (SIF) have been shown to reduce negative outcomes experienced by people who inject drugs. They are often subject to intense public and media scrutiny. This article aimed to explore population attitudes to SIFs and how these changed over time in Australia. METHODS Data were drawn from the National Drug Strategy Household Survey, a national sample collecting data on illicit drug use and attitudes towards drug policy among Australians (2001-2019). Ordinal logistic regression assessed sociodemographic characteristics associated with different attitudes to SIFs and binary logistic regression assessed trends over time and by jurisdiction. RESULTS In 2019, 54% of respondents (95% CI 52.9, 55.1) supported SIFs, 27.5% (95% CI 26.6, 28.4) opposed and 18.4% (95% CI 17.7, 19.2) were ambivalent. Support for SIFs correlated with having a university degree (OR 1.75; 95% CI 1.58, 1.94), non-heterosexual identity (OR 1.81, 95% CI 1.51, 2.17) and recent illicit drug use (OR = 1.74, 95% CI 1.55, 1.94). Male respondents or those living in socioeconomically disadvantaged areas had lower odds of supporting SIFs (OR 0.92, 95% CI 0.85, 1.00; OR 0.64-0.80, respectively). Between 2001 and 2019, support for SIFs increased modestly by 3.3%, those who 'don't know' by 7.4%, whereas opposition decreased by 11.7%. Between 2001 and 2019, support for SIFs increased in NSW and Queensland, whereas opposition decreased in all jurisdictions. DISCUSSION AND CONCLUSIONS Opposition to SIFs declined over the past 20 years, but a substantial proportion of respondents are ambivalent or 'don't know enough to say'. Plain language information about SIFs and their potential benefits, targeted to those who are ambivalent/'don't know' may further increase public support.
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Affiliation(s)
| | - Samantha Colledge-Frisby
- Burnet Institute, Melbourne, Australia
- National Drug Research Institute, Curtin University, Perth, Australia
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Nicholas Taylor
- Burnet Institute, Melbourne, Australia
- National Drug Research Institute, Curtin University, Perth, Australia
| | - Michael Livingston
- Burnet Institute, Melbourne, Australia
- National Drug Research Institute, Curtin University, Perth, Australia
| | - Marianne Jauncey
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
- Uniting Medically Supervised Injecting Centre, Sydney, Australia
| | - Amanda Roxburgh
- Burnet Institute, Melbourne, Australia
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
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Stronach O, Dietze P, Livingston M, Roxburgh A. 20-year trends in Australian methamphetamine-related deaths, 2001-2020. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2024; 131:104548. [PMID: 39141956 DOI: 10.1016/j.drugpo.2024.104548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 07/23/2024] [Accepted: 07/28/2024] [Indexed: 08/16/2024]
Abstract
BACKGROUND Over the past two decades methamphetamine-related harms have increased in Australia. Previous analysis of methamphetamine-related deaths has covered limited timeframes, and largely focused on drug-toxicity deaths. This paper examines long-term trends in methamphetamine-related deaths over 20 years, including deaths due to a range of specific causes. METHODS Descriptive analyses were conducted on Australian methamphetamine-related deaths (2001-2023) by cause, extracted from the National Coronial Information System, an online database containing deaths reported to coroners in Australia and New Zealand. Joinpoint trend analyses were used to assess changes over time between 2001 and 2020 (with data from 2021 to 2023 likely incomplete and thus excluded). RESULTS Unintentional drug toxicity was the cause of 49.8 % of methamphetamine-related deaths, intentional self-harm (including toxicity) 23.3 %, unintentional injury 15.1 %, natural causes 9.6 %, and assaults 2.3 %. Between 2001 and 2020, joinpoint analysis showed three trend change points among all-cause methamphetamine-related mortality rates, resulting in four distinct periods: two periods where they increased (2001-2006 - annual percentage change (APC) = 15.4 %; 2009-2016 - APC 25.5 %), and two where they decreased (2006-2009 - APC = -11.8 %; 2017-2020 - APC = -2.9 %). Similar patterns were evident among rates of intentional self-harm and unintentional injury. Deaths caused by unintentional drug toxicity saw two trend change points (2011, 2016), and rates increased across all three periods. Natural cause deaths had three trend change points (2007, 2010, 2015), and rates continued to rise after 2015, largely driven by increases in circulatory diseases. CONCLUSION Cause-specific models highlighted diverse trends. Recent trends show unintentional drug toxicity deaths have slightly increased, intentional self-harm stabilised, and unintentional injury and assault deaths have declined. Deaths from natural causes involving methamphetamine continued to increase, highlighting a public health concern and a potential need for early circulatory disease screening among people who use methamphetamine.
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Affiliation(s)
- Oisin Stronach
- School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia; Harm and Risk Reduction Program, Burnet Institute, Melbourne, Australia.
| | - Paul Dietze
- School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia; Harm and Risk Reduction Program, Burnet Institute, Melbourne, Australia; National Drug Research Institute, Curtin University, Perth, Australia
| | - Michael Livingston
- Harm and Risk Reduction Program, Burnet Institute, Melbourne, Australia; National Drug Research Institute, Curtin University, Perth, Australia
| | - Amanda Roxburgh
- School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia; Harm and Risk Reduction Program, Burnet Institute, Melbourne, Australia
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Makki A, Day C, Chaar BB. Professional stigma towards clients with methamphetamine use disorder - a qualitative study. J Pharm Policy Pract 2024; 17:2306869. [PMID: 38456180 PMCID: PMC10919299 DOI: 10.1080/20523211.2024.2306869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2024] Open
Abstract
Background Methamphetamine use disorder (MUD) is associated with poor health outcomes. Pharmacists play a role in delivery of substance use treatment, with several studies having examined their attitudes to people with opioid use disorder, but little is known about their attitude towards people with MUD. This study aimed to explore pharmacists' perspectives on the provision of services to clients with MUD. Methods A convenience sampling strategy was used to recruit community pharmacists across Sydney, Australia. Semi structured interviews examined views and ideas of pharmacists surrounding the treatment and management of MUD, followed by coding of transcribed interview data by all members of the research team. Results Nineteen pharmacists completed the interviews. The main theme identified was stigma held by healthcare professionals. The almost unanimous perception amongst pharmacists was fear and apprehension towards people with MUD, including underlying assumptions of criminality, misinformation regarding people with MUD, and lack of education and knowledge surrounding MUD. Conclusion A substantial amount of stigma towards people with MUD was found in this study. Negative attitudes by healthcare professionals can perpetuate healthcare disparities and impede the accessibility of future treatment programs for people with MUD. Appropriate educational interventions on MUD for pharmacists are needed.
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Affiliation(s)
- Ali Makki
- Faculty of Medicine and Health, The University of Sydney School of Pharmacy, Camperdown, Australia
| | - Carolyn Day
- Faculty of Medicine and Health Addiction Medicine, Central Clinical School, Camperdown, Australia
| | - Betty B. Chaar
- Professionalism Committee School of Pharmacy FMH, Faculty of Medicine and Health, The University of Sydney School of Pharmacy, Camperdown, Australia
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Schutz C, Smout MF. Effects of Positive versus Negative Framing on Stigma toward Individuals Recovering from Methamphetamine Use Disorder during Randomized Brief Video Exposure. J Psychoactive Drugs 2024; 56:88-96. [PMID: 36417295 DOI: 10.1080/02791072.2022.2149436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 08/24/2022] [Accepted: 10/07/2022] [Indexed: 11/24/2022]
Abstract
Eighty-two Australians (mean age = 30.07; 61% female) were blindly randomized to view either a video edited to depict a positive or negative presentation of individuals in recovery from methamphetamine use disorder. Participants completed the Social Distance Scale for Substance Users, Dangerousness Scale for Substance Users and Affect Scale for Substance Users before and after video exposure. Following video exposure, those exposed to the positive video portrayal reported lower desire for social distance (p < .001), lower perceptions of dangerousness (p = .011), and more favorable affective reactions (p < .001). Participants' previous level of contact with the target group did not predict baseline stigma or moderate the experimental effect. Participants' qualitative responses to the experiment were assessed via content analysis and indicated mainly positive or ambivalent attitudes, unchanged by the video; however, 18% of those receiving the positive video reported attitudes becoming more sympathetic/favorable. Findings suggest that media depictions which include people with methamphetamine use disorder displaying friendliness and recovery narratives may improve community perceptions of people recovering from methamphetamine use disorder, and conversely, unsmiling portrayals focusing on harm done to others increases desire for social distance and perceived dangerousness.
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Affiliation(s)
- C Schutz
- Justice and Society, University of South Australia, Adelaide, Australia
| | - M F Smout
- Justice and Society, University of South Australia, Adelaide, Australia
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Salomon A, Bartlett M, Chenery M, Jauncey M, Roxburgh A. Outrage and algorithms: Shifting drug-related stigma in a digital world. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2023; 122:104224. [PMID: 37857181 DOI: 10.1016/j.drugpo.2023.104224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 09/28/2023] [Accepted: 10/04/2023] [Indexed: 10/21/2023]
Abstract
Illicit drug dependence is one of the most stigmatised health conditions worldwide and the harmful impacts of stigma for people who use drugs are well documented. The use of stigmatising language about drugs in traditional media is also well documented. The increasing use of digital media platforms has revolutionised the way we communicate, and extended the reach of our messages. However, there are issues specific to the ways in which these platforms operate that have the potential to increase drug-related stigma. This paper outlines the importance of language, narrative, and imagery in reducing this stigma. It discusses the challenges digital media platforms present to achieving this goal, including the use of engagement strategies that trigger fear and increase stigma, the potential for amplifying stigmatising messages by using algorithms, and the potential for dissemination of misinformation. Key strategies to frame conversations about drug use are presented including 1) appeal to values of fairness and equity rather than scaring people; 2) avoid correcting misinformation as it strengthens unhelpful stigmatising frames of drug use; and 3) create a new narrative, focusing on the diversity of experiences of people who use drugs. Internationally we are at a critical juncture with respect to drug policy reform, and efforts to reduce drug-related stigma are central to building support for these reforms. The extensive reach of digital media platforms represents an important opportunity to communicate about illicit drug use. The challenge is to do so in a way that minimises stigma. If we are to achieve change, a narrative that puts values, people, health care and equity at the centre of the conversation is critical.
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Affiliation(s)
| | - Mark Bartlett
- Uniting Medically Supervised Injecting Centre, Sydney, Australia
| | | | - Marianne Jauncey
- Uniting Medically Supervised Injecting Centre, Sydney, Australia; Discipline of Addiction Medicine, the Central Clinical School, Sydney Medical School, the Faculty of Medicine and Health, University of Sydney, Sydney, Australia; National Drug and Alcohol Research Centre, UNSW, Sydney, Australia
| | - Amanda Roxburgh
- Harm and Risk Reduction Program, Burnet Institute, Melbourne, Australia; Monash Addiction Research Centre, Monash University, Melbourne, Australia; Discipline of Addiction Medicine, the Central Clinical School, Sydney Medical School, the Faculty of Medicine and Health, University of Sydney, Sydney, Australia; National Drug and Alcohol Research Centre, UNSW, Sydney, Australia.
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Torney A, Room R, Jiang H, Livingston M, Callinan S. Shifts in the Australian public's opinions towards alcohol policies: 2004-2019. Drug Alcohol Rev 2023; 42:1785-1795. [PMID: 37523328 DOI: 10.1111/dar.13727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 07/04/2023] [Accepted: 07/05/2023] [Indexed: 08/02/2023]
Abstract
INTRODUCTION After a period of stagnation, alcohol policy in Australia has received increased attention in the past decade, with Sydney's lockout laws and Queensland's restrictions on trading hours garnering media attention. This study will investigate any changing trends in support towards alcohol policy and identify any demographic-specific shifts. METHODS Respondents from the National Drug Strategy Household Survey (conducted every 3 years from 2004 to 2019) were asked to gauge their level of support for 16 alcohol policy items proposed to reduce the problems associated with excessive alcohol use. Mean levels of support for various policy options, as well as demographic predictors of support, were assessed. RESULTS After an increase from 2004 to 2013, support for more evidence-based policies on alcohol (e.g., restricting the availability of alcohol) has decreased since 2013. Support for policy items that focus less on the restriction of the availability of alcohol and more on education remained relatively stable in comparison. While demographic groups continue to vary in their extent of support, shifts appear to be occurring fairly uniformly across sex, age, states and drinking groups. DISCUSSION AND CONCLUSIONS Support for public health-oriented alcohol policies has been decreasing since 2013. The introduction of high-profile policies and less of a media focus on alcohol may be contributing to decreases in support.
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Affiliation(s)
- Alexandra Torney
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
| | - Robin Room
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
- Department of Public Health Sciences, Centre for Social Research on Alcohol and Drugs, Stockholm University, Stockholm, Sweden
| | - Heng Jiang
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
| | - Michael Livingston
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
- National Drug Research Institute, Curtin University, Perth, Australia
| | - Sarah Callinan
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
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Scott R. Methamphetamine dependence in Australia-why is 'ice' (crystal meth) so addictive? PSYCHIATRY, PSYCHOLOGY, AND LAW : AN INTERDISCIPLINARY JOURNAL OF THE AUSTRALIAN AND NEW ZEALAND ASSOCIATION OF PSYCHIATRY, PSYCHOLOGY AND LAW 2023; 31:671-704. [PMID: 39118784 PMCID: PMC11305059 DOI: 10.1080/13218719.2023.2206870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 04/13/2023] [Indexed: 08/10/2024]
Abstract
Australia has one of the highest rates in the world of the use of the crystalline form of methamphetamine, a highly addictive stimulant that is often associated with a chronic, relapsing dependency. Methamphetamine use is associated with both acquisitive and violent offending, which cause substantial personal and societal costs. Whilst the short-term euphoria and stimulation provide a positive reinforcement to methamphetamine use, the aversive states of withdrawing from methamphetamine and the associated craving, which may last up to five weeks into abstinence, underlie the negative reinforcement to continued methamphetamine use. Although many methamphetamine-dependent users experience high levels of psychological distress, it is likely that less than half engage with treatment or support services, and current intervention and treatment programmes have high discontinuation rates. Stigma and discrimination, even from paramedics and health clinicians, are prominent barriers to methamphetamine-dependent users accessing treatment in Australia.
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Affiliation(s)
- Russ Scott
- West Moreton Prison Mental Health Service, Brisbane, QLD, Australia
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8
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Folayan MO, Abeldaño Zuñiga RA, Virtanen JI, Ezechi OC, Yousaf MA, Al-Tammemi AB, Jafer M, Ellakany P, Ara E, Ayanore MA, Ishabiyi AO, Gaffar B, Aly NM, Lusher J, El Tantawi M, Nguyen AL. A multi-country survey on access to healthcare and treatment services among individuals with critical medical care needs during the first wave of the pandemic. BMC Public Health 2023; 23:90. [PMID: 36635677 PMCID: PMC9834675 DOI: 10.1186/s12889-023-15007-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 01/09/2023] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Healthcare services were significantly interrupted during the early phase of the COVID-19 pandemic. The aim of the present study was to determine the associations between sociodemographic factors and healthcare access during the first wave of the COVID-19 pandemic among individuals with critical care needs. METHODS This was a secondary analysis of the data of 5,156 participants recruited from 152 countries during the first wave of the COVID-19 pandemic. The dependent variables were self-reported difficulty of access to health care, challenges with obtaining medication, and the use of alternative medical services. The independent variables were age at last birthday; sex at birth, level of education, employment status and the macro-social vulnerability status. The confounding variable was the country income level. Three multivariable logistic regression analyses were conducted to determine the associations between the dependent variables and the independent variables after adjusting for the confounder. RESULTS Difficulty accessing health care services and obtaining medications was experienced by 1922 (37.3%) and 3746 (72.7%) participants respectively. Also, 1433 (27.8%) used alternative medical care. Retirees (AOR:1.59), unemployed (AOR:1.198), people living with HIV (AOR:2.36) and at increased risk of COVID-19 (AOR:2.10), people who used drugs (AOR:1.83) and transacted sex (AOR:1.971) had significantly higher odds for reporting difficulty with access to health care. Males (AOR:1.23), respondents with secondary level of education (AOR:1.39), retirees (AOR:2.19), unemployed (AOR:1.47), people living with HIV (AOR:2.46), people who used drugs (AOR:1.79), transacted sex (AOR:2.71) and those who might be (AOR: 1.66) and were at (AOR: 2.3) increased risk of severe COVID-19 had significantly higher odds for reporting difficulty with access to medications. People who used drugs (AOR:2.093) transacted sex (AOR:1.639), who might be (AOR: 1.211) and were at (AOR: 1.511) increased risk of severe COVID-19, and who had difficulty accessing usual healthcare (AOR: 9.047) and obtaining medications (AOR:2.16) had significantly higher odds of reporting alternative medical care use. People living with HIV (AOR:0.562) had significantly lower odds of using alternative medical care. CONCLUSION We identified populations who had challenges with access to healthcare and obtaining medications used alternative medical care except for people living with HIV. Priority attention should be given to alternative medical care use during future health pandemics.
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Affiliation(s)
- Morenike Oluwatoyin Folayan
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria.
- Department of Child Dental Health, Obafemi Awolowo University, Ile-Ife, Nigeria.
| | - Roberto Ariel Abeldaño Zuñiga
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria
- Postgraduate Department, University of Sierra Sur, Oaxaca, Mexico
| | - Jorma I Virtanen
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria
- Faculty of Medicine, University of Turku, Turku, Finland
| | - Oliver C Ezechi
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria
- The Centre for Reproductive and Population Health Studies, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria
| | - Muhammad Abrar Yousaf
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria
- Department of Biology, Faculty of Science and Technology, Virtual University of Pakistan, Lahore, Pakistan
| | - Ala'a B Al-Tammemi
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria
- Applied Science Research Center, Applied Science Private University, Amman, Jordan
- Migration Health Division, International Organization for Migration (IOM), Amman, Jordan
| | - Mohammed Jafer
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria
- Faculty of Dentistry, Dental Public Health Division, Jazan University, Jizan, Saudi Arabia
| | - Passent Ellakany
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria
- Department of Substitutive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Eshrat Ara
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria
- Department of Psychology, Government College for Women, J&K, MA Road Srinagar, Srinagar, India
| | - Martin Amogre Ayanore
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria
- Department of Health Policy Planning and Management, Fred N. Binka School of Public Health, University of Health and Allied Sciences, Ho, Ghana
| | - Anthonia Omotola Ishabiyi
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria
- Department of Sociology, Florida Atlantic University, Florida, USA
| | - Balgis Gaffar
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Nourhan M Aly
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Joanne Lusher
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria
- Provost's Group, Regent's University London, London, UK
| | - Maha El Tantawi
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Annie L Nguyen
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria
- Department of Family Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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Marsden P, Sharma AA, Rotella JA. Review article: Clinical manifestations and outcomes of chronic nitrous oxide misuse: A systematic review. Emerg Med Australas 2022; 34:492-503. [PMID: 35695047 DOI: 10.1111/1742-6723.13997] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 04/08/2022] [Indexed: 11/28/2022]
Abstract
Recreational nitrous oxide (N2 O) use is widespread, and complications associated with its use are increasingly common. We sought to identify risk factors, clinical features and outcomes in individuals presenting with effects of chronic N2 O abuse to develop an approach to clinical assessment and management. A systemic literature review was completed with searches conducted across EMBASE, MEDLINE, PSYCINFO and Cochrane databases. Our search strategy identified 612 studies, 105 met inclusion criteria, and 10 were added via hand search. Subjects from 24 case series and 91 case reports were typically in their 20s, using over 100 bulbs daily for several months. Neurological presentations, including sensory change, gait disturbance or weakness, were characteristic. Serum Vitamin B12 was normal or raised in 133 out of 243 case series subjects and 37 out of 84 reports. Serum homocysteine and methylmalonic acid were usually raised. Macrocytosis and anaemia were not commonly seen. MRI findings were abnormal with dorsal column change where specified, typically involving the cervical spine. Nerve conduction studies mostly reported a sensorimotor polyneuropathy. B12 replacement was the treatment of choice and partial recovery was most reported. This review highlights the dose-dependent nature of chronic N2 O toxicity and recognises functional B12 deficiency as the cause. As B12 is often normal, homocysteine and methylmalonic acid are important biomarkers of disease. An approach to diagnosis is offered but requires validation in prospective studies. Research exploring B12 and methionine therapy is required to refine management.
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Affiliation(s)
- Pierce Marsden
- Department of Medicine, Northern Health, Melbourne, Victoria, Australia
| | - Aakriti A Sharma
- Department of Medicine, Northern Health, Melbourne, Victoria, Australia
| | - Joe-Anthony Rotella
- Department of Emergency Medicine, Northern Health, Melbourne, Victoria, Australia
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Chan GCK, Sun T, Lim C, Stjepanović D, Rutherford B, Johnson B, Hall W, Leung J. Did the under-reporting of meth/amphetamine use increase in a general population survey in Australia as negative media coverage increased? Addiction 2022; 117:1787-1793. [PMID: 34928522 DOI: 10.1111/add.15783] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 11/28/2021] [Indexed: 11/28/2022]
Abstract
AIM To test (1) if there was a change in self-reported lifetime prevalence of meth/amphetamine use by birth cohort and (2) if the extent of under-reporting of meth/amphetamine use was associated with the proportion of the population who nominated meth/amphetamine as a drug problem. DESIGN Observational study using seven waves of repeated cross-sectional nationally representative household surveys between 2001 and 2019. SETTING Australia. PARTICIPANTS Participants were from three birth cohorts: 1951-60 (age 68-77 at the 2019 survey; n = 29 458; 55% female), 1961-1970 (age 58-67; n = 29 859; 57% female) and 1971-1980 (age 48-57; n = 28 758; 59% female). Data were weighted to align the sample to the Australian population. MEASUREMENTS Past year meth/amphetamine use; under-reporting of lifetime meth/amphetamine use in each birth cohort, year and survey stratum (operationalised as the difference between self-reported lifetime prevalence in 2001 and that of each subsequent year); proportion of the population who nominated meth/amphetamine as a drug problem in each birth cohort, year and survey stratum. Under-reporting was regressed on the proportion of people holding negative attitude towards meth/amphetamine. Survey year and birth cohort were adjusted for. FINDINGS Between 2001 and 2019, the lifetime prevalence of meth/amphetamine decreased from 6.1% (95% CI = 5.3-6.9) to 1.7% (95% CI = 1.2-2.2) in the 1951-1960 birth cohort (p < 0.001), from 13.0% (95% CI = 12.0-14.1) to 4.4% (95% CI = 3.7-5.2) in the 1961-1970 birth cohort (p < 0.001) and from 21.4% (95% CI = 19.9-22.9) to 11.2% (95% CI = 10.0-12.4) in the 1971-1980 birth cohort (p < 0.001). The proportion who nominated meth/amphetamine as a 'drug problem' increased significantly in all three cohorts (all p < 0.001) and the degree of under-reporting of meth/amphetamine use was significantly associated with proportion of people who nominated meth/amphetamine as the 'drug problem' (b = 0.09, SE = 0.01, p < 0.001). CONCLUSION In Australia, the actual prevalence of lifetime meth/amphetamine use may be two- to fourfold higher than that estimated in the most recent national household surveys (2019). The level of under-reporting is strongly associated with increasing negative attitudes towards methylamphetamine and d-amphetamine use over the same period.
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Affiliation(s)
- Gary C K Chan
- National Centre for Youth Substance Use Research, The University of Queensland, Brisbane, Australia
| | - Tianze Sun
- National Centre for Youth Substance Use Research, The University of Queensland, Brisbane, Australia
| | - Carmen Lim
- National Centre for Youth Substance Use Research, The University of Queensland, Brisbane, Australia
| | - Daniel Stjepanović
- National Centre for Youth Substance Use Research, The University of Queensland, Brisbane, Australia
| | - Brienna Rutherford
- National Centre for Youth Substance Use Research, The University of Queensland, Brisbane, Australia
| | - Benjamin Johnson
- National Centre for Youth Substance Use Research, The University of Queensland, Brisbane, Australia
| | - Wayne Hall
- National Centre for Youth Substance Use Research, The University of Queensland, Brisbane, Australia
| | - Janni Leung
- National Centre for Youth Substance Use Research, The University of Queensland, Brisbane, Australia
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Man N, Sisson SA, McKetin R, Chrzanowska A, Bruno R, Dietze PM, Price O, Degenhardt L, Gibbs D, Salom C, Peacock A. Trends in methamphetamine use, markets and harms in Australia, 2003-2019. Drug Alcohol Rev 2022; 41:1041-1052. [PMID: 35604870 DOI: 10.1111/dar.13468] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 01/18/2022] [Accepted: 03/10/2022] [Indexed: 12/19/2022]
Abstract
INTRODUCTION To describe trends in methamphetamine use, markets and harms in Australia from 2003 to 2019. METHODS Data comprised patterns of use and price from sentinel samples of people who inject drugs and who use MDMA/other illicit stimulants and population-level amphetamine-related police seizures, arrests, hospitalisations, treatment episodes and deaths from approximately 2003 to 2019. Bayesian autoregressive time-series models were analysed for: no change; constant rate of change; and change over time differing in rate after one to three changepoints. Related indicators were analysed post hoc with identical changepoints. RESULTS The percentage of people who inject drugs reporting weekly use increased from 2010 to 2013 onwards, while use among samples of people who regularly use ecstasy and other illicit stimulants decreased. Seizures and arrests rose steeply from around 2009/10 to 2014/15 and subsequently plateaued. Price increased ($15.9 [95% credible interval, CrI $9.9, $28.9] per point of crystal per year) from around 2009 to 2011, plateauing and then declining from around 2017. Hospitalisation rates increased steeply from around 2009/10 until 2015/16, with a small subsequent decline. Treatment also increased (19.8 episodes [95% CrI 13.2, 27.6] with amphetamines as the principal drug of concern per 100 000 persons per year) from 2010/11 onwards. Deaths involving amphetamines increased (0.285 per 100 000 persons per year) from 2012 until 2016. DISCUSSION AND CONCLUSIONS These findings suggest that problematic methamphetamine use and harms escalated from 2010 to 2012 in Australia, with continued demand and a sustained market for methamphetamine.
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Affiliation(s)
- Nicola Man
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Scott A Sisson
- School of Mathematics and Statistics, UNSW Sydney, Sydney, Australia.,UNSW Data Science Hub, UNSW Sydney, Sydney, Australia
| | - Rebecca McKetin
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Agata Chrzanowska
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Raimondo Bruno
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia.,School of Psychological Sciences, University of Tasmania, Hobart, Australia
| | - Paul M Dietze
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia.,Behaviours and Health Risks, Burnet Institute, Melbourne, Australia.,National Drug Research Institute, Curtin University, Melbourne, Australia
| | - Olivia Price
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Louisa Degenhardt
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Daisy Gibbs
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Caroline Salom
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia.,Institute for Social Science Research, University of Queensland, Brisbane, Australia
| | - Amy Peacock
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
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12
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Hammond NG, Sivertsen B, Skogen JC, Øverland S, Colman I. The gendered relationship between illicit substance use and self-harm in university students. Soc Psychiatry Psychiatr Epidemiol 2022; 57:709-720. [PMID: 35034147 DOI: 10.1007/s00127-021-02209-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 12/05/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE To estimate associations between multiple forms of substance use with self-harming thoughts and behaviours, and to test whether gender is an effect modifier of these associations, both independently and along with perceived risk of cannabis use. METHODS Data were drawn from the 2018 Norwegian Students' Health and Wellbeing Study (SHoT 2018). A national sample of n = 50,054 full-time Norwegian students (18-35 years) pursuing higher education completed a cross-sectional student health survey, including questions on past-year self-harm: non-suicidal thoughts of self-harm, non-suicidal self-harm, suicidal thoughts, and suicide attempt. Students reported their frequency of past-year alcohol use (range: never to ≥ 4 times/ week), illicit substance consumption, and perceived risk of cannabis use. The AUDIT and CAST screening tools measured problematic alcohol and cannabis consumption, respectively. We used logistic regression modelling adjusted for age, symptoms of depression and anxiety, and financial hardship (analytic sample range: n = 48,263 to n = 48,866). RESULTS The most frequent alcohol consumption category (≥ 4 times/ week) was nearly always associated with more than a two-fold increased likelihood of self-harm. Less frequent alcohol consumption was associated with reduced odds of suicidal thoughts [monthly or less: OR = 0.87 (95% CI: 0.75-1.00), 2-4 times/month: OR = 0.79 (95% CI: 0.69-0.91), and 2-3 times/ week: OR = 0.83 (95% CI: 0.71-0.98)]. Problematic alcohol consumption was associated with most outcomes: odds ranging from 1.09 (95% CI: 1.01-1.18) for suicidal thoughts to 1.33 (95% CI: 1.00-1.77) for suicide attempt. There was evidence of multiple illicit substance by gender interactions: consumption of all but one illicit substance category (other drug use) was associated with all four forms of self-harm for women, but findings among men were less clear. Among men, only one illicit substance category (stimulant) was associated with most forms of self-harm. Women, but not men, who perceived cannabis use as a health risk were more likely to experience non-suicidal thoughts as cannabis consumption increased, and with harmful consumption patterns. CONCLUSION Frequent alcohol consumption is associated with increased risk of self-harm and suicidality for young women and men. Associations between illicit substance use and self-harm and suicidality appear stronger in women compared to men.
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Affiliation(s)
- Nicole G Hammond
- School of Epidemiology and Public Health, University of Ottawa, 600 Peter Morand Cr, Room 308C, Ottawa, ON, K1G 5Z3, Canada
| | - Børge Sivertsen
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway.,Department of Research and Innovation, Helse-Fonna HF, Haugesund, Norway.,Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Jens Christoffer Skogen
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway.,Alcohol and Drug Research Western Norway, Stavanger University Hospital, Stavanger, Norway.,Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Simon Øverland
- Centre for Disease Burden, Norwegian Institute of Public Health, Bergen, Norway
| | - Ian Colman
- School of Epidemiology and Public Health, University of Ottawa, 600 Peter Morand Cr, Room 308C, Ottawa, ON, K1G 5Z3, Canada. .,Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway.
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13
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Anderson J. Peer support workers’ conceptions of drug users and the implications for service provision. Anthropol Med 2021; 28:477-492. [DOI: 10.1080/13648470.2021.1875317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Jane Anderson
- Anthropology and Sociology, Faculty of Arts, Humanities and Social Sciences, The University of Western, Crawley, Australia
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14
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McKetin R. Household surveys and the case of the Australian methamphetamine situation. Addiction 2021; 116:2610-2611. [PMID: 33754377 DOI: 10.1111/add.15480] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Accepted: 03/09/2021] [Indexed: 12/22/2022]
Affiliation(s)
- Rebecca McKetin
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
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15
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Changes in Adolescents' Psychosocial Functioning and Well-Being as a Consequence of Long-Term COVID-19 Restrictions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168755. [PMID: 34444502 PMCID: PMC8392883 DOI: 10.3390/ijerph18168755] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 08/11/2021] [Accepted: 08/16/2021] [Indexed: 12/24/2022]
Abstract
This work studied self-reports from adolescents on how the COVID-19 pandemic has changed their behaviors, relationships, mood, and victimization. Data collection was conducted between September 2020 and February 2021 in five countries (Sweden, the USA, Serbia, Morocco, and Vietnam). In total, 5114 high school students (aged 15 to 19 years, 61.8% females) responded to our electronic survey. A substantial proportion of students reported decreased time being outside (41.7%), meeting friends in real life (59.4%), and school performance (30.7%), while reporting increased time to do things they did not have time for before (49.3%) and using social media to stay connected (44.9%). One third of the adolescents increased exercise and felt that they have more control over their life. Only a small proportion of adolescents reported substance use, norm-breaking behaviors, or victimization. The overall COVID-19 impact on adolescent life was gender-specific: we found a stronger negative impact on female students. The results indicated that the majority of adolescents could adapt to the dramatic changes in their environment. However, healthcare institutions, municipalities, schools, and social services could benefit from the findings of this study in their work to meet the needs of those young people who signaled worsened psychosocial functioning, increased stress, and victimization.
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16
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Deen H, Kershaw S, Newton N, Stapinski L, Birrell L, Debenham J, Champion KE, Kay-Lambkin F, Teesson M, Chapman C. Stigma, discrimination and crystal methamphetamine (‘ice’): Current attitudes in Australia. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2021; 87:102982. [DOI: 10.1016/j.drugpo.2020.102982] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 10/01/2020] [Accepted: 10/03/2020] [Indexed: 10/23/2022]
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17
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Jones R, Woods C, Usher K. Methamphetamines: Cross sectional-survey exploring police and paramedic attitudes and perceptions of deservingness of care. Nurs Health Sci 2020; 23:157-166. [PMID: 33098343 DOI: 10.1111/nhs.12787] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 10/19/2020] [Accepted: 10/20/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Rikki Jones
- School of Health, University of New England, Armidale, New South Wales, Australia
| | - Cindy Woods
- Judith Lumley Centre, La Trobe University, Melbourne, Victoria, Australia
| | - Kim Usher
- School of Health, University of New England, Armidale, New South Wales, Australia
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18
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New psychoactive substances in Australia: patterns and characteristics of use, adverse effects, and interventions to reduce harm. Curr Opin Psychiatry 2020; 33:343-351. [PMID: 32250983 DOI: 10.1097/yco.0000000000000606] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
PURPOSE OF REVIEW To summarize the most recent peer-review literature on new psychoactive substances (NPS) within Australia. RECENT FINDINGS NPS use among the general Australian population is low, yet more pervasive among specific subpopulations. There is considerable heterogeneity among people who use NPS, however, overall, they are not unique from those who use more established illicit drugs. NPS have been shown to be highly adulterated, used as contaminants, variable in dose, and changeable as to the specific substances available over time. Further, analyses of coroners' cases highlight the importance of consumer understanding of NPS effects, particularly where they differ substantially to their more traditional illicit drug counterparts (e.g., synthetic vs. plant cannabinoids). One study posited that legislative approaches to NPS have been (partially) effective in reducing harms, and there are new systems being established to identify NPS-related health harms. SUMMARY There have been few studies recently published on NPS in Australia (n = 17), however, findings mostly align with the international literature with respect to the rapidly changing nature of the NPS market, the use of NPS as adulterants, and associated harms. These themes highlight the need for proactive, novel approaches to rapidly identify, and respond to emerging drugs of concern.
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19
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Jones R, Woods C, Usher K. The impact of media sensationalism and crisis framing on stigma and negative attitudes towards methamphetamine users. Int J Ment Health Nurs 2020; 29:319-321. [PMID: 32337856 DOI: 10.1111/inm.12708] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Rikki Jones
- School of Health, University of New England, Armidale, New South Wales, Australia
| | - Cindy Woods
- School of Health, University of New England, Armidale, New South Wales, Australia
| | - Kim Usher
- School of Health, University of New England, Armidale, New South Wales, Australia
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20
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Jones NS, Comparin JH. Interpol review of controlled substances 2016-2019. Forensic Sci Int Synerg 2020; 2:608-669. [PMID: 33385148 PMCID: PMC7770462 DOI: 10.1016/j.fsisyn.2020.01.019] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 01/23/2020] [Indexed: 12/14/2022]
Abstract
This review paper covers the forensic-relevant literature in controlled substances from 2016 to 2019 as a part of the 19th Interpol International Forensic Science Managers Symposium. The review papers are also available at the Interpol website at: https://www.interpol.int/content/download/14458/file/Interpol%20Review%20Papers%202019.pdf.
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Affiliation(s)
- Nicole S. Jones
- RTI International, Applied Justice Research Division, Center for Forensic Sciences, 3040 E. Cornwallis Road, Research Triangle Park, NC, 22709-2194, USA
| | - Jeffrey H. Comparin
- United States Drug Enforcement Administration, Special Testing and Research Laboratory, USA
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21
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Palmer A, Scott N, Dietze P, Higgs P. Motivations for crystal methamphetamine-opioid co-injection/co-use amongst community-recruited people who inject drugs: a qualitative study. Harm Reduct J 2020; 17:14. [PMID: 32106854 PMCID: PMC7047412 DOI: 10.1186/s12954-020-00360-9] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Accepted: 02/12/2020] [Indexed: 11/10/2022] Open
Abstract
Aims We report on motivations for crystal methamphetamine-opioid co-use/co-injection through narratives of people who inject drugs during a period of increased crystal methamphetamine use reporting in Australia. Methods Fourteen in-depth interviews were undertaken with selected participants (12 male, 2 female) from the Melbourne Injecting Drug User Cohort Study, including those in and out of opioid substitution therapy (OST). Results The main motivations for co-use reported by participants were as follows: (1) that heroin could be used to reduce the negative side effects of heavy crystal methamphetamine use, particularly during the ‘comedown’ phase; (2) that small quantities of crystal methamphetamine used with heroin could prolong the intoxication effect of heroin, and hence the time before opioid withdrawal; (3) that co-injection of crystal methamphetamine and heroin produced a more desirable intoxication effect than using either substance on its own and; (4) that crystal methamphetamine provided a substitute ‘high’ for heroin after commencing OST treatment. Conclusions Co-use of methamphetamine and opioids has been used by people who inject drugs to facilitate intoxication, sometimes as the result of ineffective opioid substitution therapy (OST) treatment and perceived lack of pleasure after stabilisation on OST treatment.
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Affiliation(s)
- Anna Palmer
- Behaviours and Health Risks Program, Burnet Institute, 85 Commercial Road, Melbourne, VIC, 3004, Australia.
| | - Nick Scott
- Behaviours and Health Risks Program, Burnet Institute, 85 Commercial Road, Melbourne, VIC, 3004, Australia.,Department of Epidemiology and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Paul Dietze
- Behaviours and Health Risks Program, Burnet Institute, 85 Commercial Road, Melbourne, VIC, 3004, Australia.,Department of Epidemiology and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Peter Higgs
- Behaviours and Health Risks Program, Burnet Institute, 85 Commercial Road, Melbourne, VIC, 3004, Australia.,Department of Public Health, La Trobe University, Plenty Rd & Kingsbury Dr, Bundoora, VIC, 3086, Australia
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22
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Ellway D, Reilly R, Le Couteur A, Ward J. Exploring How People Affected by Methamphetamine Exchange Social Support Through Online Interactions on Facebook: Content Analysis. JMIR Ment Health 2019; 6:e14011. [PMID: 31573926 PMCID: PMC6774572 DOI: 10.2196/14011] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 07/13/2019] [Accepted: 07/19/2019] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Methamphetamine is an illicit and addictive psychostimulant that remains to be a significant cause of economic burden in Australia. Social media is increasingly being used by nongovernment organizations and health services to encourage the growth of social support networks among people with health-related issues. Several studies have investigated the utility of social media in providing social support to groups of people with health-related issues. However, limited research exists that explores how people who have been directly or indirectly affected by methamphetamine use social media for social support. OBJECTIVE This study aimed to determine the types of social support being sought and provided by people affected by methamphetamine when interacting with others on a Facebook page. METHODS A total of 14,777 posts were collected from a Facebook page and transferred into an Excel document for content analysis. The posts were manually coded into categories of social support using an adapted version of Cutrona and Suhr's Social Support Behavior Code. Posts could be coded into more than one category. Saturation was reached at 2000 posts, which were used to draw inferences. RESULTS Emotional support was the most offered support type, with 42.05% (841/2000) of posts providing this form of support. This is followed by esteem support, which was provided in 40.40% (808/2000) of posts. Overall, 24.20% (484/2000) of posts offered informational support. Network support and tangible support were the least offered support types, with 2.25% (45/2000) and 1.70% (34/2000) of posts offering these types of support, respectively. CONCLUSIONS This study suggests that online social support groups can be effective in challenging stigma by encouraging people affected by methamphetamine to connect with each other and talk about their struggles. This in turn represents an important step toward successful rehabilitation.
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Affiliation(s)
- Daniel Ellway
- School of Psychology, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia
| | - Rachel Reilly
- Infection and Immunity Aboriginal Health, South Australian Health and Medical Research Institute, Adelaide, Australia
| | - Amanda Le Couteur
- School of Psychology, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia
| | - James Ward
- Infection and Immunity Aboriginal Health, South Australian Health and Medical Research Institute, Adelaide, Australia
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23
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Kumar N, Puljević C, Ferris J, Winstock A, Barratt MJ. Cannabis use patterns at the dawn of US cannabis reform. J Cannabis Res 2019; 1:5. [PMID: 33526080 PMCID: PMC7815050 DOI: 10.1186/s42238-019-0003-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 04/07/2019] [Indexed: 02/02/2023] Open
Abstract
In the United States (US), three in 10 cannabis users develop cannabis use disorder (CUD). Usage patterns in line with CUD may be associated with socio-economic disadvantage, and other negative effects. Thus, research on CUD is paramount. To provide understanding around CUD, it is necessary to detail granular cannabis usage preferences, as some risk from cannabis use may be mitigated through informed behavioral choices by users. We describe cannabis usage preferences among US Global Drug Survey (GDS) respondents, primarily young men. The cross-sectional web-based GDS (2017) was completed by 8345 US-resident respondents (median age = 23, Interquartile Range 19–32; % male = 75.48) who reported cannabis use. Of those who reported cannabis use in the past year, most (78%) reported consuming their first joint more than an hour after waking, and about half the sample (49%) had their last joint 1–2 h before bed. Cannabis was used for a median of 250 days in the last year (almost daily). Respondents spent a median of four hours a day stoned when cannabis was used. High potency herbal cannabis was the preferred variant by 62% of participants. We suggest that frequent use of cannabis may increase risk of health harms, and highlight the need to mitigate problematic use. With the rapidly developing US cannabis market, possibly problematic usage patterns may indicate potential for CUD especially within young men.
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Affiliation(s)
- Navin Kumar
- Yale Institute for Network Science, Yale University, New Haven, CT, USA. .,Center for Empirical Research on Stratification and Inequality (CERSI), Yale University, New Haven, CT, USA. .,Department of Sociology, Yale University, New Haven, CT, USA.
| | - Cheneal Puljević
- Centre for Health Service Research, University of Queensland, QLD, Brisbane, Australia
| | - Jason Ferris
- Centre for Health Service Research, University of Queensland, QLD, Brisbane, Australia
| | - Adam Winstock
- University College London, London, UK.,Global Drug Survey Ltd, London, UK
| | - Monica J Barratt
- Drug Policy Modelling Program, National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, NSW, Australia.,National Drug Research Institute, Faculty of Health Sciences, Curtin University, Perth, WA, Australia.,Behaviours and Health Risks Program, Burnet Institute, Melbourne, VIC, Australia
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24
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“A more accurate understanding of drug use”: A critical analysis of wastewater analysis technology for drug policy. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2019; 63:47-55. [DOI: 10.1016/j.drugpo.2018.10.011] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 10/29/2018] [Accepted: 10/29/2018] [Indexed: 11/21/2022]
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25
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Lea T, Hammoud M, Bourne A, Maher L, Jin F, Haire B, Bath N, Grierson J, Prestage G. Attitudes and Perceived Social Norms toward Drug Use among Gay and Bisexual Men in Australia. Subst Use Misuse 2019; 54:944-954. [PMID: 30648480 DOI: 10.1080/10826084.2018.1552302] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND Gay and bisexual men (GBM) report distinctive patterns and contexts of drug use, yet little has been published about their attitudes toward drug use. OBJECTIVES We developed measures of attitudes and perceived social norms toward drug use, and examined covariates of more accepting attitudes and norms among GBM in Australia. METHODS We analyzed baseline data from the Following Lives Undergoing Change (Flux) study. Flux is an online prospective observational study of drug use among Australian GBM. We used principal components factor analysis to generate two attitudinal scales assessing "drug use for social and sexual enhancement" and "perceptions of drug risk." A third perceived social norms scale examined "acceptability of drug use among gay friends." RESULTS Among 2,112 participants, 61% reported illicit drug use in the preceding six months. Stronger endorsement of drug use for social and sexual engagement and lower perceptions of drug risk were found among men who were more socially engaged with other gay men and reported regular drug use and drug use for sex. In multivariate analyses, all three scales were associated with recent drug use (any use in the previous six months), but only the drug use for social and sexual enhancement scale was associated with regular (at least monthly) use. CONCLUSIONS Drug use and sex are difficult to disentangle for some GBM, and health services and policies could benefit from a better understanding of attitudinal and normative factors associated with drug use in gay social networks, while recognizing the role of pleasure in substance use.
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Affiliation(s)
- Toby Lea
- a German Institute for Addiction and Prevention Research (DISuP) , Catholic University of Applied Sciences , North Rhine-Westphalia , Germany.,b Centre for Social Research in Health , UNSW Sydney , New South Wales , Australia
| | - Mohamed Hammoud
- c The Kirby Institute , UNSW Sydney , New South Wales , Australia
| | - Adam Bourne
- d Australian Research Centre in Sex , Health & Society, La Trobe University, Melbourne , Australia
| | - Lisa Maher
- c The Kirby Institute , UNSW Sydney , New South Wales , Australia
| | - Fengyi Jin
- c The Kirby Institute , UNSW Sydney , New South Wales , Australia
| | - Bridget Haire
- c The Kirby Institute , UNSW Sydney , New South Wales , Australia
| | - Nicky Bath
- e National LGBTI Health Alliance , Sydney , Australia
| | - Jeffrey Grierson
- f Faculty of Health, Social Care & Education , Anglia Ruskin University , Cambridge , UK
| | - Garrett Prestage
- c The Kirby Institute , UNSW Sydney , New South Wales , Australia
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26
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Gordon DG, de Jong G. Gaps in the ice: Methamphetamine in Australia; its history, treatment, and ramifications for users and their families. Int J Ment Health Nurs 2018; 27:1861-1868. [PMID: 29869828 DOI: 10.1111/inm.12480] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/26/2018] [Indexed: 11/30/2022]
Abstract
It is now well-established that Australia has a significant issue with methamphetamine. Recent dramatic changes in manufacturing have led to significant shifts in both the patterns of use and the relative purity of this illicit drug, with the crystalline form of methamphetamine commonly referred to as 'ice'. Excessive use not only impacts on those taking the drug, but also takes a heavy toll on their families. With few effective treatment options currently available, there is a strong focus on developing replacement pharmacotherapies and examining the efficacy of outpatient counselling and residential treatment options. Recent research in addiction care supports the positive impact that families of users can have on both treatment and recovery for their loved ones. Despite this recognition, there is little current research looking at the experiences of families of users of the uniquely problematic drug methamphetamine. This paper outlines the historical narrative that has led to the current worldwide phenomenon of ice use and explores contemporary directions of research into its impact and potential treatments. In doing so, it outlines the relatively unexplored impact of ice on families and highlights a current need for nursing research into their experiences living with loved ones using the drug.
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Affiliation(s)
- Douglas Greg Gordon
- School of Nursing and Midwifery, Edith Cowan University, Perth, Western Australia, Australia
| | - Gideon de Jong
- School of Nursing and Midwifery, Edith Cowan University, Perth, Western Australia, Australia
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27
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Winkelman TNA, Admon LK, Jennings L, Shippee ND, Richardson CR, Bart G. Evaluation of Amphetamine-Related Hospitalizations and Associated Clinical Outcomes and Costs in the United States. JAMA Netw Open 2018; 1:e183758. [PMID: 30646256 PMCID: PMC6324446 DOI: 10.1001/jamanetworkopen.2018.3758] [Citation(s) in RCA: 107] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
IMPORTANCE Despite indications of increasing amphetamine availability and psychostimulant deaths in the United States, evidence across data sources is mixed, and data on amphetamine-related hospitalizations are lacking. OBJECTIVE To clarify trends in amphetamine-related hospitalizations and their clinical outcomes and costs in the United States. DESIGN, SETTING, AND PARTICIPANTS This repeated, cross-sectional study used hospital discharge data from the Healthcare Cost and Utilization Project National Inpatient Sample. The nationally representative sample included US adults (n = 1 292 300) who had amphetamine-related hospitalizations between January 1, 2003, and December 31, 2015. Multivariable logistic and Poisson regression models were used to examine in-hospital mortality and length of stay. Analysis of these data was conducted from November 2017 to August 2018. EXPOSURE Amphetamine dependence or abuse or amphetamine poisoning. MAIN OUTCOMES AND MEASURES Annual hospitalizations, in-hospital mortality, length of stay, transfer to another facility, and costs. RESULTS Over the 2003 to 2015 study period, there were 1 292 300 weighted amphetamine-related hospitalizations. Of this population, 541 199 (41.9%) were female and 749 392 (58.1%) were male, with a mean age of 37.5 years (95% CI, 37.4-37.7 years). Amphetamine-related hospitalizations, compared with other hospitalizations, were associated with age younger than 65 years (98.0% vs 58.0%; P < .001), male sex (60.3% [95% CI, 59.7%-60.8%] vs 41.1% [95% CI, 40.9%-41.3%]), Medicaid coverage (51.2% [95% CI, 49.8%-52.7%] vs 17.8% [95% CI, 17.5%-18.1%]), and residence in the western United States (58.5% [95% CI, 55.9%-61.0%] vs 18.9% [95% CI, 18.0%-19.8%]). Amphetamine-related hospitalizations declined between 2005 and 2008, and then increased from 55 447 hospitalizations (95% CI, 44 936-65 959) in 2008 to 206 180 hospitalizations (95% CI, 95% CI, 189 188-223 172) in 2015. Amphetamine-related hospitalizations increased to a greater degree than hospitalizations associated with other substances. Adjusted mean length of stay (5.9 [95% CI, 5.8-6.0] vs 4.7 [95% CI, 4.7-4.8] days; P < .001), transfer to another facility (26.0% [95% CI, 25.3%-26.8%] vs 18.5% [95% CI, 18.3%-18.6%]; P < .001), and mean in-hospital mortality (28.3 [95% CI, 26.2-30.4] vs 21.9 [95% CI, 21.6-22.1] deaths per 1000 hospitalizations; P < .001) were higher for amphetamine-related than other hospitalizations. Annual hospital costs related to amphetamines increased from $436 million (95% CI, $312 million-$559 million) in 2003 to $2.17 billion (95% CI, $1.95 billion-$2.39 billion) by 2015. CONCLUSIONS AND RELEVANCE Given that amphetamine-related hospitalizations and costs substantially increased between 2003 and 2015, pharmacologic and nonpharmacologic therapies for amphetamine use disorders and a coordinated public health response are needed to curb these rising rates.
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Affiliation(s)
- Tyler N A Winkelman
- Division of General Internal Medicine, Department of Medicine, Hennepin Healthcare, Minneapolis, Minnesota
- Hennepin Healthcare Research Institute, Minneapolis, Minnesota
| | - Lindsay K Admon
- Department of Obstetrics and Gynecology, University of Michigan Medical School, Ann Arbor
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor
| | | | - Nathan D Shippee
- Division of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis
| | - Caroline R Richardson
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor
- Department of Family Medicine, University of Michigan Medical School, Ann Arbor
| | - Gavin Bart
- Hennepin Healthcare Research Institute, Minneapolis, Minnesota
- Division of Addiction Medicine, Department of Medicine, Hennepin Healthcare, Minneapolis, Minnesota
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Devault DA, Maguet H, Merle S, Péné-Annette A, Lévi Y. Wastewater-based epidemiology in low Human Development Index states: bias in consumption monitoring of illicit drugs. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2018; 25:27819-27838. [PMID: 30109683 DOI: 10.1007/s11356-018-2864-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Accepted: 07/27/2018] [Indexed: 06/08/2023]
Abstract
Wastewater-based epidemiology is a promising approach worldwide, and its application is currently being developed in non-advanced economies. This technology, based on known toxicokinetic data initially used to detect illicit drugs in well-managed and maintained local sewer networks, has been extended to assess other products such as pesticides, alcohol, flame retardants, nicotine, and other substances. This technology is also used in countries with non-advanced economies. The present review aims to support future wastewater-based epidemiology in such countries by providing toxicokinetic data for locally used narcotic drugs that are expected or known to be emerging in developed countries, outlining the excretion differences due to human polymorphism, and summarising the practical obstacles due to the coverage, maintenance efficiency, or type of local sewage network.Case study feedback from Martinique is presented as an example; the Martinique field study complies with the Organisation for Economic Co-operation and Development standards for health issues, but not with regard to population and urban dynamics.
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Affiliation(s)
- Damien A Devault
- Faculté de Pharmacie, Univ. Paris Sud, Univ. Paris Saclay, UMR 8079, CNRS, AgroParisTech, France, 5 rue J. B. Clement, 92290, Chatenay-Malabry, France.
| | - Hadrien Maguet
- Centre Hospitalier Universitaire de Martinique, CS 90632 - 97261, Fort-de-France Cedex, France
| | - Sylvie Merle
- Observatoire de la Santé de la Martinique, Immeuble Objectif 3000, Acajou sud, 97232, Le Lamentin, Martinique
| | - Anne Péné-Annette
- Laboratoire EA 929 AIHP-GEODE-BIOSPHERES Campus Universitaire de Schœlcher, 97275, Schœlcher, France
| | - Yves Lévi
- Faculté de Pharmacie, Univ. Paris Sud, Univ. Paris Saclay, UMR 8079, CNRS, AgroParisTech, France, 5 rue J. B. Clement, 92290, Chatenay-Malabry, France
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Butterworth P, Becker D, Degenhardt L, Hall WD, Patton GC. Amphetamine use in the fourth decade of life: Social profiles from a population-based Australian cohort. Drug Alcohol Rev 2018; 37:743-751. [PMID: 29998467 DOI: 10.1111/dar.12840] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Revised: 05/21/2018] [Accepted: 06/12/2018] [Indexed: 11/30/2022]
Abstract
INTRODUCTION AND AIMS To estimate the prevalence and frequency of amphetamine use in a cohort of Australians aged in their mid-30s. DESIGN AND METHODS Cross-sectional analysis of wave 10 data collected in 2014 from the Victorian Adolescent Health Cohort Study: a sample of 1435 persons originally selected in a stratified, random community survey of secondary school students from the state of Victoria that commenced in 1992. Weighted multinomial regression models were used to evaluate the social, health and other substance-use correlates of lifetime and current (12-month) amphetamine use and current frequency of use. RESULTS Lifetime amphetamine use was reported by 23.2% (95% confidence interval 21.0-25.5%) of respondents, and 6.5% (95% confidence interval 5.2-7.8%) reported current (12-month) use. A quarter (26%) of those currently using amphetamines, 1.7% (95% confidence interval 1.0-2.4%) of all respondents, reported frequent (at least weekly) use. Men reported greater amphetamine use than women. Current amphetamine use was associated with disrupted family circumstances, socioeconomic adversity, polydrug use and high levels of drug use within the social and familial environment. Frequent use was associated with greater likelihood of multiple adversity, unemployment, anxiety disorders and use of mental health services. DISCUSSION AND CONCLUSIONS The current results show that lifetime, current and frequent amphetamine use was common amongst adults in the fourth decade of life in this cohort, and associated with the experience of social disadvantage, poor mental health and living in a social context in which drug use is the norm.
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Affiliation(s)
- Peter Butterworth
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.,Melbourne Institute of Applied Economic and Social Research, University of Melbourne, Melbourne, Australia
| | - Denise Becker
- Centre for Adolescent Health, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia
| | - Louisa Degenhardt
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Wayne D Hall
- Centre for Youth Substance Abuse, University of Queensland, Brisbane, Australia
| | - George C Patton
- Centre for Adolescent Health, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia
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30
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Dixson G, Woolfenden S, Jayasinha R, Rawstorne P, Palmer K, Nathan S. Characteristics of Australian adolescent females in residential treatment who report using methamphetamines. Drug Alcohol Rev 2017; 37 Suppl 1:S384-S393. [PMID: 29266457 DOI: 10.1111/dar.12641] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Revised: 10/12/2017] [Accepted: 11/08/2017] [Indexed: 11/30/2022]
Abstract
INTRODUCTION AND AIMS To investigate factors associated with methamphetamine use in adolescent females referred to an Australian residential treatment service. DESIGN AND METHODS A mixed-methods explanatory sequential design was undertaken. Cross-sectional analysis of existing pre-treatment data for adolescent females aged 13-18 years (median 16.48 years) attending a treatment program between 2009 and 2015 (n = 267) was undertaken, followed by a focus group and in-depth interviews of key staff. RESULTS Female methamphetamine-users (n = 127, 47.6%) were significantly more likely than non-methamphetamine-users at pre-treatment to be in unstable living arrangements, where they moved frequently (P = 0.025), lived in more unstable (not rented or privately owned) accommodation (P = 0.012) and had problematic family situations (P = 0.004). They were more likely than non-methamphetamine-users to be to be poly-drug users (P < 0.001) and to have ever attempted suicide (P = 0.029). Cumulative trauma by someone known to the adolescent was the main predictor for female methamphetamine use (odds ratio 3.077). Qualitative data provided context and depth to quantitative findings, with an emphasis on trauma as a precursor to methamphetamine use. The qualitative interviews also highlighted changes made in service provision, given the increasing rates of methamphetamine use. DISCUSSION AND CONCLUSIONS High levels of trauma and mental health problems in this population support the notion that traumatic childhood experiences are strongly associated with problematic alcohol and other drug use, particularly, methamphetamine use, at a young age. Increased attention to decreasing family violence, abuse and neglect is required and in clinical practice, a trauma-informed model of care is recommended.
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Affiliation(s)
- Georgina Dixson
- School of Public Health & Community Medicine, UNSW Sydney, Sydney, Australia
| | - Susan Woolfenden
- School of Public Health & Community Medicine, UNSW Sydney, Sydney, Australia.,Sydney Children's Hospital Network, Sydney, Australia
| | - Ranmalie Jayasinha
- School of Public Health & Community Medicine, UNSW Sydney, Sydney, Australia
| | - Patrick Rawstorne
- School of Public Health & Community Medicine, UNSW Sydney, Sydney, Australia
| | | | - Sally Nathan
- School of Public Health & Community Medicine, UNSW Sydney, Sydney, Australia
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Giommoni L, Reuter P, Kilmer B. Exploring the perils of cross-national comparisons of drug prevalence: The effect of survey modality. Drug Alcohol Depend 2017; 181:194-199. [PMID: 29080406 DOI: 10.1016/j.drugalcdep.2017.09.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Revised: 09/23/2017] [Accepted: 09/26/2017] [Indexed: 11/17/2022]
Abstract
BACKGROUND There is significant interest in comparing countries on many different indicators of social problems and policies. Cross-national comparisons of drug prevalence and policies are often hampered by differences in the approach used to reach respondents and the methods used to obtain information in national surveys. The paper explores how much these differences could affect cross-country comparisons. METHODS This study reports prevalence of drug use according to the most recent national household survey and then adjusts estimates as if all national surveys used the same methodology. The analysis focuses on European countries for which the European Monitoring Centre for Drugs and Drug Addiction reports data, the United States, Canada, and Australia. Adjustment factors are based on US data. FINDINGS Adjusting for modality differences appears likely to modestly affect the rankings of countries by prevalence, but to an extent that could be important for comparisons. For example, general population surveys suggest that the US had some of the highest cannabis and cocaine prevalence rates circa 2012, but this is partially driven by the use of a modality known to produce higher prevalence estimates. This analysis shows that country rankings are partly an artifact of the mode of interview used in national general population surveys. CONCLUSIONS Our preliminary efforts suggest that cross-national prevalence comparisons, policy analyses and, other projects such as estimating the global burden of disease could be improved by adjusting estimates from drug use surveys for differences in modality. Research is needed to create more authoritative adjustment factors.
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Affiliation(s)
- Luca Giommoni
- Cardiff University, School of Social Sciences, United Kingdom.
| | - Peter Reuter
- School of Public Policy and Department of Criminology, University of Maryland, United States
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Barratt MJ, Ferris JA, Zahnow R, Palamar JJ, Maier LJ, Winstock AR. Moving on From Representativeness: Testing the Utility of the Global Drug Survey. SUBSTANCE ABUSE-RESEARCH AND TREATMENT 2017; 11:1178221817716391. [PMID: 28924351 PMCID: PMC5595253 DOI: 10.1177/1178221817716391] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Accepted: 05/22/2017] [Indexed: 11/16/2022]
Abstract
A decline in response rates in traditional household surveys, combined with increased internet coverage and decreased research budgets, has resulted in increased attractiveness of web survey research designs based on purposive and voluntary opt-in sampling strategies. In the study of hidden or stigmatised behaviours, such as cannabis use, web survey methods are increasingly common. However, opt-in web surveys are often heavily criticised due to their lack of sampling frame and unknown representativeness. In this article, we outline the current state of the debate about the relevance of pursuing representativeness, the state of probability sampling methods, and the utility of non-probability, web survey methods especially for accessing hidden or minority populations. Our article has two aims: (1) to present a comprehensive description of the methodology we use at Global Drug Survey (GDS), an annual cross-sectional web survey and (2) to compare the age and sex distributions of cannabis users who voluntarily completed (a) a household survey or (b) a large web-based purposive survey (GDS), across three countries: Australia, the United States, and Switzerland. We find that within each set of country comparisons, the demographic distributions among recent cannabis users are broadly similar, demonstrating that the age and sex distributions of those who volunteer to be surveyed are not vastly different between these non-probability and probability methods. We conclude that opt-in web surveys of hard-to-reach populations are an efficient way of gaining in-depth understanding of stigmatised behaviours and are appropriate, as long as they are not used to estimate drug use prevalence of the general population.
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Affiliation(s)
- Monica J Barratt
- Drug Policy Modelling Program, National Drug and Alcohol Research Centre, UNSW Australia, Sydney, NSW, Australia.,National Drug Research Institute, Faculty of Health Sciences, Curtin University, Perth, WA, Australia.,Behaviours and Health Risks Program, Burnet Institute, Melbourne, VIC, Australia
| | - Jason A Ferris
- Institute for Social Science Research, The University of Queensland, St Lucia, QLD, Australia
| | - Renee Zahnow
- Institute for Social Science Research, The University of Queensland, St Lucia, QLD, Australia
| | - Joseph J Palamar
- Department of Population Health, NYU Langone Medical Center, New York, NY, USA.,Center for Drug Use and HIV Research, NYU Rory Meyers College of Nursing, New York, NY, USA
| | | | - Adam R Winstock
- Institute of Epidemiology & Health Care, Faculty of Population Health Sciences, University College London.,Global Drug Survey Ltd, London, UK
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Hughes CE, Moxham-Hall VL. The Going Out In Sydney App: Evaluating the Utility of a Smartphone App for Monitoring Real-World Illicit Drug Use and Police Encounters Among Festival and Club Goers. Subst Abuse 2017; 11:1178221817711419. [PMID: 35153483 PMCID: PMC8832297 DOI: 10.1177/1178221817711419] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Accepted: 04/06/2017] [Indexed: 11/15/2022]
Abstract
Gaining accurate information on illicit drug use and policing in real-world settings is a challenge. This study examines the utility of a smartphone app ('Going Out In Sydney') to prospectively follow up illicit drug use and policing encounters at music festivals and licensed entertainment precincts in Sydney, Australia. In all, 38 regular festival and licensed entertainment venue attendees used the app to log nights out over a 3-month period, including (1) where they went (eg, festival, nightclub), (2) the prevalence of illicit drug use, and (3) the incidence and nature of police encounters. A survey and interview were then conducted about the utility of the app. The app enabled rich data collection (n = 353 entries) about illicit drug use and policing at both target settings. Follow-up surveys indicated that most participants were extremely satisfied with the ease of use of the app and privacy afforded, and compared with other data collection modes, such as paper-based logs and online surveys, rated the app the most desirable method of data collection. This suggests smartphone apps may be a viable option for future studies on illicit drug use and policing of drugs.
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Affiliation(s)
- Caitlin Elizabeth Hughes
- Caitlin Elizabeth Hughes, Drug Policy
Modelling Program, National Drug and Alcohol Research Centre, University of New
South Wales, Sydney, NSW 2052, Australia.
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34
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Differences in the symptom profile of methamphetamine-related psychosis and primary psychotic disorders. Psychiatry Res 2017; 251:349-354. [PMID: 28282630 DOI: 10.1016/j.psychres.2017.02.028] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Revised: 01/13/2017] [Accepted: 02/12/2017] [Indexed: 11/21/2022]
Abstract
We examined the lifetime experience of hallucinations and delusions associated with transient methamphetamine-related psychosis (MAP), persistent MAP and primary psychosis among a cohort of dependent methamphetamine users. Participants were classified as having (a) no current psychotic symptoms, (n=110); (b) psychotic symptoms only when using methamphetamine (transient MAP, n=85); (c) psychotic symptoms both when using methamphetamine and when abstaining from methamphetamine (persistent MAP, n=37), or (d) meeting DSM-IV criteria for lifetime schizophrenia or mania (primary psychosis, n=52). Current psychotic symptoms were classified as a score of 4 or more on any of the Brief Psychiatric Rating Scale items of suspiciousness, hallucinations or unusual thought content in the past month. Lifetime psychotic diagnoses and symptoms were assessed using the Composite International Diagnostic Interview. Transient MAP was associated with persecutory delusions and tactile hallucinations (compared to the no symptom group). Persistent MAP was additionally associated with delusions of reference, thought interference and complex auditory, visual, olfactory and tactile hallucinations, while primary psychosis was also associated with delusions of thought projection, erotomania and passivity. The presence of non-persecutory delusions and hallucinations across various modalities is a marker for persistent MAP or primary psychosis in people who use methamphetamine.
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McKetin R, Kothe A, Baker AL, Lee NK, Ross J, Lubman DI. Predicting abstinence from methamphetamine use after residential rehabilitation: Findings from the Methamphetamine Treatment Evaluation Study. Drug Alcohol Rev 2017; 37:70-78. [DOI: 10.1111/dar.12528] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Revised: 10/28/2016] [Accepted: 12/09/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Rebecca McKetin
- National Drug Research Institute, Faculty of Health Sciences; Curtin University; Perth Australia
- National Drug and Alcohol Research Centre; University of New South Wales; Sydney Australia
| | - Astrid Kothe
- School of Psychology; Otto-Friedrich-Universität Bamberg; Bamberg Germany
| | - Amanda L. Baker
- School of Medicine and Public Health; University of Newcastle; Newcastle Australia
| | - Nicole K. Lee
- National Drug Research Institute, Faculty of Health Sciences; Curtin University; Perth Australia
| | - Joanne Ross
- National Drug and Alcohol Research Centre; University of New South Wales; Sydney Australia
| | - Dan I. Lubman
- Turning Point; Eastern Health and Monash University; Melbourne Australia
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36
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McKetin R, Degenhardt L, Shanahan M, Baker AL, Lee NK, Lubman DI. Health service utilisation attributable to methamphetamine use in Australia: Patterns, predictors and national impact. Drug Alcohol Rev 2017; 37:196-204. [PMID: 28294443 DOI: 10.1111/dar.12518] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Revised: 10/27/2016] [Accepted: 10/27/2016] [Indexed: 11/26/2022]
Abstract
AIM AND BACKGROUND We estimated health service utilisation attributable to methamphetamine use, its national impact and examined other predictors of health service utilisation among dependent methamphetamine users. METHOD Past year rates of health service utilisation (number of attendances for general hospitals, psychiatric hospitals, emergency departments, general practitioners, psychiatrists, counsellors or psychologists, and dentists) were estimated for three levels of methamphetamine use (no use, < weekly, ≥ weekly) using panel data from a longitudinal cohort of 484 dependent methamphetamine users from Sydney and Brisbane, Australia. Marginal rates for methamphetamine use were multiplied by 2013 prevalence estimates from the National Drug Strategy Household Survey. Covariates included other substance use, demographics, mental disorders and drug treatment. FINDINGS Health service use was high. More frequent methamphetamine use was associated with more frequent presentations to emergency departments (incidence rate ratios 1.3-2.1) and psychiatric hospitals (incidence rate ratios 5.3-8.3) and fewer presentations to general practitioners, dentists and counsellors. We estimate methamphetamine use accounted for between 28 400 and 80 900 additional psychiatric hospital admissions and 29 700 and 151 800 additional emergency department presentations in 2013. More frequent presentations to these services were also associated with alcohol and opioid use, comorbid mental health disorders, unemployment, unstable housing, attending drug treatment, low income and lower education. CONCLUSIONS Frequent methamphetamine use has a significant impact on emergency medical and psychiatric services. Better provision of non-acute health care services to address the multiple health and social needs of dependent methamphetamine users may reduce the burden on these acute care services. [McKetin R, Degenhardt L, Shanahan M, Baker AL, Lee NK, Lubman DI. Health service utilisation attributable to methamphetamine use in Australia: patterns, predictors and national impact. Drug Alcohol Rev 2017;00:000-000].
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Affiliation(s)
- Rebecca McKetin
- National Drug Research Institute, Faculty of Health Sciences, Curtin University, Perth, Australia.,National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Louisa Degenhardt
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Marian Shanahan
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Amanda L Baker
- School of Medicine and Public Health, University of Newcastle, Newcastle, Australia
| | - Nicole K Lee
- National Drug Research Institute, Faculty of Health Sciences, Curtin University, Perth, Australia
| | - Dan I Lubman
- Turning Point, Eastern Health and Monash University, Melbourne, Australia
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Degenhardt L, Larney S, Chan G, Dobbins T, Weier M, Roxburgh A, Hall WD, McKetin R. Estimating the number of regular and dependent methamphetamine users in Australia, 2002-2014. Med J Aust 2016; 204:153. [PMID: 26937668 DOI: 10.5694/mja15.00671] [Citation(s) in RCA: 71] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Accepted: 10/09/2015] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To estimate the number of regular and dependent methamphetamine users in Australia. DESIGN Indirect prevalence estimates were made for each year from 2002-03 to 2013-14. We applied multiplier methods to data on treatment episodes for amphetamines (eg, counselling, rehabilitation, detoxification) and amphetamine-related hospitalisations to estimate the numbers of regular (at least monthly) and dependent methamphetamine users for each year. Dependent users comprised a subgroup of those who used the drug regularly, so that estimates of the sizes of these two populations were not additive. RESULTS We estimated that during 2013-14 there were 268 000 regular methamphetamine users (95% CI, 187 000-385 000) and 160 000 dependent users (95% CI, 110 000-232 000) aged 15-54 years in Australia. This equated to population rates of 2.09% (95% CI, 1.45-3.00%) for regular and 1.24% (95% CI, 0.85-1.81%) for dependent use. The rate of dependent use had increased since 2009-10 (when the rate was estimated to be 0.74%), and was higher than the previous peak (1.22% in 2006-07). The highest rates were consistently among those aged 25-34 years, in whom the rate of dependent use during 2012-2013 was estimated to be 1.50% (95% CI, 1.05-2.22%). There had also been an increase in the rate of dependent use among those aged 15-24 years (in 2012-13 reaching 1.14%; 95% CI, 0.80-1.69%). CONCLUSIONS There have been increases over the past 12 years in the numbers of regular and dependent methamphetamine users in Australia. Our estimates suggest that the most recent numbers are the highest for this period, and that the increase has been most marked among young adults (those aged 15-34 years). IMPLICATIONS There is an increasing need for health services to engage with people who have developed problems related to their methamphetamine use.
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Affiliation(s)
- Louisa Degenhardt
- National Drug and Alcohol Research Centre, UNSW Australia, Sydney, NSW
| | - Sarah Larney
- National Drug and Alcohol Research Centre, UNSW Australia, Sydney, NSW
| | - Gary Chan
- Centre for Youth Substance Abuse Research, University of Queensland, Brisbane, QLD
| | - Timothy Dobbins
- National Drug and Alcohol Research Centre, UNSW Australia, Sydney, NSW
| | - Megan Weier
- Centre for Youth Substance Abuse Research, University of Queensland, Brisbane, QLD
| | - Amanda Roxburgh
- National Drug and Alcohol Research Centre, UNSW Australia, Sydney, NSW
| | - Wayne D Hall
- Centre for Youth Substance Abuse Research, University of Queensland, Brisbane, QLD
| | - Rebecca McKetin
- National Drug Research Institute, Curtin University, Perth, WA
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