Our monthly ACT ATOD Research eBulletin is a concise summary of newly-published research findings and other research activities of particular relevance to ATOD and allied workers in the ACT.
Its contents cover research on demand reduction, harm reduction and supply reduction; prevention, treatment and law enforcement. ATODA's Research eBulletin is a resource for keeping up-to-date with the evidence base underpinning our ATOD policy and practice.
The 2010 ACT Inmate Health Survey (IHS) was the first survey conducted in the ACT prison, the Alexander Maconochie Centre (AMC). Results from this survey will provide the best available evidence to form a baseline assessment of the health needs of prisoners in the ACT. These results will inform the provision of health services and policy development to ensure that health service delivery in correctional facilities meets the needs of the inmate population.
Tobacco and illicit drug use among inmates of the AMC is high according to the survey of 135 inmates (a 67% participation rate). Smokers represented 85% of those surveyed and 20% of those said they commenced smoking while in prison. However, 80% of smokers surveyed expressed a desire to quit. The vast majority (91%) of inmates responded that they had used illicit drugs at some time and 67% of those had injected drugs. 79% of those surveyed reported that they were under the influence of alcohol/other drugs at the time of committing the offence that led to their imprisonment.
In September a discussion paper was developed and distributed to identified researchers based within the ACT. On 11 October 2011 a workshop was held with cross-institutional researchers, practitioners and policy makers in the ACT. At the workshop it was agreed to progress establishing a collaboration, such as a Centre for Drug Research, Policy and Practice in the ACT. Participants included representatives from the Australian National University, University of Canberra, Australian Catholic University, ACT Government Health Directorate, ATODA and the ATOD sector.
If you are interested in being involved please email Carrie Fowlie, Executive Officer, ATODA on
NHMRC conducted a public consultation on this issues paper. Feedback will inform the development of ethical guidance for HRECs and researchers, complementing and updating existing content in the National Statement on Ethical Conduct in Human Research (2007). Consultation closed on 16 December 2011.
For further information see:
Members of the Canberra collaboration made a joint submission to the consultation.
The sixteenth paper in the Series on Legislative Reform of Drug Policies published by theTransnational Institute and International Drug Policy Consortium ‘aims to set out some of the policy and public health issues raised by the appearance of a wide range of emergent psychoactive substances of diverse origin, effect and risk profile (commonly referred to as “legal highs”)…[and which] have also been variously referred to as “designer drugs”, “herbal highs”, “synthetic drugs” and more recently “research chemicals”’.
The authors examine the controls for novel psychoactive substances applied in the EU and New Zealand. They conclude ‘While new psychoactive substances pose a challenge to existing drug control regimes, their appearance provides an opportunity to consider the trial of novel policy and legislative approaches. The core aim of any drug control regime must be to protect individual and population well-being and health. It is increasingly recognised that there are unintended consequences associated with criminalisation as the primary approach for drug control. There are now increasing calls for countries to adopt approaches that minimise these unwanted impacts…Evidence to date suggests that alternatives to criminalisation exist that attain many of the desirable outcomes for governments whilst minimising the unnecessary consequences of criminalising the individual user’.
Winstock, A & Wilkins, C 2011, ‘
Legal highs’: The challenge of new psychoactive substances, Transnational Institute (TNI) and International Drug Policy Consortium (IDPC), Amsterdam & London,
http://www.idpc.net/publications/legal-highs-the-challenge-of-new-psychoactive-substances.
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How dangerous is mephedrone (meow-meow)?
A study in the UK assessed ‘the patterns of use, subjective effect profile and dependence liability of mephedrone’ by interviewing 100 mephedrone (meow-meow) users, who were associated with the dance music scene. The researchers found that ‘Mephedrone consumption results in typical stimulant-related subjective effects: euphoria, increased concentration, talkativeness, urge to move, empathy, jaw clenching, reduced appetite and insomnia. Thirty per cent of the sample potentially met criteria for DSM-IV dependence and there was evidence of a strong compulsion to use the drug (47% had used the drug for 2 or more consecutive days). Self-reported recent consumption of mephedrone was confirmed by toxicological analysis in all of the 14 participants who submitted a urine sample.’ They concluded that ‘Mephedrone has a high abuse and health risk liability, with increased tolerance, impaired control and a compulsion to use, the predominant reported dependence symptoms’.
Winstock, A, Mitcheson, L, Ramsey, J, Davies, S, Puchnarewicz, M & Marsden, J 2011, ‘Mephedrone: use, subjective effects and health risks’,
Addiction, vol. 106, no. 11, pp. 1991-6.
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Do home visits by nurses to at-risk mothers have a lasting effect on the lives of the mothers and their children?
Four hundred families in a semi-rural community in New York, USA received home visits by nurses during a mother’s pregnancy and until the child’s second birthday as part of the Elmira Nurse-Family Partnership program. A follow-up study of the children at age 19 found that ‘Prenatal and infancy home visitation reduced the proportion of girls entering the criminal justice system…[however] there were few program effects for boys’. The research showed that ‘Girls in the nurse-visited group born to high-risk (unmarried and low-income) mothers had fewer children and were less likely to have received Medicaid than were high-risk girls in the comparison group. This pattern of effects for crime, childbirth, and use of Medicaid is consistent with earlier findings from this trial for the youths’ mothers: high-risk nurse-visited mothers had fewer arrests, had fewer and more widely spaced subsequent children, and used less public assistance during the 15 years after the birth of the first child than did their comparison group counterparts’. The lack of impact on boys’ outcomes is disappointing.
Eckenrode, J, Campa, M, Luckey, DW, Henderson, CRJ, Cole, R, Kitzman, H, Anson, E, Sidora-Arcoleo, K, Powers, J & Olds, D 2010, ‘Long-term effects of prenatal and infancy nurse home visitation on the life course of youths: 19-year follow-up of a randomized trial’,
Archives of Pediatrics and Adolescent Medicine, vol. 164, no. 1, pp. 9-15.
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Is there a link between greater availability of alcohol and increased levels of violence in the vicinity?
A study conducted by NDRI researchers of the link between licensed outlets and violence in Perth discovered that ‘the higher the amount of alcohol sold per off-site outlet the greater the risk of reported assault within an LGA Local Government Authority area]…Notably, volume of alcohol sold appeared to have greatest impact on assaults occurring at private residences…For on-site outlets…greater numbers of such premises within an LGA predicted greater levels of assault’. The researchers concluded that ‘The link between on-site outlets and violence may be primarily underpinned by negative amenity effects while off-site outlet effects occur via increased availability. Alcohol sales volumes from off-site outlets influence levels of violence, which occur at both licensed and residential settings. The substantial and wide-ranging effects of liquor stores on alcohol-related harms may have been underestimated in the literature and by policy makers’.
Liang, W & Chikritzhs, T 2011, ‘Revealing the link between licensed outlets and violence: counting venues versus measuring alcohol availability’,
Drug and Alcohol Review, vol. 30, no. 5, pp. 524-35.
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Does increased police and security at licensed premises reduce the rate of alcohol-related injury?
Community interventions implemented in Geelong since 2007 to reduce the number of alcohol-related presentations to hospital emergency departments include a Night-Watch Radio Program connecting security staff via radio with relevant personnel, ID scanners to detect fake IDs, increased police visibility, undercover police presence, and local celebrities endorsing safe drinking behaviour. A study of the effectiveness of these interventions has found that ‘Alcohol-related injury [hospital emergency department] presentations in the Geelong region have risen consistently since 2005. Furthermore, none of the interventions implemented in Geelong coincides significantly with any sustained decrease in alcohol-related injury rates’. The researchers query ‘whether targeting the night-time economy is effective and whether interventions should instead be targeted at reducing whole-of-community alcohol consumption’.
Miller, P, Sonderlund, A, Coomber, K, Palmer, D, Gillham, K, Tindall, J & Wiggers, JH 2011, ‘Do community interventions targeting licensed venues reduce alcohol-related emergency department presentations?’,
Drug and Alcohol Review, vol. 30, no. 5, pp. 546-53.
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Is there a relationship between severity of injury in motor vehicle accidents and the level of the driver’s blood alcohol level?
A study of the severity of automotive injuries associated with elevated blood alcohol concentration (BACs) analysed the injuries of all people in US fatal automotive accidents over the period 1994 to 2008. The researchers found that ‘Accident severity increases significantly even when the driver is merely “buzzed” [has a BAC that is positive but below the legal limit], a finding that persists after standardization for various confounding factors. Three mechanisms mediate between buzzed driving and high accident severity: compared to sober drivers, buzzed drivers are significantly more likely to speed, to be improperly seatbelted and to drive the striking vehicle. In addition, there is a strong “dose-response” relationship for all three factors in relation to accident severity (e.g. the greater the BAC, the greater the average speed of the driver and the greater the severity of the accident). They concluded that ‘The severity of life-threatening motor vehicle accidents increases significantly at blood alcohol concentrations (BACs) far lower than the current US limit of 0.08%. Lowering the legal limit could save lives, prevent serious injuries and reduce financial and social costs associated with motor vehicle accidents’.
Phillips, DP & Brewer, KM 2011, ‘The relationship between serious injury and blood alcohol concentration (BAC) in fatal motor vehicle accidents: BAC = 0.01% is associated with significantly more dangerous accidents than BAC = 0.00%’,
Addiction, vol. 106, no. 9, pp. 1614-22.
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How can ACT Policing improve its approach to policing licensed premises?
ACT Policing (ACTP) data shows ‘there has been a general increase in the number of recorded assault offences’ in the ACT over the period 2005-06 to 2008-09, and ‘almost two-thirds of all offenders charged with an assault-related offence in 2009 had consumed alcohol prior to the offence or were intoxicated at the time of being arrested’.
Over the 2009-10 summer period, the Australian Institute of Criminology (AIC) evaluated ‘the ACTP response to alcohol-related crime in entertainment precincts’. The AIC made recommendations to improve ‘the operation and effectiveness of the ACT Policing approach to policing licensed premises, in the following areas: adoption of a clear long-term strategy to address alcohol-related crime and antisocial behaviour problems; more rigorous enforcement of liquor licensing legislation; intelligence-led policing of licensed premises; monitoring alcohol-related problems and the response and impact of policing; workforce and organisational development; working with licensees, managers and security; alcohol counselling and treatment; developing strategies to reduce the consumption of alcohol; and further research and evaluation.
Smith, L, Morgan, A & McAtamney, A 2011,
Policing licensed premises in the Australian Capital Territory, Australian Institute of Criminology, Canberra, (pdf 2.29 MB)
http://www.aic.gov.au/en/publications/current%20series/tbp/41-60/tbp048.aspx.
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Is there an association between comorbid substance use disorder, post traumatic stress disorder, and violence?
A recent article in
Addictive Behaviors journal looks at the prevalence of violent behaviour among individuals with both substance use disorder (SUD) and post traumatic stress disorder (PTSD). It presents research findings of 102 individuals receiving integrated treatment for comorbid SUD and PTSD, of whom more than half reported committing violence in their lifetimes. ‘Bivariate associations were found between violence perpetration and trait aggression, higher levels of alcohol and cannabis use, lower levels of other opiate use, and experiencing more severe PTSD symptoms, particularly in relation to hyperarousal...however, only higher levels of physical aggression and more severe PTSD hyperarousal symptoms remained as independent predictors of violence perpetration’.
The researchers point out that ‘These findings highlight the importance of assessing for PTSD amongst those with SUD particularly in forensic settings. They also indicate that it is the hyperarousal symptoms of PTSD specifically that need to be targeted by interventions aimed at reducing violence amongst individuals with SUD and PTSD’.
Barrett, EL, Mills, KL & Teesson, M 2011, ‘Hurt people who hurt people: violence amongst individuals with comorbid substance use disorder and post traumatic stress disorder’,
Addictive Behaviors, vol. 36, no. 7, pp. 721-8.
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Do adulterants in illicit drugs pose a serious threat to health?
The abstract of this comprehensive review reads as follows.
Widespread public perception is that illicit drugs contain substances that are a serious risk to health, even though adulterants are often not considered in clinical or forensic toxicology. This review attempts to present an evidence-based overview of adulterants in illicit drugs, and their associated toxicity. Adulterants are deliberately added to increase bulk, enhance or mimic a pharmacological effect, or to facilitate drug delivery. Those present unintentionally are as a result of poor manufacturing techniques. From the reports gathered, adulterants are predominantly substances which are readily available, commonly being caffeine, procaine, paracetamol, and sugars. These are likely to have minimal impact on users’ health at low dosages. Other adulterants, particularly in injectable drugs, have the potential to cause serious health issues, but the quantities reported, such as strychnine in heroin, are not life-threatening. The most commonly identified bacterial contaminants identified are Bacillus and Clostridium species. When death or serious illness due to adulteration occurs, circulation of information is particularly vital, such as in the USA regarding heroin and cocaine adulterated with fentanyl, and in Scotland recently regarding anthrax contaminated heroin. The complex interactions of supply, demand, and control of illicit drugs have a tangible impact on their adulteration. Continuing vigilance and the circulation of information is, therefore, desirable as a public health issue. As part of that strategy, analyses performed for adulterants needs to be encouraged, which are considerably limited in number and scope at the moment.
Cole, C, Jones, L, McVeigh, J, Kicman, A, Syed, Q & Bellis, M 2011, ‘Adulterants in illicit drugs: a review of empirical evidence’,
Drug Testing and Analysis, vol. 3, no. 2, pp. 89-96.
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Is routine counselling necessary for methadone treatment to be effective?
A review reported in the leading journal
Addiction compared the effectiveness of ‘12-months of Interim Methadone (IM; supervised methadone with emergency counseling only for the first 4 months of treatment), Standard Methadone treatment (SM; with routine counseling) and Restored Methadone treatment (RM: routine counseling with smaller caseloads)’. The researchers found that ‘At 12 months…there were no significant differences in retention in treatment among the IM, SM and RM’. They concluded that ‘Limited availability of drug counseling services should not be a barrier to providing supervised methadone to adults dependent on heroin - at least for the first 4 months of treatment’.
Schwartz, RP, Kelly, SM, O'Grady, KE, Gandhi, D & Jaffe, JH 2011, ‘Randomized trial of standard methadone treatment compared to initiating methadone without counseling: 12-month findings’,
Addiction, 2011 Oct 26. doi: 10.1111/j.1360-0443.2011.03700.x. [Epub ahead of print].
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Is methamphetamine use increasing among arrestees?
‘Recent data from the Australian Institute of Criminology’s Drug Use Monitoring in Australia (DUMA) program shows an increase in the use of methamphetamine among police detainees. Voluntary urinalysis undertaken by detainees’ shows that in the first three-quarters of 2011, 21 percent of police detainees tested positive to methamphetamine—up from 16 percent in 2010 and 13 percent in 2009. Trend analysis suggests that the continuing decline in methamphetamine use since 2004 may have ended, with rates of use among police detainees increasing in both 2010 and 2011. Self-report data also indicates that methamphetamine is considered by users to be higher in quality and easier to obtain in 2011 compared with earlier years. Methamphetamine users also report an increase in the number of people selling the drug.’
Macgregor, S & Payne, J 2011,
Increase in use of methamphetamine, Research in Practice no. 22, Australian Institute of Criminology, Canberra,
http://www.aic.gov.au/en/publications/current%20series/rip/21-40/rip22.aspx.
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New Reports
Association of Participating Service Users (APSU) 2011, ‘Coming soon: “Locked Out”’, a report on the impact that criminal check records have on the lives of consumers of illicit drugs. Key findings online at
http://www.apsuonline.org.au/2011/11/09/locked-out/ .
Australian Injecting and Illicit Drug Users League 2011,
'Why wouldn't I discriminate against all of them?' A report on stigma and discrimination towards the injecting drug user community, Australian Injecting and Illicit Drug Users League, Canberra,
http://www.aivl.org.au/database/?q=node/1110.
Australian Institute of Health and Welfare 2011,
Alcohol and other drug treatment services in Australia 2009-10: report on the National Minimum Data Set, Drug Treatment Series no. 14, cat. no. HSE 114, AIHW, Canberra,
http://www.aihw.gov.au/publication-detail/?id=10737420496&tab=2.
Australian Institute of Health and Welfare 2011,
Drugs in Australia 2010: tobacco, alcohol and other drugs, Drug Statistics Series no. 27, cat. no. PHE 154, Australian Institute of Health and Welfare, Canberra,
http://www.aihw.gov.au/publication-detail/?id=10737420497.
Butler, T, Lim, D & Callander, D 2011,
National Prison Entrants’ Bloodborne Virus and Risk Behaviour Survey report 2004, 2007, and 2010, National Drug Research Institute (Curtin University) & The Kirby Institute (The University of New South Wales), Sydney,
http://www.med.unsw.edu.au/NCHECRweb.nsf/resources/Reports-1/$file/2010+npebbvs+-+ONLINE.pdf.
Costello, D, Robertson, AJ & Ashe, M 2011,
Drink or drunk: why do staff at licensed premises continue to serve patrons to intoxication despite current laws and interventions? Final report, Monograph Series no. 38, National Drug Law Enforcement Research Fund, Canberra,
http://www.ndlerf.gov.au/pub/Monograph_38.pdf.
National Health and Medical Research Council 2011,
Consensus-based clinical practice guideline for the management of volatile substance use in Australia, National Health and Medical Research Council, Melbourne,
http://www.nhmrc.gov.au/guidelines/publications/cp136-and-cp136a.
NIDAC Online Consultation 1: Alcohol, Summary of Findings,
http://www.nidac.org.au/index.php?option=com_content&view=article&id=90&Itemid=63
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