The 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.

 

In the September 2014 issue


ACT Research Spotlight

Research Findings

New Reports
 

What is the impact on mortality of weight gain following quitting smoking?
 
A team of researchers in the United States compared the risk of all-cause mortality and mortality from all cancers combined, lung cancer, respiratory diseases, cardiovascular diseases and diabetes mellitus between normal weight smokers and overweight or obese ex-smokers. They used data from the 1997 to 2004 US National Health Interview Surveys which were linked to records in the National Death Index, with mortality follow-up to December 2006. The sample was limited to normal weight smokers and overweight/obese ex-smokers 25 years of age and older.

‘Results showed that in both women and men, normal-weight smokers, relative to overweight or obese ex-smokers, had a higher risk of mortality from all causes combined, all cancers combined, lung cancer, cardiovascular and respiratory diseases. Among women, there was no difference in mortality risk from diabetes mellitus between normal-weight smokers and overweight or obese ex-smokers. Among men, there was some evidence that the risk of mortality was higher in obese ex-smokers than normal-weight smokers.’

The researchers concluded that ‘…overall, mortality risk is smaller in overweight or obese ex-smokers than normal-weight smokers. Smoking cessation interventions can tailor messages that highlight the greater reduction in mortality associated with quitting, compared with potential weight gain’.

Siahpush, M, Singh, GK, Tibbits, M, Pinard, CA, Shaikh, RA & Yaroch, A 2014, ‘It is better to be a fat ex-smoker than a thin smoker: findings from the 1997–2004 National Health Interview Survey−National Death Index linkage study’, Tobacco Control, vol. 23, no. 5, pp. 395-402, open access: http://tobaccocontrol.bmj.com/content/23/5/395.full.

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How effective are smoking bans in prisons in reducing mortality attributable to smoking?

An analysis using data from all US state prisons from 2001 to 2011 aimed to determine the level of mortality attributable to smoking and years of potential life lost from smoking among people in prison and whether bans on smoking in prison are associated with reductions in smoking-related deaths. The smoking attributable mortality, morbidity, and economic costs system of the Centers for Disease Control and Prevention was used to calculate smoking attributable mortality, years of potential life lost, and the age-adjusted smoking attributable mortality and years of potential life lost rates per 100,000 population. The researchers found that ‘The most common causes of deaths related to smoking among people in prison were lung cancer, ischemic heart disease, other heart disease, cerebrovascular disease, and chronic airways obstruction. The age adjusted smoking attributable mortality and years of potential life lost rates were 360 and 5149 per 100 000, respectively; these figures are higher than rates in the general US population (248 and 3501, respectively). The number of states with any smoking ban increased from 25 in 2001 to 48 by 2011. In prisons the mortality rate from smoking related causes was lower during years with a ban than during years without a ban…Prisons that implemented smoking bans had a 9% reduction…in smoking related deaths. Bans in place for longer than nine years were associated with reductions in cancer mortality’. They concluded that ‘Smoking contributes to substantial mortality in prison, and prison tobacco control policies are associated with reduced mortality. These findings suggest that smoking bans have health benefits for people in prison, despite the limits they impose on individual autonomy and the risks of relapse after release’.

Binswanger, IA, Carson, EA, Krueger, PM, Mueller, SR, Steiner, JF & Sabol, WJ 2014, ‘Prison tobacco control policies and deaths from smoking in United States prisons: population based retrospective analysis’, BMJ: British Medical Journal, vol. 349, p. g4542, open access http://www.bmj.com/content/349/bmj.g4542.

Comment: This is yet another study demonstrating the positive benefits that flow from imposing smoking bans in prisons. It had support to the claims that governments that continue to permit smoking in prisons are breaching their duty of care towards both prisoners and prison staff. Experience demonstrates, however, that it is not easy to institute such bans, and doing so needs to be done in a planned manner with a long lead time.
ATODA notes that ACT Corrective services has begun some preliminary work in this space, and that this has been identified as an area of need in the Tobacco Reduction Strategy.

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Are reduced nicotine cigarettes coming back on the agenda? 

Abstract: The U.S. FDA has the authority to limit the nicotine content of cigarettes; however, there are concerns that reduced nicotine cigarettes will be smoked more intensely and, therefore, will increase exposure to toxic chemicals in smoke. This study examined changes in consumer behavior and exposure in response to cigarettes with substantially reduced nicotine content.

Methods: Seventy-two adult smokers completed an unblinded trial of reduced nicotine cigarettes. Participants completed a 7-day baseline period during which they smoked their usual cigarette brand, followed by consecutive 7-day periods smoking cigarettes with progressively lower nicotine levels (0.6, 0.3, and 0.05 mg emission Quest cigarettes). Nicotine dependence and withdrawal, smoking behavior, and biomarkers of exposure were assessed for each 7-day period.

Results: Significant reductions in nicotine intake were observed between usual brand smoking (∼1.2 mg nicotine) and the 0.3 and 0.05 mg nicotine emission cigarettes, but not the 0.6 mg cigarette. The findings provide little evidence of compensatory smoking of Quest cigarettes, with no increases in exhaled breath carbon monoxide levels, smoking intensity, or levels of 1-hydroxypyrene across study periods. No significant differences were observed for smoking urges or measures of nicotine dependence.

Conclusions: The study adds to the evidence that cigarettes with markedly reduced nicotine content are not associated with increased smoking intensity or exposure to smoke toxicants.

Impact: The findings add to the evidence base on reduced nicotine content cigarettes and have the potential to inform FDA policy on nicotine levels.

Hammond, D & O’Connor, RJ 2014, ‘Reduced nicotine cigarettes: smoking behavior and biomarkers of exposure among smokers not intending to quit’, Cancer Epidemiology Biomarkers & Prevention, online ahead of print.

Comment: Tobacco harm reduction strategies are increasingly being discussed in Australia, but low nicotine cigarettes do not seem to be on anyone’s agenda. This largely reflects the understanding that such products result in people smoking more or inhaling more deeply to get the nicotine that they need (titration), without producing any beneficial outcomes. The body of research to which this study belongs may lead some to challenge these long-held assumptions.
 

How likely are survivors of cancer to continue smoking? 
 
A study in the United States analysed data on smoking and cessation from a longitudinal study of long-term survivors of 10 cancers from cancer registries in 11 states. The researchers found that ‘Approximately 9 years after diagnosis, 9.3% of all survivors were current (past 30-day) smokers. Smoking prevalence was highest among survivors of bladder (17.2%), lung (14.9%), and ovarian (11.6%) cancers. Most current smokers (83%) smoked daily, averaging 14.7 cigarettes per day (cpd). Forty percent of daily smokers smoked more than 15 cpd…Current smoking was associated with younger age, lower education and income, and greater alcohol consumption. Quitting after diagnosis was associated with having a smoking-related cancer. Roughly, a third of current smokers intended to quit, 40% within the next month. The odds of intending to quit were lower if survivors were married, older, or smoked more’. They concluded that ‘…smoking can persist long after initial diagnosis and at high levels...Some survivors’ daily levels of smoking suggest a dependence on tobacco…Those who smoke heavily long after their diagnosis may require more intense treatment addressing specific psychosocial characteristics such as perceptions of risk, beliefs of fatalism, etc., that may influence motivation to quit’.

Westmaas, JL, Alcaraz, KI, Berg, CJ & Stein, KD 2014, ‘Prevalence and correlates of smoking and cessation-related behavior among survivors of ten cancers: findings from a nationwide survey nine years after diagnosis’, Cancer Epidemiology Biomarkers & Prevention, online ahead of print.

Comment: This study further demonstrates the intractable nature of cigarette smoking among some populations, highlighting the need for cessation strategies that are narrowly targeted to support particular population groups, whilst maintaining broad community-level preventive initiatives such as increasing the price of cigarettes and reducing their physical availability.
 
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With increasing moves to decriminalise and/or legalise cannabis, what business methods might the cannabis industry adopt from the tobacco industry? 

A recent article in the New England Journal of Medicine draws attention to possible negative results from the decriminalisation and legalisation of cannabis.

‘Given the lessons learned from the 20th-century rise of another legal addictive substance, tobacco, we believe that such an industry could transform marijuana and its effects on public health…

The burgeoning marijuana industry is already following the same successful business strategy by increasing potency and creating new delivery devices. The concentration of tetrahydrocannabinol (THC), marijuana’s principal psychoactive constituent, has more than doubled over the past 40 years. Producers are manufacturing strains that they claim are less addictive or less harmful to mental health, but no supporting scientific evidence has been published. New vaporizer delivery systems developed by some manufacturers may reduce lung irritation from smoking but may also allow users to consume more THC (the component most closely associated with euphoria, addictive potential, and mental health side effects) by enabling them to inhale more often and more deeply. The business community recognizes these innovations’ economic potential: a recent joint venture between a medical-marijuana provider and an electronic-cigarette maker sent stock prices soaring…

Furthermore, the marijuana industry will have unprecedented opportunities for marketing on the Internet, where regulation is minimal and third-party tracking and direct-to-consumer marketing have become extremely lucrative. When applied to a harmful, addictive commodity, these marketing innovations could be disastrous. This strategy poses a particular threat to young people. Adolescents are more likely than adults to seek novelty and try new products. The developing adolescent brain is particularly vulnerable to the development of addiction…

History and current evidence suggest that simply legalizing marijuana, and giving free rein to the resulting industry, is not the answer. To do so would be to once again entrust private industry with safeguarding the health of the public—a role that it is not designed to handle.’

Richter, KP & Levy, S 2014, ‘Big marijuana-lessons from big tobacco’, New England Journal of Medicine, vol. 371, no. 5, pp. 399-401.

Comment: The major take-home message for Australia from this type of commentary is that it would be disastrous for our nation to follow the American lead in loosening restrictions on the availability of cannabis without ensuring that the for-profit sector, in the cannabis market, is prohibited or is strictly regulated. To Australians, but not to many Americans, it seems self-evident that a legalised regime of cannabis should have the drug regulated at least as strictly as tobacco, if not more so.
 

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To what extent would harm reduction strategies be appropriate in relation to the sale of electronic cigarettes in Australia? 

The sale of electronic cigarettes containing nicotine is prohibited in Australia, and in one state (WA) the prohibition even applies to electronic cigarettes that contain no nicotine. The Australian authors of an commentary in The Lancet Respiratory Medicine state that ‘The public health harms feared by those who support a ban on electronic nicotine delivery systems are most likely to occur if the sale and promotion of these products is unregulated…We do not have to choose between banning electronic nicotine delivery systems sales and allowing their unregulated sale. We can regulate sales in ways that address the legitimate concerns of those who support a ban, while still allowing smokers to buy electronic nicotine delivery systems. For example, adult smokers could be allowed to buy approved products from a few licensed sales outlets. These sales could be regulated in ways that help research to inform future decisions about how to regulate these products.

‘Advertising of electronic nicotine delivery systems products could be banned and consumer law could be used to ensure their safety to users and others (eg, to children by requiring child-resistant containers for nicotine). At the point of sale, purchasers could be advised to avoid dual use (except as a time-limited pathway to quitting) and clearly told that we do not have definitive evidence about the health effects of the use of electronic nicotine delivery systems as a long-term alternative to cigarette smoking.

‘This type of regulation would facilitate research on the uptake and use of electronic nicotine delivery systems...[and] could also be readily reversed if electronic nicotine delivery systems prove to be as disappointing as their critics predict. If, however, the products help smokers to quit and are much safer substitutes for combustible cigarettes, as their advocates claim, then these restrictions could be relaxed. This could be done while also increasing restrictions on the sale of cigarettes, such as by reducing the number of outlets in which cigarettes can be sold; by allowing electronic nicotine delivery systems to be sold in the same places so that they can compete with combustible cigarettes among current smokers; and through reducing young people’s access to both products to minimise new young recruits to electronic nicotine delivery systems and smoking among adolescents and young adults’.

Hall, W & Gartner, C 2014, ‘Should Australia reconsider its ban on the sale of electronic nicotine delivery systems?’, The Lancet Respiratory Medicine, vol. 2, no. 8, pp. 602-4.

Comment: Co-author Dr Coral Gartner was a presenter at this week's 7th Annual ACT ATOD Sector Conference 2014.
 

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What unintended adverse consequences are produced by crime prevention initiatives?

Criminologists have pointed out that we have little knowledge about what really works in crime prevention, including those relating to drug offences; that some crime prevention interventions produce unintended adverse consequences; and just because a program works in one context does not mean it will work in another. This study is the first to review the harmful effects of crime prevention programs, based on 15 Campbell Collaboration systematic reviews. It covered 574 experimental and quasi-experimental studies (published and unpublished) with 645 independent effect sizes reviewed. The review identified 22 harmful effects from 22 unique studies of individual-based crime prevention interventions, mostly reported since 1990 and all but two were conducted in the USA. ‘The studies covered a wide range of interventions, from anti-bullying programs at schools, to second responder interventions involving police, to the Scared Straight program for juvenile delinquents, with more than half taking place in criminal justice settings. Boot camps and drug courts accounted for the largest share of studies with harmful effects.’ Incarceration-based drug treatment programs also demonstrated adverse consequences. (No adverse consequences were reported from studies of cognitive-based therapy for offenders, drug substitution, early family/parent training, mentoring, self-control programs, or serious juvenile offender programs, non-custodial employment.) The main explanations of the harmful effects of these programs were failure to conceptualise the program adequately, poor implementation, and that the program has the effect of training participants in deviancy (peer contagion), rather than preventing it. The authors argue that these disappointing findings highlight the need for more, and more rigourous, evaluations of complex social interventions such as crime prevention.
 
Welsh, BC & Rocque, M 2014, ‘When crime prevention harms: a review of systematic reviews’, Journal of Experimental Criminology, vol. 10, no. 3, pp. 245-66.

Comment: Please note that only 22 of the 574 crime prevention programs assessed (4%) were found to have produced harmful consequences. In the cases where drug courts and prison-based drug treatment produced harms, poor implementation was the leading cause. Nonetheless, the review does alert us to the need to be very cautious in developing and implementing complex social interventions such as crime prevention programs.


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To what extent do restorative justice conferences reduce post-traumatic stress symptoms among victims of crime?

A randomised controlled trial was conducted in London, by Australian and international researchers, to examine the impact on victims’ post-traumatic stress symptoms (PTSS) of face-to-face restorative justice conference (RJC) meetings led by police officers between crime victims and their offenders. The study found that ‘PTSS scores are significantly lower among victims assigned to RJC in addition to criminal justice processing through the courts than to customary criminal justice processing alone’. The researchers concluded that ‘…restorative justice conferences reduce clinical levels of PTSS and possibly PTSD [post-traumatic stress disorder] in a short-term follow-up assessment’.

Angel, CM, Sherman, LW, Strang, H, Ariel, B, Bennett, S, Inkpen, N, Keane, A & Richmond, TS 2014, ‘Short-term effects of restorative justice conferences on post-traumatic stress symptoms among robbery and burglary victims: a randomized controlled trial’, Journal of Experimental Criminology, vol. 10, no. 3, pp. 291-307.

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How has coverage of reporting on alcohol in Australian newspapers changed over recent years?

An Australian study examined news coverage of alcohol-related matters in Australian newspapers over the period 2000 to 2011. ‘Across the period, the most common themes were promotion (21%), drink-driving (16%) and restrictions/policy (16%). Themes of restrictions/policy and responsible beverage services became more common over time. Promotion and business-related articles significantly declined over time. Overall, the topic slant of the majority of news related articles disapproved of alcohol use. Disapproval increased over time while approval of alcohol use decreased. While the slant of opinion pieces was predominantly approving of alcohol, this decreased over time. Presence of an alcohol industry representative in articles declined over time.’ They concluded that ‘The presentation of alcohol use in Australian newspapers became more disapproving over time, which may suggest that harmful alcohol use has become less acceptable among the broader Australian community.’

Azar, D, White, V, Bland, S, Livingston, M, Room, R, Chikritzhs, T, Durkin, S, Gilmore, W & Wakefield, M 2014, ‘“Something’s brewing”: the changing trends in alcohol coverage in Australian newspapers 2000-2011’, Alcohol and Alcoholism, vol. 49, no. 3, pp. 336-42.

Comment: Many people have argued that we need cultural change in Australia if we are to reduce the current unacceptable levels of alcohol-related harm. This study is encouraging in that it suggests that this may be occurring.

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What is the latest evidence on the circumstances surrounding the cultivation and consumption of cannabis for medical purposes? 

A cross-cultural study of small-scale cannabis cultivation for medical purposes used web surveys conducted by the Global Cannabis Cultivation Research Consortium in Australia, Belgium, Denmark, Finland, Germany and the UK. The study compared reports of medical motives, for what conditions cannabis was used, whether users had diagnoses for these conditions and whether the use of cannabis had been recommended as a treatment of those conditions by a medical doctor. The researchers reported that ‘Findings from countries were quite similar, even though several national differences in details were found. Growing cannabis for medical purposes was widespread. The majority of medical growers reported cultivating cannabis for serious conditions. Most of them did have a formal diagnosis. One fifth had got a recommendation from their doctor, but in most cases cannabis use was self-medication which was not discussed with their doctors’.

They concluded that ‘There is a wider demand for licit access for medical cannabis than currently available in these countries. Ideologically, medical growers can be seen distancing themselves from both the legal and illicit drug markets. From a harm reduction perspective, it is worrying that, in the context of present health and control policies in these countries, many medical growers are using cannabis to treat serious medical conditions without proper medical advice and doctor’s guidance’.

Hakkarainen, P, Frank, VA, Barratt, MJ, Dahl, HV, Decorte, T, Karjalainen, K, Lenton, S, Potter, G & Werse, B 2014, ‘Growing medicine: small-scale cannabis cultivation for medical purposes in six different countries’, International Journal of Drug Policy, online ahead of print.

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What are the views of cannabis growers about regulation of cannabis cultivation under a non-prohibition cannabis model?

The Global Cannabis Cultivation Research Consortium online web survey collected data from largely ‘small-scale’ cannabis cultivators, 18 years and over, in 11 countries. Data from 1,722 current and recent cannabis growers in Australia, Denmark and the UK, who were all asked about policy, were analysed to investigate ‘…support for various frameworks for cultivation: (no regulation (free market); adult only; growing licenses; restrictions on plant numbers; licensed business-only sale; approved commercial growing; etc.). Among current growers, support for these options are compared across countries, across scale of growing operations, and by demographics, drug use and crime variables’.

The researchers found that, ‘Despite some differences between countries overall there was a great deal of consistency in support for various policy settings…more than two-thirds of the sample believed “only adults should be legally able to grow cannabis”, and only a slightly smaller proportion believed that “while anyone should be able to grow, sale should be limited to licensed commercial businesses”, and that “commercial growers should be licensed”… he finding that 85% would support regulation of some sort bodes well for future negotiations of legal regulatory frameworks for cannabis growing’. They stated that ‘The results have relevance for the provisions regarding cannabis cultivation in the design of new non-prohibitionist models of cannabis which are increasingly under consideration’.

Lenton, S, Asmussen Frank, V, Barratt, MJ & Potter, G 2014, ‘Attitudes of cannabis growers to regulation of cannabis cultivation under a non-prohibition cannabis model’, International Journal of Drug Policy.


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What is the latest in the war of words about drug prohibition and legalisation?

A recent issue of the Australian & New Zealand Journal of Criminology published an article by leading Australian criminologist Dr Don Weatherburn discussing ‘The pros and cons of prohibiting drugs’. He drafted this article in response to the report, released in 2012 by the independent think-tank Australia21 The prohibition of illicit drugs is killing and criminalising our children and we are all letting it happen. Weatherburn summarises article thus: ‘In September 2012, a group known as Australia 21 called for a rethink on the prohibition against illegal drugs. If the response from Australian Federal, State, and Territory Governments is any guide, the call fell on deaf ears. In recent years, even scholarly debate about the merits of prohibition appears to have subsided. This paper acknowledges that social and financial costs of the prohibition against illegal drugs but argues that prohibition also prevents a great deal of harm. The multifarious nature of drug-related harm and the differences between people in the weight assigned to various harms makes it impossible say what policy best minimizes drug-related harm.’

In response, well-known opponents of drug prohibition, Dr Alex Wodak, wrote an article titled ‘The abject failure of drug prohibition’ to which Weatherburn responded asking ‘Really?’.
These three contributions provide a valuable, scholarly overview of contemporary thinking about drug prohibition and alternative approaches.

Weatherburn, D 2014, ‘The pros and cons of prohibiting drugs’, Australian & New Zealand Journal of Criminology, vol. 47, no. 2, pp. 176-89.
Wodak, A 2014, ‘The abject failure of drug prohibition’, Australian & New Zealand Journal of Criminology, vol. 47, no. 2, pp. 190-201.
Weatherburn, D 2014, ‘The abject failure of drug prohibition? Really?’, Australian & New Zealand Journal of Criminology, vol. 47, no. 2, pp. 202-6.

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What resources are available to assist the prevention of viral hepatitis B and C among people who inject drugs?

The World Health Organisation (WHO) convened a Guideline Development Panel to develop recommendations on the prevention of viral hepatitis B (HBV) and viral hepatitis C (HCV) among people who inject drugs (PWID). ‘The WHO recommendations include the following for working with PWID: offer the rapid HBV vaccination regimen; offer incentives to increase uptake and completion of the HBV vaccine schedule; needle and syringe programs should also provide low dead-space syringes for distribution; and offer peer interventions to reduce the incidence of viral hepatitis. This guideline complements other WHO documents regarding PWID, including HIV prevention initiatives such as needle and syringe programs and opioid substitution therapy. This guidance offers a first step in the prevention of HBV and HCV among PWID. However, the lack of high quality evidence in this area necessitates further research and resources for implementation.’

Walsh, N, Verster, A, Rodolph, M & Akl, EA 2014, ‘WHO guidance on the prevention of viral hepatitis B and C among people who inject drugs’, International Journal of Drug Policy, vol. 25, no. 3, pp. 363-71, Open access http://www.ijdp.org/article/S0955-3959%2814%2900012-7/fulltext .

Comment: This is a summary of report recently released by WHO: Consolidated guidelines on HIV prevention, diagnosis, treatment and care for key populations, http://www.who.int/hiv/pub/guidelines/keypopulations/en/ . In addition to the content summarised above, in this document, for the first time, WHO has come out in support of community-based naloxone programs (such as the I-ENAACT program currently operating in the ACT) that aim to reduce the incidence of opioid overdose morbidity and mortality.


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What is the effect on the injecting behaviour of people who inject drugs of them being diagnosed with hepatitis C?

A team of Australian researchers conducted a study to investigate whether informing people who inject drugs (PWID) of their hepatitis C virus (HCV) diagnosis was associated with a change in injecting behaviour. A prospective, longitudinal study was undertaken of PWID recruited from street drug markets across Melbourne. Interviews and HCV testing were conducted at three-monthly intervals. The researchers examined the association between receiving a diagnosis of HCV and injecting frequency and injecting equipment borrowing. They found that ‘Thirty-five individuals received a diagnosis of HCV during the study period. Receiving a diagnosis of HCV was associated with a decrease of 0.35 injections per month…but there was no change in injecting equipment borrowing’. They concluded ‘A small reduction in injecting frequency was observed in PWID who received a diagnosis of HCV’.

Aspinall, EJ, Weir, A, Sacks-Davis, R, Spelman, T, Grebely, J, Higgs, P, Hutchinson, SJ & Hellard, ME 2014, ‘Does informing people who inject drugs of their hepatitis C status influence their injecting behaviour? Analysis of the Networks II study’, International Journal of Drug Policy, vol. 25, no. 1, pp. 179-82.
 

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What would be the effect on patients of the Government covering the cost of dispensing fees for opioid substitution treatment?

Opioid substitution therapy (OST) medicines are subsidised by the Australian Government but patients need to pay the dispensing fees. A study conducted in Perth sought the opinions of OST patients and stakeholders about the potential impact of dispensing fees on compliance and OST program retention. The findings were that ‘Almost all of the stakeholders commented that there was a positive correlation between time on the OST program and success in terms of relapse. Most stakeholders advocated for OST fees to contribute towards the Pharmaceutical Benefits Scheme Safety Net, and for fee subsidy…82.4%...of the 138 survey participants stated that dispensing fees impacted significantly on patients’ finances and lifestyle, specifically those patients with major debt. The cost of dispensing fees was identified by 46.3%...of survey participants as the biggest impacting factor on patient success’. The researchers concluded that the ‘Findings provided insight into OST patients’ financial difficulties with data suggesting that dispensing fees are likely to have a negative impact on OST patients’ compliance with therapy, retention in the OST program and lifestyle. Government sponsorship of the OST dispensing fees should be considered as sponsorship would potentially increase the retention rates of income-poor OST program recipients’.

Shepherd, A, Perrella, B & Hattingh, HL 2014, ‘The impact of dispensing fees on compliance with opioid substitution therapy: a mixed methods study’, Substance Abuse Treatment, Prevention and Policy, vol. 9, no. 1, p. 32, open access http://www.substanceabusepolicy.com/content/9/1/32/ .

Comment: This important study confirms previous Australian research showing that the costs of OST to patients is significant in terms of treatment entry, retention and success. It is likely that positive cost effectiveness would be derived through governments covering the dispensing fees.

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Scalability in health promotion: what's that, and how to improve it?
 
Abstract: Increased focus on prevention presents health promoters with new opportunities and challenges. In this context, the study of factors influencing policy-maker decisions to scale up health promotion interventions from small projects or controlled trials to wider state, national or international roll-out is increasingly important. This study aimed to: (i) examine the perspectives of senior researchers and policy-makers regarding concepts of ‘scaling up’ and ‘scalability’; (ii) generate an agreed definition of ‘scalability’ and (iii) identify intervention and research design factors perceived to increase the potential for interventions to be implemented on a more widespread basis or ‘scaled up’. A two-stage Delphi process with an expert panel of senior Australian public health intervention researchers (n = 7) and policy-makers (n = 7) and a review of relevant literature were conducted. Through this process ‘scalability’ was defined as: the ability of a health intervention shown to be efficacious on a small scale and or under controlled conditions to be expanded under real world conditions to reach a greater proportion of the eligible population, while retaining effectiveness. Results showed that in health promotion research insufficient attention is given to issues of effectiveness, reach and adoption; human, technical and organizational resources; costs; intervention delivery; contextual factors and appropriate evaluation approaches. If these issues were addressed in the funding, design and reporting of intervention research, it would advance the quality and usability of research for policy-makers and by doing so improve uptake and expansion of promising programs into practice. [Emphasis in original.]
 
Milat, AJ, King, L, Bauman, AE & Redman, S 2013, ‘The concept of scalability: increasing the scale and potential adoption of health promotion interventions into policy and practice’, Health Promot Int, vol. 28, no. 3, pp. 285-98.


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New Reports

ACT Government, Justice and Community Safety Directorate quarterly, Statistical profile, ACT criminal justice, ACT Government, Justice and Community Safety, http://www.justice.act.gov.au/criminal_and_civil_justice/criminal_justice_statistical_profiles .
 
Australian Institute of Health and Welfare 2014, Alcohol and other drug treatment services in Australia 2012-13, Drug Treatment Series 24, cat. no. HSE 150, AIHW, Canberra, report http://www.aihw.gov.au/publication-detail/?id=60129548206 ;media release http://www.aihw.gov.au/media-release-detail/?id=60129548371 .
 
Australian Institute of Health and Welfare 2014, Prisoner health services in Australia 2012, AIHW bulletin no. 123, cat. no. AUS 183, AIHW, Canberra, http://www.aihw.gov.au/publication-detail/?id=60129548273 .
 
Australian National Council on Drugs 2014, Medicinal use of cannabis: background and information paper, ANCD, Canberra, http://www.ancd.org.au/images/PDF/Generalreports/Medicinal_Cannabis_Information_Paper.pdf .
 
Global Commission on Drug Policy 2014, Taking control: pathways to drug policies that work, Global Commission on Drug Policy, [Rio de Janeiro], http://www.globalcommissionondrugs.org/new-report-world-leaders-call-for-ending-criminalization-of-drug-use-and-possession-and-responsible-legal-regulation-of-psychoactive-substances-2/ .
 
Lancaster, K, Ritter, A & Matthew-Simmons, F 2014, Young people’s opinions on alcohol and other drugs issues, Research Paper no. 27, Australian National Council on Drugs, Canberra, http://ancd.org.au/publications-and-reports-list/research-papers .
 
LeeJenn Health Consultants 2014, Medication treatment options for amphetamine-type stimulant users, Research Paper no. 29, Australian National Council on Drugs, Canberra, http://ancd.org.au/publications-and-reports-list/research-papers .
 
National Coronial Information System 2014, Opioid related deaths in Australia (2007-2011), NCIS Melbourne, http://www.ncis.org.au/wp-content/uploads/2014/08/NCIS-Fact-sheet_Opioid-Related-Deaths-in-Australia-2007-2011.pdf .
 
NSW Centre for Road Safety 2014, Drug driving fact sheet Transport for NSW, Sydney, August 2014, http://roadsafety.transport.nsw.gov.au/aboutthecentre/research/drugdriving/index.html .
 
Parliament of Victoria, Law Reform, Drugs and Crime Prevention Committee 2014, Enquiry into the supply and use of methamphetamines, particularly ice, in Victoria: final report, 2 vols., Parliament of Victoria, Melbourne, http://www.parliament.vic.gov.au/lrdcpc/article/2135 .
 
Pascal, R, Gilmore, W, Broyd, A, Lensvelt, E & Chikritzhs, T 2014, Trends in estimated alcohol attributable deaths in Australia, 1996-2010: alcoholic liver disease, liver cancer, and colorectal cancer, National Alcohol Indicators Project Bulletin no. 13, National Drug Research Institute, Curtin University of Technology, Perth, W.A., http://www.ndri.curtin.edu.au/publications/naip.html .
 
Roche, A, Trifonoff, A, White, M, Evans, K, Battams, S, Adams, V & Scarfe, A 2014, From policy to implementation: child and family sensitive practice in the alcohol and other drugs sector, Research Paper no. 28, Australian National Council on Drugs, Canberra, http://ancd.org.au/publications-and-reports-list/research-papers .
 
Roxburgh, A & Burns, L 2014, Accidental drug-induced deaths due to opioids in Australia, 2010, National Drug and Alcohol Research Centre, Sydney, http://ndarc.med.unsw.edu.au/resource/accidental-drug-induced-deaths-due-opioids-australia-2010 .
 
World Health Organization 2014, Global status report on alcohol and health 2014, World Health Organization, Geneva, http://www.who.int/substance_abuse/publications/global_alcohol_report/en/ .
 
 
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