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.
The Research School of Population Health, ANU & the Alcohol Tobacco and Other Drug Association ACT (ATODA) will be hosting an ACT Alcohol, Tobacco and Other Drug Networking Workshop on
The workshop aims to gather ACT based alcohol, tobacco and other drug researchers across institutions and other key stakeholders to network, exchange ideas and support future collaborations. It is hoped that the workshop will initiate a more regular gathering of ACT researchers, policy makers and services with an interest in ATOD research. This could generate important networking and collaborative opportunities including consultancy opportunities, applications for grants, etc.
Time: 1pm for arrival. Event from 1:30pm - 4:30pm (followed by networking drinks until 5:30pm)
Australia’s history of comprehensive tobacco control has assisted in reducing smoking rates from approximately 34 per cent in 1980 to less than 20 per cent in 2007 [
]. However, 47 per cent of Aboriginal and Torres Strait Islander people smoke daily . The reasons for this are complex with research indicating the importance of numerous factors in smoking behaviors (including initiation, maintenance and quitting) .
This research investigates various factors and their influence on tobacco smoking behaviours among Aboriginal and Torres Strait Islander people aged 12 and over in the Australian Capital Territory region. Factors include gender, age, education, employment, cultural event attendance and social network characteristics. The research uses a mixed-method approach, including a longitudinal survey, key informant interviews and focus groups. Quantitative and qualitative analysis is being used to study numerous factors and smoking behaviours.
This paper draws on analysis of the wave one survey with results indicating that 36.4% (95% CI, 27.8–44.9) of Aboriginal and Torres Strait Islander respondents were tobacco smokers, 28.6% (95% CI, 12.2–45.0) of males and 39.2% (95% CI, 27.8–50.6) of females. There were generally low levels of nicotine dependence (43.3% of smokers reported low dependence and 31.7% low-moderate) and there was a significant difference between smokers and non-smokers who indicated that all of their five closest friends and family were smokers (37.9%) c
= 8.060, p<0.01. Tobacco smokers were 2.9 times more likely than non-smokers to have all five of their closest social circle as tobacco smokers. The results also reiterated the importance of the social determinants, including education and employment. There was a significant difference between being a smoker (62.5%) and completing Year 12 (χ
= 11.087, p<0.01). Based on the odds ratio, an Aboriginal and Torre Strait Islander participant who completed Year 12 was 4.6 times more likely to be a non-smoker than a smoker, and unemployed participants were 4.6 times more likely to be a smoker than respondents who were employed. Age was also strong predictor of smoking status and other factors associated with smoking behaviours will also be presented.
These results highlight the importance of the awareness of smoking cessation techniques and available aids, such as available smoking cessation services and the wide range of Nicotine Replacement Therapies (NRT). Increasing awareness and community education regarding services and products such as the inhalator, gum, spray and patches could help promote and facilitate quit attempts, reduce craving and manage expectations among the community.
Addressing smoking is complex and challenging. These findings highlight the need to shape appropriate tobacco control for the community, including the need to raise awareness, tailoring and managing expectations of available pharmacological support, including NRT. A better understanding of community awareness of smoking supports and other characteristics will assist to refine and improve tobacco control and cessation support.
The PhD candidate is funded by the ACT Government under the ACT Aboriginal and Torres Strait Islander Tobacco Control Strategy.
1. Australian Institute of Health and Welfare: Australia’s health 2010.
2. Johnston V, Thomas DP: What works in Indigenous tobacco control? The perceptions of remote Indigenous community members and health staff.
Most of the reports and research items referenced below are available from the Alcohol and Other Drug Council of Australia’s
Does peer-eductaion reduce risky injecting among young injecting drug users?
Brief summaries of other research findings are available from the NDSIS national ATOD workforce development portal Drugfields: Research in Brief
As part of the Drug Users Intervention Trial (DUIT) conducted in the US from 2002 to 2005, a survey was undertaken of young injecting drug users (IDUs) in five US cities. The researchers ‘identified four distinct classes of injection risk behaviour. One-third of the sample exhibited little or no risk behaviour (low risk) at baseline. Another group was characterised by sharing mainly equipment other than syringes; participants in this class either refrained from sharing syringes, or always cleaned the syringes with bleach. The third class (moderate risk) was characterised by low frequency sharing of syringes and equipment. Participants in the high-risk group shared equipment frequently, shared syringes at least some of time, and were more likely to share syringes frequently’. The trial compared a peer education intervention (PEI) with a time-matched, attention control group. The researchers found that ‘the DUIT PEI intervention was most beneficial for young IDUs who exhibited high-risk behaviour’. They concluded that the peer education intervention ‘…had a significant impact on self-reported injecting behaviour among young IDUs with high-risk injecting behaviour. For young IDUs who are not high-risk, standard counselling and testing interventions may be as effective as enhanced interventions. Targeting the PEI to high-risk young IDUs may achieve significant behaviour change at a lower cost’.
Mackesy-Amiti, ME, Finnegan, L, Ouellet, LJ, Golub, ET, Hagan, H, Hudson, SM, Latka, MH & Garfein, RS 2013, ‘Peer-education intervention to reduce injection risk behaviors benefits high-risk young injection drug users: a latent transition analysis of the CIDUS 3/DUIT study’, AIDS Behav
, vol. 17, no. 6, pp. 2075-83.
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What impact does exercise have on the concentration of THC in cannabis users?
: The major psychoactive ingredient of cannabis, Δ9-tetrahydrocannabinol (THC) accumulates in fat tissue from where it slowly diffuses back into blood. THC pre-treated rats can show elevated plasma cannabinoid levels when subjected to conditions that promote fat utilization, such as fasting. Here we examine whether fasting and exercise increase plasma THC concentrations in regular cannabis users.
: Fourteen regular cannabis users completed 35 min of exercise on a stationary bicycle in either a fed or overnight fasted state. Plasma cannabinoid levels were assessed prior to exercise, immediately post-exercise and 2 h post-exercise. Plasma samples were also analyzed for indices of lipolysis (free fatty acids (FFA) and glycerol).
: Exercise induced a small, statistically significant increase in plasma THC levels accompanied by increased plasma FFA and glycerol levels. Exercise-induced increases in plasma THC concentrations were positively correlated with body mass index. Fasting induced a significant increase in plasma FFA levels, and a lowering of blood glucose, but did not significantly alter plasma cannabinoid levels.
: Here we demonstrate that exercise enhances plasma THC levels in regular cannabis users. The lack of a fasting effect may reflect the modest duration of fasting used which was associated with only a modest increase in fat utilization relative to exercise. Overall, these results suggest that exercise may elevate blood THC levels by releasing dormant THC from fat stores. These data suggest the interpretation of blood THC levels in roadside and workplace tests might be complicated by recent exercise.’
Wong, A, Montebello, ME, Norberg, MM, Rooney, K, Lintzeris, N, Bruno, R, Booth, J, Arnold, JC & McGregor, IS 2013, ‘Exercise increases plasma THC concentrations in regular cannabis users’, Drug and Alcohol Dependence
, online ahead of print.
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Can involvement in 12-steps mutual-help organisations help young people with dual substance abuse and mental health disorders?
A study conducted in the United States investigated whether 12-step mutual-help organisations (MHOs), such as Alcoholics Anonymous (AA) and Narcotics Anonymous (NA), are beneficial for young adults with dual diagnosis (DD), that is, comorbid substance use disorders (SUD) and mental health disorders. The researchers found that ‘For DD and SUD-only patients, post treatment attendance and active involvement in 12-step organizations were similarly high. Overall, DD patients had significantly lower [per cent days abstinent] relative to SUD-only patients. All patients appeared to benefit significantly from attendance and active involvement’. They conclude that ‘Despite concerns regarding the clinical utility of 12-step MHOs for DD patients, findings indicate that DD young adults participate and benefit as much as SUD-only patients, and may benefit more from high levels of active involvement, particularly having a 12-step sponsor’.
Bergman, BG, Greene, MC, Hoeppner, BB, Slaymaker, V & Kelly, JF 2013, ‘Psychiatric comorbidity and 12-step participation: a longitudinal investigation of treated young adults’, Alcoholism: Clinical and Experimental Research
, online ahead of print.
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How strong is the link between heavy drinking and liver cirrhosis?
Researchers estimated the relationship between total and beverage-specific alcohol consumption and liver disease mortality in Australia from 1935 to 2006. They found that data for the period up to 1975 ‘suggest a strong association between per capita consumption and liver disease mortality, with a rise of 16% in cirrhosis mortality per litre. This association was somewhat weaker in the more recent period [1976-2006] (9% per litre). Furthermore the results of beverage-specific modelling…suggest that spirits was the key beverage driving the association between per capita consumption and mortality prior to 1975. However, the relationship between spirits consumption and liver disease mortality was non-significant in the last three decades, while beer consumption was significantly linked with mortality. These changes may be due to shifts in people’s drinking preferences and the increased role of non-alcohol causes in liver cirrhosis mortality, particularly the sharp increase in hepatitis C prevalence over recent decades. The shift from spirits to beer as the most significant beverage associated with liver disease mortality suggests that the heaviest drinkers in Australia may have shifted from spirits to beer in the last quarter of the twentieth century’.
Further, they found that the effect of a 1 litre increase in per capita alcohol consumption on liver disease mortality rate in Australia (10%) is similar to that in the USA (9%), but weaker than those in the UK (18%) and Canada (17%). ‘It is noted that the impact of changes in per capita consumption appears to be slightly larger on female liver disease in Australia, while in Canada, Northern, Central and Eastern Europe, males have a higher risk of cirrhosis when aggregate alcohol consumption increases’.
They concluded that ‘spirits consumption was found to be a strong predictor of liver disease mortality rates between 1935 and 1975, but weak and insignificant between 1976 and 2006. The association between wine consumption and liver disease mortality was weak and insignificant at both time periods. Beer consumption has historically made up the biggest share of the total alcohol consumption in Australia, but the effect of beer consumption on liver disease mortality was weaker than the effect of spirits between 1935 and 1975. From 1975 to 2006, beer consumption was the only significant beverage predictor for the liver diseases’. They commented that ‘the shift between spirits and beer as the most influential beverage type in these analyses is suggestive of a role for alcohol pricing in reducing liver disease mortality, mirroring as it does a shift in the approach to excise taxation for these two beverages’.
Jiang, H, Livingston, M, Room, R, Dietze, P, Norström, T & Kerr, WC 2013, ‘Alcohol consumption and liver disease in Australia: a time series analysis of the period 1935–2006’, Alcohol and Alcoholism
, online ahead of print.
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Many models of addiction exist, what are the most prominent?
Professor Robert West has been prominent for a number of years it is writing about theories and models of addiction/drug use/drug misuse/drug dependence. This 166-page report, published by the European Monitoring Centre for Drugs and Drug Addiction and available free online, is described by the publisher as follows: ‘A better understanding of the complex science of “addiction” can improve responses to drug problems. This report contains a critical review of existing addiction theories and explores how these can be organised into an overarching structure to inform how we assess, prevent and treat addictive behaviours. This model is not limited to illicit drugs, but can also be applied to alcohol, tobacco and even non-pharmacological addictions, such as gambling or compulsive use of the Internet. Models of addiction
delivers the message that understanding the biological basis of addiction, along with the broader social and psychological aspects of addictive behaviour, can lead to successful prevention and treatment responses.’
West, R 2013, Models of addiction
, EMCDDA Insights no. 14, European Monitoring Centre for Drugs and Drug Addiction, Lisbon, http://www.emcdda.europa.eu/publications/insights/models-addiction
Comment: There is an adage that ‘There is nothing more practical than a good theory’. This overview of addiction theory picks up on that same, assisting AOD practitioners and policy workers to be more aware of the theoretical underpinnings of their professions and practice.
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What is happening in the United States with regard to naloxone take-home programs?
‘The opioid overdose epidemic is an alarming and serious public health problem in the United States (US) that has been escalating for 11 years. The 2011 National Survey on Drug Use and Health (NSDUH) demonstrated that 1 in 20 persons in the US aged 12 or older reported nonmedical use of prescription painkillers in the past year. Prescription drug overdose is now the leading cause of accidental death in the United States – surpassing motor vehicle accidents. Great efforts have been initiated to curb the overdose crisis. Notable examples of these efforts are (1) the Drug Enforcement Administration’s (DEA) National Take-Back Initiative instituted in 2010; (2) the Prescription Drug Monitoring Programs (PDMPs) implemented in most US states to provide practitioners with point-of-care information regarding a patient's controlled substance use; (3) the naloxone rescue programs initiated in the community to avert mortality resulting from overdose. The use of naloxone rescue strategies has gained traction as an effective measure to prevent fatal opioid overdose. Many US federal-government agencies are working to make these strategies more accessible to first responders and community participants. This new approach faces many challenges, such as accessibility to naloxone and the equipment and training needed to administer it, but none is more challenging than the fear of legal repercussions. US federal-government agencies, local governments, health care institutions, and community-based organizations have begun to tackle these barriers, and naloxone take-home programs have gained recognition as a feasible and sensible preventive strategy to avoid a fatal result from opioid overdose. Although many challenges still need to be overcome, it is important for federal government research agencies to initiate and support independent and rigorous evaluation of these programs to inform policymakers how effective these programs can be to save lives and curb the opioid overdose public health crisis.’
Straus, MM, Ghitza, UE & Tai, B 2013, ‘Preventing deaths from rising opioid overdose in the US – the promise of naloxone antidote in community-based naloxone take-home programs’, Substance Abuse and Rehabilitation
, vol. 2013, no. 4, pp. 65-72.
Comment: A public status report on the ACT Opioid Overdose Prevention and Management program (that includes the prescription of take home naloxone to eligible participants) is now available at http://www.atoda.org.au/wp-content/uploads/I-ENAACT_Public_Status_Report_August_2013_Final.pdf
The program is being led by the Canberra Alliance for Harm Minimisation and Advocacy with the multidisciplinary Implementing-Expanded Naloxone Availability in the ACT Committee (I-ENAACT).
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Is it effective to train family members in the use of take-home naloxone?
An evaluation of a heroin overdose management training program for family members based on emergency recovery procedures and take-home naloxone (THN) administration was undertaken at three sites in England. The findings were that ‘study participants who had received THN training reported greater overdose-related knowledge relative to those receiving basic information only…There were also more positive opioid overdose-related attitudes among the trained group at follow-up…At the individual level, 35% and 54% respectively of the experimental group increased their knowledge and attitudes compared with 11% and 30% of the control group. During follow-up, 13 participants witnessed an overdose with Naloxone administered on 8 occasions: five among the THN-trained group and three among the controls’. The researchers concluded that ‘Take-home naloxone training for family members of heroin users increases opioid-overdose related knowledge and competence and these benefits are well-retained after 3 months’.
Williams, AV, Marsden, J & Strang, J 2013, ‘Training family members to manage heroin overdose and administer naloxone: randomised trial of effects on knowledge and attitudes’, Addiction
, online ahead of print.
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Is routine outcome monitoring after drug misuse treatment feasible?
‘The routine collection of drug treatment outcomes to manage quality of care, improve patient satisfaction, and allocate treatment resources is currently hampered by two key difficulties: (1) problems locating clients once they leave treatment; and (2) the prohibitive cost of obtaining meaningful and reliable post-treatment data. This pilot describes precise methods for an economical staff-based routine outcome monitoring (ROM) system using an 18-item core measure telephone survey. As implemented at Narconon™ of Oklahoma, a behavioural and social skills based, residential drug rehabilitation program, the system was psychometrically adequate for aggregate reporting while providing clinically useful information. Standardized procedures for staff training, collecting client contact information, structuring exit interviews and maintaining post-treatment telephone contact produced follow-up rates that improved from 57.6% to 100% over the course of the project. Aggregate data was used to improve program delivery and thereby post-treatment substance use and social outcomes. These methods and use of data may contribute to the discussion on how to best monitor outcomes.’
Lennox, RD, Sternquist, MA & Paredes, A 2013, ‘A simplified method for routine outcome monitoring after drug abuse treatment’, Substance Abuse: Research and Treatment
, vol. 7, pp. 155-69.
Comment: Although over the years there has been much commentary questioning the treatment approaches used by this organisation, the article is useful in drawing attention to the value and feasibility of building treatment outcome assessment, through post-treatment follow-ups, into routine agency practice. The authors point out that US government contractual arrangements mandate, and fund, this type of continuing care and assessment: ‘All programs receiving discretionary grants are required to submit staff-collected enrolment, discharge, and 3 or 6-month post-enrolment follow-up data using this instrument. Discretionary grants include 10–20 percent funding for dedicated follow- up activities that are expected to attempt contact with 100 percent of all discharged clients and, minimally, obtain data from 80 percent’.
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How effective is it to commence tobacco dependence treatment in association with inpatient psychiatry?
A study in the United States evaluated the efficacy of a motivational tobacco cessation treatment combined with nicotine replacement, relative to usual care, initiated in an inpatient psychiatric setting. The researchers assigned participants recruited from a locked acute psychiatry unit with a 100% smoking ban to intervention or usual care. Prior to hospitalisation, the participants averaged 19 cigarettes per day, with only 16% intending to quit smoking in the next 30 days. The study found that verified smoking 7-day abstinence was significantly higher for intervention than usual care 3, 6, 12 and 18 months later. Psychiatric measures did not predict abstinence; measures of motivation and tobacco dependence did. The usual care group had a significantly greater likelihood than the intervention group of psychiatric rehospitalisation. The researchers concluded that ‘The findings support initiation of motivationally tailored tobacco cessation treatment during acute psychiatric hospitalization. Psychiatric severity did not moderate treatment efficacy, and cessation treatment appeared to decrease rehospitalisation risk, perhaps by providing broader therapeutic benefit’.
Prochaska, JJ, Hall, SE, Delucchi, K & Hall, SM 2013,'Efficacy of initiating tobacco dependence treatment in inpatient psychiatry: a randomized controlled trial’, American Journal of Public Health
, online ahead of print.
Comment: The evidence continues to build about the desirability and feasibility of managing tobacco for the clients and staff of residential psychiatric and drug treatment services.
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Are adolescents more likely to take up smoking if they watch people smoking in movies?
Almost ten thousand adolescent never-smokers from state-funded schools in Germany, Iceland, Italy, The Netherlands, Poland, and the United Kingdom were surveyed in 2009-10 and followed up in 2011. The research investigated whether taking up smoking is associated with the amount of exposure the adolescent had to smoking in movies. The findings were that ‘During the observation period…17% of the sample initiated smoking. The estimated mean exposure to on-screen tobacco was 1560 occurrences. Overall, and after controlling for age; gender; family affluence; school performance; TV screen time; personality characteristics; and smoking status of peers, parents, and siblings, exposure to each additional 1000 tobacco occurrences increased the adjusted relative risk for smoking onset by 13%...The crude relationship between movie smoking exposure and smoking initiation was significant in all countries; after covariate adjustment, the relationship remained significant in Germany, Iceland, The Netherlands, Poland, and UK’. The researchers concluded that ‘Seeing smoking in movies is a predictor of smoking onset in various cultural contexts. The results confirm that limiting young people’s exposure to movie smoking might be an effective way to decrease adolescent smoking onset’.
Morgenstern, M, Sargent, JD, Engels, RCME, Scholte, RHJ, Florek, E, Hunt, K, Sweeting, H, Mathis, F, Faggiano, F & Hanewinkel, R 2013, ‘Smoking in movies and adolescent smoking initiation: longitudinal study in six European countries’, American Journal of Preventive Medicine
, vol. 44, no. 4, pp. 339-44.
Comment: The evidence linking the observation of smoking in movies to smoking incidence in various community population groups continues to build. It is probably time that the Australian public health community started to pressure the regulatory authorities in this country to attend to this form of smoking promotion.
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How popular are pro-smoking apps?
‘Pro-smoking applications (app) provide information about brands of tobacco products, where to buy them, and encourage their use.’ Research undertaken by the University of Sydney’s School of Public Health ascertained from where these apps are being downloaded, and whether app stores play a role in promoting or regulating these apps, particularly those that appear to target children. ‘Apps were deemed popular if at any time in their lifespan they achieved a top 25 ranking overall across all apps, or a top 25 ranking in any particular category of apps. The researchers found that ‘Fifty-eight pro-smoking apps reached “popularity” status in Apple and Android stores in one or more of 49 countries, particularly Italy, Egypt, Germany, Belgium and the USA…Two pro-smoking apps in the Apple store were extremely popular in the ‘Educational Games’ and ‘Kids’ Games’ categories’. They concluded ‘Pro-smoking apps were popular in many countries. Most apps were assigned to entertainment and games categories, with some apps specifically targeting children through placement in categories directed at children. App stores that feature pro-smoking apps may be in violation of tobacco control laws’.
BinDhim, NF, Freeman, B & Trevena, L 2013, ‘Pro-smoking apps: where, how and who are most at risk’, Tobacco Control
, online ahead of print.
Comment: The tobacco industry continues to exploit every opportunity they can find to promote cigarette smoking. The time has come for governments to intervene in the new media, introducing controls on the promotion of smoking there in much the same way as they have for television and other long-standing types of media.
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How effective is cognitive behavioural therapy on outcome in buprenorphine/naloxone treatment of opioid dependence?
Researchers in the United States conducted a 24-weeks randomised clinical trial in 141 opioid-dependent patients in a primary care clinic. Patients were randomised to physician management or to physician management plus cognitive behavioural therapy. They found that ‘Although both groups demonstrated significant reductions in opioid use during treatment, we were unable to detect improvement in self-report of opioid use, opioid abstinence, study completion, or cocaine abstinence in patients who received cognitive behavioural therapy in addition to physician management compared with those who received physician management alone’. They concluded that ‘Among patients receiving buprenorphine/naloxone in primary care for opioid dependence, the effectiveness of physician management did not differ significantly from that of physician management plus cognitive behavioural therapy’.
Fiellin, DA, Barry, DT, Sullivan, LE, Cutter, CJ, Moore, BA, O'Connor, PG & Schottenfeld, RS 2013, ‘A randomized trial of cognitive behavioral therapy in primary care-based buprenorphine’, The American Journal of Medicine
, vol. 126, no. 1, pp. 74.e11-74.e17.
Comment: This is an interesting finding as many would have expected improved outcomes through combining opioid substitution therapy with CBT. More research is needed, in diverse settings, to ascertain how robust this finding is.
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Do you think that alcohol and energy drinks are nothing to worry about?
Prominent Australian researchers have recently drawn attention to emerging evidence about the links between alcohol and energy drinks, and have expressed concern about the research in this area and how it is being communicated. They point out that ‘Drinkers who consume energy drinks record higher breath alcohol concentrations than those who don’t. Heavy drinkers are mixing alcohol with energy drinks to enable them to drink longer and get more drunk. While the trend is concerning many public health researchers – because the risks remain unknown – others are attempting to allay these fears, claiming there’s nothing to worry about.’ The authors point out that most of the research in this area has been conducted among people with relatively low blood alcohol concentrations, leading to the broad conclusion of lack of impact of combining these types of drinks. It appears, however, that the problems arise when people with high blood alcohol concentrations (above 0.08) also consume energy drinks. The thrust of this commentary is that some researchers who argue against restrictions on combining energy drinks and alcohol seem to have inappropriately close links with the energy drinks industry.
They conclude that ‘There are two core issues of public health concern which need be investigated. First, is there an interaction between alcohol and energy drink consumption at higher levels of intoxication, as seen on our streets – for example, when people have had 10 drinks or have a BAC greater than 0.10?
‘And second, is there an interaction between a given level of alcohol use and the effects of higher levels of energy drink use – for example, between two and three standard cans?
‘Until we know the answers to these questions we shouldn’t be misleadingly reassured by laboratory studies which purport to show that energy drinks have no effects on intoxication.’
Miller, P & Hall, W 2013, Think alcohol and energy drinks are nothing to worry about? Think again
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What relationship exists between increasing cigarette tax and alcohol consumption?
A study using data on over 20,000 alcohol consumers from the US National Epidemiological Survey found that increases in cigarette taxes were associated with ‘…modest reductions in typical quantity of alcohol consumption and frequency of binge drinking among smokers. Cigarette taxation was not associated with changes in alcohol consumption among non-smokers’. This association applied only to male smokers and was stronger among hazardous drinkers, young adult smokers, and smokers in the lowest income category. The researchers concluded that ‘…increases in cigarette taxes are associated with modest to moderate reductions in alcohol consumption among vulnerable groups’.
Young-Wolff, KC, Kasza, KA, Hyland, AJ & McKee, SA 2013, ‘Increased cigarette tax is associated with reductions in alcohol consumption in a longitudinal U.S. sample’, Alcoholism: Clinical and Experimental Research
, online ahead of print.
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Should more changes be made in the law as a tool for improving population health?
‘Although legal interventions are responsible for many sentinel public health achievements, law is underutilized as a tool for advancing population health. Our purpose was to identify critical opportunities for public health lawmaking. We articulated key criteria and illustrated their use with 5 examples. These opportunities involve significant health problems that are potentially amenable to change through law and for which an effective legal intervention is available: optimizing graduated driver licensing laws, increasing tax rates on alcoholic beverages, regulating sodium in foods, enacting laws to facilitate reversal of opioid overdoses, and improving mental health interventions in the college setting. We call for a national conversation about critical opportunities for public health law to advance evidence-based policymaking.’
Mello, MM, Wood, J, Burris, S, Wagenaar, AC, Ibrahim, JK & Swanson, JW 2013, ‘Critical opportunities for public health law: a call for action’, American Journal of Public Health
, online ahead of print.
Comment: for many decades legislation (and its effective enforcement) has been a core policy instrument in diverse public health domains, including substance abuse. This important new article draws attention to opportunities for using law to improve public health in domains where this is not happening sufficiently
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How frequently are opioid-dependent people involved with the criminal justice system?
An examination was undertaken of an entire population of opioid-dependent clients’ contact with the criminal justice system to develop more accurate population-wide measures of offending among opioid-dependent people in Australia. This involved ‘All entrants [48,069 people] to opioid substitution therapy (OST) for opioid dependence in New South Wales, Australia, between 1985 and 2010, with data on court appearances from 1 December 1993 to 31 March 2011’. The findings were that ‘A total of 638 545 charges were laid against cohort members between 1993 and 2011. Eight in 10 males (79.7%) and 67.9% of females had at least one charge…The most frequent charges were theft (24.5% of charges), traffic/vehicle (16.3%), offences against justice (10.5%), illicit drug (10.0%), intentional injury (9.9%) and public order offences (8.9%). Overall, 20.8% of the cohort accounted for 67.4% of charges. The most frequently appearing 5.6% of the cohort accounted for 24.3% of costs ($75.5 million).
The researchers concluded that ‘…this study demonstrated that there is considerable contact with the criminal justice system across OST clients in NSW, resulting in substantial costs for the court system. A minority of opioid-dependent people account for the majority of this contact, and charge rates vary with age, sex and time. Although these levels of engagement with the criminal justice system may be as a result of increased levels of surveillance by police over potentially “known” clients, these findings suggest considerable scope for the implementation of interventions to reduce criminal activity among this population’.
Degenhardt, L, Gisev, N, Trevena, J, Larney, S, Kimber, J, Burns, L, Shanahan, M & Weatherburn, D 2013, ‘Engagement with the criminal justice system among opioid-dependent people: a retrospective cohort study’, Addiction, online ahead of print.
Comment: this study adds to the body of evidence about the effectiveness, and cost-effectiveness, of intelligence-led policing, focusing on offenders and places where criminal behaviour is concentrated. It also draws attention to the importance of identifying offenders experiencing substance use disorders and diverting them from the criminal justice system into effective treatment programs.
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Australian Bureau of Statistics 2013, Apparent consumption of alcohol, Australia, 2011-12
, Australian Bureau of Statistics, Canberra, http://www.abs.gov.au/ausstats/abs@.nsf/mf/4307.0.55.001
Australian Bureau of Statistics 2013, Information Paper: the non-observed economy and Australia's GDP, 2012
Institute of Child Protection Studies (ICPS)
2013 Research Update from the Institute of Child Protection Studies.
Quarterly Research Update – Institute of Child Protection Studies, Australian Catholic University: Canberra
PrOWfile: European Profile of Outreach Workers in Harm Reduction 2013, Professional profile of the outreach worker in harm reduction
, PrOWfile, http://www.apdes.pt/files/prowfile/
Pudney, S, Bono, ED & Bryan, M 2013, Licensing and regulation of the cannabis market in England and Wales: towards a cost benefit analysis
Institute for Social & Economic Research (ISER), University of Essex, https://www.iser.essex.ac.uk/2013/09/15/a-cost-benefit-analysis-of-cannabis-legalisation
United Kingdom, Ministry of Justice 2013, Transforming rehabilitation: a summary of evidence on reducing reoffending
, Ministry of Justice, London, http://www.justice.gov.uk/transforming-rehabilitation
For information on other reports
, please visit the ‘Did you see that report?
’ page at the website of the National Drugs Sector Information Service.
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The Institute of Child Protection Studies is seeking a full-time Project Manager for a new project on contact between children in out-of-home care and their parents. This project has been funded for three years by the Australian Research Council, and is being implemented by ICPS in partnership with the University of Melbourne.
The Project Manager will manage key aspects of the project, including managing stakeholder relationships, meeting key milestones and undertaking data collection and analysis. The position is based in Canberra, but some interstate travel will be required.
The successful applicant will have a higher degree in Psychology, Social Work or a related field, and display a track record in research, as well as the ability to manage research projects and deliver high quality project outcomes. As the position involves child-related employment, a Working with Children clearance will be required.
The Australian Catholic University has a range of generous conditions of employment and entitlements, including generous leave conditions, flexible working arrangements, salary packaging benefits and comprehensive staff development programs.
Total remuneration valued to $101,440-$119,702 per annum, including salary component $85,718-$101,206 (Academic Classification Level B), employer contribution to superannuation and annual leave loading.
For more information, including to view the Position Description and to apply, visit: