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.
As readers of the ATODA Research eBulletin would know, a program providing naloxone to potential opioid overdose witnesses is being implemented in the ACT, and subject to an external evaluation.
Interim findings from the evaluation were released in February 2014 in the report:
. The findings are positive with regard to both program implementation and outcomes in terms of overdose reversals.
Researchers from the Drug Policy Modelling Program have been interested in the processes that have underpinned the development of the Canberra naloxone program. They conducted interviews with many of the key players and analyse them to identify what could be learned from this intervention. Their findings have recently been published:
Analysis of how policy processes happen in real-world, contemporary settings is important for generating new and timely learning which can inform other drug policy issues. This paper describes and analyses the process leading to the successful establishment of Australia's first peer-administered naloxone program. Within a case study design, qualitative data were collected using semi-structured interviews with key individuals associated with the initiative (n = 9), and a collaborative approach to data analysis was undertaken. Central to policy development in this case was the formation of a committee structure to provide expert guidance and support. The collective, collaborative and relational features of this group are consistent with governing by network. The analysis demonstrates that the Committee served more than a merely consultative role. We posit that the Committee constituted the policy process of stakeholder engagement, communication strategy, program development, and implementation planning, which led to the enactment of the naloxone program. We describe and analyse the roles of actors involved, the goodwill and volunteerism which characterised the group's processes, the way the Committee was used as a strategic legitimising mechanism, the strategic framings used to garner support, emergent tensions and the evolving nature of the Committee. This case demonstrates how policy change can occur in the absence of strong political imperatives or ideological contestation, and the ways in which a collective process was used to achieve successful outcomes.
Lancaster, K & Ritter, A 2014, ‘Making change happen: a case study of the successful establishment of a peer-administered naloxone program in one Australian jurisdiction’,
was chosen by the Scientific Program Committee to reflect the changing times and increased pressures faced by the drug and alcohol sector.
The conference will feature an exciting program of international and national speakers, focusing on new treatments, prevention and policy in the areas of drug and alcohol research. With original and innovative work from the field, the program will encourage alternative presentation styles.
The 2014 Scientific Program Committee invites the submission of abstracts for original work in consideration for symposia at the 2014 APSAD Conference.
Dr Tom Calma has been involved in Indigenous affairs at a local, community, state, national and international level, worked in the public sector for 40 years and is currently on a number of boards and committees focussing on rural and remote Australia, health, education and economic development.
On 20 February 2014, Dr Tom Calma AO was formally installed as University of Canberra Chancellor. He also is the first Aboriginal or Torres Strait Islander man to hold the position of chancellor of an Australian university in higher education.
Are people who were physically abused as children more likely to use drugs?
Researchers from the National Drug and Alcohol Research Centre interviewed three hundred Sydney people who inject drugs on their histories of childhood physical abuse (CPA) to determine whether an association exists between such abuse and the age of onset of psychoactive substance use and injecting, and the extent of polydrug use as well. They found that ‘40.3% had experienced severe abuse (SA), 34.0% mild–moderate abuse (MMA) and 25.7% no abuse history (NA)...a history of severe CPA was a significant independent correlate of an earlier age at first alcohol intoxication compared to both the NA…and MMA…groups. Severe CPA was also a significant independent correlate of an earlier age at first illicit drug use…In contrast, CPA histories were not independently associated with the onset of injecting drug use’. They concluded that ‘Severe childhood physical abuse severity is associated with an earlier initiation into drug use. Any level of abuse is associated with more extensive life-time and recent polydrug use’.
Darke, S & Torok, M 2014, ‘The association of childhood physical abuse with the onset and extent of drug use among regular injecting drug users’, Addiction
, online ahead of print.
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How effective is restorative justice in reducing future crime and increasing victim satisfaction?
Restorative justice has been defined as ‘A process whereby all parties with a stake in a particular offence come together to resolve collectively how to deal with the aftermath of the offence and its implications for the future’. It has been used with the perpetrators of a variety of crimes, many of them drug-related.
A recent Campbell Collaboration review examined ten studies to assess the effect of face-to-face restorative justice conferencing (RJC) on repeat offending and on available measures of victim impact. The reviewers found that ‘The impact of RJCs on 2-year convictions was reported to be cost-effective in the 7 UK experiments, with up to 14 times as much benefit in costs of the crimes prevented (in London), and 8 times overall, as the cost of delivering RJCs. The effect of conferencing on victims’ satisfaction with the handling of their cases is uniformly positive…as are several other measures of victim impact’. They concluded that ‘RJCs delivered in the manner tested by the ten eligible tests in this review appear likely to reduce future detected crimes among the kinds of offenders who are willing to consent to RJCs, and whose victims are also willing to consent. The condition of consent is crucial not just to the research, but also to the aim of its generalizability. The operational basis of holding such conferences at all depends upon consent, since RJCs without consent are arguably unethical and breach accepted principles of restorative justice. The conclusions are appropriately limited to the kinds of cases in which RJCs would be ethical and appropriate. Among the kinds of cases in which both offenders and victims are willing to meet, RJCs seem likely to reduce future crime. Victims’ satisfaction with the handling of their cases is consistently higher for victims assigned to RJCs than for victims whose cases were assigned to normal criminal justice processing’.
Strang, H et al.
2013, ‘Restorative justice conferencing (RJC) using face-to-face meetings of offenders and victims: effects on offender recidivism and victim satisfaction. A systematic review’, Campbell Systematic Reviews
, vol. 12, p. 63, http://www.campbellcollaboration.org/lib/project/63/
Comment: The ACT’s Restorative Justice Unit operates according to the Crimes (Restorative Justice) Act 2004 and has been in operation since 31st January 2005. Part of the Justice and Community Safety Directorate (JACS), restorative justice at this time, is only open to young offenders and their victims. For more information visit www.justice.act.gov.au/criminal_and_civil_justice/restorative_justice
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Does urine screening contribute to the medical management of treatment service users?
Urine screening is widely used as part of the management of people receiving treatment for substance use disorders. While it is clear that this screening is useful for assessing and monitoring drug use, researchers explain that the outcomes on medical management
of urine screening have not yet been established. This systematic review covered studies in which the main outcome was ‘…medical management or consequences of management for patients in terms of psychoactive substance consumption and its complications, be they medical, social or professional’. Just eight studies met the inclusion criteria, and the methodological quality was judged to be generally poor. The reviewers concluded that ‘Few studies, with poor quality, have assessed the value of [urine screening] in managing patients using psychoactive substances’, and that the studies that have been conducted have failed to show that such screening is useful for those purposes.
Dupouy, J et al.
2014, ‘Does urine drug abuse screening help for managing patients? A systematic review’, Drug and Alcohol Dependence
, vol. 136, pp. 11-20.
Comment: It has long been observed that a very significant proportion of medical interventions do not have a sound evidentiary base. This study suggests that this conclusion applies to urine screening. That said, the adage that the absence of evidence of effectiveness is not evidence of the absence of effectiveness needs to be borne in mind. This systematic review highlights the need for more research to guide people responsible for the medical management of those experiencing substance use disorders.
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How feasible is it to monitor the drug use of nightclub patrons?
The epidemiology on recreational drug use is based on self-reported user surveys. The scope of this is limited as users are often not aware of exactly what drug(s) they are using. Waste water (sewage plant) analysis has been used to identify ‘regional’ recreational drug use but is limited by a lack of understanding of the metabolism and stability of novel recreational drugs.
: The feasibility of collecting pooled urine samples from a sub-population attending a night-club using a portal urinal to confirm the classical and novel recreational drugs being used.
Design and Methods
: Urine samples were collected from a nightclub over one weekend for analysis by various chromatographic techniques involving mass spectrometry.
Results: Classical recreational drugs and novel psychoactive substance, including mephedrone, 3-trifluoromethylphenylpiperazine and 2-aminoindane were found. Parent drug/metabolites were also detected for amphetamine, cocaine, ketamine, MDMA, mephedrone and 3-trifluoromethylphenylpiperazine.
: Anonymous pooled urine samples from within a nightclub can be used to confirm the actual drugs being used by some individuals within this sub-population. Metabolite detection indicates drugs were being used and not simply discarded into the urinal. This methodology could be used to monitor recreational drug trend in other environments, e.g. schools, geographical regions/areas and compare drug use over time.
Archer, JRH et al.
2014, ‘Taking the Pissoir—a novel and reliable way of knowing what drugs are being used in nightclubs’, Journal of Substance Use
, vol. 19, no. 1-2, pp. 103-7.
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Does giving up smoking lead to improved mental health?
An analysis of twenty-six studies that assessed mental health before and after smoking cessation found that ‘Anxiety, depression, mixed anxiety and depression, and stress significantly decreased between baseline and follow-up in quitters compared with continuing smokers’. The researchers concluded that ‘Whether or not smoking cessation directly causes the observed improvement in mental health, there are direct clinical implications. Smokers can be reassured that stopping smoking is associated with mental health benefits. This could also overcome barriers that clinicians have toward intervening with smokers with mental health problems. Furthermore, challenging the widely held assumption that smoking has mental health benefits could motivate smokers to stop’.
Taylor, G et al.
2014, ‘Change in mental health after smoking cessation: systematic review and meta-analysis’, BMJ: British Medical Journal
, vol. 348.
Comment: While prohibiting cigarette use among people in residential treatment for mental health and substance use disorders remains controversial in some settings, the evidence base continues to build as to the appropriateness and effectiveness of such policies. This study has clear implications for both residential and non-residential treatment services. ATODA is currently delivering The Under 10% Project, that aims to improve the health and wellbeing of the Canberra community by strengthening tobacco management practices in health and community sector workplaces that support disadvantaged people. For more information visit: http://under10percent.org.au/about/
What proportion of prisoners world-wide have hepatitis C?
A systematic review and meta-analysis of the literature was undertaken to determine the rate of new hepatitis C virus [HCV] infections and the prevalence of HCV antibody-positives among detainees in prisons and closed settings world-wide. ‘The summary prevalence estimate of anti-HCV [HCV antibody-positives] in general detainees was 26%...and in detainees with a history of IDU, 64%...The regions of highest prevalence were Central Asia [38%]…and Australasia [35%]…We estimate that 2.2 million…detainees globally are anti-HCV positive, with the largest populations in North America (668,500…) and East and Southeast Asia (638,000…)’. The researchers concluded ‘HCV is a significant concern in detained populations, with one in four detainees anti-HCV-positive. Epidemiological data on the extent of HCV infection in detained populations is lacking in many countries. Greater attention towards prevention, diagnosis, and treatment of HCV infection among detained populations is urgently required’.
Larney, S et al
. 2013, ‘Incidence and prevalence of hepatitis C in prisons and other closed settings: results of a systematic review and meta-analysis’, Hepatology
, vol. 58, no. 4, pp. 1215-24.
Comment: This international overview confirms observations from Australia about the prevalence of hepatitis C among prison populations. Although the new direct-acting antiviral drugs coming on the market are able to cure hepatitis C infection, concern is increasingly being expressed about the likely cost of these drugs. The excessive costs may be impediments to the deployment of these new treatments among prison populations.
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Would legalising the currently-illegal opioids reduce overdose deaths?
Overdose is the leading cause of premature mortality among heroin users. We examine whether the provision of regulated and quality-controlled heroin to users in specified doses would reduce heroin overdose rates. We also address this in the context of the epidemic of prescription opioid use and deaths seen in recent years in the United States and internationally. We explore the extent to which any change in legal access to heroin would affect overdose rates, and note that this depends upon the validity of the two main assumptions that variations in illicit drug purity and/or the presence of drug contaminants are major causes of overdose. Toxicological and demographic data from studies of heroin overdose deaths do not support these assumptions. The surge in the use of pharmaceutical opioids provides an example of the legal delivery of opioids of known dosage and free of contaminants, where overdose deaths can be examined to test these assumptions. Rates of fatal opioid overdose have escalated, with increased rates of prescribing of pharmaceutical opioids. On the basis of the experience with prescription opioids, unregulated legal heroin access would not reduce overdose rates.
Darke, S & Farrell, M 2014, ‘Would legalizing illicit opioids reduce overdose fatalities? Implications from a natural experiment’, Addiction
, online ahead of print.
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Are there relationships between the use of energy drinks, soft drinks and drug use among secondary school students?
Researchers examined energy drink and soft drink use among secondary school students in the USA in 2010-2011, and the relationships between the use of those beverages and use of drugs, using national school survey data. They found that ‘Approximately 30% of students reported consuming energy drinks or shots; more than 40% reported daily regular soft drink use, and about 20% reported daily diet soft drink use’. Importantly, ‘Beverage consumption was strongly and positively associated with past 30-day alcohol, cigarette, and illicit drug use. The observed associations between energy drinks and substance use were significantly stronger than those between regular or diet soft drinks and substance use’. In other words, the study shows that ‘…adolescent consumption of energy drinks/shots is widespread and that energy drink users report heightened risk for substance use’. The authors point out that this is a correlational study that cannot demonstrate patterns of causality. Nonetheless, based on these findings they concluded that ‘Education for parents and prevention efforts among adolescents should include education on the masking effects of caffeine in energy drinks on alcohol- and other substance-related impairments, and recognition that some groups (such as high sensation–seeking youth) may be particularly likely to consume energy drinks and to be substance users’.
Terry-McElrath, YM, O'Malley, PM & Johnston, LD 2014, Energy drinks, soft drinks, and substance use among United States secondary school students’, Journal of Addiction Medicine
, vol. 8, no. 1, pp. 6-13.
Comment: The energy drink industry is running an international campaign to downplay the relationship between their products and the use of alcohol and other drugs. The study adds to the growing body of research evidence about those relationships.
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Is drug-driving increasing as a factor in the deaths of motor vehicle drivers?
An analysis of substances detected in drivers killed in motor vehicle crashes in six US states found that ‘Of the 23,591 drivers studied, 39.7% tested positive for alcohol and 24.8% for other drugs. During the study period, the prevalence of positive results for nonalcohol drugs rose from 16.6% in 1999 to 28.3% in 2010…whereas the prevalence of positive results for alcohol remained stable. The most commonly detected nonalcohol drug was cannabinol, the prevalence of which increased from 4.2% in 1999 to 12.2% in 2010…The increase in the prevalence of nonalcohol drugs was observed in all age groups and both sexes. These results indicate that nonalcohol drugs, particularly marijuana, are increasingly detected in fatally injured drivers’. The researchers concluded ‘These results suggest that drugged driving, specifically driving under the influence of cannabinol and narcotics, may be playing an increasing role in fatal motor vehicle crashes. To control the ongoing epidemic of drugged driving, it is imperative to strengthen and expand drug testing and intervention programs for drivers’.
Brady, JE & Li, G 2014, ‘Trends in alcohol and other drugs detected in fatally injured drivers in the United States, 1999-2010’, American Journal of Epidemiology
, online ahead of print.
Comment: High prevalence’s of both pharmaceutical and illicit psychoactive drugs are routinely found among people killed in road crashes. While this descriptive epidemiological information is useful, it highlights the lack of evaluation research findings on interventions that aim to reduce drug-impaired driving.
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How appropriate is general practice as a location for reducing drug-related deaths?
Researchers in Scotland conducted a survey of five hundred GPs’ knowledge of and willingness to be involved in drug-related death [DRD] prevention, including naloxone administration. Fifty-five per cent of those contacted responded to the questionnaire. ‘There was some awareness of the naloxone programme but little involvement (3.3%), 9% currently provided routine overdose prevention, there was little involvement in displaying overdose prevention information…Knowledge of DRD risk was mixed. There was tentative willingness to be involved in naloxone prescribing with half of respondents willing to provide this to drug users or friends/family. However half were uncertain GP based naloxone provision was essential to reduce DRDs’. The researchers concluded that ‘There was poor awareness of the Scottish National Naloxone Programme in participants. Results indicated GPs did not currently feel sufficiently skilled or knowledgeable to be involved in naloxone provision. Appropriate training was identified as a key requirement’.
Matheson, C et al.
2014, ‘Reducing drug related deaths: a pre-implementation assessment of knowledge, barriers and enablers for naloxone distribution through general practice’, BMC Family Practice
, vol. 15, no. 1, p. 12.
Comment: The incidence of opioid overdose deaths is increasing in many countries, dramatically so in some places. People are talking about the potential for GPs (as well as specialist drug services) to contribute to overdose prevention among their patients to whom they prescribe opioids, or who are known to be illicit opioid users. Those contributions can include counselling and training about overdose prevention and resuscitation, and the prescribing of naloxone to potential overdose witnesses.
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Is contingency management an effective intervention for opioid-dependent people?
A study undertaken in the USA examined whether contingency management (CM) was effective in opioid-dependent patients initiating intensive outpatient psychosocial treatment. Patients at two community-based clinics were randomised to standard care or standard care plus CM for twelve weeks. The patients in the CM group earned opportunities to win prizes for attending treatment and submitting drug-negative samples: ‘On Tuesdays through Fridays, three name slips were drawn from the hat at the start of the first counseling session. The individuals whose names were drawn drew once from a standard prize bowl. This bowl comprised 200 cards: 174 were small prizes (choice of $1 McDonald’s coupons, food items, bus tokens, etc.), 25 were large prizes (choice of $20 movie tickets, CDs, watches, dish sets, etc.), and one was a jumbo prize (choice of stereo, DVD player, or TV). Sample prizes were available for selection immediately in group, or patients could choose from the full range of prizes after the session’.
The researchers found that ‘Opioid-dependent patients receiving maintenance pharmacotherapy attended treatment on fewer days and achieved less abstinence than their opioid-dependent counterparts who were not on opioid agonist therapy (i.e who were receiving psychosocial interventions)...Nonmaintained opioid-dependent patients evidenced similar outcomes as substance abusing patients who were not opioid-dependent. CM also improved retention and abstinence…with no interaction effects with opioid dependence/maintenance status noted. These data suggest that CM may be an effective psychosocial intervention potentially suitable for the growing population of opioid-dependent patients, including those not receiving maintenance pharmacotherapy’.
Petry, NM & Carroll, KM 2013, ‘Contingency management is efficacious in opioid-dependent outpatients not maintained on agonist pharmacotherapy’, Psychol Addict Behav
, vol. 27, no. 4, pp. 1036-43.
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Which pharmacological treatment is most effective for opioid dependence?
‘The aim of this review was to update and summarize the scientific knowledge on the long term outcomes of the different pharmacological treatment options for opioid dependence currently available and to provide a critical discussion on the different treatment options based on these results. We performed a literature search using the PubMed databases and the reference lists of the identified articles. Data from research show that the three pharmacological options reviewed are effective treatments for opioid dependence with positive long term outcomes. However, each one has its specific target population and setting. While methadone and buprenorphine are first line options, heroin-assisted treatment is a second line option for those patients refractory to treatment with methadone with concomitant severe physical, mental, social and/or functional problems. Buprenorphine seems to be the best option for use in primary care offices. The field of opioid dependence treatment is poised to undergo a process of reinforcement and transformation. Further efforts from researchers, clinicians and authorities should be made to turn new pharmacological options into clinical reality and to overcome the structural and functional obstacles that maintenance programmes face in combatting opioid dependence.’
Garcia-Portilla, MP et al.
2014, ‘Long term outcomes of pharmacological treatments for opioid dependence: does methadone still lead the pack?’, British Journal of Clinical Pharmacology
, vol. 77, no. 2, pp. 272-84.
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How effective is peer-delivered information in reducing ecstasy and methamphetamine use at music events?
Data were collected between November 2006 and May 2007 at music festivals, dance events and nightclubs in Sydney, Adelaide and Canberra to ascertain the effectiveness of peer-delivered information in reducing ecstasy and methamphetamine use. Peer educators promoted a unique ecstasy-related health message about serotonin syndrome to experimental sites but not at control sites. ‘The unique ecstasy-related message was recalled immediately post-intervention and after three months. Additionally, aspects of drug involvement decreased at three month follow-up among the experimental and control group.’ The researchers concluded ‘The peer education methodology used was an effective way to disseminate information to ecstasy users’.
Silins, E, Bleeker, AM, Simpson, M, Dillon, P & Copeland, J 2013, ‘Does peer-delivered information at music events reduce ecstasy and methamphetamine use at three month follow-up? Findings from a quasi-experiment across three study sites’, Journal of Addiction & Prevention
, online ahead of print.
Comment: Prevention receives insufficient attention under Australia’s National Drug Strategy. The potential for peer education has not been adequately realised to date, with very little resources being allocated to this area.
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Do psychedelics have a role in the prevention and treatment of drug use disorders?
The introduction to a recent issue of Current Drug Abuse Reviews
states ‘There is a profound unmet need to develop more treatment options for individuals with substance abuse disorders. Psychedelic assisted psychotherapy represents a promising treatment for addiction. After being suppressed for over 30 years, psychedelic psychotherapy research is beginning to make a comeback. Researchers worldwide are using psychedelics to investigate the neuroscience of non-ordinary states of consciousness and spirituality and as potential treatments for (psychological) conditions such as posttraumatic stress disorder (PTSD) and anxiety related to end-stage illnesses. Much of the focus of this new era of research is on the treatment of addiction, and this volume presents the most compelling work being done in this area’. It includes reviews on topics from the historical use of psychedelics, particularly in ethnobotany, psychiatry and psychology, to studies examining the effects of these drugs as an auxiliary therapy for addiction and other pathologies associated with chronic and/or traumatic stress.
Vargas-Perez, H & Doblin, R 2013, ‘Hot topic: the potential of psychedelics as a preventative and auxiliary therapy for drug abuse’, Current Drug Abuse Reviews
, vol. 6, no. 1, pp. 1-2, free full text at http://www.benthamsciencepublisher.com/journal/index.php?journalID=cdar
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How common is it for women to continue risky drinking when they become pregnant?
A study of the characteristics of women who engage in risky drinking before pregnancy examined how their drinking patterns changed when they became pregnant. A sample of 1,577 women from the 1973-78 cohort of the Australian Longitudinal Study on Women's Health were included if they first reported being pregnant in 2000, 2003, 2006, 2009 and reported risky drinking patterns prior to that pregnancy. The researchers found that ‘When reporting risky drinking patterns prior to pregnancy only 6% of women reported weekly drinking only, whereas 46% reported binge drinking only and 48% reported both…Most women (46%) continued these risky drinking patterns into pregnancy, with 40% reducing these behaviors, and 14% completely ceasing alcohol consumption. Once pregnant, women who binged only prior to pregnancy were more likely to continue (55%) rather than reduce drinking (29%)’. The researchers concluded that ‘The substantial number of women that continued these behaviors into pregnancy, particularly those who binge drank, suggests that more needs to be done to address risky drinking behaviors in women of childbearing age in an effort to avoid alcohol use during pregnancy’.
Anderson, AE et al.
2014, ‘Risky drinking patterns are being continued into pregnancy: a prospective cohort study’, PLoS One
, vol. 9, no. 1, p. e86171, http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0086171
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Would a minimum unit price for alcohol affect different socioeconomic groups differently?
A modelling study conducted in England assessed the effect of a 45 UK pence minimum unit price (one unit being 8 g or 10 ml of pure alcohol). In the model used, the introduction of the minimum price led to ‘an immediate reduction in consumption of 1·6%...Moderate drinkers were least affected in terms of consumption…and spending…The greatest behavioural changes occurred in harmful drinkers…especially in the lowest income quintile…Estimated health benefits from the policy were also unequally distributed. Individuals in the lowest socioeconomic group (living in routine or manual worker households and comprising 41·7% of the sample population) would accrue 81·8% of reductions in premature deaths and 87·1% of gains in terms of quality-adjusted life-years…Because harmful drinkers on low incomes purchase more alcohol at less than the minimum unit price threshold compared with other groups, they would be affected most by this policy’. The researchers concluded ‘Because harmful drinkers on low incomes purchase more alcohol at less than the minimum unit price threshold compared with other groups, they would be affected most by this policy. Large reductions in consumption in this group would however coincide with substantial health gains in terms of morbidity and mortality related to reduced alcohol consumption’.
Holmes, J et al.
2014, ‘Effects of minimum unit pricing for alcohol on different income and socioeconomic groups: a modelling study’, The Lancet
, online ahead of print.
Comment: This study quantifies and highlights one of the ethical dilemmas in population-wide prevention programs. Setting minimum unit prices for alcoholic beverages produces significantly greater financial hardships for poor people than for the more well-to-do, but the former reap health and related benefits to a far greater degree than do the latter. The ethical dilemma comes from the fact that many people feel that financial hardships and health benefits are non-commensurable.
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Bailey, TJ, Lindsay, VL & Royals, J 2013, Alcohol ignition interlock schemes: best practice review, Centre for Automotive Safety Research, The University of Adelaide, Adelaide, http://casr.adelaide.edu.au/publications/list/?id=1394.
Closing the Gap Clearinghouse (AIHW & AIFS) 2013, Diverting Indigenous offenders from the criminal justice system, Australian Institute of Health and Welfare & Australian Institute of Family Studies, Canberra & Melbourne, http://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=60129545614.
Entwistle, G, Sindicich, N & Burns, L 2013, Rise in LSD use among regular psychostimulant users: why the increase and is it a cause for concern?, EDRS Drug Trends Bulletin, National Drug and Alcohol Research Centre, Sydney, http://ndarc.med.unsw.edu.au/resource/rise-lsd-use-among-regular-psychostimulant-users-why-increase-and-it-cause-concern.
European Monitoring Centre for Drugs and Drug Addiction 2013, Prevention of drug use, European Monitoring Centre for Drugs and Drug Addiction, http://www.emcdda.europa.eu/topics/prevention.
Hughes, C., Ritter, A., Cowdery, N., Philips, B. 2014. Australian threshold quantities for ‘drug trafficking’” Are they placing drug users at risk of unjustified sanction?, Trends & Issues in crime and criminal justice, No. 467, Australian Institute of Criminology, Canberra
International Drug Policy Consortium (IDPC) & Eurasian Harm Reduction Network (EHRN) nd (c. 2014), Training toolkit on drug policy advocacy, International Drug Policy Consortium, London, http://idpc.net/policy-advocacy/training-toolkit.
National Institute on Drug Abuse (USA) 2014, Principles of adolescent substance use disorder treatment: a research-based guide, National Institute on Drug Abuse, Rockville, MD, http://www.drugabuse.gov/publications/principles-adolescent-substance-use-disorder-treatment-research-based-guide.
Olsen, A, McDonald, D, Lenton, S & Dietze, P 2014, Key interim findings - independent evaluation of the ‘Implementing Expanding Naloxone Availability in the ACT (I-ENAACT)’ Program, 2011-2013, ACT Health, Canberra, http://www.health.act.gov.au/publications/reports/alcohol-and-other-drug-reports/naloxone .
Terer, K & Brown, R 2014, Effective drink driving prevention and enforcement strategies: approaches to improving practice, Trends & Issues in Crime and Criminal Justice no. 472, Australian Institute of Criminology, Canberra, http://www.aic.gov.au/publications/current%20series/tandi/461-480/tandi472.html.
The Executive Director, United Nations Office on Drugs and Crime 2013, Contribution of the Executive Director of the United Nations Office on Drugs and Crime to the high-level review of the implementation of the Political Declaration and Plan of Action on International Cooperation towards an Integrated and Balanced Strategy to Counter the World Drug Problem, to be conducted by the Commission on Narcotic Drugs in 2014, http://idpc.net/blog/2014/01/unodc-executive-director-releases-contributions-ahead-of-cnd-high-level-segment-on-drugs .
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