Drug and alcohol review最新文献

{"title":"Evaluation of the national alcohol control strategy (Green Paper on Alcohol Policy) of Estonia","authors":"Jürgen Rehm,&nbsp;Rainer Reile,&nbsp;Daniela Correia,&nbsp;Maria Neufeld,&nbsp;Huan Jiang","doi":"10.1111/dar.14024","DOIUrl":"10.1111/dar.14024","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Estonia is a Baltic country with high adult alcohol per capita (APC) consumption. Since 2013, its alcohol control policy has been guided by the <i>Green Paper on Alcohol Policy</i> (<i>GP</i>), which is the equivalent of a non-binding national alcohol action plan. This contribution attempts to evaluate the overall impact of the <i>GP</i> on APC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>For the overall evaluation, APC was quantitatively compared for three periods: pre-<i>GP</i> (2000–2012), the core period of the <i>GP</i> (2013–2019) and the COVID-19 phase (2020–2022), using Analysis of Variance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>APC decreased on average by 0.25 L of pure alcohol per year in the 7 years defined as the core period of the <i>GP</i>, whereas it increased in the other periods between 2001 and 2022 (period 2001–2012: +0.47 L; 2020–2022: +0.27 L). These differences were statistically significant (<i>F</i> [1, 18] = 5.22, <i>p</i> = 0.035). Moreover, there was no overall trend of decreasing APC during the core period of the <i>GP</i> in neighbouring countries (Latvia, Lithuania and Poland).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion and Conclusions</h3>\u0000 \u0000 <p>The combination of the various measures of the national alcohol policy was associated with a marked decrease in APC.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":"44 3","pages":"891-896"},"PeriodicalIF":3.0,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dar.14024","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unmet treatment need: The size of the gap for alcohol and other drugs in Australia","authors":"Alison Ritter,&nbsp;Keelin O'Reilly","doi":"10.1111/dar.14008","DOIUrl":"10.1111/dar.14008","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Assessing unmet demand for alcohol and other drug (AOD) treatment requires accurately counting those in treatment and determining those in need of treatment. Using updated epidemiological and treatment data, this study sought to provide an updated estimate of the unmet demand for AOD treatment in Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Australian prevalence rates for alcohol, cannabis, methamphetamine and opioid use disorders were obtained from the Global Burden of Disease and research studies. The estimated proportion of people who would likely not seek or need treatment were subtracted from the diagnosed population. The number of people receiving treatment was estimated using AOD treatment databases and previous research.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>An estimated 752,812 to 1,291,119 people met criteria for a substance use disorder in Australia in 2023. Removing the proportion of people who would not need or seek treatment resulted in between 406,697 and 668,497 people as the potential treatment population. The number of people who received treatment in Australia was estimated at 198,731 people. The unmet demand for AOD treatment was estimated to be between 207,966 and 469,767 in 2023.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion and Conclusions</h3>\u0000 \u0000 <p>In Australia, we only treat between 30% and 48% of the population who would seek and benefit from AOD treatment. This is a conservative analysis that assumes only 40% of the alcohol and cannabis use disorder population would seek treatment. The findings from this analysis highlight the continued significant unmet treatment needs of people with substance use disorders. Treatment resources need to be doubled in order to address this unmet treatment population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":"44 3","pages":"772-782"},"PeriodicalIF":3.0,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dar.14008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143398667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A qualitative exploration of triggers for alcohol use and access to support during the COVID-19 pandemic among people identifying as problem drinkers in the United Kingdom","authors":"Hadia Yaqubi,&nbsp;Tom May,&nbsp;Alexandra Burton","doi":"10.1111/dar.14013","DOIUrl":"10.1111/dar.14013","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>A polarisation of drinking behaviour was observed during the coronavirus disease (COVID-19) pandemic, with some people reported to be drinking more alcohol and others less. We aimed to understand how and why the COVID-19 pandemic and associated restrictions impacted alcohol use and access to support and services during this time.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted semi-structured qualitative interviews with 27 participants, including 20 people identifying as problem drinkers and seven alcohol service providers. Data were analysed using thematic analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We identified two main triggers for alcohol use during the pandemic: (i) loss of daily routine and activity resulted in drinking to cope with social isolation and boredom; and (ii) drinking alleviated feelings of fear, anxiety and anger over the imposition of pandemic restrictions. Regarding access to services, two main themes were generated: (i) remote service provision was perceived as inferior to in-person services; and (ii) the need to offer choice and flexibility in how services were provided, with service providers reporting more positive experiences of online and telephone service delivery than service users.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion and Conclusions</h3>\u0000 \u0000 <p>This study provides new insights into potential triggers for alcohol use among people identifying as problem drinkers during the COVID-19 pandemic. The acceptability of remote forms of service provision were dependent on service user access to, and comfort with using technology. Hybrid delivery models may therefore be suitable in some but not all circumstances, and efforts should be made to promote equitable access to services.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":"44 3","pages":"858-870"},"PeriodicalIF":3.0,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dar.14013","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143398662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A mixed-methods study of staff perspectives on the barriers and facilitators to the implementation of patient-reported routine outcome measures and feedback in alcohol and other drug treatment","authors":"Nina Pocuca,&nbsp;Gabrielle Campbell,&nbsp;Anthony Barnett,&nbsp;Alison K. Beck,&nbsp;Rhiannon Ellem,&nbsp;Catherine A. Quinn,&nbsp;Peter J. Kelly,&nbsp;Briony Larance,&nbsp;Amanda L. Baker,&nbsp;Jason P. Connor,&nbsp;John Marsden,&nbsp;Gary C. K. Chan,&nbsp;Luke Connelly,&nbsp;Sabrina Lenzen,&nbsp;Michael Farrell,&nbsp;Robert Stirling,&nbsp;Suzie Hudson,&nbsp;Leanne Hides","doi":"10.1111/dar.14007","DOIUrl":"10.1111/dar.14007","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Preliminary evidence supports the use of patient-reported outcome measures (PROM) and feedback for enhancing client outcomes in alcohol and other drug (AOD) treatment. However, successful implementation remains challenging. This mixed-methods study applied the Consolidated Framework for Implementation Research (CFIR) framework to examine inner setting and staff characteristics that act as barriers and facilitators to the implementation of PROMs in AOD treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>To understand CFIR-informed barriers and facilitators to implement PROMs in AOD treatment, qualitative interviews were conducted with <i>N</i> = 23 AOD counsellors. A separate quantitative survey was conducted with <i>N</i> = 108 AOD counsellors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Four qualitative themes emerged: (i) PROMs and feedback are valuable to AOD treatment; (ii) counsellor resistance towards PROMs and feedback is a barrier to successful implementation; (iii) competing interests and logistical issues are barriers to the implementation of PROMs and feedback; and (iv) PROMs are a burden to clients that may serve to disengage them from treatment. Survey results indicated a positive association between leadership support (CFIR inner setting construct) and counsellor knowledge and beliefs regarding PROMs and feedback (CFIR staff characteristics construct; <i>β</i> = 0.35, 95% CI [0.13, 0.60]). Findings demonstrated a positive association between available PROMs resources (CFIR inner setting construct) and both knowledge and beliefs regarding PROMs and feedback (<i>β</i> = 0.31, 95% CI [0.14, 0.48]) and self-efficacy to implement PROMs and feedback (CFIR staff characteristics construct; <i>β</i> = 0.18, 95% CI [0.04, 0.32]).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion and Conclusions</h3>\u0000 \u0000 <p>Findings point to the critical need to adopt a whole-of-organisation approach to foster buy-in for PROMs and feedback to support successful implementation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":"44 3","pages":"759-771"},"PeriodicalIF":3.0,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dar.14007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143390505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development, dissemination and community response towards the first community notice regarding misrepresented illicit anabolic-androgenic steroids in circulation in Australia","authors":"Timothy Piatkowski,&nbsp;Isabelle Volpe,&nbsp;Rita Brien,&nbsp;Ross Coomber,&nbsp;Monica Barratt,&nbsp;Emma Kill,&nbsp;Geoff Davey,&nbsp;Cameron Francis,&nbsp;Sarah Cresswell,&nbsp;Alan White,&nbsp;Madeline Harding,&nbsp;Karen Blakey,&nbsp;Steph Reeve,&nbsp;Brooke Walters,&nbsp;Jason Ferris,&nbsp;Cheneal Puljević","doi":"10.1111/dar.14015","DOIUrl":"10.1111/dar.14015","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Drug alerts aimed at both people who use drugs and health workers help to prevent acute harms from unpredictable illicit drug markets and by equipping health workers to handle unusual drug events and share vital information with service users. However, there has never been an alert produced for anabolic-androgenic steroids (AAS), an important class of illicit drugs. We report on the development, implementation and community receptivity of the first-ever AAS community drug alert.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Based on findings from samples collected during the first month of an AAS checking trial conducted by drug checking service CheQpoint, we identified contamination in two oxandrolone samples, which prompted issuing of the first-ever AAS community notice. Drawing on digital ethnographic techniques, we collected and analysed social media comments on the notice to assess AAS community perceptions and the broader impact of this harm reduction initiative.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The Instagram post by CheQpoint reached 1376 users, with 3429 impressions and 87 interactions. Community feedback indicated receptivity to the notice, with several people in the community recognising the prevalence of AAS adulteration. Responses highlighted the need for more thorough testing and indication of sample content, given the perception of a growing number of new people using AAS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion and Conclusions</h3>\u0000 \u0000 <p>This study, the first to describe a community notice for illicit market AAS, reveals a strong demand for harm reduction interventions. We call for the urgent expansion of drug-checking services to provision for AAS and, thus, provide equitable health support to address systemic gaps for this group.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":"44 3","pages":"735-741"},"PeriodicalIF":3.0,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dar.14015","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143390506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating routine screening for pregnancy intention and contraceptive use into care of women who use alcohol or other drugs","authors":"Bridin Murnion,&nbsp;Vicki Chase,&nbsp;Grace Carniato,&nbsp;Kate Masters,&nbsp;Kelly McNamara","doi":"10.1111/dar.14023","DOIUrl":"10.1111/dar.14023","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>There are high rates of unplanned pregnancy and low rates of contraceptive use in women with substance use disorders. Women who use drugs experience many barriers to health. In addiction treatment services in New South Wales, Australia, patients undergo routine health screening on treatment entry and annually thereafter. An integrated pregnancy and contraceptive screening tool was developed. The aim of this cross-sectional study was to report the feasibility and preliminary outcomes of this tool.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A pregnancy intention screening (PIS) tool was developed and integrated into the electronic medical record and the annual routine screening. This tool consisted of four yes/no questions about current pregnancy, future pregnancy plans and contraceptive use. Responses to these questions are reported. Descriptive statistics were used to report demographic and outcome data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>One hundred women were offered and completed the survey. There were low rates of effective or highly effective contraceptive use (24.5 percent of eligible participants). Seventy-four percent of participants wanted further information on contraception.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion and Conclusions</h3>\u0000 \u0000 <p>As with other studies, our studies demonstrate low rates of contraceptive use and high rates of interest in contraception use among women who use drugs. The PIS tool was completed by all women to whom it was offered, suggesting high levels of patient acceptability. Integration of a PIS tool was effective in identifying women with contraceptive needs and was acceptable to women.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":"44 3","pages":"754-758"},"PeriodicalIF":3.0,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dar.14023","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143390507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychoactive substance use among Russian migrants relocated in Georgia following the 2022 invasion of Ukraine: Qualitative study","authors":"David Otiashvili,&nbsp;Tamar Mgebrishvili,&nbsp;Mariam Sherozia,&nbsp;Marika Alania,&nbsp;Irma Kirtadze","doi":"10.1111/dar.14019","DOIUrl":"10.1111/dar.14019","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Study aimed at exploring the experience of migrants from Russia who use psychoactive substances, who arrived in Georgia in the wake of the invasion of Ukraine.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Qualitative individual interviews and focus group discussions. The data collection took place from May to August 2023.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The final sample consisted of 23 respondents, who were mostly young and employed. Participants left Russia because of the war in Ukraine and the threat of conscription in Russia, but also due to political dissent. Participants experienced depressive symptoms and a worsening of mental health conditions. The increased consumption of sedatives and alcohol was closely associated with the efforts to manage stress and depression, acting as a means to cope with adverse effects on mental health. The absence of leisure alternatives emerged as a significant factor, with drug use becoming a feature of socialising in circumstances where such behaviour was not typical in their Russian lives. Participants exhibited low awareness of available relevant health services (including drug-related) and typically addressed recurrent health needs by consulting Russian specialists online or Russian-speaking professionals within Georgia's migrant community.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion and Conclusions</h3>\u0000 \u0000 <p>Migration was associated with a deterioration in mental health status and substance use often manifested as a maladaptive strategy to cope with mental health problems. The difficulties encountered in the process of assimilation contributed to behaviours related to drug consumption. Immigration policies need to be inclusive of the health needs of migrants and provide opportunity to integrate effectively into society.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":"44 3","pages":"897-907"},"PeriodicalIF":3.0,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143381749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers to the use of no and low alcohol products in high-risk drinkers","authors":"Emma L. Davies,&nbsp;Parvati Perman-Howe,&nbsp;Jennifer Seddon,&nbsp;Timothy Piatkowski,&nbsp;Cheneal Puljevic,&nbsp;Monica J. Barratt,&nbsp;Adam R. Winstock,&nbsp;Jason A. Ferris","doi":"10.1111/dar.14006","DOIUrl":"10.1111/dar.14006","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Consuming no or low (NoLo) alcohol products in place of regular strength alcohol products could reduce alcohol-related harms in high risk drinkers. This study provides a new perspective by exploring beliefs about NoLo products and motives for their use by level of risky drinking using a model of behaviour change.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The 2022 Global Drug Survey included items on NoLo product use, beliefs, and motives for consuming or not consuming NoLo products. Findings were mapped onto the COM-B (capability-opportunity-motivation) model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In a sample of 33,033 respondents (59.5% cis men; 37.3% cis women; 3.2% trans/non-binary) over half (52.2%) reported NoLo product use in the last 12 months. Recent NoLo use was associated with older age, employment status and more common in respondents who drank alcohol compared to non-drinkers. High-risk drinkers were more likely to believe NoLo products could help them to drink less and to avoid embarrassment. However, higher risk drinkers who had never consumed NoLo products were more likely to report that they drank to be intoxicated and believed they would not have a good time if they switched.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion and Conclusions</h3>\u0000 \u0000 <p>People who are drinking for enhancement motives (e.g., for fun, to feel intoxicated) may be less amenable to substituting regular strength alcohol products for NoLo products. NoLo use may help some higher risk drinkers consume less alcohol, and social and motivational factors could be targeted to increase their use. There should be renewed focus on broader intervention strategies, such as creating viable social alternatives to consuming alcohol.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":"44 3","pages":"842-857"},"PeriodicalIF":3.0,"publicationDate":"2025-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dar.14006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143381810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What influences Australian pharmacists' decisions to supply opioids? Results from a survey and randomised controlled factorial experiment","authors":"Louisa Picco,&nbsp;Ting Xia,&nbsp;Rose Laing,&nbsp;Elizabeth Grist,&nbsp;Jana Dostal,&nbsp;Suzanne Nielsen","doi":"10.1111/dar.14009","DOIUrl":"10.1111/dar.14009","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Prescription drug monitoring programs (PDMP) identify medication-related risks to support clinical decision-making. This study aims to report prescription medication refusal rates based on PDMP alerts and determine how PDMP alerts and other characteristics influence pharmacists' decisions to supply opioids.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Pharmacists completed an online survey and randomised controlled factorial experiment. Generalised linear models explored differences in the proportion of refusals by state. Pharmacists indicated their likelihood to supply opioids based on six clinical vignettes. Mixed-effect linear regression models explored the association between vignette and pharmacy-related characteristics and the likelihood to supply opioids.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Data related to 598 pharmacists (<i>n</i> = 3370 vignettes). Jurisdiction was associated with refusals; Western Australian pharmacists had significantly lower odds of refusing supply compared with Victorian pharmacists (odds ratio = 0.186, 95% confidence interval 0.104–0.331). The factorial experiment revealed the strongest predictors of reduced likelihood to supply were the PDMP high dose (β = −2.76, <i>p</i> &lt; 0.001) and multiple prescriber (β = −3.79, <i>p</i> &lt; 0.001) alerts. Unemployment (β = −0.0421, <i>p</i> &lt; 0.001), hepatitis C (β = −0.260, <i>p</i> = 0.009), depression (β = −0.301, <i>p</i> = 0.003), high opioid dose (β = −0.259, <i>p</i> = 0.002) and co-prescribed opioids with benzodiazepines (β = −0.478, <i>p</i> = 0.001) resulted in smaller reductions in the likelihood to supply. Older patient age, patient familiarity and rural/remote pharmacies were associated with significant, albeit small increases in the likelihood to supply with respective 0.293-, 0.250- and 0.339-unit increases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion and Conclusions</h3>\u0000 \u0000 <p>Jurisdictional differences in refusal to supply were observed, while PDMP alerts were the strongest predictor of reduced likelihood to supply opioids in the factorial experiment. Unintended consequences of PDMPs including abrupt opioid discontinuation observed elsewhere, should be avoided following the implementation of this supply-side policy in Australia.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":"44 3","pages":"783-792"},"PeriodicalIF":3.0,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dar.14009","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143363898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Local environments, accessibility and affordability: A qualitative analysis of alcohol purchasing across different socio-economic areas in Victoria, Australia","authors":"Gabriel Caluzzi,&nbsp;Klaudia Kepa,&nbsp;Alexandra Torney,&nbsp;Michael Livingston,&nbsp;Yvette Mojica-Perez,&nbsp;Nicholas Taylor,&nbsp;Sarah Callinan,&nbsp;Amy Pennay","doi":"10.1111/dar.14018","DOIUrl":"10.1111/dar.14018","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Alcohol purchasing practices—linked to consumption practices and potential harms—vary across socio-economic environments. While there is an epidemiological link between purchasing and harm, little qualitative research unpacks purchasing practices with an eye to socio-economic status (SES). Drawing on qualitative interviews, this paper takes an ecological approach to examine how people in different SES areas discuss their alcohol purchasing practices to understand how SES influences alcohol purchasing.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This analysis draws on 45 interviews with people who drink alcohol in Victoria, Australia conducted in 2023–2024. Participants were purposively recruited from low, middle and high SES neighbourhoods. All interviews were recorded, transcribed and analysed thematically.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Accessibility to alcohol outlets influenced purchasing patterns, with those in low SES neighbourhoods facing barriers to accessing on-premises venues. Neighbourhood-level norms shaped feelings of safety and enthusiasm for attending on-premises venues, often tied to local gentrification. Low SES neighbourhood participants were more constrained by on-premises costs but less conscious of alcohol budgeting, in contrast to the middle and high SES neighbourhood participants, who were more intentional about their budgeting. Participants from all groups noted cost of living concerns influenced alcohol affordability, contrasting this with the continued affordability of cheap wine.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion and Conclusion</h3>\u0000 \u0000 <p>This analysis provides important context as to how neighbourhood SES can influence purchasing practices. Notably, the emphasis on off-premises purchasing was common across the groups, influenced by cost of living pressures and perceived affordability of wine.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":"44 3","pages":"871-880"},"PeriodicalIF":3.0,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dar.14018","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143363887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}