Drug and alcohol review最新文献

{"title":"Changes over time in novel benzodiazepines contributing to fatal overdoses in Victoria, Australia","authors":"Jennifer L. Schumann,&nbsp;Rebekka Syrjanen,&nbsp;Jeremy A. Dwyer","doi":"10.1111/dar.14054","DOIUrl":"10.1111/dar.14054","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Novel benzodiazepines (NBZN) have increased in availability and use since the mid-2000s, with a corresponding rise in associated harms including deaths.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study used data from the Victorian Overdose Deaths Register to explore which specific NBZNs and combinations of NBZNs contributed over time to Victorian overdose deaths between January 2009 and December 2023.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were 140 NBZN-involved overdose deaths in Victoria, with an observable increase in deaths from 2019 onward. Eight main groupings of deaths in time were identified, based on contributing NBZNs. Key groupings included etizolam-related deaths between 2019 and 2021, followed by flualprazolam and clonazolam deaths, and later, bromazolam and clobromazolam combinations in 2022–2023.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion and Conclusions</h3>\u0000 \u0000 <p>These findings reflect the transiency of NBZNs in Victoria's unregulated drug market and highlight the importance of certain harm reduction measures in addressing increasing NBZN use. These include public education around the risks of using benzodiazepines not dispensed from pharmacies and the use of drug checking services to assist people obtaining benzodiazepines from unregulated drug markets.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":"44 4","pages":"1285-1289"},"PeriodicalIF":3.0,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dar.14054","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143959072","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":"Trends in novel opioid use and detections in exposures and police drug seizures in New South Wales.","authors":"Janette L Smith, Jared Brown, David Atefi, Thanjira Jiranantakan, Vanessa Shaw, Christopher Ewers, Lorraine du Toit-Prinsloo, Darren M Roberts","doi":"10.1111/dar.14057","DOIUrl":"https://doi.org/10.1111/dar.14057","url":null,"abstract":"<p><strong>Introduction: </strong>Novel opioids, including non-medical and non-opium-based opioids such as fentanyl analogues and nitazenes, pose a significant risk of harm due to their high potency. There is little published data on novel opioid detections and harms in Australia, yet they are implicated in multiple deaths. This study describes the detections and harms of novel opioids in New South Wales.</p><p><strong>Methods: </strong>A retrospective analysis was conducted using four statewide datasets: Coronial Toxicology, the Illicit Drug Analysis Unit, the Prescription, Recreational and Illicit Substance Evaluation Program (PRISE), and the NSW Poisons Information Centre. These datasets were interrogated for available data (cases or substances seized by police) on novel opioid detections between 1 January 2019 and 31 May 2024.</p><p><strong>Results: </strong>Overall, there were 106 novel opioid detections in 103 cases. PRISE identified 91% of clinical cases, reflecting the program's reach. Fentanyl analogues predominated until 2021, whereas nitazenes predominated from 2022. Most detections were acetylfentanyl (n = 54), followed by isotonitazene detections (n = 13). Positive detections were more frequent in urine compared to blood, supporting testing on both samples. Overall numbers were low, but they were often associated with harm, including deaths.</p><p><strong>Discussion and conclusions: </strong>We anticipate that these data underestimate the harms from novel opioids; for example, these drugs are not being tested routinely in laboratory testing of biological samples, and not all police seizures are analysed. A change in the predominant novel opioid was observed during the study period. Enhancing systems for readiness to detect and respond to novel opioids is vital, including resourcing laboratories.</p>","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143971603","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":"A systematic review of the economic evidence surrounding the management of alcohol withdrawal","authors":"Darren Quelch,&nbsp;Rachel Granger,&nbsp;Huw Lloyd-Williams,&nbsp;Arlene Copland,&nbsp;Gareth Roderique-Davies,&nbsp;Bev John,&nbsp;Rhiannon Tudor Edwards","doi":"10.1111/dar.14053","DOIUrl":"10.1111/dar.14053","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Issues</h3>\u0000 \u0000 <p>Alcohol withdrawal syndrome (AWS) is a medical emergency associated with lengthy hospital stays and an increased frequency of alcohol-related hospital admissions. Rising numbers of alcohol-related health presentations and limited resources of alcohol treatment services necessitate the implementation of both cost-effective and clinically effective interventions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Approach</h3>\u0000 \u0000 <p>A systematic literature search was conducted to review the economic evidence base for AWS interventions. A search of PubMed, Medline, Embase, Web-of-Science and Proquest identified 6347 articles. Following duplicate removal, 5250 English language papers were screened; 58 papers met eligibility criteria. Fifty papers were excluded at full-text screening; 8 papers were included. A novel logic model describing factors impacting clinical and cost-effectiveness of AWS management was developed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Key Findings</h3>\u0000 \u0000 <p>The United States (3), the United Kingdom (3), France (1) and Switzerland (1) based studies took primarily a health sector perspective, with most reporting on cost savings, rather than full health economic evaluations. Both patient- or symptom-specific guidelines and outpatient treatment reduce service costs in select patient populations, without impacting on treatment outcomes. Additional psychological outpatient support may also be a cost-effective addition to treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications</h3>\u0000 \u0000 <p>Where clinically suitable, early transition of AWS treatment to outpatient settings, alongside implementation of patient- or symptom-specific treatment guidelines, both may improve the cost-effectiveness of alcohol treatment services. Significant heterogeneity among current study methodology, patient population and poor-quality economic evidence means further studies are required.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>To develop a more robust understanding of cost and clinical-effectiveness, we propose a transdisciplinary research agenda between health economics, academic expertise and AWS services to address the current evidence gap in this area.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":"44 4","pages":"990-1009"},"PeriodicalIF":3.0,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dar.14053","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143984463","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":"The language of alcohol: Similarities and differences in how drinkers and policymakers frame alcohol consumption","authors":"Emma Moreton,&nbsp;Emma Davies,&nbsp;James Morris,&nbsp;Richard Cooke","doi":"10.1111/dar.14056","DOIUrl":"10.1111/dar.14056","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The primary objective of the paper was to compare semantic domains reported by drinkers and policymakers in their alcohol consumption narratives. The research question was ‘How do drinkers and policymakers use semantic domains to construct alcohol consumption narratives?’.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Secondary analysis of open-ended survey responses (The Drinker Corpus: TDC) and three English alcohol policies (The Policy Corpus: TPC).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Wmatrix software was used to identify semantic domains that appeared more frequently in our corpora compared to general usage. Wmatrix outputs a log-likelihood (LL) score; a score of 6.63 corresponds to a <i>p</i> value of 0.05, indicating frequently used domains.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Five domains appeared more frequently in both corpora than general usage: ‘Cause &amp; Effect/Connection’; ‘Disease’; ‘Drinks and Alcohol’; ‘Excessive drinking’; ‘Knowledge’ (LL &gt;226.68 for all). Domains were represented differently in the two corpora; the TPC focused on long-term health consequences, like liver disease, whereas the TDC talked about short-term consequences like hangovers. The ‘Emotional actions’ domain appeared in the TDC more than expected (LL = 231.26). Drinkers reported experiencing positive and negative emotions following drinking. The ‘Social actions/states/processes’ domain was used more frequently in the TPC than expected (LL = 408.17). Policymakers talked about changing ‘behaviour’ in partnership with organisations rather than working with drinkers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion and Conclusions</h3>\u0000 \u0000 <p>This study shows that while drinker and policymaker alcohol consumption narratives draw on the same semantic domains, how these domains are used to construct these narratives differs. To improve the effectiveness of policy initiatives, we recommend greater dialogue between policymakers and drinkers.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":"44 4","pages":"1194-1206"},"PeriodicalIF":3.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dar.14056","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143986418","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 retrospective medical record audit of the management of cannabis-related emergency department presentations, hospital admissions and hyperemesis of pregnant women who self-reported non-medicinal cannabis use to a substance use in parenting and pregnancy service","authors":"Siyu Qian,&nbsp;Sarah Seddon","doi":"10.1111/dar.14059","DOIUrl":"10.1111/dar.14059","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Research on cannabis-related hyperemesis and its identification and management during pregnancy is scarce. This study aimed to investigate the management of cannabis-related emergency department (ED) presentations, hospital admissions and hyperemesis of pregnant women who self-reported non-medicinal cannabis use to a substance use in pregnancy and parenting service (SUPPS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective medical record audit was conducted on 75 SUPPS patients who identified cannabis as their primary drug of concern and gave birth between January 2015 and May 2020 in Australia. Their ED presentations and hospital admissions in the 12 months prior to the baby's delivery were examined. A descriptive analysis was conducted.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The patients had 232 ED presentations and 183 hospital admissions. History of cannabis use was identified and documented in 34% of the ED presentations and 53% of the hospital admissions. Screening of current substance use was conducted in 45% of the ED presentations and 53% of the hospital admissions. Withdrawal symptoms were documented in 3% of the ED presentations and 13% of the hospital admissions. Cannabis use status was asked in 36% of the ED presentations and 52% of the hospital admissions. Take home medications were provided in 12% of the ED presentations and 12% of the hospital admissions. Referral to SUPPS was made in 7% of the hospital admissions, but none from ED.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion and Conclusions</h3>\u0000 \u0000 <p>Gaps in the management of cannabis-related ED presentations and hospital admissions were identified. Routine substance use screening should be conducted to enable early identification of cannabis use during pregnancy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":"44 4","pages":"1036-1048"},"PeriodicalIF":3.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143984681","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":"Exploring housing instability through a gender lens among people who inject drugs in Montreal, Canada","authors":"Farzaneh Vakili,&nbsp;Stine Bordier Høj,&nbsp;Nanor Minoyan,&nbsp;Sasha Udhesister,&nbsp;Valérie Martel Laferrière,&nbsp;Julie Bruneau,&nbsp;Sarah Larney","doi":"10.1111/dar.14050","DOIUrl":"10.1111/dar.14050","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Housing instability contributes to harm among people who inject drugs (PWID). We examined determinants of varying levels of housing instability and explored gender differences in housing instability and associated determinants among PWID.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>We used baseline data from HEPCO, a community-based cohort of PWID in Montreal, Canada (2011–2022). Housing (past 3 months) was categorised as stable, precarious (i.e., temporary accommodation) or unsheltered. Multinomial logistic regression was used to assess relationships between sociodemographic factors, recent drug use, and housing instability. A multivariable model was constructed using the full sample. Gender differences were explored via stratified and unadjusted analyses given the relatively small number of women.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 911 PWID (748 men and 163 women) were included. In the multivariable model, not living in a marriage-like relationship, recent incarceration, and not reporting recent heroin use were associated with both precarious housing and being unsheltered, relative to stable housing. Employment, consumption of cocaine, amphetamines, and other opioids were only associated with being unsheltered. In stratified analyses, precarious and unsheltered housing was reported by 14.1% and 23.3% of women and 20.9% and 30.9% of men. Sociodemographic factors and drug use patterns also differed by gender. Although most associations with housing instability were in similar directions for men and women, several estimates differed in magnitude, denoting some signals of gender differences.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion and Conclusion</h3>\u0000 \u0000 <p>Almost half the sample was unsheltered or precariously housed. Studies with larger samples of women should formally examine the relevance of developing gender-specific responses to housing instability.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":"44 4","pages":"1138-1150"},"PeriodicalIF":3.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dar.14050","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763394","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":"Smoking cessation services and willingness to receive quitting support among people living in prison in Finland","authors":"Otto Ruokolainen,&nbsp;Hanna Ollila,&nbsp;Patrick Sandström,&nbsp;Tommi Härkänen,&nbsp;Mika Rautanen","doi":"10.1111/dar.14051","DOIUrl":"10.1111/dar.14051","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Smoking is frequent among people living in prison (PLIP) yet little is known about smoking cessation support in prison. This study aims to investigate correlates of being offered help for smoking cessation and willingness to receive smoking cessation support among PLIP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross-sectional, nationally representative study of Finnish PLIP in 2020–2022 was used (<i>N</i> = 529 of whom <i>n</i> = 364 (69%) smoked daily) (response rate 82.5%). Dependent variables included not having been offered help for smoking cessation during the prison time and willingness to receive cessation support. Independent variables included socio-demographic, health- and wellbeing-related, and prison-related variables. Regression analyses were utilised.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of daily smoking PLIP, 75% were not offered support for smoking cessation. In the multiple adjusted model, women had a higher prevalence of not being offered help for smoking cessation than men. Among men, the use of pharmacotherapy for smoking cessation (vs. never use) or longer imprisonment time (vs. shorter imprisonment time) were associated with a lower prevalence of being offered help for smoking cessation. Among both genders, at least moderate willingness to stop smoking (vs. low) was associated with a higher prevalence of wishing to receive support for smoking cessation, while smoking 11–20 cigarettes per day (vs. 1–10 cigarettes per day) was associated with a higher willingness to receive cessation support among men.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion and Conclusions</h3>\u0000 \u0000 <p>Smoking cessation support is wanted among PLIP who are willing to quit smoking, while support services should be targeted more for women and for men who have spent relatively little time in prison.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":"44 4","pages":"1092-1107"},"PeriodicalIF":3.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751327","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":"Tobacco smoking in Sub-Saharan Africa: A systematic review and meta-analysis","authors":"Habte Belete,&nbsp;Tesfa Mekonen,&nbsp;Jason P. Connor,&nbsp;Gary Chan,&nbsp;Leanne Hides,&nbsp;Janni Leung","doi":"10.1111/dar.14040","DOIUrl":"10.1111/dar.14040","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Population-level smoking (cigarette or tobacco or nicotine use) has reduced in high-income nations, but not proportionally compared to less developed regions. This study aimed to estimate smoking prevalence in Sub-Saharan Africa (SSA).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Approach</h3>\u0000 \u0000 <p>Databases searched included PubMed, EMBASE, PsycINFO, African Journal Online, the Global Health Data Exchange and Google Scholar. The search terms included ‘cigarette’, ‘smoking’, ‘tobacco’, ‘nicotine’, ‘prevalence’ and ‘Sub-Saharan Africa’. Prevalence data on smoking was extracted separately for adolescents (10–17) and adults (18+). Prevalence of lifetime, past 12- and 6-month smoking was included. Weighted pooled prevalence was calculated using MetaXL, while meta-regression analysis was conducted with Stata version 17. For the estimation of pooled prevalence, we employed a DerSimonian–Laird estimation method. The risk of bias tool was utilised to assess the quality of the studies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Key Findings</h3>\u0000 \u0000 <p>We included 195 papers. Overall, between 2018 and 2023, the weighted lifetime smoking prevalence was 8.8% (95% confidence interval [CI] 5.1, 13.4%), with a past-year prevalence of 10.8% (CI 4.0%, 19.9%), and daily smoking was 3.5% (CI 0.0%, 9.5%) in SSA. Among adolescents, the lifetime prevalence was 4.5% (CI 2.0%, 8.0%), with a past-year prevalence of 4.1% (CI 0.0%, 13.4%) and daily smoking was 4.7% (CI 1.0%, 10.6%). Among adults, the lifetime prevalence of smoking was 12.7% (CI 6.6%, 20.4%), 12.1% (CI 2.6%, 26.2%) in the past year and daily smoking was 3.3% (CI 0.0%, 9.8%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications</h3>\u0000 \u0000 <p>These findings highlight the importance of maintaining consistent monitoring and ensuring timely follow-up in implementing smoking prevention measures and regulations in SSA countries.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":"44 4","pages":"1079-1091"},"PeriodicalIF":3.0,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dar.14040","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709113","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":"Changing patterns of opioid agonist therapy prescribing in a network of specialised clinics providing care to people with opioid use disorder in Victoria, Australia, 2015 to 2023","authors":"Joshua Dawe,&nbsp;Anna Lee Wilkinson,&nbsp;Michael Curtis,&nbsp;Jason Asselin,&nbsp;Charles Henderson,&nbsp;Eric Makoni,&nbsp;Paul Dietze,&nbsp;Margaret Hellard,&nbsp;Mark Stoové,&nbsp;the Australian Collaboration for Coordinated Enhanced Sentinel Surveillance of Blood Borne Viruses and Sexually Transmissible Infections (ACCESS)","doi":"10.1111/dar.14049","DOIUrl":"10.1111/dar.14049","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Long-acting injectable buprenorphine (LAIB) reduces the frequency of contact with opioid agonist therapy (OAT) service providers. Limited data exist on OAT prescribing in Australia after the introduction of subsidised LAIB prescribing in September 2019. This ecological study describes trends in OAT prescribing between 2015 and 2023 across a network of primary care services in Victoria, Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We utilised electronic medical records from 17 clinics in Victoria that provide services to people with opioid dependence to describe OAT prescribing patterns. We described the annual number and type (methadone, buprenorphine, LAIB) of OAT prescriptions issued, individuals prescribed, and individuals initiating OAT. Interrupted time series assessed changes in quarterly OAT prescribing following the introduction of LAIB.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Between 2015 and 2023, the average annual number of OAT prescriptions issued, and the average number of recipients prescribed OAT were 47,648 and 6470, respectively. Between 2020 and 2023, the proportion of individuals initiating on LAIB increased from 7% (73/1078) to 31% (357/1146). There was increasing quarterly OAT prescribing before the introduction of LAIB, after which methadone and buprenorphine prescribing declined by 2.6% (CR 0.974; 95% CI 0.968–0.980) and 3.2% (CR 0.968; 95% CI 0.963–0.973), respectively. After being introduced, quarterly LAIB prescribing increased by 13.1% (CR 1.131; 95% CI 1.096–1.167).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion and Conclusions</h3>\u0000 \u0000 <p>We found substantial changes in OAT prescribing patterns in Victoria between 2015 and 2023, with shifts away from oral methadone and sublingual buprenorphine to LAIB. Alongside ongoing monitoring of prescribing patterns, future research should assess how LAIB impacts patient health and social outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":"44 4","pages":"983-989"},"PeriodicalIF":3.0,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dar.14049","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708964","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":"Sociocultural context of SMART recovery in Singapore: A qualitative exploration of members and facilitators perspectives and experiences","authors":"Wan Jie Tan,&nbsp;Briony Larance,&nbsp;Matthew J. Schweickle,&nbsp;Angie S. X. Lim,&nbsp;Kate Lowe,&nbsp;Peter J. Kelly","doi":"10.1111/dar.14048","DOIUrl":"10.1111/dar.14048","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Various services and mutual-aid groups, such as SMART Recovery, provide support for substance use rehabilitation in Singapore. Despite this, substance use remains a growing public health concern with a large treatment gap. This suggests potential barriers to accessing substance use treatment unique to Singapore's sociocultural context. Culture can play a significant role in shaping members' experiences. Hence, this study sought to explore members' and facilitators' experiences and perspectives of SMART Recovery within Singapore's sociocultural context.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A critical realist position guided the present study. Semi-structured, in-depth interviews were conducted with 18 participants (14 members and 4 facilitators) in 2023. Data were analysed using reflexive thematic analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Five themes were generated from the data: (i) Non-disclosure from fear of negative social evaluation; (ii) Stigma and shame surrounding the use of substances; (iii) Linguistic challenges as a barrier to participation; (iv) A ‘second family’ fostered through continued engagement with SMART Recovery; and (v) Facilitation approach and quality affected by sociocultural factors (e.g., sensitivity to relational cues). Although there were initial sociocultural challenges, this improved through continued engagement, and the experience of SMART Recovery was largely positive. Facilitators also identified that their facilitation style is influenced by sociocultural factors, which in turn affects members' experience of SMART Recovery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion and Conclusions</h3>\u0000 \u0000 <p>Members and facilitators in Singapore face sociocultural challenges that influence their experience of SMART Recovery. This study highlights the need to optimise services to the needs of this population. Future research can identify processes of change that foster members’ engagement in SMART Recovery.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":"44 4","pages":"961-974"},"PeriodicalIF":3.0,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dar.14048","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709004","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}