Drug and alcohol review最新文献

{"title":"Risky Drinking in Midlife Men: Insights From Australia's National Drug Strategy Household Survey","authors":"Stefano Zaccagnini,&nbsp;Ashlea Bartram,&nbsp;Michael Livingston,&nbsp;James A. Smith,&nbsp;Nataly Bovopoulos,&nbsp;Jacqueline Bowden","doi":"10.1111/dar.70149","DOIUrl":"10.1111/dar.70149","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Australian midlife men are more likely to drink exceeding Australia's Alcohol guidelines for adults compared to midlife women. Despite this, there is a paucity of research investigating the factors associated with risky drinking for midlife men to inform preventive health efforts. This study investigates these factors and how they differ between younger and older midlife men.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Secondary data analysis was conducted using the 2019 and 2022/23 waves of the National Drug Strategy Household Survey. Data for midlife men (aged 30–59 years, <i>n</i> = 6471) were analysed, comprising younger (aged 30–44 years, <i>n</i> = 3311) and older (45–59 years, <i>n</i> = 3160) midlife age groups. Associations between behavioural, psychological and demographic factors and risky drinking, and interactions with midlife age groups were examined using chi-square and multivariable logistic regression analyses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall, 42.9% of midlife men reported risky drinking. Past year tobacco (OR = 1.70, CI = 1.35–2.14) and illicit/non-medicinal drug use (OR = 3.54, CI = 2.92–4.31), residing in Rural/Remote/Regional locations (OR = 1.76, CI = 1.48–2.11), higher psychological distress scores (OR = 1.37, CI = 1.05–1.79), working managerial (OR = 1.48, CI = 1.14–1.91) or tech/trade (OR = 1.48, CI = 1.17–1.87) occupations, and higher household earnings (OR = 1.70, CI = 1.41–2.06) were all significantly associated with risky drinking. Greater psychological distress scores were significantly associated with risky drinking among younger (OR = 0.49, CI = 0.32–0.75), but not older midlife men, while being married/de facto relationship was significantly associated with risky drinking among older (OR = 1.55, CI = 1.01–2.39), but not younger midlife men.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion and Conclusion</h3>\u0000 \u0000 <p>This study highlights a range of modifiable and non-modifiable factors that may inform the development of future preventive health policy and practise strategies for this high prevalence group.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":"45 4","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dar.70149","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147671368","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":"Exploring Age and Sex Differences in the Use of Cannabis Vaping Products: Results From the Canadian Cannabis Survey 2020–2023","authors":"Fathima Fataar,&nbsp;Matthew J. Dann,&nbsp;Samantha Goodman,&nbsp;Hanan Abramovici","doi":"10.1111/dar.70155","DOIUrl":"10.1111/dar.70155","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Use of cannabis vaping products has been increasing in Canada. This study examined the prevalence and patterns of use of cannabis vaping products, including higher-risk use, by sex and age.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data were from four cycles of the Canadian Cannabis Survey, an annual web-based survey of people aged ≥ 16 years in Canada. Past 12-month consumers of cannabis for non-medical purposes were analysed (<i>n</i>₂₀₂₀ = 3405; <i>n</i>₂₀₂₁ = 2802; <i>n</i>₂₀₂₂ = 2801; <i>n</i>₂₀₂₃ = 2972). Cannabis vaping measures included frequency of use and co-use with nicotine or tobacco. Logistic regression models tested differences in outcomes, overall and by sex and age.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among past 12 month cannabis consumers, use of cannabis vaping products in the past 12 months increased from 22% (95% CI 20%–23%) in 2020 to 37% (95% CI 35%–39%) in 2023, with increases in all sex and age categories, most notably youth (16–19 years) whose use doubled from 33% (95% CI 27%–38%) to 66% (95% CI 60%–72%). Daily/almost daily use of cannabis vaping products also increased overall, from 2% (95% CI 1%–2%) in 2020 to 6% (95% CI 5%–7%) in 2023. There were few sex differences in patterns of use. The proportion of vaping product consumers classified as low risk increased from 13% (95% CI 10.3–16.6) in 2020 to 22% (95% CI 19.1–24.7) in 2023. The proportion classified as high risk also increased, while the proportion classified as moderate risk decreased.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion and Conclusions</h3>\u0000 \u0000 <p>Following legalization (2020 to 2023), there was a continued increase in the use of cannabis vaping products, especially among youth. Continued monitoring as well as additional public education efforts, especially related to potency and risks of vaping, are warranted.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":"45 4","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dar.70155","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147671424","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":"Features of Alcohol Harm Reduction Campaigns That Resonate With Older Adults: Insights From an Australian Qualitative Study Using Prompt Videos","authors":"Tina Lam,&nbsp;Nilakshi Gunatillaka,&nbsp;Aislinn Lalor,&nbsp;Michael Savic,&nbsp;Laura Alfrey,&nbsp;Jasmin Grigg,&nbsp;Peta Stragalinos,&nbsp;Nazgol Karimi,&nbsp;Suzanne Nielsen","doi":"10.1111/dar.70147","DOIUrl":"10.1111/dar.70147","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Many countries around the world including Australia, New Zealand, England and the United States of America face increasing alcohol use and alcohol-related harms amongst the ageing population. Despite alcohol being linked to diseases such as cancer and dementia, many conventional alcohol harm reduction campaigns don't resonate with older audiences. This qualitative study aimed to investigate what features of alcohol harm reduction campaigns appeal to a middle-aged and older audience.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In-depth interviews were conducted with 45 Australian participants aged 54–74 years (mean age 62 years, 62% female, 42% drinking beyond national guidelines). Data analysis followed an inductive thematic approach.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Participants reflected on the construction of their own drinking identities, provided feedback on six pre-existing alcohol harm reduction campaigns, and expressed their preferences for future campaigns. Some participants felt defensive or conflicted about whether alcohol harm reduction campaigns would be appropriate or effective with their demographic. Despite this, participants broadly endorsed campaigns that employed a more positive tone, provided practical advice, and were delivered by a relatable messenger.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion and Conclusion</h3>\u0000 \u0000 <p>Findings suggest the use of motivational messaging, as delivered by a non-authoritarian and gender-matched messenger, for future campaigns with this demographic may reduce expressed resistance to health messaging. This large qualitative study generated rich, novel, and nuanced accounts of older adults' perspectives on alcohol harm reduction campaigns.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":"45 4","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13046093/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147607978","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":"Executive Functions in Alcohol Use Disorder: The Positive Role of Neuropsychological Rehabilitation—Prospective Cohort Study","authors":"Sónia Ferreira,&nbsp;Leonor Bacelar-Nicolau,&nbsp;Maria Oliveira,&nbsp;Samuel Pombo,&nbsp;Enrique Vásquez-Justo,&nbsp;Cristina Ribeiro","doi":"10.1111/dar.70154","DOIUrl":"10.1111/dar.70154","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Executive functioning (EF) consists of basic components (inhibition, working memory [WM] and flexibility) and more complex components that depend on the proper functioning of the basic components. Deficits in EF are common in alcohol use disorder (AUD) and can impact treatment effectiveness and quality of life. This study examined the impact of neuropsychological rehabilitation (NR) on improving these functions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>A prospective observational cohort study was conducted in an AUD treatment unit, with three evaluation points: baseline and after 3 and 6 months. The study compared EF recovery in patients undergoing group therapy for AUD (WTG: weekly therapeutic groups; NRG: NR group). The sample consisted of 65 participants who underwent medically assisted detoxification from April 2021 to August 2023. The following instruments were administered: a sociodemographic questionnaire, the Hospital Anxiety and Depression Scale, the Dependency Severity Questionnaire, the Frontal Assessment Battery (FAB), the Wisconsin Card Sorting Test, the Trail Making Test, the Verbal Fluency Test, the Wechsler Adult Intelligence Scale and the Colour and Word Test—Stroop. Statistical procedures included parametric and nonparametric tests and linear mixed-effects models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>EF improved in both groups, but the NRG showed a higher increase in The FAB after 3 months, which was reflected in better performance in its key components (WM and flexibility). This improvement was maintained 6 months after the start of treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion and Conclusions</h3>\u0000 \u0000 <p>Integrating NR into AUD treatments appears to contribute to greater and faster improvement.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":"45 4","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147590732","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":"What Are the Characteristics of Households That Purchase Alcohol-Free and Low-Alcohol Drinks in Great Britain in 2018 and 2021?","authors":"Zoe L. Clarke,&nbsp;Robert Pryce,&nbsp;John Holmes,&nbsp;Abigail K. Stevely,&nbsp;Luke B. Wilson,&nbsp;Inge Kersbergen","doi":"10.1111/dar.70146","DOIUrl":"10.1111/dar.70146","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The increasing popularity of alcohol-free and low-alcohol (NoLo) drinks could reduce alcohol-related harm if those at greatest risk replace their standard alcoholic drinks with these products. This paper aimed to identify: (i) characteristics associated with occasional purchase of NoLo drinks in Great Britain in 2021; and (ii) whether these characteristics changed between 2018 and 2021.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Logistic regression using data from Worldpanel by Numerator dataset detailing alcoholic and NoLo drink purchases in the off-trade (i.e., shops) by households in Great Britain in 2018 (<i>n</i> = 14,702) and 2021 (<i>n</i> = 15,257). The primary outcome was occasional NoLo purchasing (≥ 4 times in the past year), and secondary outcomes were occasional NoLo beer, cider or wine purchasing.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In 2021, 5.7% of households purchased NoLo ≥ 4 in the past year, compared to 3.0% in 2018. In 2021, these households were more likely to be alcohol purchasers than non-purchasers [low-risk purchasers (≤ 112 g per week): OR = 7.11, <i>p</i> &lt; 0.001; increasing risk (113–280 g per week): OR = 10.72, <i>p</i> &lt; 0.001; higher risk (&gt; 280 g per week): OR = 12.10, <i>p</i> &lt; 0.001] and less likely to be from lower social grades than grade AB (Grade C2: OR = 0.72, <i>p</i> = 0.008; Grade D: OR = 0.58, <i>p</i> &lt; 0.001; Grade E: OR = 0.46, <i>p</i> &lt; 0.001). Results were similar for occasional purchasers of NoLo beer, but there was no significant association with social grade for purchasing NoLo cider or wine. The characteristics associated with occasional NoLo purchasing did not change significantly between 2018 and 2021.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion and Conclusions</h3>\u0000 \u0000 <p>Households from higher social grades who purchase more alcohol are more likely to regularly purchase NoLo products.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":"45 4","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13040626/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147590556","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":"Approach With Caution: A Pilot Randomised Controlled Trial of Approach Bias Modification for People Undergoing Residential Treatment for Methamphetamine Use Disorder","authors":"Victoria Manning,&nbsp;Danielle Whelan,&nbsp;Hugh Piercy,&nbsp;Malcolm Hopwood,&nbsp;Michael Maloney,&nbsp;Eli Kotler,&nbsp;Goke Okedara,&nbsp;Dan I. Lubman,&nbsp;Shalini Arunogiri,&nbsp;Joshua B. B. Garfield","doi":"10.1111/dar.70151","DOIUrl":"10.1111/dar.70151","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Less than one-quarter of people who attend residential rehabilitation for methamphetamine use disorder (MUD) remain abstinent for 1 year. Approach bias modification (ApBM), a cognitive training intervention, reduces relapse rates when delivered during residential rehabilitation for alcohol use disorder. However, there has been little research on ApBM for MUD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Twenty-four patients with MUD attending four residential treatment services in Melbourne were randomised, between March 2020 and August 2024, to 6 sessions of either ApBM (<i>n</i> = 10) or sham-control training (<i>n</i> = 14). Safety was monitored during the intervention and acceptability was assessed at the end of training. A blinded researcher assessed methamphetamine use, craving, and dependence severity at follow-ups 1 and 3 months after discharge from residential treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Three ApBM and five control participants experienced adverse psychological reactions to the training task, resulting in two ApBM and 1 control participants withdrawing. However, participants who completed training generally provided positive acceptability ratings (mean Endorsement and Discomfort Scale scores of 69.13 [SD = 10.93] in the ApBM group and 58.83 [SD = 13.41] in controls). Directions of differences in proportions reporting past-month abstinence at 1-month (ApBM: 5/7 [71%]; controls: 5/11 [46%]) and 3-month follow-ups (ApBM: 4/7 [57%]; controls: 3/9 [33%]) and continuous abstinence at 3-month follow-up (ApBM: 3/7 [43%]; controls: 2/11 [18%]) favoured ApBM; however, these differences did not approach significance in this very small sample. Craving and MUD severity outcomes also did not differ significantly between groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion and Conclusions</h3>\u0000 \u0000 <p>Further research on ApBM's efficacy for MUD may be warranted, but safety concerns suggest caution.</p>\u0000 \u0000 <p><b>Trial Registration:</b> Australian New Zealand Clinical Trials Registry ACTRN12620000072910. Registered on 30 January 2020 (prospectively registered): https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=378804&amp;isReview=true.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":"45 4","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13041745/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147590780","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":"Higher THC Concentration Medicinal Cannabis Products Efficacy and Safety Considerations: A Rapid Review","authors":"Myfanwy Graham,&nbsp;Dereje Assefa,&nbsp;Ngo Cong-Lem,&nbsp;Suzanne Nielsen","doi":"10.1111/dar.70145","DOIUrl":"10.1111/dar.70145","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Issues</h3>\u0000 \u0000 <p>Higher delta-9-tetrahydrocannabinol (THC) concentration medicinal cannabis products are characterised by a higher THC and minimal cannabidiol (CBD) content. This rapid review aims to systematically summarise and evaluate the available evidence regarding the efficacy and safety of higher THC potency medicinal cannabis products relevant to the Australian market in adult populations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Approach</h3>\u0000 \u0000 <p>The rapid literature review protocol was prospectively registered with Open Science Framework: https://doi.org/10.17605/OSF.IO/HNFUT. The comprehensive search (1-January-2014–30-July-2024) included Medline, EMBASE, EMCARE, CINAHL, SCOPUS and the Cochrane Central Register of Controlled Trials databases. Eligible studies (randomised controlled trials and observational studies) were screened by two independent reviewers and then extracted.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Key Findings</h3>\u0000 \u0000 <p>We identified 9969 records, resulting in 15 studies (six RCTs and nine observational), with THC concentrations of 16%–22% that met inclusion criteria. Studies examining efficacy for pain (<i>n</i> = 4), ulcerative colitis (<i>n</i> = 1) and chronic obstructive pulmonary disease (<i>n</i> = 1) reported mixed outcomes. Reported adverse events included psychiatric, nervous system and gastrointestinal effects. Validated cannabis use disorder (CUD) screening tools were notably absent from the included studies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications</h3>\u0000 \u0000 <p>Few studies have assessed products equivalent to the Australian Category 5 medicinal cannabis product definition, with most having THC concentrations lower than those available for prescription in Australia, including products reported to contain up to 88% THC. High-quality RCTs and longitudinal studies that incorporate validated CUD screening tools are needed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>No evidence was found on safety or efficacy of prescribed Category 5 medicinal cannabis products with THC concentrations above 22% w/w (220 mg/g).</p>\u0000 </section>\u0000 </div>","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":"45 4","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13040133/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147590769","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":"Rethinking Alcohol Harm Reduction","authors":"Gabriel Caluzzi","doi":"10.1111/dar.70152","DOIUrl":"10.1111/dar.70152","url":null,"abstract":"<p>Alcohol harm reduction (AHR) includes a pragmatic set of strategies to reduce the acute harms of alcohol consumption without necessarily reducing use, such as managed alcohol plans and intoxication management facilities. While well established in illicit drug research, harm reduction's application to alcohol remains less explicitly examined, both conceptually and in terms of policy articulation. In contrast to population-level consumption-reduction strategies – many of which are effective at preventing harm – AHR often places greater emphasis on acute and immediate harms and may require consumers to take an active role, a feature that has raised concerns about industry mobilising ‘responsible drinking’ narratives. AHR also tends to be subsumed within other alcohol policies and has a less consolidated evidence base. However, drawing on international and Australian evidence, this article outlines practical and ethical reasons for a more explicit focus on AHR, including the substantial burden alcohol places on frontline health systems, its disproportionate impacts on socially disadvantaged populations and its frequent involvement in polydrug use and overdose. AHR can also facilitate cross-sectoral collaboration and lateral policymaking, and contribute to the ethical obligation of policymakers to redress the harms of alcohol commercialisation. Beyond formal policy, AHR already occurs in clinical, educational and nightlife settings. Recognising this, future research and policy efforts should focus on clarifying how harm reduction can be more explicitly integrated within alcohol policy frameworks to complement population-level approaches.</p>","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":"45 4","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13036818/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147580817","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":"Systematic Review and Meta-Analysis of the Prevalence of Substance Use Among Adolescents in South Africa","authors":"Carrie Brooke-Sumner,&nbsp;Lauro Estivalete Marchionatti,&nbsp;Zeina Mneimneh,&nbsp;Nadine Harker,&nbsp;Catherine O. Egbe,&nbsp;Dan Jenkins,&nbsp;Noluthando Mpisane,&nbsp;Meghan Mosalisa,&nbsp;Yeukai Chideya,&nbsp;Nuhaa Holland,&nbsp;Lesley-Ann Erasmus-Claassen,&nbsp;Giovanni Salum,&nbsp;Jason Bantjes","doi":"10.1111/dar.70143","DOIUrl":"10.1111/dar.70143","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Substance use among young people is a growing public health concern in South Africa (SA), with implications for short- and long-term mental health, education and development. A lack of use data is among several challenges impeding progress to support young people. To address this gap, this study aimed to synthesise published prevalence data on substance use among adolescents under 19 years of age in SA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a systematic review and meta-analysis following PRISMA guidelines. Searches were run across PubMed, PsycINFO, Web of Science and Scielo. Studies reporting original SA prevalence data in community or school-based samples were included. The Joanna Briggs Institute checklist for prevalence studies was used to assess study quality. Meta-analyses were performed in R, using random effects models and heterogeneity was assessed using <i>I</i>² statistics and meta-regression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thirty publications met inclusion criteria, and these reported 202 prevalence estimates (<i>n</i> = 120,041, mean age 16.1 years). The most commonly reported substances used were alcohol (35.09%, 95% CI 23.83–48.30), tobacco (25.47%, 95% CI 14.56–33.01) and cannabis (10.47%, 95% CI 5.98–17.71) with lifetime prevalence of any substance use of 13.05%, 95% CI 9.65–17.42. Similarly, 12-month data indicated high exposure levels: alcohol 17.45% (95% CI 11.39–25.78), tobacco 11.57% (95% CI 8.92–14.88) and cannabis 6.66% (95% CI 4.82–9.13). However, substantial heterogeneity across studies was detected.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion and Conclusions</h3>\u0000 \u0000 <p>High exposure to substances in SA, especially alcohol, tobacco and cannabis, underscores the urgent need for nationally representative surveillance and evidence-based prevention efforts tailored to adolescents, to avoid progression of substance use into substance use disorder.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":"45 4","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13033819/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147572841","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":"Factors Associated With Opioid Agonist Treatment Engagement and Harm Reduction Service Use: Findings From the New South Wales Opioid Dependence Survey","authors":"Thomas Santo Jr,&nbsp;Chrianna Bharat,&nbsp;Craig Rodgers,&nbsp;Mary Harrod,&nbsp;Sophia Taylor,&nbsp;Emma Zahra,&nbsp;Rachel Sutherland,&nbsp;Amy Peacock,&nbsp;Jason Grebely,&nbsp;Matthew Hickman,&nbsp;Michael Farrell,&nbsp;Louisa Degenhardt","doi":"10.1111/dar.70132","DOIUrl":"10.1111/dar.70132","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Opioid agonist treatment (OAT) is one of the most effective treatments for opioid dependence, but there can be barriers to accessing treatment. This study examined characteristics associated with OAT engagement—never, previous or current—among people with opioid dependence in NSW, Australia, following recent reforms to OAT access.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Between October 2023 and March 2024, people with opioid dependence were recruited from services and community settings across NSW. Participants completed structured interviews on socio-demographics, mental health disorders, substance use and use of prevention and treatment services. Logistic regression was used to examine associations between participant characteristics and engagement with OAT.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 403 participants (mean age 44; 65% male), 77% were currently receiving OAT (60% methadone, 11% sublingual buprenorphine and 27% long-acting injectable buprenorphine), 13% previously and 9% never. Differences between OAT status groups included those currently receiving OAT reporting lower rates of homelessness and extra-medical opioid use, and greater group therapy engagement and past-year receipt of naloxone kits compared to those previously and never receiving OAT. Past-month daily injecting drug use was higher among those previously and never receiving OAT; those previously receiving OAT also reported the highest rate of past-year supervised injecting facility use and overdoses in the past 6 months.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion and Conclusions</h3>\u0000 \u0000 <p>Those not receiving OAT reported greater social instability, recent injecting drug use and drug-related harm. Variation in harm reduction service use suggests tailored strategies are needed to reach those outside OAT. These findings highlight the need for integrated, diverse strategies to address dependence-related harms.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":"45 3","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12998408/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147472906","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}