Drug and alcohol review最新文献

{"title":"Concerns and Experiences of Alcohol and Other Drug Healthcare Staff Regarding Intoxication Detection and Driving Safety of Opioid Treatment Clients","authors":"Daniel T. Winter,&nbsp;Gabriel A. Verón,&nbsp;Carolyn A. Day,&nbsp;Nicholas Lintzeris,&nbsp;Paul S. Haber,&nbsp;Lauren A. Monds","doi":"10.1111/dar.70144","DOIUrl":"10.1111/dar.70144","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Accurate detection and management of intoxication is critical in healthcare, particularly in alcohol and other drug (AOD) settings. While alcohol intoxication is often reliably assessed, drug intoxication is harder to detect. For clients receiving opioid agonist treatment (OAT), intoxication status can impact safety, treatment planning and driving eligibility. This study explores AOD healthcare staff confidence, training and concerns in managing intoxication and driving safety amongst OAT clients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>A cross-sectional survey was conducted with staff across 12 public AOD clinics in New South Wales, Australia. Data were collected on self-reported confidence and training regarding client intoxication and driving safety, concerns and experiences managing intoxicated OAT clients, and substances of concern for intoxication and driving safety.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Seventy-nine staff (58% nursing, 19% allied health, 17% medical, 6% other) completed the survey, with a median of 7 years' AOD experience. Two-thirds reported confidence managing intoxicated OAT clients, and 87% felt adequately trained. Key barriers to managing suspected intoxication included risk of aggression (72%), concern about upsetting clients (44%), and risk of incorrect assessment (38%). Half of staff (55%) reported encountering an intoxicated client in the past year. Substances of greatest concern for client intoxication and driving safety were benzodiazepines (95%), heroin (94%), alcohol (92%) and amphetamines (87%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussions and Conclusions</h3>\u0000 \u0000 <p>While many AOD staff feel relatively confident identifying and managing client intoxication, they reported concerns around managing such scenarios. Ongoing training, alongside tools or structured frameworks, may support healthcare staff to better detect and manage intoxication and driving safety of clients.</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/PMC12997014/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147472934","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":"Using Mandatory Sales Reports to Monitor Same-Day Alcohol Delivery Trends in New South Wales","authors":"Nicholas Taylor,&nbsp;Kira Button,&nbsp;Michael Livingston,&nbsp;Amy Peacock,&nbsp;William Gilmore,&nbsp;Michala Kowalski","doi":"10.1111/dar.70142","DOIUrl":"10.1111/dar.70142","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Industry reports suggest that same-day alcohol delivery service usage has increased substantially in recent years. In 2021, the New South Wales (NSW) government established a framework to reduce the risks associated with same-day deliveries, which included mandatory sales reports from retailers. Using this data, this study aims to quantify the nature of the same-day delivery market across NSW.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Six-monthly aggregate data from July 2021 to June 2024 were obtained on the volume of beer, wine and spirits self-reported by alcohol retailers as sold by same-day delivery, by delivery postcode. Frequencies were used to examine the number of retailers, postcodes and amount of alcohol sold in each reporting period. Heat maps were used to examine sales per capita by postcode. Comparisons were also made with data extracted from publicly available industry reports and national consumption estimates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Forty-nine retailers reported sales, with four accountable for 89% of alcohol sold, and only 8 retailers consistently reporting across the entire period. Market share fluctuated substantially by retailer and liquor category. Statewide per capita consumption was 0.09 L of pure alcohol in 2021–22, 0.07 in 2022–23, and 0.08 in 2023–24. Comparison to industry data suggested that on average over a litre of pure alcohol was delivered per transaction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion and Conclusion</h3>\u0000 \u0000 <p>NSW sales data has the potential to provide a unique insight into the nature of the same-day delivery market. The current level of data aggregation limits its utility; a lack of compliance checking and anomalies in the data bring its validity into question.</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/PMC12998493/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147472993","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":"Attitudes to Drug Policy in Australia, 2001–2022/23: What Does This Mean for Drug Policy Reform in Australia?","authors":"Zachary Lloyd,&nbsp;Amanda Roxburgh","doi":"10.1111/dar.70130","DOIUrl":"10.1111/dar.70130","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>We are at a critical juncture for drug policy reform. Toxic drug supply is driving unprecedented deaths in North America, with countries calling for decriminalisation. Policy reform in Australia has occurred in some states (e.g., decriminalisation in the Australian Capital Territory), stalling in others (e.g., the second supervised injecting facility [SIF] in Victoria). The objectives of this paper are to present trends in attitudes to drug policy in Australia, 2001–2022/23 and media reporting of related policies, to explore how public opinion and media attention have changed over time.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Analysis of (i) National Drug Strategy Household Survey data on attitudes to drugs/drug policies; and (ii) Factiva for media reporting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In 2022/23, Australians supported needle and syringe programs (67.8%), SIFs (58.3%), take home naloxone (60.9%) and drug checking services (64.4%). They opposed legalisation of methamphetamine (86.6%), heroin (85.6%), cocaine (78.2%) and ecstasy (75.8%), while a larger proportion supported cannabis legalisation (44.6%). Australians supported a health response to possession of drugs (57.3% for methamphetamine, 80.9% for cannabis) rather than a criminal response. Methamphetamine was increasingly reported as the drug of most concern (2.9%–42.5%), decreasing for heroin (44.9%–11.4%), 2001–2022/23. Methamphetamine media articles increased (272–2426); heroin decreased (2136–973), 2000–2023. Mentions increased for SIFs (spiking at 175, 2019) and decriminalisation/legalisation (spiking at 242, 2019).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion and Conclusions</h3>\u0000 \u0000 <p>Support for harm reduction remains high and low for legalisation. Media focused on methamphetamine, SIFs and decriminalisation/legalisation. Despite opposition towards legalisation, most Australians favoured a health response to drug use.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":"45 3","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12989179/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147462781","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":"First Survey of Non-Alcoholic Beer Labels by Producer Type","authors":"Molly A. Bowdring,&nbsp;Judith J. Prochaska","doi":"10.1111/dar.70138","DOIUrl":"10.1111/dar.70138","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Non-alcoholic beverages that mirror alcohol are growing in popularity and availability. Regulations are needed to maximise their potential for positive public health impact. In the United States, labelling of non-alcoholic beers (defined as &lt; 0.5% alcohol by volume) is largely self-regulated. The objective of this work was to characterise US non-alcoholic beer labelling practices.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We purchased non-alcoholic beers from 47 distinct producers available from an online national distributor. We coded labels for: alcohol content (terminology [alcohol-free or non-alcoholic] and alcohol by volume [%]), nutritional content (calories, carbohydrates, protein, fat), health warnings (pregnancy, alcohol-sensitivity, general health and other) and age-restrictions (assessed in relation to state-wide age restrictions). We report descriptives split by producer type: non-alcoholic only versus full-strength and non-alcoholic (dual).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 47 labels evaluated, all reported alcohol content using both alcohol by volume and terminology. Among beers from non-alcoholic only producers, 80% included caloric, carbohydrate, protein and fat content, compared to 60% from dual producers. Less than a quarter of labels included any type of health warning (all from dual producers) and only five labels communicated an age restriction (all from dual producers, none made in or imported to states with age restrictions).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion and Conclusion</h3>\u0000 \u0000 <p>Variation in non-alcoholic beer labelling highlights inconsistencies that could be addressed by federal regulations. Non-alcoholic only producers had labels more consistent with soft drink labels, whereas more dual producers included a health warning or age-restriction (though this practice was still rare).</p>\u0000 </section>\u0000 </div>","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":"45 3","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147430992","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":"SMART Family and Friends Mutual-Help Groups: Findings From a Mixed-Methods Formative Implementation Evaluation","authors":"Alison K. Beck,&nbsp;Rebecca M. Gray,&nbsp;Megan Wells,&nbsp;Frank P. Deane,&nbsp;Briony Larance,&nbsp;Leanne Hides,&nbsp;Victoria Manning,&nbsp;Amanda L. Baker,&nbsp;Anthony Shakeshaft,&nbsp;Elizabeth Dale,&nbsp;Angela Argent,&nbsp;Peter J. Kelly","doi":"10.1111/dar.70137","DOIUrl":"10.1111/dar.70137","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Improving support for people affected by another's substance use disorder (affected family members [AFM]) is a priority, but implementation is challenging. This mixed-methods evaluation assessed the perceived effectiveness of SMART Family and Friends training and applied the Consolidated Framework for Implementation Research (CFIR) to examine program implementation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p><i>N</i> = 24 participants with professional or lived experience of supporting AFMs were recruited and trained to deliver groups. Training was evaluated using the Work Practice Questionnaire. Semi-structured interviews (<i>n</i> = 19) captured experiences of training and group delivery. Transcripts were analysed using iterative categorisation, informed by CFIR domains.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Participants felt equipped to deliver groups (<i>M</i> = 20.79, SD = 3.09) and found the training useful (<i>M</i> = 28.40, SD = 2.74) and relevant (<i>M</i> = 27.16, SD = 2.85). The approach, applicability and structure of the intervention (intervention characteristics) promoted engagement. Workplace characteristics influenced time and resources available to support implementation, with adequate staffing paramount (inner setting). Participants identified a clear need for the program, but practical and attitudinal barriers complicated engagement (outer setting). Lived experience promoted facilitator engagement and also raised wellbeing and training considerations (individual characteristics). Challenges associated with delivery modality and experiences facilitating groups (implementation process) were identified.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion and Conclusions</h3>\u0000 \u0000 <p>SMART Family and Friends has potential for scaled implementation by peers and providers within voluntary positions and those employed within existing AOD and community service programs, although service limitations and barriers around help-seeking may hinder delivery. Efforts to address training and infrastructure considerations, particularly among those with lived experience, are needed. Improved understanding of the support needs and preferences of AFMs is warranted.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":"45 3","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12969542/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147376466","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 Opioid Agonist Treatment for Opioid Dependence During Pregnancy: A Population-Based Study in New South Wales 2005–2021","authors":"Duong Thuy Tran,&nbsp;Bianca Varney,&nbsp;Nicola Jones,&nbsp;Chrianna Bharat,&nbsp;Jonathan Brett,&nbsp;Ju-Lee Oei,&nbsp;Sallie-Anne Pearson,&nbsp;Louisa Degenhardt,&nbsp;Alys Havard","doi":"10.1111/dar.70139","DOIUrl":"10.1111/dar.70139","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The objective of this study was to examine trends in opioid agonist treatment (OAT) during pregnancy for opioid dependence, by OAT type (methadone, buprenorphine) and during-pregnancy OAT type change.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data linkage study. The cohort included pregnancies resulting in childbirth among people who received OAT within 4 years prior to birth, New South Wales, 1 January 2005–31 December 2021. We calculated the prevalence of OAT during pregnancy by OAT type and year of birth; prevalence rate ratios (PRR) and proportions experiencing OAT type change during pregnancy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The cohort included 5212 childbirths among 3303 people. OAT was received in 4102 (78.7%) pregnancies. The annual prevalence of OAT during pregnancy was 77.2% in 2005, 86.2% in 2012 and 63.2% in 2021 (PRR 0.99; 95% confidence interval [CI] 0.99–1.00). Between 2005 and 2021, methadone use during pregnancy decreased from 70.9% to 37.4% (PRR 0.97; 95% CI 0.96–0.98) while buprenorphine use increased from 12.3% to 29.3% (PRR 1.07; 95% CI 1.06–1.08). Overall, changes in OAT type occurred in 226 pregnancies (5.5%). Among 971 pregnancies initially on buprenorphine, methadone was later used among 193, with this proportion decreasing over time. Of the 3131 pregnancies initially on methadone, buprenorphine was later used among only 33.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion and Conclusions</h3>\u0000 \u0000 <p>Three in four people in the cohort received OAT during pregnancy, with no statistically significant change in annual prevalence over the 2005–2021 period. Given prior evidence indicating higher rates of treatment discontinuation with buprenorphine versus methadone, the increased buprenorphine use during pregnancy highlights the need for targeted strategies to support treatment retention.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":"45 3","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12969545/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147376458","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":"‘SASADECC’—A Unique Model of Collaborative Care Between Government and Non-Government Health Services for Adolescents With Complex Substance Use Issues","authors":"David E. A. Gordon,&nbsp;Belinda Volkov,&nbsp;Arezu Akbarian,&nbsp;Lauren A. Monds,&nbsp;Mark Montebello","doi":"10.1111/dar.70109","DOIUrl":"10.1111/dar.70109","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Despite the importance of early intervention, major treatment gaps exist for adolescents with substance use issues. This report describes a unique collaboration between government and non-government health services—The Specialist Addiction Service for Adolescents (SASA) adolescent addiction psychiatry service and Sydney Drug Education and Counselling Centre youth alcohol and other drug counselling service.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The collaboration developed organically from available resources and close collaboration between the services. Informal client and referrer feedback, demographic data, outcome measures and clinical notes (2019–2022) were reviewed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Feedback on the collaboration was positive overall. There were 149 Sydney Drug Education and Counselling Centre clients seen by SASA during the study period. Of these, 50 study participants were identified with valid serial outcome measures (VSOM) for analysis. Study participants did not differ significantly in demographics and primary drug of concern compared to all clients (with and without VSOM) combined. Overall, participants showed statistically significant improvements between entry and exit scores for the Severity of Dependence Scale, and for the Depression Anxiety Stress Scales—Short Form (DASS21) depression and the anxiety subscales, but not for the stress subscale. The majority of participants reported improvements towards substance use goals and psychological function. Many also improved in other areas of concern including social-occupation function and risk issues.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion and Conclusions</h3>\u0000 \u0000 <p>The collaboration provides a useful model of collaborative care between government and non-government services for adolescents with substance use issues. This paper reflects on learnings from the model for consideration in future service developments.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":"45 3","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12971295/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147389841","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":"Prevalence, Associations and Comorbidity of Cannabis Use and Cannabis Use Disorders in the Australian National Mental Health Surveys From 2007 to 2020–22","authors":"Jack Wilson,&nbsp;Matthew Sunderland,&nbsp;Siobhan O’Dean,&nbsp;Tim Slade,&nbsp;Danielle Dawson,&nbsp;Olivia Dobson,&nbsp;Janni Leung,&nbsp;Gary Chan,&nbsp;Maree Teesson,&nbsp;Wayne Hall,&nbsp;Nicola Newton,&nbsp;Valentina Lorenzetti,&nbsp;Emily Stockings","doi":"10.1111/dar.70134","DOIUrl":"10.1111/dar.70134","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>As cannabis policies become more liberal, and products increasingly potent, it is important to monitor changes in rates of cannabis use and those at risk of harm. We used data from the largest national mental health survey in Australia to examine changes in prevalence, associations and comorbidity of past 12-month cannabis use and cannabis use disorder (CUD) from 2007 to 2020–22.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data were drawn from the two most recent Australian National Surveys of Mental Health and Wellbeing (age range: 16–85): 2007 (<i>n</i> = 8841) and 2020–22 (<i>n</i> = 15,893). The prevalence of use and CUD were estimated and logistic regression was used to examine associations between individual characteristics and cannabis use outcomes, as well as changes in strength of association over time.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Prevalence of recent cannabis use was stable from 2007 (6.7%, 95% CI 6.0%, 7.3%) to 2020–22 (6.7%, 95% CI 6.2%, 7.1%), as was CUD (1.0%, 95% CI 0.7%, 1.3%; 0.6%, 95% CI 0.4%, 0.8%). Respondents were significantly more likely to report CUD if they were younger (16–25 years), male, initiated cannabis use &lt; 18 years, reported recent polysubstance use, exhibited other substance and mental disorders and had visited mental health services (OR 3.26–78.00). Compared to 2007, the association between younger age and CUD was stronger in 2020–22 (OR 2.39, 95% CI 1.20, 4.77), whereas the association between polysubstance use and CUD was weaker (OR 0.42, 95% CI 0.20, 0.91).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion and Conclusions</h3>\u0000 \u0000 <p>Findings suggest that population-level use and CUD may have remained stable over time, but young people may now be more vulnerable to developing CUD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":"45 3","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12968346/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147376377","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 the Utility and Appropriateness of Dose Thresholds for Issuing of Public Drug Alerts on High-Dose MDMA: A Qualitative Study","authors":"Jack Freestone,&nbsp;Harriet MacDonald,&nbsp;Stassi Kypri,&nbsp;Brendan Clifford,&nbsp;Krista J. Siefried,&nbsp;Nadine Ezard","doi":"10.1111/dar.70140","DOIUrl":"10.1111/dar.70140","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Drug alerts are sometimes issued when samples are found to exceed a pre-determined dose threshold. In Australia, it is common for alerts to be issued when MDMA pills contain ≥ 150 mg of MDMA free-base or 179 mg hydrochloride. Nineteen such alerts were issued in Australia in 2024, raising concerns that repeat alerts may lose impact over time. This study examined experts' viewpoints on the appropriateness and utility of using a 150 mg threshold to trigger high-dose MDMA alerts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Fifteen participants responsible for the design and dissemination of drug-alerts in Australia completed an online survey and seven participated in a focus group. The survey and focus group elicited reflections on the use of thresholds when issuing alerts about high-dose MDMA. Data were thematically analysed using a qualitative description methodology.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Although thresholds are binary and cannot account for evolving trends in MDMA manufacture or consumption, most agreed that 150 mg free-base is a reasonable threshold for issuing alerts. It was noted that 150 mg of MDMA may cause harm, that high-dose alerts are contingent on a threshold, and that thresholds enable rapid communications. Due to Australia's limited capacity to monitor community perceptions of alerts, there was little evidence to justify a change in the threshold.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion and Conclusions</h3>\u0000 \u0000 <p>Notifying communities about products containing ≥ 150 mg MDMA remains a harm-reduction priority. Establishing a database containing dosage and purity results for all analytically tested samples and increasing efforts to monitor community responses to and perceptions of drug alerts may improve future risk communication.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":"45 3","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12968355/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147376387","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":"Illegal Drug Use, Sleep, and Mental Health Amongst Young Women Living in the Slums of Kampala","authors":"Rachel Culbreth,&nbsp;Karen Nielsen,&nbsp;Kate Mobley,&nbsp;Jane Palmier,&nbsp;Anna Kavuma,&nbsp;Rogers Kasirye,&nbsp;Monica H. Swahn","doi":"10.1111/dar.70120","DOIUrl":"10.1111/dar.70120","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>This study sought to evaluate correlates of illegal drug use amongst young women living in the slums of Kampala who are at a heightened risk of substance use due to environmental adversities and social inequities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Baseline survey and urine drug screen (UDS) data amongst young women living in the slums of Kampala were utilised from the TOPOWA (meaning ‘empowerment’) cohort study. A composite measure of illegal drug use, consisting of self-reported use or positive UDS, was assessed for associations with sociodemographic characteristics (age, religion, education, parental living status and biological children) and psychosocial variables (post-traumatic stress disorder, mental health quality, sleep quality and transactional sex/sex work).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 300 total participants, 44 (14.7%) self-reported drug use or had positive UDS results. Khat was the most common drug detected in UDS results (<i>n</i> = 12) and from self-report (<i>n</i> = 33). The distribution of sleep quality differed; those with drug use had a higher reported percentage of fairly bad (20.5%) and very bad (13.6%) sleep quality (<i>p</i> = 0.002). In multivariable models, sleep quality was associated with lower odds of any drug use (OR 0.45; 95% CI 0.26, 0.74) and transactional sex was associated with higher odds of any drug use (OR 2.39; 95% CI 1.18, 4.89).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion and Conclusions</h3>\u0000 \u0000 <p>While the prevalence of illegal drug use in this study is lower than previous research on adolescents in Uganda, targeted prevention programs highlighting the risks associated with poor sleep and transactional sex for young women living in the slums of Kampala are recommended.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":"45 3","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147376406","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}