{"title":"Emerging Risks of Nitazene-Adulterated Vapes in Australia: Balancing Regulation, Access and Harm Reduction","authors":"James Martin, Jennifer L. Schumann","doi":"10.1111/dar.70081","DOIUrl":"10.1111/dar.70081","url":null,"abstract":"","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":"45 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146046220","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}
Emma L. Keller, Brock Peake, Bradley S. Simpson, Marie Longo, Jason M. White, Cobus Gerber
Introduction
The residue analysis of disposed paraphernalia from people who inject drugs is a novel way to discern drug taking behaviours. This study aimed to investigate the presence of conventional and novel psychoactive substances (NPS) in drug paraphernalia in South Australia.
Methods
Drug paraphernalia were collected in November and December 2024 from sharps disposal bins at three needle and syringe program locations. A total of 300 items of paraphernalia were taken from bins, including syringes, bags, drug storage vials/containers and filters. The items were rinsed with methanol, the solvent filtered and prepared for analysis using a Sciex 6500 + QTrap liquid chromatography tandem mass spectrometry (LC–MS/MS) and detections confirmed using authentic reference materials.
Results
A high proportion of paraphernalia contained methamphetamine (61%) and/or heroin (38%). A majority (57%) of the items analysed contained 2 or more drugs. In total, 14 different NPS were detected across 46 items of paraphernalia.
Discussion and Conclusions
The large number of paraphernalia items that had multiple drugs detected was likely an indication of polysubstance use. Residue analysis of drug paraphernalia is an objective approach to complement those currently used to ascertain drug trends, which strengthens harm reduction and public health responses to drug use. This study shows that drug residue analysis is feasible, non-invasive and effective, providing a near-real time approach to monitor the appearance of high potency NPS and other drugs being consumed, and determining trends in conventional substance use by people who inject drugs.
{"title":"Traces of Use: Uncovering Drug Use Insights From Paraphernalia Analysis","authors":"Emma L. Keller, Brock Peake, Bradley S. Simpson, Marie Longo, Jason M. White, Cobus Gerber","doi":"10.1111/dar.70105","DOIUrl":"10.1111/dar.70105","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The residue analysis of disposed paraphernalia from people who inject drugs is a novel way to discern drug taking behaviours. This study aimed to investigate the presence of conventional and novel psychoactive substances (NPS) in drug paraphernalia in South Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Drug paraphernalia were collected in November and December 2024 from sharps disposal bins at three needle and syringe program locations. A total of 300 items of paraphernalia were taken from bins, including syringes, bags, drug storage vials/containers and filters. The items were rinsed with methanol, the solvent filtered and prepared for analysis using a Sciex 6500 + QTrap liquid chromatography tandem mass spectrometry (LC–MS/MS) and detections confirmed using authentic reference materials.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A high proportion of paraphernalia contained methamphetamine (61%) and/or heroin (38%). A majority (57%) of the items analysed contained 2 or more drugs. In total, 14 different NPS were detected across 46 items of paraphernalia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion and Conclusions</h3>\u0000 \u0000 <p>The large number of paraphernalia items that had multiple drugs detected was likely an indication of polysubstance use. Residue analysis of drug paraphernalia is an objective approach to complement those currently used to ascertain drug trends, which strengthens harm reduction and public health responses to drug use. This study shows that drug residue analysis is feasible, non-invasive and effective, providing a near-real time approach to monitor the appearance of high potency NPS and other drugs being consumed, and determining trends in conventional substance use by people who inject drugs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":"45 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12831012/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146040633","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}
Daniel Dutkiewicz, Hester Wilson, Thanjira Jiranantakan, Peter Chisholm, Kaniz Fatema, Mark Hardy
Introduction
Nitazenes, benzimidazole synthetic potent opioid μ-receptor agonists, have been implicated in increased risk for opioid toxicity. Subtypes of nitazenes, including protonitazene, have been recently detected in multiple overdose cases in Australia. We describe a case report of protonitazene dependence, inpatient withdrawal management and induction onto opioid dependence treatment.
Case Presentation
A 22-year-old man with no significant medical history presented to a metropolitan emergency department in opioid withdrawal after regular vaping of a product sold as cannabinoids. He required higher than expected buprenorphine doses and other standard treatment including diazepam and olanzapine to manage opioid withdrawal. Blood and urine samples taken in the emergency department later tested positive for protonitazene. Analysis of the vaping liquid was only positive for protonitazene. He was discharged for outpatient follow-up to later receive a 300 mg subcutaneous buprenorphine monthly injection.
Discussion and Conclusions
This case describes the clinical presentation of dependence, withdrawal and buprenorphine induction for opioid dependence due to chronic protonitazene vaping. Future research may help guide optimal doses of buprenorphine to manage nitazene withdrawal. Vaping devices have increased in popularity, especially amongst youth, which poses public health risks to the community if adulterated with other substances. Detection of nitazenes currently requires specialised laboratories. Protonitazene withdrawal management was complex in this case report. Youth are at risk of harms in vaping products adulterated with other substances, including nitazenes. State-wide toxicosurveillance programs, such as the NSW PRISE program, are essential for coordinating detection, clinical management and community awareness of nitazenes.
{"title":"Management of Opioid Withdrawal Syndrome and Commencement of Opioid Dependence Treatment Following Chronic Use of a Vaping Product Containing Protonitazene: Case Report","authors":"Daniel Dutkiewicz, Hester Wilson, Thanjira Jiranantakan, Peter Chisholm, Kaniz Fatema, Mark Hardy","doi":"10.1111/dar.70104","DOIUrl":"10.1111/dar.70104","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Nitazenes, benzimidazole synthetic potent opioid μ-receptor agonists, have been implicated in increased risk for opioid toxicity. Subtypes of nitazenes, including protonitazene, have been recently detected in multiple overdose cases in Australia. We describe a case report of protonitazene dependence, inpatient withdrawal management and induction onto opioid dependence treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case Presentation</h3>\u0000 \u0000 <p>A 22-year-old man with no significant medical history presented to a metropolitan emergency department in opioid withdrawal after regular vaping of a product sold as cannabinoids. He required higher than expected buprenorphine doses and other standard treatment including diazepam and olanzapine to manage opioid withdrawal. Blood and urine samples taken in the emergency department later tested positive for protonitazene. Analysis of the vaping liquid was only positive for protonitazene. He was discharged for outpatient follow-up to later receive a 300 mg subcutaneous buprenorphine monthly injection.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion and Conclusions</h3>\u0000 \u0000 <p>This case describes the clinical presentation of dependence, withdrawal and buprenorphine induction for opioid dependence due to chronic protonitazene vaping. Future research may help guide optimal doses of buprenorphine to manage nitazene withdrawal. Vaping devices have increased in popularity, especially amongst youth, which poses public health risks to the community if adulterated with other substances. Detection of nitazenes currently requires specialised laboratories. Protonitazene withdrawal management was complex in this case report. Youth are at risk of harms in vaping products adulterated with other substances, including nitazenes. State-wide toxicosurveillance programs, such as the NSW PRISE program, are essential for coordinating detection, clinical management and community awareness of nitazenes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":"45 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146040607","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}
MohammadHossein Hadi, Sanjib Saha, Dennis Petrie, Maame Esi Woode, Ulf-Göran Gerdtham
Issues
Although alcohol consumption is linked to atrial fibrillation (AF), the relationship across different intake levels and between sexes remains unclear. This study presents the first network meta-analysis of prospective cohort studies bringing greater precision to these associations.
Approach
A systematic review identified five meta-analyses on alcohol and AF risk. From these, 13 cohort studies totalling over 80 million person-years were included in a random-effects network meta-analysis, including sex-stratified analyses.
Key Findings
Compared to low-level consumption (< 12 g/day), moderate intake (12–< 24 g/day) slightly increased AF risk (hazard ratio [HR] = 1.07; 95% confidence interval [CI] 1.04–1.10), similar at 24–< 36 g/day (HR = 1.09; 95% CI 1.00–1.20). No significant risk increase was observed for 36–< 60 g/day. Heavy consumption (≥ 60 g/day) showed the highest risk (HR = 2.84; 95% CI 1.57–5.14). Non-drinkers (‘Former’, ‘Never’ or ‘Occasional’) had HRs near 1, except ‘None’, which showed a slight increase (HR = 1.08; 95% CI 1.04–1.11).
Implications
In males, moderate consumption increased AF risk slightly, while heavy intake had a more pronounced effect (HR = 1.49; 95% CI 1.22–1.81). In females, moderate intake had no significant effect, but heavy intake significantly increased risk (HR = 2.53; 95% CI 1.05–6.08).
Conclusion
This network meta-analysis shows a nonlinear relationship between alcohol consumption and AF risk. Low-level or occasional intake poses the lowest risk. In males, moderate consumption slightly increases AF risk, while in females, risk rises substantially only with heavy intake. These findings support limiting alcohol consumption to reduce AF risk and highlight the need for further sex-stratified studies and consideration of sex-specific recommendations.
Registration
This network meta-analysis is a split review of an overview of reviews examining alcohol-attributable health and social harms, registered under PROSPERO ID442338.
问题：虽然饮酒与房颤（AF）有关，但不同摄入量和性别之间的关系尚不清楚。本研究首次提出了前瞻性队列研究的网络荟萃分析，使这些关联更加精确。方法：一项系统综述确定了5项关于酒精和房颤风险的荟萃分析。从这些研究中，13项队列研究总计超过8000万人年被纳入随机效应网络荟萃分析，包括性别分层分析。主要发现：与低水平摄入相比(提示：在男性中，适度摄入会略微增加房颤风险，而大量摄入则有更明显的影响（HR = 1.49; 95% CI 1.22-1.81）。在女性中，适度摄入无显著影响，但大量摄入显著增加风险（HR = 2.53; 95% CI 1.05-6.08）。结论：该网络荟萃分析显示饮酒与房颤风险之间存在非线性关系。少量或偶尔摄入的风险最低。在男性中，适量摄入会轻微增加房颤风险，而在女性中，只有大量摄入才会显著增加房颤风险。这些发现支持限制饮酒以降低房颤风险，并强调需要进一步的性别分层研究和考虑性别特异性建议。注册：该网络荟萃分析是一项针对酒精导致的健康和社会危害的综述的拆分性综述，注册号为PROSPERO ID442338。
{"title":"Alcohol Consumption and Atrial Fibrillation Risk: An Overview of Systematic Reviews and Network Meta-Analysis","authors":"MohammadHossein Hadi, Sanjib Saha, Dennis Petrie, Maame Esi Woode, Ulf-Göran Gerdtham","doi":"10.1111/dar.70089","DOIUrl":"10.1111/dar.70089","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Issues</h3>\u0000 \u0000 <p>Although alcohol consumption is linked to atrial fibrillation (AF), the relationship across different intake levels and between sexes remains unclear. This study presents the first network meta-analysis of prospective cohort studies bringing greater precision to these associations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Approach</h3>\u0000 \u0000 <p>A systematic review identified five meta-analyses on alcohol and AF risk. From these, 13 cohort studies totalling over 80 million person-years were included in a random-effects network meta-analysis, including sex-stratified analyses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Key Findings</h3>\u0000 \u0000 <p>Compared to low-level consumption (< 12 g/day), moderate intake (12–< 24 g/day) slightly increased AF risk (hazard ratio [HR] = 1.07; 95% confidence interval [CI] 1.04–1.10), similar at 24–< 36 g/day (HR = 1.09; 95% CI 1.00–1.20). No significant risk increase was observed for 36–< 60 g/day. Heavy consumption (≥ 60 g/day) showed the highest risk (HR = 2.84; 95% CI 1.57–5.14). Non-drinkers (‘Former’, ‘Never’ or ‘Occasional’) had HRs near 1, except ‘None’, which showed a slight increase (HR = 1.08; 95% CI 1.04–1.11).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications</h3>\u0000 \u0000 <p>In males, moderate consumption increased AF risk slightly, while heavy intake had a more pronounced effect (HR = 1.49; 95% CI 1.22–1.81). In females, moderate intake had no significant effect, but heavy intake significantly increased risk (HR = 2.53; 95% CI 1.05–6.08).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This network meta-analysis shows a nonlinear relationship between alcohol consumption and AF risk. Low-level or occasional intake poses the lowest risk. In males, moderate consumption slightly increases AF risk, while in females, risk rises substantially only with heavy intake. These findings support limiting alcohol consumption to reduce AF risk and highlight the need for further sex-stratified studies and consideration of sex-specific recommendations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Registration</h3>\u0000 \u0000 <p>This network meta-analysis is a split review of an overview of reviews examining alcohol-attributable health and social harms, registered under PROSPERO ID442338.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":"45 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146003308","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}
The growing accessibility of movies through streaming platforms has expanded audience reach, but also increases exposure to alcohol portrayals, which is an established risk factor for alcohol use. Hence, estimating alcohol depictions is important yet challenging due to the time and labor involved. Artificial Intelligence offers a scalable solution for analysing movie frames; however, processing every frame of a full-length movie at 25 frames per second (fps) requires extensive computational resources. Thus, we aimed to test whether lower-frequency sampling would affect the accuracy of alcohol exposure estimates.
Methods
We analysed 20 feature-length movies with varying known alcohol visibility and analysed each frame using zero-shot predictions from a LLaVA v1.6 model (accuracy = 95%) as our baseline. We applied uniform downsampling from 25 fps (full-framerate) to 1 fps and sparse interval sampling of 1 frame per N seconds (N = 1,2,…,10), measuring both alcohol-proportion estimates and execution time. To assess the sampling-induced error, we computed the difference score, as the difference between sampled and full-frame alcohol proportions.
Results
A sampling frequency of 1 fps yielded an average difference score below 0.10 compared to the full-frame analysis, while reducing execution time by 25-fold. Error increased at sparser intervals, reaching a difference score of 0.46 at one frame per 10 s.
Discussion and Conclusion
Reducing the sampling frequency from 25 to 1 fps resulted in only a minimal loss of accuracy but a substantial reduction in execution time. This finding supports 1 fps as a practical and scalable sampling frequency for large-scale movie alcohol exposure estimation.
{"title":"A Scalable Sampling Approach for Artificial Intelligence-Based Alcohol Content Estimation in Movies","authors":"Samatha Pararath Salim, Zhen He, Emmanuel Kuntsche, Joshua Millward, Benjamin Riordan","doi":"10.1111/dar.70098","DOIUrl":"10.1111/dar.70098","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The growing accessibility of movies through streaming platforms has expanded audience reach, but also increases exposure to alcohol portrayals, which is an established risk factor for alcohol use. Hence, estimating alcohol depictions is important yet challenging due to the time and labor involved. Artificial Intelligence offers a scalable solution for analysing movie frames; however, processing every frame of a full-length movie at 25 frames per second (fps) requires extensive computational resources. Thus, we aimed to test whether lower-frequency sampling would affect the accuracy of alcohol exposure estimates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analysed 20 feature-length movies with varying known alcohol visibility and analysed each frame using zero-shot predictions from a LLaVA v1.6 model (accuracy = 95%) as our baseline. We applied uniform downsampling from 25 fps (full-framerate) to 1 fps and sparse interval sampling of 1 frame per N seconds (<i>N</i> = 1,2,…,10), measuring both alcohol-proportion estimates and execution time. To assess the sampling-induced error, we computed the difference score, as the difference between sampled and full-frame alcohol proportions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A sampling frequency of 1 fps yielded an average difference score below 0.10 compared to the full-frame analysis, while reducing execution time by 25-fold. Error increased at sparser intervals, reaching a difference score of 0.46 at one frame per 10 s.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion and Conclusion</h3>\u0000 \u0000 <p>Reducing the sampling frequency from 25 to 1 fps resulted in only a minimal loss of accuracy but a substantial reduction in execution time. This finding supports 1 fps as a practical and scalable sampling frequency for large-scale movie alcohol exposure estimation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":"45 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145997642","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}
Olivier Droulers, Arnaud Bigoin Gagnan, Sophie Lacoste-Badie
Introduction
The visual design of alcohol beverage packaging plays a crucial role in shaping consumer perceptions and purchase decisions, yet regulations in many countries are relatively lax. Guidelines often focus on the inclusion of health warnings rather than overall label or packaging design, giving producers considerable freedom. In recent years, wine manufacturers have increasingly featured images on their labels that are unrelated to the product, most notably animals such as mammals, birds and insects, a strategy likely intended to exploit attentional bias. The present study examines how such imagery on wine labels influences consumer attention and memorisation.
Methods
A within-subject experimental design was conducted with 93 participants, each exposed to two conditions: wine labels that feature either animals or inanimate objects. Attention was measured using an eye-tracking method in a laboratory setting at a French university. Each participant viewed 16 different wine bottles, resulting in 1488 observations. After exposure, label recognition was assessed via a declarative method.
Results
Wine labels featuring animals captured attention more rapidly, sustained attention for longer and were better recognised than labels featuring inanimate objects.
Discussion and Conclusions
The findings suggest that, beyond mandating health warnings on alcohol packaging, policymakers should consider stricter regulations on the visual content of labels to limit the persuasive power of alcohol marketing.
{"title":"Influence of Wine Label Imagery: Eye-Tracking Evidence and Regulatory Implications","authors":"Olivier Droulers, Arnaud Bigoin Gagnan, Sophie Lacoste-Badie","doi":"10.1111/dar.70094","DOIUrl":"10.1111/dar.70094","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The visual design of alcohol beverage packaging plays a crucial role in shaping consumer perceptions and purchase decisions, yet regulations in many countries are relatively lax. Guidelines often focus on the inclusion of health warnings rather than overall label or packaging design, giving producers considerable freedom. In recent years, wine manufacturers have increasingly featured images on their labels that are unrelated to the product, most notably animals such as mammals, birds and insects, a strategy likely intended to exploit attentional bias. The present study examines how such imagery on wine labels influences consumer attention and memorisation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A within-subject experimental design was conducted with 93 participants, each exposed to two conditions: wine labels that feature either animals or inanimate objects. Attention was measured using an eye-tracking method in a laboratory setting at a French university. Each participant viewed 16 different wine bottles, resulting in 1488 observations. After exposure, label recognition was assessed via a declarative method.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Wine labels featuring animals captured attention more rapidly, sustained attention for longer and were better recognised than labels featuring inanimate objects.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion and Conclusions</h3>\u0000 \u0000 <p>The findings suggest that, beyond mandating health warnings on alcohol packaging, policymakers should consider stricter regulations on the visual content of labels to limit the persuasive power of alcohol marketing.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":"45 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12801100/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145964998","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}
Shijia Winson Lu, Kaniz Fatema, Gilbert Whitton, Daniel Dutkiewicz, Anna Tran, Peter McCaul, Mark Hardy, Iftikhar Ahmad
Introduction
Alcohol use disorder (AUD) remains a leading cause of preventable disease burden globally, with relapse following inpatient withdrawal a persistent challenge. The Alcohol Relapse Risk Scale (ARRS), developed in Japan, is a validated tool designed to assess relapse risk. This study aimed to evaluate its applicability in an Australian inpatient context.
Methods
A cross-sectional study was conducted across two sites within South Western Sydney Local Health District (SWSLHD): the Withdrawal Management Unit and a Hospital Consultation-Liaison Service. A total of 101 patients with AUD completed the ARRS following informed consent. Internal consistency was assessed using Cronbach's α. Predictive validity was analysed using Pearson's correlation, logistic regression and receiver operating characteristic curve analysis.
Results
Participants were predominantly middle-aged males with high daily alcohol intake (~20 standard drinks). The ARRS demonstrated strong overall internal consistency (Cronbach's α = 0.86). The Positive Expectancy subscale recorded the highest scores, particularly beliefs about alcohol alleviating loneliness. The Craving and Availability subscale had the lowest scores, possibly due to stigma or framing. The Negative Emotion subscale showed poor reliability (α = 0.467). Among 64 participants followed up at 4 weeks, relapse was significantly associated with higher scores on the Insight Into Mental Conditions subscale. A cutoff score of 71.5 yielded reasonable sensitivity (0.8) but low specificity (0.42).
Discussion and Conclusions
The ARRS is a promising tool for assessing relapse risk in Australian inpatient settings. Its multidimensional structure supports its clinical utility, though further validation and cultural adaptation are recommended for broader application.
{"title":"Cross-Cultural Evaluation of the Alcohol Relapse Risk Scale in an Australian Inpatient Setting","authors":"Shijia Winson Lu, Kaniz Fatema, Gilbert Whitton, Daniel Dutkiewicz, Anna Tran, Peter McCaul, Mark Hardy, Iftikhar Ahmad","doi":"10.1111/dar.70093","DOIUrl":"10.1111/dar.70093","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Alcohol use disorder (AUD) remains a leading cause of preventable disease burden globally, with relapse following inpatient withdrawal a persistent challenge. The Alcohol Relapse Risk Scale (ARRS), developed in Japan, is a validated tool designed to assess relapse risk. This study aimed to evaluate its applicability in an Australian inpatient context.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross-sectional study was conducted across two sites within South Western Sydney Local Health District (SWSLHD): the Withdrawal Management Unit and a Hospital Consultation-Liaison Service. A total of 101 patients with AUD completed the ARRS following informed consent. Internal consistency was assessed using Cronbach's <i>α</i>. Predictive validity was analysed using Pearson's correlation, logistic regression and receiver operating characteristic curve analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Participants were predominantly middle-aged males with high daily alcohol intake (~20 standard drinks). The ARRS demonstrated strong overall internal consistency (Cronbach's <i>α</i> = 0.86). The Positive Expectancy subscale recorded the highest scores, particularly beliefs about alcohol alleviating loneliness. The Craving and Availability subscale had the lowest scores, possibly due to stigma or framing. The Negative Emotion subscale showed poor reliability (<i>α</i> = 0.467). Among 64 participants followed up at 4 weeks, relapse was significantly associated with higher scores on the Insight Into Mental Conditions subscale. A cutoff score of 71.5 yielded reasonable sensitivity (0.8) but low specificity (0.42).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion and Conclusions</h3>\u0000 \u0000 <p>The ARRS is a promising tool for assessing relapse risk in Australian inpatient settings. Its multidimensional structure supports its clinical utility, though further validation and cultural adaptation are recommended for broader application.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":"45 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145964641","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}
Bianca Whiteside, Paul M. Dietze, Amanda Roxburgh, Fiona H. McKay, Matthew Dunn
Issues
Drug consumption rooms (DCR) are implemented in part to reduce the impacts of active drug markets in their immediate vicinity. This scoping review sought to document the concepts and indicators used to describe the impact of DCRs on the nearby neighbourhood.
Approach
We conducted a scoping review of peer-reviewed and grey literature, focusing on evaluations of DCRs and related neighbourhood impacts. Articles were included if they contained research looking at operational DCRs and their impact on the surrounding neighbourhood, available in full text and in English. Four databases (Medline, Embase, SocIndex and Scopus) were searched in October 2023. Grey literature was searched using the Google Scholar search engine.
Key Findings
621 publications were identified and screened; after title and abstract and full text screening, 15 articles explicitly discussing neighbourhood impacts were included. Studies were predominately conducted in Australia (33%, n = 5) and Canada (27%, n = 4). When discussing neighbourhood impacts, concepts ‘public amenity’ (33%, n = 5) and ‘public order’ (27%, n = 4) were favoured. Drug-related variables including ‘public injecting’ (93%, n = 14) and ‘publicly discarded needle/syringe’ (87%, n = 13) were largely used to measure the impact of DCRs on these neighbourhoods.
Implications and Conclusion
Concepts describing impacts of DCRs on surrounding neighbourhoods are inconsistently used in DCR literature. Research shows increased support for DCRs when improvements in neighbourhood amenity are evident. We propose the consistent use of the concept drug-related public amenity, defined as measurable indicators of public drug use and publicly discarded drug-related litter that affect the cleanliness, safety and accessibility of shared spaces.
{"title":"Defining Public Amenity and Related Concepts in the Drug Consumption Room Literature: A Scoping Review","authors":"Bianca Whiteside, Paul M. Dietze, Amanda Roxburgh, Fiona H. McKay, Matthew Dunn","doi":"10.1111/dar.70097","DOIUrl":"10.1111/dar.70097","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Issues</h3>\u0000 \u0000 <p>Drug consumption rooms (DCR) are implemented in part to reduce the impacts of active drug markets in their immediate vicinity. This scoping review sought to document the concepts and indicators used to describe the impact of DCRs on the nearby neighbourhood.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Approach</h3>\u0000 \u0000 <p>We conducted a scoping review of peer-reviewed and grey literature, focusing on evaluations of DCRs and related neighbourhood impacts. Articles were included if they contained research looking at operational DCRs and their impact on the surrounding neighbourhood, available in full text and in English. Four databases (Medline, Embase, SocIndex and Scopus) were searched in October 2023. Grey literature was searched using the Google Scholar search engine.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Key Findings</h3>\u0000 \u0000 <p>621 publications were identified and screened; after title and abstract and full text screening, 15 articles explicitly discussing neighbourhood impacts were included. Studies were predominately conducted in Australia (33%, <i>n</i> = 5) and Canada (27%, <i>n</i> = 4). When discussing neighbourhood impacts, concepts ‘public amenity’ (33%, <i>n</i> = 5) and ‘public order’ (27%, <i>n</i> = 4) were favoured. Drug-related variables including ‘public injecting’ (93%, <i>n</i> = 14) and ‘publicly discarded needle/syringe’ (87%, <i>n</i> = 13) were largely used to measure the impact of DCRs on these neighbourhoods.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications and Conclusion</h3>\u0000 \u0000 <p>Concepts describing impacts of DCRs on surrounding neighbourhoods are inconsistently used in DCR literature. Research shows increased support for DCRs when improvements in neighbourhood amenity are evident. We propose the consistent use of the concept <i>drug-related public amenity</i>, defined as measurable indicators of public drug use and publicly discarded drug-related litter that affect the cleanliness, safety and accessibility of shared spaces.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":"45 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145964960","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}
Alcohol marketing significantly influences consumption patterns, particularly among youth, heavy drinkers and women. Digital platforms have amplified this impact through targeted, immersive campaigns. However, monitoring such marketing remains a challenge due to its opaque and dynamic nature. This study introduces SCANNER Alcohol, an AI-enabled system designed to detect alcohol marketing in online content at the brand level.
Methods
SCANNER Alcohol integrates object detection (logos) and optical character recognition (text) to automatically identify 134 alcohol brands within image and video data. The system was trained using annotated datasets of brand logos and validated through standard machine learning metrics. Real-world performance was assessed using social media screen recordings (brand accounts and 12 h of general use), benchmarked against manual coding.
Results
SCANNER Alcohol achieved high algorithmic accuracy, with a mean average precision of 0.94, recall of 0.96 and F1 score of 0.95. In real-world testing, the model demonstrated strong performance, correctly identifying 98.9% of alcohol-branded posts in social media videos. SCANNER Alcohol achieved a low 6.7% false discovery rate, indicating high precision and low noise in the detection output.
Discussion and Conclusions
SCANNER Alcohol is the first system to combine brand-level object and text detection for automated digital alcohol marketing surveillance. Its high accuracy on real-world data and ethical design make it a valuable tool for public health monitoring. SCANNER Alcohol offers a scalable, adaptable and ethically sensitive solution to support regulatory efforts to hold alcohol companies accountable for their digital marketing practices and to ultimately reduce alcohol-related harm.
{"title":"Automated Detection of Digital Alcohol Marketing Using SCANNER: An Integrated Deep-Learning Approach","authors":"Florentine Martino, Navoda Liyana Pathirana, Luai Saif, Asim Bhatti, Kathryn Backholer","doi":"10.1111/dar.70095","DOIUrl":"10.1111/dar.70095","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Alcohol marketing significantly influences consumption patterns, particularly among youth, heavy drinkers and women. Digital platforms have amplified this impact through targeted, immersive campaigns. However, monitoring such marketing remains a challenge due to its opaque and dynamic nature. This study introduces <i>SCANNER Alcohol</i>, an AI-enabled system designed to detect alcohol marketing in online content at the brand level.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p><i>SCANNER Alcohol</i> integrates object detection (logos) and optical character recognition (text) to automatically identify 134 alcohol brands within image and video data. The system was trained using annotated datasets of brand logos and validated through standard machine learning metrics. Real-world performance was assessed using social media screen recordings (brand accounts and 12 h of general use), benchmarked against manual coding.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p><i>SCANNER Alcohol</i> achieved high algorithmic accuracy, with a mean average precision of 0.94, recall of 0.96 and <i>F</i>1 score of 0.95. In real-world testing, the model demonstrated strong performance, correctly identifying 98.9% of alcohol-branded posts in social media videos. <i>SCANNER Alcohol</i> achieved a low 6.7% false discovery rate, indicating high precision and low noise in the detection output.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion and Conclusions</h3>\u0000 \u0000 <p><i>SCANNER Alcohol</i> is the first system to combine brand-level object and text detection for automated digital alcohol marketing surveillance. Its high accuracy on real-world data and ethical design make it a valuable tool for public health monitoring. <i>SCANNER Alcohol</i> offers a scalable, adaptable and ethically sensitive solution to support regulatory efforts to hold alcohol companies accountable for their digital marketing practices and to ultimately reduce alcohol-related harm.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":"45 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12741508/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145833425","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}
Danielle M. Russell, Ele Morrison, Jason Grebely, Carla Treloar, John Gobeil, Jess Doumany, M. J. Stowe, Paul Dietze, Kate Seear, Natalie Taylor, Alison Ritter
Partnerships between researchers and consumers—specifically, people who use drugs in the context of our research co-production—can significantly enhance the relevance and impact of research. Funders increasingly emphasise the value of community-researcher collaborations, yet translating this commitment into effective practice remains challenging. This commentary draws from our experience in developing an application for a collaborative grant with the National Health and Medical Research Council (NHMRC) in Australia, focusing on issues that impact people who use drugs. We reflect on four key insights that emerged from the grant-writing process: (i) expectations and resources, highlighting the gap between the expectations of funding bodies, the way resourcing is used in academic contexts and the resources required for meaningful community involvement; (ii) grant success metrics, examining the disconnect between funding criteria and the realities of co-production; (iii) representation, addressing the challenges of ensuring equitable and authentic consumer participation; and (iv) sharing power, discussing how power dynamics between researchers and community members influence the research process. In conclusion, we propose that researchers must work with consumers to foster more equitable working relationships and ensure there are adequate resources to support meaningful collaborations. Funding bodies, in turn, need to reconsider success metrics and ensure that their processes are mindful of the practical requirements that are necessary to facilitate genuine, equitable partnerships between researchers and consumers.
{"title":"Navigating the Gap: An Examination of Funder Rhetoric and Reality Regarding Community-Research Partnerships","authors":"Danielle M. Russell, Ele Morrison, Jason Grebely, Carla Treloar, John Gobeil, Jess Doumany, M. J. Stowe, Paul Dietze, Kate Seear, Natalie Taylor, Alison Ritter","doi":"10.1111/dar.70084","DOIUrl":"10.1111/dar.70084","url":null,"abstract":"<p>Partnerships between researchers and consumers—specifically, people who use drugs in the context of our research co-production—can significantly enhance the relevance and impact of research. Funders increasingly emphasise the value of community-researcher collaborations, yet translating this commitment into effective practice remains challenging. This commentary draws from our experience in developing an application for a collaborative grant with the National Health and Medical Research Council (NHMRC) in Australia, focusing on issues that impact people who use drugs. We reflect on four key insights that emerged from the grant-writing process: (i) expectations and resources, highlighting the gap between the expectations of funding bodies, the way resourcing is used in academic contexts and the resources required for meaningful community involvement; (ii) grant success metrics, examining the disconnect between funding criteria and the realities of co-production; (iii) representation, addressing the challenges of ensuring equitable and authentic consumer participation; and (iv) sharing power, discussing how power dynamics between researchers and community members influence the research process. In conclusion, we propose that researchers must work with consumers to foster more equitable working relationships and ensure there are adequate resources to support meaningful collaborations. Funding bodies, in turn, need to reconsider success metrics and ensure that their processes are mindful of the practical requirements that are necessary to facilitate genuine, equitable partnerships between researchers and consumers.</p>","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":"45 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12723201/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145809734","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}
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