Drug and alcohol review最新文献_第6页

Demographic Predictors of Medicinal Cannabis Users' Perceived Level of Physician Support for Medicinal Cannabis Prescriptions in New Zealand 新西兰药用大麻使用者对医生支持药用大麻处方的感知水平的人口预测。

IF 2.6 3区医学 Q2 SUBSTANCE ABUSE

Drug and alcohol review

Pub Date : 2025-10-29 DOI: 10.1111/dar.70063

Vinuli Withanarachchie, Chris Wilkins, Karl Parker, Marta Rychert

Introduction

Studies indicate that access to prescribed medicinal cannabis (MC) is influenced by demographic factors, though few have explored the roles of ethnicity and income. Patients' perceptions of physician support for MC may be an important barrier. New Zealand implemented a legal MC scheme in 2020. This paper aimed to identify demographic predictors of accessing an MC prescription and perceptions of physician support for MC.

Methods

An anonymous online survey (New Zealand Drug Trends Survey), promoted via Meta was completed by 10,781 New Zealanders aged 16+ years in 2024. This paper focuses on 1742 respondents who used cannabis primarily for medicinal purposes in the previous 6 months. Logistic regression models predicted obtaining MC prescriptions, perceived physician refusal to prescribe, and perceptions of physician support.

Results

Mental health (73.8%), sleep (71.6%) and pain (59.5%) were most treated with MC. Two-fifths of female MC users (41.5%) were treating women's health conditions. MC prescriptions were less common among females, Māori, Pacific Peoples, lower income-earners (≤ $60,000) and those treating substance dependency. Individuals aged 60+ years, tertiary educated, with a medical diagnosis, earning $60,001+, treating sleep, gastrointestinal, neurological, or mental health were more likely to be MC prescription holders. Younger individuals, not employed, Māori or Pacific were more likely not to request a MC prescription because of anticipated refusal. Older MC prescription holders perceived more support from physicians for MC use.

Discussion and Conclusions

Ethnic, gender and socio-economic disparities limit access to MC prescriptions. Improving equitable access to legal MC requires greater support for open patient-physician conversations about MC use.

导言：研究表明，获得处方药用大麻（MC）受到人口因素的影响，尽管很少有人探讨种族和收入的作用。患者对医生支持MC的看法可能是一个重要的障碍。新西兰在2020年实施了合法的MC计划。本文旨在确定获得MC处方的人口统计学预测因素和医生对MC支持的看法。方法：通过Meta推广的一项匿名在线调查（新西兰药物趋势调查）于2024年完成了10,781名16岁以上的新西兰人。本文的重点是1742受访者谁使用大麻主要用于药用目的，在过去的6个月。逻辑回归模型预测获得MC处方、感知医生拒绝处方和感知医生支持。结果：MC对心理健康（73.8%）、睡眠（71.6%）和疼痛（59.5%）的治疗效果最好。五分之二（41.5%）的女性MC使用者在治疗女性健康问题。MC处方在女性、Māori、太平洋民族、低收入者（≤6万美元）和治疗药物依赖者中较不常见。年龄在60岁以上、受过高等教育、有医学诊断、年收入60,001美元以上、治疗睡眠、胃肠、神经或心理健康的人更有可能持有MC处方。年轻人，没有工作，Māori或太平洋更有可能不要求MC处方，因为预期会被拒绝。年龄较大的MC处方持有人认为医生对MC使用的支持更多。讨论和结论：种族、性别和社会经济差异限制了获得MC处方的机会。改善获得合法MC的公平机会需要更多地支持关于MC使用的公开医患对话。

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引用次数: 0

Regional Variation in Alcohol Consumption in the Northern Territory: An Update 北领地酒精消费的区域差异：最新情况。

IF 2.6 3区医学 Q2 SUBSTANCE ABUSE

Drug and alcohol review

Pub Date : 2025-10-27 DOI: 10.1111/dar.70055

Sarah Clifford, Cassandra J. C. Wright, Tanya Chikritzhs, Michael Livingston

Introduction

Alcohol consumption is higher in the Northern Territory (NT) than the rest of Australia. There is large regional variation in alcohol policy implementation, but no contemporary basic epidemiological data demonstrating variation in consumption. This study replicates and updates Gray and Chikritzhs' work from 2000, which showed substantial regional differences.

Methods

Quarterly wholesale data was provided by NT Liquor Licensing for 2022 and 2023. Per capita alcohol consumption of adults (15 years+) by beverage type was estimated across four regions (Top End, Lower Top End, Barkly and Central). We used independent t-tests to compare mean quarterly litres of pure alcohol consumption between Top End (the most populated region) and other regions. We also compared the proportion of beverage types.

Results

Since Gray and Chikritzhs' work, consumption has fallen in all regions, by between 4.94% and 38.12%. Mean quarterly per capita consumption was significantly lower in Central (2.50 L) compared to Top End (3.28 L) [Correction added on 12 November 2025, after first online publication: In the Abstract section, under Results, the following data have been corrected: ’34.4%’, ‘2.65 L’, and ‘3.24 L’ to ‘38.12%’, ‘2.50 L’ and ‘3.28 L’ in this version.]. Across all regions there were clear seasonal trends, with lowest consumption in Quarter 1 (January–March) and highest consumption in Quarter 3 (July–September). Despite reductions, in most NT regions alcohol consumption remains higher per capita than the national average. Cask wine consumption has notably decreased since previous estimates.

Discussion and Conclusions

The decrease in cask wine is likely attributable to policies which targeted this beverage specifically. Per capita consumption in the Central Australian region is now lower than the national average, which is inconsistent with the greater rates of alcohol-related harms, and further investigation of moderating factors is warranted.

简介：北领地（NT）的酒精消费量高于澳大利亚其他地区。在酒精政策执行方面存在很大的区域差异，但没有当代基本流行病学数据表明消费的差异。这项研究复制并更新了Gray和Chikritzhs从2000年开始的研究，他们的研究显示了巨大的地区差异。方法：采用2022年和2023年北领地酒牌提供的季度批发数据。按饮料类型估计了四个地区（高端、低端、巴克利和中部）成人（15岁以上）的人均酒精消费量。我们使用独立t检验来比较Top End（人口最多的地区）和其他地区的平均季度纯酒精消费量。我们还比较了饮料种类的比例。结果：自Gray和Chikritzhs的工作以来，所有地区的消费量都下降了4.94%至34.4%。中环的人均季度平均耗油量（2.65升）明显低于中高档（3.24升）。所有地区都有明显的季节性趋势，第一季度（1月至3月）的消费量最低，第三季度（7月至9月）的消费量最高。尽管有所减少，但在大多数北部地区，人均酒精消费量仍然高于全国平均水平。自之前的估计以来，桶装葡萄酒的消费量明显下降。讨论和结论：桶装葡萄酒的减少可能是由于专门针对这种饮料的政策。澳大利亚中部地区的人均消费量现在低于全国平均水平，这与酒精相关危害的较高发生率不一致，有必要进一步调查缓和因素。

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引用次数: 0

Changes in Risk Behaviour Among People With Recent Injecting Drug Use in Oslo 2002–2024 2002-2024年奥斯陆近期注射吸毒人群危险行为的变化。

IF 2.6 3区医学 Q2 SUBSTANCE ABUSE

Drug and alcohol review

Pub Date : 2025-10-26 DOI: 10.1111/dar.70060

Eirik Opheim, Kristian Malme, Olav Dalgard, Hanne Sørli, Øystein Backe, Tarjei Foshaug, Vibeke Dahl, Katrine Stålberg, Birgitte Harestad, Ragnhild Kyte Gjøstein, Morten T. Indreiten, Rikard Rykkvin, Kjersti Ulstein, Tore W. Steen, Linda Wüsthoff, Håvard Midgard

Introduction

Sharing needles, syringes and drug preparation paraphernalia among people who inject drugs poses a significant risk of transmission of blood-borne infections. To achieve and maintain the elimination of viral hepatitis by 2030, risk behaviour must be kept at a low level. The aim of this study was to assess changes in injecting risk behaviour among people who inject drugs in Oslo between 2002 and 2024.

Methods

This was an analysis of eight cross-sectional studies among people who inject drugs in Oslo conducted in 2002, 2012, 2015, 2018, 2021, 2022, 2023 and 2024. We calculated prevalence estimates of recent (past 4 weeks) risk behaviour each year and used generalised estimating equations to identify factors associated with recent risk behaviour.

Results

A total of 1648 participants were included. The median age was 39.4 years, 71.7% were men and 54.2% reported daily injecting drug use. Recent sharing of needles/syringes decreased from 17.8% (95% CI 13.6, 22.5) in 2002 to 4.2% (95% C: 1.9, 7.8) in 2024. Recent sharing of needles/syringes was negatively associated with increasing age (every 10-year increment; aOR 0.62; 95% CI 0.50, 0.76) and was associated with daily injecting (aOR 2.07; 95% CI 1.38, 3.12) compared to less than daily and with mixed heroin and amphetamine as the drug most frequently injected (aOR 1.63; 95% CI: 1.04, 2.55) compared to heroin alone.

Discussion and Conclusions

A decline in the prevalence of recent risk behaviour among people who inject drugs in Oslo was observed between 2002 and 2024. Risk behaviour remains common among younger individuals.

导言：在注射毒品的人群中共用针头、注射器和药物制备用具会造成传播血源性感染的重大风险。为了到2030年实现并保持消除病毒性肝炎，必须将危险行为保持在低水平。这项研究的目的是评估2002年至2024年间奥斯陆注射吸毒者注射风险行为的变化。方法：对2002年、2012年、2015年、2018年、2021年、2022年、2023年和2024年在奥斯陆进行的8项注射毒品人群的横断面研究进行分析。我们计算了每年最近（过去4周）危险行为的患病率估计值，并使用广义估计方程来确定与最近危险行为相关的因素。结果：共纳入1648名受试者。中位年龄为39.4岁，71.7%为男性，54.2%报告每日注射吸毒。最近共用针头/注射器从2002年的17.8%（95%置信区间13.6,22.5）下降到2024年的4.2%（95%置信区间：1.9,7.8）。最近共用针头/注射器与年龄增长呈负相关（每10年增加一次；aOR为0.62；95% CI为0.50,0.76），与每日注射相关（aOR为2.07；95% CI为1.38,3.12），与每日注射不足相关；与单独注射海洛因相比，最常注射的药物是混合海洛因和安非他明（aOR为1.63；95% CI为1.04,2.55）。讨论和结论：2002年至2024年期间，奥斯陆注射吸毒者中近期危险行为的流行率有所下降。危险行为在年轻人中仍然很常见。

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引用次数: 0

The Role of Self-Reported Willingness to Use Drugs in Public Health Research: Population-Level Projections of Adolescents' Decriminalised Cannabis Use and Associated Risk Profiles 自我报告的药物使用意愿在公共卫生研究中的作用：青少年大麻非刑事化使用的人口水平预测和相关风险概况。

IF 2.6 3区医学 Q2 SUBSTANCE ABUSE

Drug and alcohol review

Pub Date : 2025-10-26 DOI: 10.1111/dar.70061

Jasmina Burdzovic Andreas, Anne Line Bretteville-Jensen

Introduction

Public health planning in jurisdictions considering cannabis policy shifts may benefit from projections concerning post-policy changes in cannabis use and user profiles. Multiple scenarios concerning decriminalised cannabis use among Norwegian high school students were projected using a simple but under-utilised tool: their self-reported willingness to do so.

Methods

A nationally representative sample of Norwegian high school students (N = 3490) reported on their characteristics, cannabis use, and whether they would use cannabis if doing so were non-punishable. These estimates were scaled up to census data and used to project the population sizes of students who may initiate/increase decriminalised cannabis use under various hypothetical willingness-to-behaviour transition scenarios. Multinomial regression models were used to identify risk profiles associated with willingness to use decriminalised cannabis.

Results

One in five participants (20.3%) reported lifetime cannabis use, corresponding to 38,200 student users nationally. Among never-users, 8.0% reported willingness to initiate decriminalised cannabis use, while 22.3% were unsure. Among users, 40.3% reported willingness to increase decriminalised cannabis use, while 30.3% were unsure. Multiple projection scenarios indicated that both the prevalence (e.g., 12,000 new users nationally if all non-users willing to initiate use would do so) and frequency of cannabis use (e.g., 15,400 more frequent users nationally if all users willing to increase use would do so) would increase under decriminalisation, especially among youth with certain socio-demographic characteristics and recent histories of frequent use.

Discussion and Conclusions

Asking young people about their intended cannabis use under different policies provides an easily understandable and highly relevant tool in public health research and planning.

导言：考虑大麻政策转变的司法管辖区的公共卫生规划可能受益于有关大麻使用和使用者概况的政策后变化的预测。使用一种简单但未充分利用的工具预测了挪威高中生使用大麻非刑事化的多种情况：他们自我报告的意愿。方法：挪威高中生的全国代表性样本（N = 3490）报告了他们的特征，大麻使用情况，以及如果这样做不会受到惩罚，他们是否会使用大麻。这些估计被扩大到人口普查数据，并用于预测在各种假设的意愿向行为过渡情景下可能开始/增加非刑事化大麻使用的学生的人口规模。使用多项回归模型来确定与使用非刑事化大麻意愿相关的风险概况。结果：五分之一的参与者（20.3%）报告终生使用大麻，相当于全国38,200名学生使用者。在从未使用过大麻的人群中，8.0%的人表示愿意开始使用大麻，而22.3%的人不确定。在使用者中，40.3%的人表示愿意增加大麻的非刑事化使用，而30.3%的人不确定。多种预测情景表明，在除罪化的情况下，使用大麻的流行程度（例如，如果所有非使用者都愿意开始使用大麻，全国将有12,000名新使用者）和频率（例如，如果所有使用者都愿意增加使用大麻，全国将有15,400名更频繁的使用者）都会增加，特别是在具有某些社会人口特征和最近经常使用大麻的青年中。讨论和结论：询问年轻人在不同政策下的大麻预期使用情况，为公共卫生研究和规划提供了一个易于理解和高度相关的工具。

{"title":"The Role of Self-Reported Willingness to Use Drugs in Public Health Research: Population-Level Projections of Adolescents' Decriminalised Cannabis Use and Associated Risk Profiles","authors":"Jasmina Burdzovic Andreas, Anne Line Bretteville-Jensen","doi":"10.1111/dar.70061","DOIUrl":"10.1111/dar.70061","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Public health planning in jurisdictions considering cannabis policy shifts may benefit from projections concerning post-policy changes in cannabis use and user profiles. Multiple scenarios concerning decriminalised cannabis use among Norwegian high school students were projected using a simple but under-utilised tool: their self-reported willingness to do so.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A nationally representative sample of Norwegian high school students (<i>N</i> = 3490) reported on their characteristics, cannabis use, and whether they would use cannabis if doing so were non-punishable. These estimates were scaled up to census data and used to project the population sizes of students who may initiate/increase decriminalised cannabis use under various hypothetical willingness-to-behaviour transition scenarios. Multinomial regression models were used to identify risk profiles associated with willingness to use decriminalised cannabis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>One in five participants (20.3%) reported lifetime cannabis use, corresponding to 38,200 student users nationally. Among never-users, 8.0% reported willingness to initiate decriminalised cannabis use, while 22.3% were unsure. Among users, 40.3% reported willingness to increase decriminalised cannabis use, while 30.3% were unsure. Multiple projection scenarios indicated that both the prevalence (e.g., 12,000 new users nationally if all non-users willing to initiate use would do so) and frequency of cannabis use (e.g., 15,400 more frequent users nationally if all users willing to increase use would do so) would increase under decriminalisation, especially among youth with certain socio-demographic characteristics and recent histories of frequent use.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion and Conclusions</h3>\u0000 \u0000 <p>Asking young people about their intended cannabis use under different policies provides an easily understandable and highly relevant tool in public health research and planning.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":"45 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145372406","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}

引用次数: 0

Using Item Response Theory Models in Scaling Severity Scores in Alcohol Research—A Tutorial 项目反应理论模型在酒精研究严重程度评分中的应用。

IF 2.6 3区医学 Q2 SUBSTANCE ABUSE

Drug and alcohol review

Pub Date : 2025-10-26 DOI: 10.1111/dar.70053

Daniel Schulze, Kim Bloomfield, Pimrapat Gebert, Ulrike Grittner

Introduction

Questionnaires are frequently used in the assessment of drug and alcohol dependence.

Methods

Typically, sum scores are used for aggregation, which come with several underlying assumptions. If untested psychometrically, the reliability and sufficiency of a sum score as a measure of the characteristic of interest remain unclear. A simple sum score, for example, does not weight the items and therefore each item contributes with the same level of importance to the total. However, weighting more severe symptoms higher would often be desirable. Additionally, sum scores do not reflect the unreliability of the questionnaire items; i.e., the proneness of an item to measurement error. Unreliability reduces the effects of interest, e.g., an analysis of group differences on a score will underestimate true effects. Latent variable models account for measurement error and provide reliable estimates of a person's score on the underlying constructs.

Results

In this paper, we showcase the application of item response theory models from psychometrics for the analysis of categorical questionnaire data. Using non-technical language, we introduce the most common models and discuss model parameters, model fit, and group comparisons. These aspects allow for the evaluation of the assumptions underlying a sum score.

Discussion and Conclusions

We introduce these concepts with the help of real data from the Danish alcohol and drug consumption survey from 2011, using items on alcohol harms to others. The data and the full reproducible code in STATA and R are provided. Reporting guidelines are given as well as a discussion of pitfalls and limitations.

导言：调查问卷常用于评估药物和酒精依赖。方法：通常，总和分数用于汇总，这有几个潜在的假设。如果未经心理测量学测试，作为兴趣特征测量的总分数的可靠性和充分性仍然不清楚。例如，一个简单的总和分数没有对项目进行加权，因此每个项目对总数的贡献具有相同的重要程度。然而，加重更严重的症状往往是可取的。此外，总和得分并不能反映问卷项目的不信度；即，一个项目对测量误差的倾向。不可靠性降低了兴趣的影响，例如，对分数的组差异的分析将低估真实的影响。潜在变量模型解释了测量误差，并提供了一个人在潜在构念上得分的可靠估计。结果：本文展示了心理测量学项目反应理论模型在分类问卷数据分析中的应用。使用非技术语言，我们介绍了最常见的模型，并讨论了模型参数、模型拟合和组比较。这些方面允许评估作为总分数基础的假设。讨论和结论：我们借助2011年丹麦酒精和药物消费调查的真实数据介绍了这些概念，使用了酒精对他人危害的项目。在STATA和R中提供了数据和完整的可复制代码。报告准则以及陷阱和限制的讨论给出。

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引用次数: 0

A Systematic Review of the Impact of the Alcohol Hangover Upon Negative Affect 酒精宿醉对负面情绪影响的系统综述。

IF 2.6 3区医学 Q2 SUBSTANCE ABUSE

Drug and alcohol review

Pub Date : 2025-10-23 DOI: 10.1111/dar.70052

Rebecca Rothman, Amie C. Hayley, Blair Aitken, Luke A. Downey

Issue

Alcohol hangovers can occur after a single episode of drinking and begin as blood alcohol concentration returns to zero. While hangovers are widely known for their physical symptoms, they also include psychological symptoms such as a depressed mood. These psychological impacts, particularly negative affect (e.g., anxiety, stress), remain less well understood, yet may contribute to maladaptive drinking behaviours and reinforce the cycle of excessive alcohol consumption.

Approach

This systematic review, pre-registered and reported in alignment with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Synthesis without Meta-analysis guidelines, aimed to comprehensively examine the association between alcohol hangovers and negative affect. Searches were performed in MEDLINE, Embase, PsycNET, Scopus and CINAHL from inception to January 2025. Two independent reviewers screened articles, assessed the risk of bias and extracted data.

Key Findings

Twenty-two studies (n = 6152; mean age 26.9 years, 57% female) demonstrated a significant association between hangovers and increased negative affect, including anxiety, stress and depression. Maladaptive emotional regulation, avoidant coping styles, repetitive negative thinking and greater baseline anxiety exacerbated these negative experiences, while social support and mental resilience offered potential protective factors.

Implications

The findings highlight the clinical importance of addressing psychological factors in alcohol-related harm. The tendency to return to binge drinking despite negative hangover experiences suggests that psychological factors may perpetuate unhealthy alcohol consumption.

Conclusion

This review supports a strong link between alcohol hangovers and heightened negative affect. Effective interventions must address both the reduction of negative affect and the underlying drivers of binge drinking to promote healthier alcohol consumption patterns.

问题：酒精宿醉可能在一次饮酒后发生，并在血液酒精浓度降至零时开始。虽然宿醉的生理症状广为人知，但它也包括心理症状，比如情绪低落。这些心理影响，特别是负面影响（如焦虑、压力），仍然不太清楚，但可能导致不适应饮酒行为，并加强过度饮酒的循环。方法：本系统综述，按照系统综述和荟萃分析首选报告项目（PRISMA）和无荟萃分析综合指南进行预注册和报告，旨在全面检查酒精宿醉和负面影响之间的关系。在MEDLINE， Embase, PsycNET， Scopus和CINAHL中进行了自成立至2025年1月的检索。两名独立审稿人筛选了文章，评估了偏倚风险并提取了数据。主要发现：22项研究（n = 6152，平均年龄26.9岁，57%为女性）表明宿醉与焦虑、压力和抑郁等负面情绪增加之间存在显著关联。适应不良的情绪调节、回避型应对方式、重复的消极思维和更大的基线焦虑加剧了这些负面经历，而社会支持和心理弹性提供了潜在的保护因素。意义：研究结果强调了在酒精相关危害中解决心理因素的临床重要性。尽管有负面的宿醉经历，但仍倾向于酗酒，这表明心理因素可能使不健康的酒精消费持续存在。结论：本综述支持酒精宿醉与负面情绪加剧之间的密切联系。有效的干预措施必须同时解决减少负面影响和酗酒的潜在驱动因素，以促进更健康的酒精消费模式。

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引用次数: 0

Keynote Abstracts 主题摘要

IF 2.6 3区医学 Q2 SUBSTANCE ABUSE

Drug and alcohol review

Pub Date : 2025-10-23 DOI: 10.1111/dar.70015

引用次数: 0

Rates and Clinical Characteristics of Self-Administered Fatal Ketamine-Related Poisoning in Australia, 2000–2025 2000-2025年澳大利亚自我给药致死性氯胺酮相关中毒的发生率和临床特征。

IF 2.6 3区医学 Q2 SUBSTANCE ABUSE

Drug and alcohol review

Pub Date : 2025-10-21 DOI: 10.1111/dar.70058

Shane Darke, Michael Farrell, Johan Duflou, Julia Lappin, Agata Chrzanowska, Amy Peacock

Introduction

Recent years have seen marked increases in the non-medical use of ketamine. We aimed to determine: (i) the population mortality rates of self-administered fatal ketamine-related poisoning cases in Australia, 2000–2022; (ii) the characteristics, toxicology and major autopsy findings of cases in Australia, 2000–2025; and (iii) changes in case characteristics across the period 2000–2025.

Methods

Retrospective study of fatal ketamine-related poisoning in Australia retrieved from the National Coronial Information System.

Results

118 cases were identified, 100 (84.7%) of which occurred after 2014. There was a significant upward trend in event rates between 2000 and 2022 (IRR = 1.16). The mean age was 36.2 years and 77.1% were male. The majority (72.9%) of poisonings were unintentional, in 19.5% the final route of ketamine administration was by injection, and a history of substance use problems was documented in 50.8%. There were no significant differences in these case characteristics across the study period. In 14 cases, the decedent was documented as being prescribed take-home ketamine at the time of death and had consumed this medication. The median blood ketamine concentration was 0.20 mg/L (range 0.01–25.0), which did not significantly differ across time. Psychoactive drugs other than ketamine were present in all cases, most frequently hypnosedatives (68.6%) and opioids (62.7%), with a significant difference across time observed in the presence of hypnosedatives (OR 1.45). Cardiomegaly was diagnosed in 13.9% and cardiac fibrosis in 11.1%.

Discussion and Conclusions

There has been a significant increase in self-administered ketamine-related poisoning deaths. Caution should be exercised in prescribing ketamine for self-administration.

近年来，氯胺酮的非医疗使用明显增加。我们的目的是确定：(i) 2000-2022年澳大利亚自我服用致命氯胺酮相关中毒病例的人口死亡率；（ii） 2000-2025年澳大利亚病例的特征、毒理学和主要尸检结果；（iii） 2000-2025年期间病例特征的变化。方法：回顾性研究从国家冠状信息系统中检索的澳大利亚与氯胺酮相关的致死性中毒病例。结果：确诊病例118例，其中2014年以后发病100例（84.7%）。2000年至2022年间，事件发生率呈显著上升趋势（IRR = 1.16）。平均年龄36.2岁，77.1%为男性。绝大多数（72.9%）为非故意中毒，19.5%的患者最终给药途径为注射氯胺酮，50.8%的患者有药物使用史。在整个研究期间，这些病例特征没有显著差异。在14起案件中，记录显示死者在死亡时服用了可带回家的氯胺酮，并服用了这种药物。血氯胺酮中位浓度为0.20 mg/L（范围0.01 ~ 25.0），不同时间间无显著差异。除氯胺酮外，所有病例均存在精神活性药物，最常见的是催眠镇静剂（68.6%）和阿片类药物（62.7%），在催眠镇静剂的存在下，不同时间观察到显著差异（OR 1.45）。13.9%的人被诊断为心脏肥大，11.1%的人被诊断为心脏纤维化。讨论和结论：与氯胺酮有关的自我服用中毒死亡人数显著增加。开氯胺酮自行给药时应谨慎。

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引用次数: 0

The Cost of Poor Policy Implementation and Maintenance: The Northern Territory's Alcohol Floor Price 政策执行和维护不力的成本：北领地的酒精最低价格。

IF 2.6 3区医学 Q2 SUBSTANCE ABUSE

Drug and alcohol review

Pub Date : 2025-10-21 DOI: 10.1111/dar.70056

Nicholas Taylor, Ryan Baldwin, Michael Livingston

引用次数: 0

Perceived Barriers to Care Among People Who Use Drugs in Vietnam 在越南，吸毒人员的护理障碍。

IF 2.6 3区医学 Q2 SUBSTANCE ABUSE

Drug and alcohol review

Pub Date : 2025-10-20 DOI: 10.1111/dar.70054

Hieu Ngoc Nguyen, Li Li, Van Thi Nguyen, Diep Bich Nguyen, Than Dang Phan, Thang Hong Pham

Introduction

Understanding how health literacy, depressive symptoms and family support for people who use drugs (PWUD) influence the perceived barriers to care is essential to helping them navigate healthcare challenges. Our study aims to explore this complex relationship among PWUD in Vietnam.

Methods

We utilised baseline data from an intervention trial conducted in three provinces of Vietnam. Multiple linear regression models were used to explore the relationships between health literacy, depressive symptoms, family support and perceived barriers to care. We also conducted interaction terms and the Wald test follow-up to investigate the effect of health literacy on the association between depressive symptoms, family support and barriers to care.

Results

Among 690 PWUD, depressive symptom level was positively associated with perceived barriers (β = 0.273; SE = 0.049; p < 0.001), while family support for care (β = −0.116; SE = 0.060; p = 0.001) and health literacy level (β = −0.237; SE = 0.078; p < 0.001) were negatively associated with perceived barriers. The association between family support for care and perceived barriers was significantly stronger among PWUD with low health literacy compared to those with high health literacy levels (p = 0.024).

Discussion and Conclusions

This study underscores the importance of developing an intervention that integrates mental health support, family involvement and health literacy training to ensure effective care, especially among PWUD with limited health literacy.

简介：了解健康素养、抑郁症状和对吸毒者的家庭支持（PWUD）如何影响感知到的护理障碍，对于帮助他们应对医疗保健挑战至关重要。我们的研究旨在探讨越南PWUD之间的这种复杂关系。方法：我们利用在越南三个省进行的干预试验的基线数据。采用多元线性回归模型探讨健康素养、抑郁症状、家庭支持和感知护理障碍之间的关系。我们还进行了交互条件和Wald测试随访，以调查健康素养对抑郁症状、家庭支持和护理障碍之间的关联的影响。结果：在690名PWUD患者中，抑郁症状水平与感知障碍呈正相关（β = 0.273; SE = 0.049; p）。讨论和结论：本研究强调了开发一种整合心理健康支持、家庭参与和健康素养培训的干预措施的重要性，以确保有效的护理，特别是在健康素养有限的PWUD患者中。

{"title":"Perceived Barriers to Care Among People Who Use Drugs in Vietnam","authors":"Hieu Ngoc Nguyen, Li Li, Van Thi Nguyen, Diep Bich Nguyen, Than Dang Phan, Thang Hong Pham","doi":"10.1111/dar.70054","DOIUrl":"10.1111/dar.70054","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Understanding how health literacy, depressive symptoms and family support for people who use drugs (PWUD) influence the perceived barriers to care is essential to helping them navigate healthcare challenges. Our study aims to explore this complex relationship among PWUD in Vietnam.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We utilised baseline data from an intervention trial conducted in three provinces of Vietnam. Multiple linear regression models were used to explore the relationships between health literacy, depressive symptoms, family support and perceived barriers to care. We also conducted interaction terms and the Wald test follow-up to investigate the effect of health literacy on the association between depressive symptoms, family support and barriers to care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 690 PWUD, depressive symptom level was positively associated with perceived barriers (<i>β</i> = 0.273; SE = 0.049; <i>p</i> < 0.001), while family support for care (<i>β</i> = −0.116; SE = 0.060; <i>p</i> = 0.001) and health literacy level (<i>β</i> = −0.237; SE = 0.078; <i>p</i> < 0.001) were negatively associated with perceived barriers. The association between family support for care and perceived barriers was significantly stronger among PWUD with low health literacy compared to those with high health literacy levels (<i>p</i> = 0.024).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion and Conclusions</h3>\u0000 \u0000 <p>This study underscores the importance of developing an intervention that integrates mental health support, family involvement and health literacy training to ensure effective care, especially among PWUD with limited health literacy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":"45 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145336694","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}

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