Drug and alcohol review最新文献_第8页

“The compounds for females are really commonly faked!”: Women's challenges in anabolic steroid acquisition and the place of drug checking interventions "针对女性的化合物真的普遍造假！"：妇女在获取合成类固醇方面面临的挑战以及药物检查干预措施的作用。

IF 3 3区医学 Q2 SUBSTANCE ABUSE

Drug and alcohol review

Pub Date : 2024-08-26 DOI: 10.1111/dar.13931

Timothy Piatkowski, Ingrid Amalia Havnes, Emma Kill, Monica J. Barratt

Introduction

Women who use drugs, particularly those using anabolic-androgenic steroids (AAS), encounter heightened social risks influenced by the legal status of AAS, varying regionally. In jurisdictions where AAS are legal, medical guidance and prescription are common, while in illegal regions, there are challenges associated with acquisition and safer usage. Therefore, we aimed to explore the experiences of women who use AAS in Australia, where these substances are criminalised, with a focus on the challenges they encounter in acquiring and using these drugs.

Methods

We focused on data from six women in a broader study interviewing 15 AAS users. The data were subjected to iterative inductive analysis, resulting in two theme-categories.

Results

Women who use AAS face distinct challenges in accessing reliable suppliers, with men seemingly having ‘easier’ access. Women experience this disparity as increasing their vulnerability to unsafe products, further compounded by their lack of knowledge regarding these substances. Moreover, mislabelling and counterfeiting of female-specific AAS substances is described to further compound these risks, reflecting the participants' expressed need for enhanced intervention and quality control in the AAS market.

Discussion and Conclusions

Ensuring product reliability, transparency and accountability are perceived as essential for the health and safety of women who use AAS. To address these issues, interventions should provide women with comprehensive drug checking services tailored to their health needs. ‘Steroid literacy’ must be an integral component, equipping women with knowledge to make informed decisions in the gendered AAS market.

导言：吸毒妇女，尤其是使用合成代谢雄性类固醇（AAS）的妇女，会因 AAS 的法律地位不同而面临不同的社会风险。在合成类固醇合法的地区，医疗指导和处方很常见，而在非法地区，则存在与获取和更安全使用相关的挑战。因此，我们旨在探究在澳大利亚使用AAS的女性的经历，因为在澳大利亚，这些物质被定为犯罪，重点是她们在获取和使用这些药物时遇到的挑战：我们在一项更广泛的研究中采访了 15 名使用安非他明类兴奋剂的女性，重点是六名女性的数据。我们对这些数据进行了反复归纳分析，得出了两个主题类别：结果：使用安非他明类兴奋剂的女性在获得可靠的供应商方面面临着明显的挑战，而男性似乎 "更容易 "获得这些供应商。妇女认为这种差异增加了她们对不安全产品的脆弱性，而她们对这些物质缺乏了解又进一步加剧了这种脆弱性。此外，据描述，女性专用的动情激素物质的错误标签和伪造进一步加剧了这些风险，这反映出参与者表示需要加强对动情激素市场的干预和质量控制：确保产品的可靠性、透明度和问责制被认为对使用动情激素的妇女的健康和安全至关重要。为解决这些问题，干预措施应根据妇女的健康需求为她们提供全面的药物检查服务。类固醇扫盲 "必须是一个不可或缺的组成部分，让妇女掌握相关知识，以便在性别化的 AAS 市场上做出明智的决定。

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引用次数: 0

Healthcare utilisation and associated costs for methadone versus buprenorphine recipients: Examination of interlinked primary and secondary care electronic health records in England 美沙酮与丁丙诺啡接受者的医疗利用率和相关成本：对英格兰相互关联的初级和中级医疗电子健康记录的研究。

IF 3 3区医学 Q2 SUBSTANCE ABUSE

Drug and alcohol review

Pub Date : 2024-08-23 DOI: 10.1111/dar.13933

Eleni Domzaridou, Thomas Allen, Matthew J. Carr, Tim Millar, Roger T. Webb, Darren M. Ashcroft

Introduction

More evidence for patterns of healthcare utilisation and associated costs among people receiving opioid agonist therapy (OAT) is needed. We investigated primary and secondary healthcare usage and costs among methadone and buprenorphine recipients in England.

Methods

We conducted a cohort study using the Clinical Practice Research Datalink GOLD and Aurum databases of patients who were prescribed OAT between 1 January 2007 and 31 July 2019. The cohort was linked to Hospital Episode Statistics admitted patient care, outpatient and emergency department data, neighbourhood- and practice-level Index of Multiple Deprivation quintiles and mortality records. Negative binomial regression models were applied to estimate weighted rate ratios (wRR) of healthcare utilisation. Total and mean costs were calculated using Unit Costs of Health and Social Care and the National Healthcare Service Payment by Results National Tariffs.

Results

Among 12,639 patients observed over 39,016 person-years, we found higher rate of hospital admissions (wRR 1.18; 1.08–1.28) among methadone compared with buprenorphine recipients. The commonest hospital discharge diagnoses among methadone patients were infectious diseases (19.2%), mental and behavioural disorders (17.0%) and drug-related poisoning (16.5%); the three commonest among buprenorphine patients were mental and behavioural diseases (21.5%), endocrine (13.8%) and genitourinary system diseases (13.1%). Methadone patients had similar mean costs compared with buprenorphine patients (cost difference: £539.01; 432.11–1006.69).

Discussion and Conclusions

Differences in healthcare utilisation frequency for methadone versus buprenorphine recipients were observed. The differences in associated costs were mainly driven by hospital admissions. These findings offer valuable insights for optimising care strategies and resource allocation for OAT recipients.

导言：我们需要更多的证据来证明接受阿片类激动剂治疗（OAT）者的医疗保健使用模式和相关费用。我们调查了英格兰美沙酮和丁丙诺啡接受者的初级和二级医疗保健使用情况及成本：我们利用临床实践研究数据链 GOLD 和 Aurum 数据库对 2007 年 1 月 1 日至 2019 年 7 月 31 日期间接受 OAT 治疗的患者进行了一项队列研究。该队列与医院事件统计（Hospital Episode Statistics）的住院病人护理、门诊和急诊科数据、邻里和实践层面的多重贫困指数五分位数以及死亡记录相关联。负二项回归模型用于估算医疗保健使用的加权比率（wRR）。总成本和平均成本采用《医疗与社会保健单位成本》（Unit Costs of Health and Social Care）和《国家医疗保健服务按效果付费国家收费标准》（National Healthcare Service Payment by Results National Tariffs）进行计算：在 39,016 人年中观察到的 12,639 名患者中，我们发现美沙酮患者的入院率（wRR 1.18；1.08-1.28）高于丁丙诺啡患者。美沙酮患者最常见的出院诊断是传染病（19.2%）、精神和行为障碍（17.0%）以及药物中毒（16.5%）；丁丙诺啡患者最常见的三种诊断是精神和行为障碍（21.5%）、内分泌疾病（13.8%）以及泌尿生殖系统疾病（13.1%）。美沙酮患者与丁丙诺啡患者的平均费用相似（费用差异：539.01英镑；432.11-1006.69英镑）：美沙酮患者与丁丙诺啡患者的医疗使用频率存在差异。相关费用的差异主要由入院治疗引起。这些发现为优化 OAT 受试者的护理策略和资源分配提供了宝贵的见解。

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引用次数: 0

Characteristics of consumers of alcohol-free and low-alcohol drinks in Great Britain: A cross-sectional study 英国无酒精和低酒精饮料消费者的特征：横断面研究。

IF 3 3区医学 Q2 SUBSTANCE ABUSE

Drug and alcohol review

Pub Date : 2024-08-21 DOI: 10.1111/dar.13930

Parvati R. Perman-Howe, John Holmes, Jamie Brown, Inge Kersbergen

Introduction

The impact of alcohol-free and low-alcohol (no/lo) drinks on public health and health inequalities depends on who consumes them and how they are consumed. This study aimed to estimate: (i) the proportions of adults in Great Britain who consume no/lo drinks at different frequencies and in different settings; and (ii) the associations between no/lo drink consumption and individual characteristics.

Method

Pooled data (N = 7691) from four waves of a repeat cross-sectional survey on alcohol use completed in 2022–2023 by adults (16+) resident in Great Britain were analysed using descriptive statistics and logistic regression models.

Results

In all, 31.3% of adults reported ever consuming no/lo drinks and 9.8% reported drinking them weekly. Ever consumption of no/lo drinks was associated with: being an increasing risk drinker of alcohol relative to not drinking (OR_adj: 3.96, 95% CI 3.27–4.80), being aged 16–24 compared with 65+ (OR_adj:1.29, 95% CI 1.07–1.57), having previously smoked compared with having never smoked (OR_adj:1.19, 95% CI 1.05–1.34) and living in a rural rather than urban area (OR_adj:1.14, 95% CI 1.00–1.29). It was less likely among those in lower social grades or with lower educational qualifications; those living in Yorkshire and the Humber, and Scotland, compared with the South-East of England; and those using nicotine products.

Discussion and Conclusions

A third of adults in Great Britain have consumed no/lo drinks and approximately one in 10 do so weekly. Consumption is more common among riskier drinkers of alcohol and among more advantaged social groups, which may contribute to the sustaining or widening of health inequalities.

导言：无酒精饮料和低酒精饮料对公共健康和健康不平等的影响取决于饮用者和饮用方式。本研究旨在估算：(i) 大不列颠成年人在不同场合以不同频率饮用无酒精和低酒精饮料的比例；(ii) 无酒精和低酒精饮料消费与个人特征之间的关联：采用描述性统计和逻辑回归模型分析了 2022-2023 年对居住在大不列颠的成年人（16 岁以上）进行的四波重复性酒精使用情况横断面调查的汇总数据（N = 7691）：总共有 31.3% 的成年人表示曾经饮用过无醇/低醇饮料，9.8% 表示每周饮用一次。曾经饮用不含酒精/露酒精饮料与以下因素有关：相对于不饮酒，饮酒风险增加（ORadj：3.96，95% CI：3.27-4.80）；年龄为 16-24 岁而非 65 岁以上（ORadj：1.29，95% CI：1.07-1.57）；曾经吸烟而非从不吸烟（ORadj：1.19，95% CI：1.05-1.34）；居住在农村而非城市（ORadj：1.14，95% CI：1.00-1.29）。与英格兰东南部相比，社会等级较低或学历较低者、居住在约克郡和汉伯郡以及苏格兰的人以及使用尼古丁产品的人吸烟的可能性较低：大不列颠三分之一的成年人饮用过无糖/低糖饮料，大约十分之一的人每周饮用一次。在风险较高的饮酒者和条件较好的社会群体中，饮酒更为普遍，这可能会导致健康不平等的持续或扩大。

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引用次数: 0

The prevalence and magnitude of price promotions in online alcohol retail outlets 网上酒类零售店价格促销的普遍性和规模。

IF 3 3区医学 Q2 SUBSTANCE ABUSE

Drug and alcohol review

Pub Date : 2024-08-21 DOI: 10.1111/dar.13935

Tazman Davies, Paula O'Brien, Jacqueline Bowden, Mark Petticrew, Simone Pettigrew

Introduction

We examined the prevalence of price promotions (i.e., proportion of products on price promotion) and the magnitude of price promotions (i.e., size of the price discount compared to the regular price) among online alcohol retailers.

Methods

In August 2023, we web-scraped product information for all alcoholic beverages available for sale in the online stores of two leading alcohol retailers in Sydney, Australia. Products were classified into five primary alcohol categories: wine, spirits, beer, cider and premix drinks. We considered three types of price promotion: temporary price discounts (e.g., ‘was $5 now $4’), multi-buy discounts (e.g., buy one get one free) and ‘any six’ discounts (e.g., 5% off when purchased in a bundle of any six similar products). The prevalence and mean magnitude of price promotions were estimated overall and by product category and price promotion type.

Results

In total, data for 11,184 products were collected. Of these, 62% were the subject of at least one of the assessed forms of price promotion. The most frequently price-promoted category was wine (91% of products), followed by spirits (35%), premix drinks (30%), cider (28%) and beer (21%). Of all price promotions, 61% were ‘any six’ discounts, 31% were temporary price discounts, and 7% were multi-buy discounts. Across all price promotions, the mean magnitude of price discount relative to the regular price was 11% and ranged from less than 1% to 71%.

Discussion and Conclusions

Policymakers should consider restricting price promotions as part of a suite of strategies to reduce alcohol-related harms.

介绍：我们研究了在线酒类零售商中价格促销的普遍程度（即价格促销产品的比例）和价格促销的幅度（即与正常价格相比价格折扣的大小）：2023 年 8 月，我们通过网络抓取了澳大利亚悉尼两家主要酒类零售商网店中所有酒精饮料的产品信息。产品主要分为五类：葡萄酒、烈酒、啤酒、苹果酒和预混合饮料。我们考虑了三种类型的价格促销：临时价格折扣（如 "原价 5 澳元，现价 4 澳元"）、多买折扣（如买一送一）和 "任意六件 "折扣（如购买任意六件同类产品时可享受 5% 优惠）。对价格促销的普遍程度和平均幅度进行了总体估算，并按产品类别和价格促销类型进行了分类：共收集了 11 184 种产品的数据。结果：共收集到 11 184 种产品的数据，其中 62% 的产品至少有一种价格促销形式。最常进行价格促销的产品类别是葡萄酒（91%），其次是烈酒（35%）、预混合饮料（30%）、苹果酒（28%）和啤酒（21%）。在所有价格促销中，61%是 "任意六种 "折扣，31%是临时价格折扣，7%是多次购买折扣。在所有价格促销活动中，相对于正常价格的平均价格折扣幅度为 11%，从不到 1%到 71%不等：政策制定者应考虑限制价格促销，将其作为减少酒精相关危害的一系列策略的一部分。

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引用次数: 0

Reasons pregnant people use cannabis to self-treat health conditions during pregnancy: Results from a US population-based survey 孕妇在怀孕期间使用大麻自我治疗健康状况的原因：美国人口调查的结果。

IF 3 3区医学 Q2 SUBSTANCE ABUSE

Drug and alcohol review

Pub Date : 2024-08-21 DOI: 10.1111/dar.13934

Claudia Zaugg, Mishka Terplan, Kieran Mailman, Sarah C. M. Roberts

Introduction

Little is known about reasons pregnant people self-treat health conditions and pregnancy-related symptoms with cannabis.

Methods

We administered a cross-sectional survey to 3571 pregnant and recently pregnant people from US population-based panels. Participants who used cannabis at some point during pregnancy were asked which health conditions or symptoms they used cannabis to treat and reasons they used cannabis for self-treatment. We explored differences in reasons for self-treatment by sociodemographics.

Results

Nine-hundred forty-six participants indicated they used cannabis during pregnancy. Fifty-seven percent (n = 578) of those who used cannabis during pregnancy indicated they used cannabis exclusively for health purposes; 39% (n = 347) indicated they used cannabis for health and recreation. The most common reasons for self-treatment were believing cannabis was safer and more effective than other medications or treatments. Some participants reported not having health insurance or a health care provider as reasons for self-treatment. Black and Hispanic people, and people with household income under $25,000, were more likely than White people and people with household income between $25,000–$49,999 to report barriers to other medications or treatments as reasons for self-treatment. People with high school education were more likely than people with more education to report viewing cannabis as safe and effective for self-treatment.

Discussion and Conclusions

Most pregnant people self-treating health conditions or symptoms with cannabis are doing so because they consider it safer and more effective than other medications or treatments. Some people, particularly people of colour and low-income people, may also self-treat because they face barriers to other treatments.

简介：人们对孕妇用大麻自我治疗健康状况和妊娠相关症状的原因知之甚少：我们对来自美国人口调查小组的 3571 名孕妇和近期怀孕者进行了横断面调查。我们询问了在怀孕期间使用过大麻的参与者，他们使用大麻治疗哪些健康状况或症状，以及他们使用大麻进行自我治疗的原因。我们探讨了不同社会人口统计学背景下自我治疗原因的差异：结果：946 名参与者表示他们在怀孕期间使用过大麻。在怀孕期间吸食大麻的人中，57%（n = 578）表示他们吸食大麻完全是为了健康；39%（n = 347）表示他们吸食大麻是为了健康和娱乐。自我治疗的最常见原因是认为大麻比其他药物或治疗方法更安全有效。一些参与者称，没有医疗保险或医疗服务提供者是他们进行自我治疗的原因。黑人和西班牙裔以及家庭收入低于 25,000 美元的人比白人和家庭收入在 25,000 美元至 49,999 美元之间的人更有可能将其他药物或治疗方法的障碍作为自我治疗的原因。接受过高中教育的人比接受过高等教育的人更有可能认为大麻对自我治疗安全有效：大多数孕妇用大麻自我治疗健康状况或症状是因为他们认为大麻比其他药物或治疗方法更安全有效。有些人，特别是有色人种和低收入人群，也可能因为面临其他治疗方法的障碍而进行自我治疗。

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引用次数: 0

Can the THC concentration predict the number of patients with cannabis-related diagnoses? 四氢大麻酚浓度能否预测大麻相关诊断患者的人数？

IF 3 3区医学 Q2 SUBSTANCE ABUSE

Drug and alcohol review

Pub Date : 2024-08-20 DOI: 10.1111/dar.13923

Jakob Manthey, Moritz Rosenkranz, Benjamin Jonas, Larissa Schwarzkopf

Introduction

The use of high-potency cannabis products is associated with an increased risk of mental disorders. This study investigates whether the rising THC concentration in Germany is associated with an increase in cannabis-related diagnoses.

Methods

The number of insured persons with at least one cannabis-related ICD-10 F12 diagnosis (e.g., harmful use, dependence) in outpatient care was provided by statutory health insurance funds between 2009 and 2021. The dependent variable is the ratio of (a) the number of insured persons with at least one F12 diagnosis to (b) all insured persons who have used cannabis in the last year. Information on THC concentration in cannabis flower was provided by law enforcement agencies. Using generalised mixed linear models, the dependent variable was predicted by the median THC concentration in cannabis flower.

Results

The regression results show that an increase in THC concentration by one percentage point is significantly associated with an increase in the proportion of diagnoses (women: +0.17; men: +0.42). THC concentration positively predicted the proportion of diagnoses in all 16 federal states for men and in 15 federal states for women.

Discussion and Conclusions

Compared to low-potency products, using high-potency products may pose additional health risks, which may be particularly pronounced in men. Acknowledging the limitations of the ecological study design and uncertainties inherent to the analysed data, further investigations on the sex-specific impact of THC exposure are required. Limiting the THC concentration in cannabis products and closely monitoring THC consumption in the population appears necessary.

导言：使用高浓度大麻产品与精神失常风险增加有关。本研究调查了德国四氢大麻酚浓度的上升是否与大麻相关诊断的增加有关：2009年至2021年期间，法定医疗保险基金提供了门诊中至少有一项与大麻相关的ICD-10 F12诊断（如有害使用、依赖）的参保人数。因变量是(a)至少有一项 F12 诊断的被保险人数与(b)去年使用过大麻的所有被保险人的比率。关于大麻花中四氢大麻酚浓度的信息由执法机构提供。利用广义混合线性模型，用大麻花中四氢大麻酚浓度的中位数来预测因变量：回归结果显示，四氢大麻酚浓度每增加一个百分点，诊断比例就会增加一个百分点（女性：+0.17；男性：+0.42）。在所有 16 个联邦州和 15 个联邦州，男性和女性的四氢大麻酚浓度都能正向预测诊断比例：与低浓度产品相比，使用高浓度产品可能会带来额外的健康风险，这一点可能在男性中尤为明显。考虑到生态研究设计的局限性和分析数据固有的不确定性，需要进一步调查四氢大麻酚暴露对不同性别的影响。限制大麻产品中四氢大麻酚的浓度并密切监测人群中四氢大麻酚的摄入量似乎很有必要。

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引用次数: 0

Clinical profiles of people enrolling in alcohol and other drug treatment in Australia: Do youth differ from young adults and adults? 澳大利亚接受酒精和其他药物治疗者的临床概况：青少年与年轻人和成年人有区别吗？

IF 3 3区医学 Q2 SUBSTANCE ABUSE

Drug and alcohol review

Pub Date : 2024-08-19 DOI: 10.1111/dar.13925

Gabrielle Campbell, Nina Pocuca, Grace Newland, Rhiannon Ellem, Sophia Glasgow, Julie Dignan, Holly Stokes, Leanne Hides

Introduction

To examine and compare age groups on socio-demographic, substance use, mental health, social and risk behaviour profiles of people entering alcohol and other drug (AOD) treatment in a large non-government organisation (NGO) in Queensland and New South Wales, Australia.

Methods

Design—Cross-sectional study; analysis of baseline routine outcome measures (ROM) and AOD minimum datasets for drug and alcohol treatment services. Setting and participants—People enrolling in Lives Lived Well, a large NGO AOD service between November 2020 and October 2022. Main outcome measures—Socio-demographic, substance use, mental health, social factors and risk behaviours, by youth (≤24 years), young adults (25–35 years) and adults (>35 years).

Results

Between November 2020 and October 2022, 9413 clients enrolled in Lives Lived Well (LLW) AOD services and completed baseline ROMs. Over one-fifth (21.9%) were youth (n = 2066), one-third (32.4%) were young adults (n = 3052) and just under half (45.6%) were adults >35 years (n = 4295). The most common primary drug of concern was cannabis for youth, methamphetamine for young adults and alcohol for adults >35 years. Nearly two-thirds (61.3%) reported moderate to severe symptoms of depression and 55.0% reported moderate to severe anxiety. Just under half (47.2%) screened positive for PTSD and two-in-five (40.4%) reported recent suicidal ideation. Co-occurring mental health symptoms were more common in youth compared with young adults and adults >35 years.

Discussion and Conclusions

Co-occurring mental health symptoms were high in the sample, particularly among youth. All age groups present with unique and complex socio-demographic and clinical profiles that are important to understand to provide the most appropriate and effective treatment.

导言：在澳大利亚昆士兰州和新南威尔士州的一家大型非政府组织（NGO）中，研究并比较各年龄组接受酒精和其他药物（AOD）治疗者的社会人口、药物使用、心理健康、社会和危险行为概况：设计：横断面研究；分析吸毒和酗酒治疗服务的基线常规结果测量（ROM）和 AOD 最低数据集。地点和参与者--2020 年 11 月至 2022 年 10 月期间加入大型非政府组织 AOD 服务机构 "美好生活 "的人。主要结果测量-社会人口学、药物使用、心理健康、社会因素和危险行为，按青年（≤24 岁）、年轻成人（25-35 岁）和成人（大于 35 岁）分类：在 2020 年 11 月至 2022 年 10 月期间，9413 名客户参加了 "美好生活"（LLW）AOD 服务，并完成了基线 ROM。超过五分之一（21.9%）为青少年（n = 2066），三分之一（32.4%）为年轻成年人（n = 3052），略低于一半（45.6%）为年龄大于 35 岁的成年人（n = 4295）。最常见的主要关注药物是青少年的大麻、青壮年的甲基苯丙胺和年龄大于 35 岁的成年人的酒精。近三分之二（61.3%）的人报告有中度至重度抑郁症状，55.0%的人报告有中度至重度焦虑症状。略低于一半（47.2%）的人创伤后应激障碍筛查呈阳性，五分之二（40.4%）的人报告最近有自杀倾向。与年轻人和年龄大于 35 岁的成年人相比，共存心理健康症状在年轻人中更为常见：在样本中，共存精神健康症状的比例很高，尤其是在青少年中。所有年龄组都有独特而复杂的社会人口和临床特征，了解这些特征对于提供最适当、最有效的治疗非常重要。

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引用次数: 0

Novel harm reduction measures at music festivals in Australia: Pilot implementation of the Emerging Drugs Network of Australia–Victoria toxicosurveillance methodology 澳大利亚音乐节上的新型减毒措施：澳大利亚维多利亚州新兴毒品网络毒性监测方法的试点实施。

IF 3 3区医学 Q2 SUBSTANCE ABUSE

Drug and alcohol review

Pub Date : 2024-08-19 DOI: 10.1111/dar.13922

Rebekka Syrjanen, Martin Dutch, Shaun L. Greene, Tom Lyons, Ginny McKinnon, Dimitri Gerostamoulos, Jennifer L. Schumann, the EDNAV Project Research Group

Introduction

Harm reduction strategies at music festivals seek to create a safer environment for patrons. The Emerging Drugs Network of Australia–Victoria (EDNAV) project is a state-wide toxicosurveillance network that derives drug intelligence from a sample of patients presenting to hospital with illicit drug-related toxicity. This publication describes the preliminary outcomes of conducting toxicosurveillance for critically unwell festival patrons within on-site medical facilities.

Methods

Blood samples were collected from patrons who presented with severe illicit drug-related toxicity across three festivals (2022/2023). Blood samples were analysed via liquid chromatography–tandem mass spectrometry for over 700 pharmaceutical and illicit drugs.

Results

There were 1603 individual medical encounters across the festivals, 228 of which were illicit drug related. A blood sample was collected for 24 patients, with a median age of 22 years (range 18–39 years). A median of two drugs (range 1–5 drugs) were reported and four drugs (range 0–8 drugs) were analytically confirmed per patient. The most frequently reported exposures were congruent with analytical results, 3,4-methylenedioxymethamphetamine (reported n = 17, detected n = 20), ketamine (reported n = 9, detected n = 13) and cocaine (reported n = 9, detected n = 12). An unreported illicit drug and/or new psychoactive substance (NPS) was detected in 18 patients, including methylamphetamine (n = 10), a cathinone (n = 7), benzodiazepine-type NPS (n = 6), N-ethylamphetamine (n = 1), 3-hydroxyphencyclidine (n = 1) and/or 4-hydroxy-N-methyl-N-isopropyltryptamine (n = 1).

Discussion and Conclusions

EDNAV toxicosurveillance serves as an additional tool within a multi-faceted approach to harm reduction at festivals. Continued data collection will allow for the characterisation of high-risk drug use patterns to provide evidence-based messaging to festival patrons and key stakeholders.

导言：音乐节的减害策略旨在为观众创造一个更安全的环境。澳大利亚维多利亚州新兴毒品网络（EDNAV）项目是一个全州范围的毒物监测网络，它从因非法药物相关中毒而入院的患者样本中获取毒品情报。本刊物介绍了在现场医疗设施内对身体状况严重不适的节日观众进行毒物监测的初步结果：方法：从三个音乐节（2022/2023 年）中出现严重非法药物相关中毒症状的观众身上采集血液样本。通过液相色谱-串联质谱法对血液样本中的 700 多种药物和违禁药物进行分析：结果：在这三个节日中，共有 1603 人次就诊，其中 228 人次与违禁药物有关。为 24 名患者采集了血液样本，中位年龄为 22 岁（18-39 岁不等）。每位患者报告的毒品数量中位数为 2 种（范围为 1-5 种），经分析确认的毒品数量中位数为 4 种（范围为 0-8 种）。报告暴露最多的毒品与分析结果一致：3,4-亚甲二氧基甲基苯丙胺（报告人数=17，检测人数=20）、氯胺酮（报告人数=9，检测人数=13）和可卡因（报告人数=9，检测人数=12）。在18名患者中检测出了一种未报告的非法药物和/或新型精神活性物质（NPS），包括甲基苯丙胺（10人）、卡西酮（7人）、苯二氮卓类NPS（6人）、N-乙基苯丙胺（1人）、3-羟基苯环利定（1人）和/或4-羟基-N-甲基-N-异丙基色胺（1人）：EDNAV 毒物监测是节日减低危害的多方面方法中的另一种工具。持续的数据收集将有助于确定高风险药物使用模式的特征，从而为音乐节观众和主要利益相关者提供以证据为基础的信息。

{"title":"Novel harm reduction measures at music festivals in Australia: Pilot implementation of the Emerging Drugs Network of Australia–Victoria toxicosurveillance methodology","authors":"Rebekka Syrjanen, Martin Dutch, Shaun L. Greene, Tom Lyons, Ginny McKinnon, Dimitri Gerostamoulos, Jennifer L. Schumann, the EDNAV Project Research Group","doi":"10.1111/dar.13922","DOIUrl":"10.1111/dar.13922","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Harm reduction strategies at music festivals seek to create a safer environment for patrons. The Emerging Drugs Network of Australia–Victoria (EDNAV) project is a state-wide toxicosurveillance network that derives drug intelligence from a sample of patients presenting to hospital with illicit drug-related toxicity. This publication describes the preliminary outcomes of conducting toxicosurveillance for critically unwell festival patrons within on-site medical facilities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Blood samples were collected from patrons who presented with severe illicit drug-related toxicity across three festivals (2022/2023). Blood samples were analysed via liquid chromatography–tandem mass spectrometry for over 700 pharmaceutical and illicit drugs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were 1603 individual medical encounters across the festivals, 228 of which were illicit drug related. A blood sample was collected for 24 patients, with a median age of 22 years (range 18–39 years). A median of two drugs (range 1–5 drugs) were reported and four drugs (range 0–8 drugs) were analytically confirmed per patient. The most frequently reported exposures were congruent with analytical results, 3,4-methylenedioxymethamphetamine (reported <i>n</i> = 17, detected <i>n</i> = 20), ketamine (reported <i>n</i> = 9, detected <i>n</i> = 13) and cocaine (reported <i>n</i> = 9, detected <i>n</i> = 12). An unreported illicit drug and/or new psychoactive substance (NPS) was detected in 18 patients, including methylamphetamine (<i>n</i> = 10), a cathinone (<i>n</i> = 7), benzodiazepine-type NPS (<i>n</i> = 6), <i>N</i>-ethylamphetamine (<i>n</i> = 1), 3-hydroxyphencyclidine (<i>n</i> = 1) and/or 4-hydroxy-<i>N</i>-methyl-<i>N</i>-isopropyltryptamine (<i>n</i> = 1).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion and Conclusions</h3>\u0000 \u0000 <p>EDNAV toxicosurveillance serves as an additional tool within a multi-faceted approach to harm reduction at festivals. Continued data collection will allow for the characterisation of high-risk drug use patterns to provide evidence-based messaging to festival patrons and key stakeholders.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":"43 7","pages":"2045-2054"},"PeriodicalIF":3.0,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dar.13922","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142003883","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}

引用次数: 0

An empirically based typology of temporary alcohol abstinence challenge participants using latent class analysis 利用潜类分析法，根据经验对临时戒酒挑战参与者进行分类。

IF 3 3区医学 Q2 SUBSTANCE ABUSE

Drug and alcohol review

Pub Date : 2024-08-18 DOI: 10.1111/dar.13924

Nathalie Kools, Andrea D. Rozema, Jeroen K. Vermunt, Rob H. L. M. Bovens, Dike van de Mheen, Jolanda J. P. Mathijssen

Introduction

Identifying subgroups of Temporary (alcohol) Abstinence Challenge (TAC) participants may offer opportunities to enhance intervention effectiveness. However, knowledge about such subgroups is missing. This study aimed to (i) describe a TAC population; (ii) identify subgroups of participants based on determinants of changes in drinking behaviour; and (iii) characterise subgroups in terms of sociodemographic and other characteristics.

Methods

Data from 3803 Dutch TAC participants were analysed to identify subgroups using three-step Latent Class Analysis. Classes were based on determinants of changes in drinking behaviour (i.e., drinking refusal self-efficacy, craving and behavioural automaticity) and were characterised by sociodemographic characteristics, drinking behaviour, previous participation in TACs, self-reported health and life satisfaction.

Results

The majority of TAC participants were female, highly educated, employed, 53 years old on average, participated in previous TACs and reported relatively high alcohol use. Four classes of participants were identified: (i) ‘ordinary drinkers’ (49.0%); (ii) ‘drinkers in control’ (21.4%); (iii) ‘habitual drinkers with perceived control to refuse’ (18.4%); and (iv) ‘drinkers not in control’ (11.2%). Class 2 drank least often and non-excessive volumes, while other classes typically drank 4 or more days per week and 3 to 4 glasses per drinking day, with the highest alcohol use found in class 4.

Discussion and Conclusions

Different configurations of determinants in this study's four subgroups may require different intervention approaches and might inform personalised support. Future research is needed to examine the predictive value of these subgroups on post-challenge drinking behaviour to assess support needs and participation value.

导言：识别临时戒酒挑战赛（TAC）参与者中的亚群体可能为提高干预效果提供机会。然而，有关此类亚群的知识尚缺。本研究旨在：(i) 描述临时戒酒挑战人群；(ii) 根据饮酒行为变化的决定因素确定参与者亚群；(iii) 从社会人口学和其他特征方面描述亚群的特征：对 3803 名荷兰 TAC 参与者的数据进行分析，采用三步潜类分析法确定亚组。这些类别是基于改变饮酒行为的决定因素（即拒绝饮酒的自我效能感、渴望和行为自动性），并根据社会人口学特征、饮酒行为、以前参加戒酒中心的情况、自我报告的健康状况和生活满意度来确定：大多数戒酒中心参与者为女性，受过高等教育，有工作，平均年龄 53 岁，曾参加过戒酒中心活动，并报告了相对较高的饮酒量。参与者分为四类(i) "普通饮酒者"（49.0%）；(ii) "有控制能力的饮酒者"（21.4%）；(iii) "有控制能力的习惯性饮酒者"（18.4%）；(iv) "无控制能力的饮酒者"（11.2%）。第 2 类饮酒频率最低，饮酒量也不多，而其他类别一般每周饮酒 4 天或以上，每天饮酒 3 至 4 杯，其中第 4 类饮酒量最高：在本研究的四个分组中，不同的决定因素可能需要不同的干预方法，并可能为个性化支持提供依据。未来的研究需要考察这些分组对挑战后饮酒行为的预测价值，以评估支持需求和参与价值。

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引用次数: 0

Screening and early intervention for substance use during pregnancy: A retrospective case note review of antenatal care records 孕期药物使用的筛查和早期干预：产前护理记录的回顾性病例记录。

IF 3 3区医学 Q2 SUBSTANCE ABUSE

Drug and alcohol review

Pub Date : 2024-08-13 DOI: 10.1111/dar.13927

Matthew W. R. Stevens, Megan Cooper, Lynette Cusack, Robert L. Ali, Chris Holmwood, Annette L. Briley

Introduction

Screening for substance use during pregnancy is critical for enhancing maternal health and perinatal outcomes. However, disparities persist in screening and intervention rates within maternity services. This retrospective case note review explored contemporaneous practices around screening and interventions for substance use among pregnant women during routine antenatal care.

Methods

A random sample of 100 sets of maternity records were reviewed. Eligible cases included any woman attending initial pregnancy assessments at one of two South Australian metropolitan Hospital-based antenatal clinics, from July 2019–September 2020. Screening rates for past and current alcohol, tobacco and other substance use were identified and compared with data from a subset of a nationally representative survey. Intervention details and referral pathways were also assessed.

Results

The final sample of eligible cases (n = 93) demonstrated prioritisation of screening for current use, over past use, across all substances (p < 0.001). Screening was most likely for tobacco and least likely for e-cigarettes (p < 0.001). Significant underreporting of past use compared with the benchmark was identified for all substances (except tobacco, p = 0.224). Interventions typically involved written resources, which were usually declined by clients.

Discussion and Conclusions

Despite longstanding recommendations, screening and intervention practices for substance use appear inconsistent. With the recent emergence of vaping, no evidence of updated approaches to identifying e-cigarette consumption in pregnant women was found. Several opportunities for enhancing routine screening and intervention practices within antenatal clinics were identified, and will inform the development of policy directives, targeted training modules, and other resources for health professionals working in these services.

导言：筛查孕期药物使用情况对于改善孕产妇健康和围产期结果至关重要。然而，产科服务中的筛查和干预率仍存在差异。这项回顾性病例研究探讨了在常规产前检查中对孕妇进行药物使用筛查和干预的做法：方法：随机抽样审查了 100 份产科记录。符合条件的病例包括 2019 年 7 月至 2020 年 9 月期间，在南澳大利亚州两家都市医院产前诊所中的一家接受初次妊娠评估的任何女性。我们确定了过去和现在的酒精、烟草和其他物质使用筛查率，并将其与一项全国代表性调查的子集数据进行了比较。此外，还对干预细节和转诊途径进行了评估：结果：符合条件的最终样本（n = 93）显示，在所有物质的使用中，优先筛查当前使用情况，而不是过去使用情况（p 讨论和结论：尽管建议由来已久，但针对药物使用的筛查和干预措施似乎并不一致。最近出现了吸食电子烟的现象，但没有证据表明有更新的方法来识别孕妇吸食电子烟的情况。研究发现了一些在产前检查诊所加强常规筛查和干预措施的机会，并将为制定政策指令、开发有针对性的培训模块以及为在这些服务机构工作的医疗专业人员提供其他资源提供参考。

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引用次数: 0