It is broadly recognised that chemsex is more prevalent among men who have sex with men, but little is known about chemsex in the context of commercial sexual encounters between men. This study investigates sex worker advertising characteristics and their advertised willingness to engage in chemsex with clients.
Methods
Data were web scraped from the profiles of US-based male sex workers (N = 3773) advertising services on an internet advertising platform in February 2021. This study describes the association between chemsex advertising and advertised age, race/ethnicity, sexual orientation, encounter type and COVID-19 acknowledgement.
Results
28.5% of sex workers (n = 1077) advertised chemsex, 64.7% of whom were 25–34 years-old (n = 697). The odds of chemsex advertising increased between ages 21–24 (aOR = 1.20, 95% CI 1.09–1.32) and declined among sex workers over 35 years-old (aOR = 0.97, 95% CI 0.95–1.00). Sex workers advertising as bisexual were more likely to advertise chemsex than those identifying as gay (aOR = 1.38, 95% CI 1.18–1.63). Sex workers acknowledging COVID-19 were less likely to advertise chemsex compared to those who did not (aOR = 0.65, 95% CI 0.48–0.89). Encounter type was associated with chemsex advertising among sex workers in this sample; sex workers not offering the “boyfriend experience” were more than 50% less likely to advertise chemsex than those who did offer the boyfriend experience (aOR = 0.47, 95% CI 0.36–0.61).
Discussion and Conclusions
Chemsex advertising in this population is likely influenced by multiple sociodemographic and occupational characteristics. Identifying sex workers likely to engage in chemsex based on advertising data could inform targeted education and harm-reduction campaigns in this population.
{"title":"Party and play: Associations between US male sex workers' internet advertising characteristics and advertising chemsex to prospective clients","authors":"Kristopher J. Jackson","doi":"10.1111/dar.13896","DOIUrl":"10.1111/dar.13896","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>It is broadly recognised that chemsex is more prevalent among men who have sex with men, but little is known about chemsex in the context of commercial sexual encounters between men. This study investigates sex worker advertising characteristics and their advertised willingness to engage in chemsex with clients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data were web scraped from the profiles of US-based male sex workers (<i>N</i> = 3773) advertising services on an internet advertising platform in February 2021. This study describes the association between chemsex advertising and advertised age, race/ethnicity, sexual orientation, encounter type and COVID-19 acknowledgement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>28.5% of sex workers (<i>n</i> = 1077) advertised chemsex, 64.7% of whom were 25–34 years-old (<i>n</i> = 697). The odds of chemsex advertising increased between ages 21–24 (aOR = 1.20, 95% CI 1.09–1.32) and declined among sex workers over 35 years-old (aOR = 0.97, 95% CI 0.95–1.00). Sex workers advertising as bisexual were more likely to advertise chemsex than those identifying as gay (aOR = 1.38, 95% CI 1.18–1.63). Sex workers acknowledging COVID-19 were less likely to advertise chemsex compared to those who did not (aOR = 0.65, 95% CI 0.48–0.89). Encounter type was associated with chemsex advertising among sex workers in this sample; sex workers not offering the “boyfriend experience” were more than 50% less likely to advertise chemsex than those who did offer the boyfriend experience (aOR = 0.47, 95% CI 0.36–0.61).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion and Conclusions</h3>\u0000 \u0000 <p>Chemsex advertising in this population is likely influenced by multiple sociodemographic and occupational characteristics. Identifying sex workers likely to engage in chemsex based on advertising data could inform targeted education and harm-reduction campaigns in this population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":"43 7","pages":"1954-1961"},"PeriodicalIF":3.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dar.13896","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141466878","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}
Rufina H. W. Chan, Dong Dong, Jiazhou Yu, Jean H. Kim
Introduction
Due to the widespread use of social media by young adults, the alcohol industry has been increasingly using social media marketing (SMM) to target potential customers. This study examines the prevalence and factors associated with past-month exposure to alcohol SMM among young Chinese adults, a group with rapidly increasing uptake of alcohol consumption.
Methods
An anonymous, random telephone survey was conducted between June and August 2021 on Hong Kong Chinese residents between 18 and 34 years old (n = 675).
Results
Of respondents, 52.3% reported past-month exposure to alcohol SMM (68.6% of past-month drinkers and 48.0% of non-past-month drinkers, p < 0.05) while 71.6% reported exposure to non-SMM alcohol marketing. Direct alcohol SMM exposure was reported by 40.9% (e.g., business-to-consumer postings, alcohol banner ads) while 27.4% of respondents reported exposure to indirect alcohol SMM marketing (e.g., shared/‘liked’ alcohol brand posts). Of those exposed to alcohol SMM, 13.7–15.5% reported that the various forms indirect alcohol SMM influenced them to drink more (vs. 6.2–8.9% for direct alcohol SMM). Being male, lower-income, university educated and spirits/cocktail drinker were independently associated with exposure to direct alcohol SMM (ORmv 1.71–3.14). Past-month exposure to indirect alcohol SMM was independently associated with lower income, not working full-time and drinking any type of alcohol (ORmv 1.59–4.44).
Discussion and Conclusion
The comparative effectiveness of indirect SMM on influencing young adults drinking intentions may be a form of peer endorsement of drinking. The pervasiveness of alcohol SMM and lack of alcohol SMM policies may indicate the need for greater alcohol marketing regulation in this region.
{"title":"Who is being targeted by alcohol social media marketing? A study of Chinese young adults in Hong Kong","authors":"Rufina H. W. Chan, Dong Dong, Jiazhou Yu, Jean H. Kim","doi":"10.1111/dar.13892","DOIUrl":"10.1111/dar.13892","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Due to the widespread use of social media by young adults, the alcohol industry has been increasingly using social media marketing (SMM) to target potential customers. This study examines the prevalence and factors associated with past-month exposure to alcohol SMM among young Chinese adults, a group with rapidly increasing uptake of alcohol consumption.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>An anonymous, random telephone survey was conducted between June and August 2021 on Hong Kong Chinese residents between 18 and 34 years old (<i>n</i> = 675).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of respondents, 52.3% reported past-month exposure to alcohol SMM (68.6% of past-month drinkers and 48.0% of non-past-month drinkers, <i>p</i> < 0.05) while 71.6% reported exposure to non-SMM alcohol marketing. Direct alcohol SMM exposure was reported by 40.9% (e.g., business-to-consumer postings, alcohol banner ads) while 27.4% of respondents reported exposure to indirect alcohol SMM marketing (e.g., shared/‘liked’ alcohol brand posts). Of those exposed to alcohol SMM, 13.7–15.5% reported that the various forms indirect alcohol SMM influenced them to drink more (vs. 6.2–8.9% for direct alcohol SMM). Being male, lower-income, university educated and spirits/cocktail drinker were independently associated with exposure to direct alcohol SMM (OR<sub>mv</sub> 1.71–3.14). Past-month exposure to indirect alcohol SMM was independently associated with lower income, not working full-time and drinking any type of alcohol (OR<sub>mv</sub> 1.59–4.44).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion and Conclusion</h3>\u0000 \u0000 <p>The comparative effectiveness of indirect SMM on influencing young adults drinking intentions may be a form of peer endorsement of drinking. The pervasiveness of alcohol SMM and lack of alcohol SMM policies may indicate the need for greater alcohol marketing regulation in this region.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":"43 6","pages":"1435-1444"},"PeriodicalIF":3.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dar.13892","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141476180","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}
Pieter Baker, Becky L. Genberg, Jacquie Astemborski, Shruti H. Mehta, Gregory D. Kirk, Javier Cepeda
Introduction
Given structural barriers, access to services is key for preventing drug-related harms and managing chronic disease among people who inject drugs (PWID). The Patient Activation Measure (PAM), a validated scale to assess self-efficacy in navigating one's own health care, was operationalised to improve service utilisation and outcomes but has not been assessed among PWID. We characterised PAM and its association with healthcare and harm reduction utilisation among PWID in the AIDS Linked to IntraVenous Experience cohort in Baltimore.
Methods
From 2019 to 2020, participants completed surveys on PAM, service utilisation and drug use. We used log-binomial regression to identify correlates of “Lower” PAM and modelled the association between lower PAM and service utilisation, stratified by recent IDU.
Results
Participants (n = 351) were primarily male (67%), Black (85%) and 24% reported recent IDU. Lower PAM was significantly more common in those reporting IDU (aPR 1.45; 95% CI 1.03, 2.04), heavy alcohol (aPR 1.77; 95% CI 1.24, 2.51) and marijuana (aPR: 1.70; 95% CI 1.23, 2.36) but less common among women (aPR 0.57; 95% CI 0.38, 0.84) and those living with HIV (APR 0.52; 95% CI 0.35, 0.78). In modelling service utilisation, lower PAM was associated with a lower prevalence of methadone utilisation (aPR 0.27; 95% CI 0.09, 0.84) among those reporting IDU, but a higher prevalence of methadone utilisation (aPR 2.72; 95% CI 1.46, 5.08) among those not reporting IDU, after controlling for correlates of PAM.
Discussion and Conclusion
PAM-tailored interventions targeting methadone utilisation warrant consideration but should account for socio-structural barriers to utilisation and correlates of PAM among PWID.
导言：鉴于存在结构性障碍，获得服务是注射吸毒者（PWID）预防毒品相关伤害和控制慢性疾病的关键。患者激活量表（PAM）是一种经过验证的量表，用于评估患者在自我医疗保健中的自我效能，其操作性旨在提高服务利用率和效果，但尚未在注射吸毒者中进行过评估。我们对巴尔的摩市艾滋病与静脉内经验相关队列中的吸毒者进行了PAM及其与医疗保健和减低危害利用率的关联性分析：从 2019 年到 2020 年，参与者完成了有关 PAM、服务利用率和药物使用情况的调查。我们使用对数二项式回归法确定了 "较低 "PAM 的相关因素，并根据最近的 IDU 分层模拟了较低 PAM 与服务利用率之间的关联：参与者（n = 351）主要为男性（67%）、黑人（85%），其中 24% 的人表示最近曾使用过 IDU。较低的 PAM 在报告 IDU（aPR 1.45；95% CI 1.03，2.04）、大量饮酒（aPR 1.77；95% CI 1.24，2.51）和吸食大麻（aPR：1.70；95% CI 1.23，2.36）的人群中更为常见，但在女性（aPR 0.57；95% CI 0.38，0.84）和 HIV 感染者（APR 0.52；95% CI 0.35，0.78）中较少见。在对服务利用率进行建模时，较低的 PAM 与报告 IDU 的人群中较低的美沙酮利用率（aPR 0.27；95% CI 0.09，0.84）相关，但在控制了 PAM 的相关因素后，未报告 IDU 的人群中较高的美沙酮利用率（aPR 2.72；95% CI 1.46，5.08）：讨论和结论：针对美沙酮使用情况的PAM干预措施值得考虑，但应考虑到使用美沙酮的社会结构障碍和PAM在PWID中的相关因素。
{"title":"Relationship between patient activation and utilisation of health care and harm reduction services among people who inject drugs in Baltimore, Maryland","authors":"Pieter Baker, Becky L. Genberg, Jacquie Astemborski, Shruti H. Mehta, Gregory D. Kirk, Javier Cepeda","doi":"10.1111/dar.13893","DOIUrl":"10.1111/dar.13893","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Given structural barriers, access to services is key for preventing drug-related harms and managing chronic disease among people who inject drugs (PWID). The Patient Activation Measure (PAM), a validated scale to assess self-efficacy in navigating one's own health care, was operationalised to improve service utilisation and outcomes but has not been assessed among PWID. We characterised PAM and its association with healthcare and harm reduction utilisation among PWID in the AIDS Linked to IntraVenous Experience cohort in Baltimore.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>From 2019 to 2020, participants completed surveys on PAM, service utilisation and drug use. We used log-binomial regression to identify correlates of “Lower” PAM and modelled the association between lower PAM and service utilisation, stratified by recent IDU.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Participants (<i>n</i> = 351) were primarily male (67%), Black (85%) and 24% reported recent IDU. Lower PAM was significantly more common in those reporting IDU (aPR 1.45; 95% CI 1.03, 2.04), heavy alcohol (aPR 1.77; 95% CI 1.24, 2.51) and marijuana (aPR: 1.70; 95% CI 1.23, 2.36) but less common among women (aPR 0.57; 95% CI 0.38, 0.84) and those living with HIV (APR 0.52; 95% CI 0.35, 0.78). In modelling service utilisation, lower PAM was associated with a lower prevalence of methadone utilisation (aPR 0.27; 95% CI 0.09, 0.84) among those reporting IDU, but a higher prevalence of methadone utilisation (aPR 2.72; 95% CI 1.46, 5.08) among those not reporting IDU, after controlling for correlates of PAM.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion and Conclusion</h3>\u0000 \u0000 <p>PAM-tailored interventions targeting methadone utilisation warrant consideration but should account for socio-structural barriers to utilisation and correlates of PAM among PWID.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":"43 7","pages":"1859-1864"},"PeriodicalIF":3.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141476179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A reflection on improving the lives of people who use and inject drugs","authors":"Maureen Steele","doi":"10.1111/dar.13889","DOIUrl":"10.1111/dar.13889","url":null,"abstract":"","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":"43 5","pages":"1112-1115"},"PeriodicalIF":3.0,"publicationDate":"2024-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141455907","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}
Anna Olsen, Chris Gough, Annie Madden, Lisa Maher, Suzie Hudson, Geoff Ward, Peter Higgs
<p>While most special sections in <i>Drug and Alcohol Review</i> are focused on a particular research topic, this collection is devoted posthumously to a person and her interests; Jude Byrne. Unique in her ability to lead work across advocacy, policy and research, Jude used her intelligence and living experience as a person who used drugs to influence policy and practice across the alcohol and other drug, blood-borne virus and community sectors. As we noted in an earlier editorial [<span>1</span>], Jude's impact was significant and wide-reaching. Beginning locally, Jude was responsible for many grassroots initiatives based on local emerging community needs, including respite services for mothers and their children, and forming drug user organisations. Jude also contributed to policy and service delivery for people who use drugs (PWUD) on a global level. She pursued the ethical and methodological development of our field by representing the voices of PWUD in numerous international forums, including on World Health Organization Guidelines Development Working Groups and through her longstanding leadership on the International Network of People Who Use Drugs Board. This collection reflects the key areas influenced by her life and work.</p><p>Celebrating Jude's life and work, we have also included her recorded voice. In February 2020, Peter Higgs recorded this (https://bcove.video/3KqLnCH) video interview with Jude for a conference in Manchester that was cancelled because of COVID. Cheekily titled, <i>Ageing Disgracefully</i>, Jude's recording reminds us that older PWUD are absent from much of the narrative about harm reduction and care. Jude describes her involvement in one of the last projects she worked on—<i>A Hidden Population</i>—aiming to build capacity within aged care providers to respond to the unique needs of older PWUD. We hear her powerful narrative about the fear that many people with a history of drug use have about relying on aged care services for support. Indeed, the need to include lived and living experience in academic, clinical and policy work is a thread that runs through this special section.</p><p>Three of the papers included in this issue outline approaches to community–researcher partnerships. Building on early work by the Australian Injecting and Illicit Drug Users League, International Network of People Who Use Drugs and other organisations, these papers examine not only why community-researcher partnerships are good practice but also address the pragmatics of building, performing and assessing these partnerships.</p><p>Berg et al. [<span>2</span>] advocate for meaningful roles for people with lived-experience in research. For example, the dual-interview approach, where peer and academic researchers conduct research interviews together, breaks down power dynamics and assumptions about identity and capability in research. While peers and academics are often considered to bring different skill sets to research, Berg et al. a
{"title":"Ageing disgracefully with Jude Byrne: A special section recognising her life and work","authors":"Anna Olsen, Chris Gough, Annie Madden, Lisa Maher, Suzie Hudson, Geoff Ward, Peter Higgs","doi":"10.1111/dar.13891","DOIUrl":"10.1111/dar.13891","url":null,"abstract":"<p>While most special sections in <i>Drug and Alcohol Review</i> are focused on a particular research topic, this collection is devoted posthumously to a person and her interests; Jude Byrne. Unique in her ability to lead work across advocacy, policy and research, Jude used her intelligence and living experience as a person who used drugs to influence policy and practice across the alcohol and other drug, blood-borne virus and community sectors. As we noted in an earlier editorial [<span>1</span>], Jude's impact was significant and wide-reaching. Beginning locally, Jude was responsible for many grassroots initiatives based on local emerging community needs, including respite services for mothers and their children, and forming drug user organisations. Jude also contributed to policy and service delivery for people who use drugs (PWUD) on a global level. She pursued the ethical and methodological development of our field by representing the voices of PWUD in numerous international forums, including on World Health Organization Guidelines Development Working Groups and through her longstanding leadership on the International Network of People Who Use Drugs Board. This collection reflects the key areas influenced by her life and work.</p><p>Celebrating Jude's life and work, we have also included her recorded voice. In February 2020, Peter Higgs recorded this (https://bcove.video/3KqLnCH) video interview with Jude for a conference in Manchester that was cancelled because of COVID. Cheekily titled, <i>Ageing Disgracefully</i>, Jude's recording reminds us that older PWUD are absent from much of the narrative about harm reduction and care. Jude describes her involvement in one of the last projects she worked on—<i>A Hidden Population</i>—aiming to build capacity within aged care providers to respond to the unique needs of older PWUD. We hear her powerful narrative about the fear that many people with a history of drug use have about relying on aged care services for support. Indeed, the need to include lived and living experience in academic, clinical and policy work is a thread that runs through this special section.</p><p>Three of the papers included in this issue outline approaches to community–researcher partnerships. Building on early work by the Australian Injecting and Illicit Drug Users League, International Network of People Who Use Drugs and other organisations, these papers examine not only why community-researcher partnerships are good practice but also address the pragmatics of building, performing and assessing these partnerships.</p><p>Berg et al. [<span>2</span>] advocate for meaningful roles for people with lived-experience in research. For example, the dual-interview approach, where peer and academic researchers conduct research interviews together, breaks down power dynamics and assumptions about identity and capability in research. While peers and academics are often considered to bring different skill sets to research, Berg et al. a","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":"43 5","pages":"1037-1039"},"PeriodicalIF":3.0,"publicationDate":"2024-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dar.13891","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141426511","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}
Vivian C. Praeger, Matthew Y. Frei, Dan Pham, Adrian J. Praeger, Dan I. Lubman, Shalini Arunogiri
Introduction
Inducting buprenorphine from methadone has traditionally involved initial opioid withdrawal, with risk of mental state deterioration in patients with serious mental illness (SMI). Micro-dosing of buprenorphine, with small incremental doses, is a novel off-label approach to transitioning from methadone and does not require a period of methadone abstinence. Given the limited literature about buprenorphine microdosing, we aimed to evaluate the feasibility and safety of inducting buprenorphine in a series of patients on methadone with SMI.
Methods
For this retrospective case series, we reviewed the records of 16 patients with SMI at a Melbourne addiction treatment centre, from January 2021 to July 2022, who transitioned via micro-dosing, from high-dose methadone (>30 mg) to buprenorphine and depot-buprenorphine. Psychiatric diagnoses, mental state, other substance withdrawal, transfer success, transition time, opioid withdrawal symptoms and overall patient experience were collected via objective and subjective reporting.
Results
Methadone to buprenorphine transfer was completed by 88% of patients. Mental health measures remained stable with the exception of mildly increased anxiety. Median transfer time was 6.5 days for inpatients, 9 days for mixed setting and 10 days for outpatients. Most patients (93%) rated their experience ‘manageable’ reporting mild withdrawal symptoms. One patient met study criteria for precipitated withdrawal.
Discussion and Conclusions
This retrospective case series provides evidence that the use of a micro-dosing buprenorphine induction for methadone to buprenorphine transitions, including to depot-buprenorphine, has negligible risk, is tolerated by patients with SMI and is unlikely to precipitate an exacerbation of their mental illness.
{"title":"Rotation from methadone to buprenorphine using a micro-dosing regime in patients with opioid use disorder and serious mental illness: A case series","authors":"Vivian C. Praeger, Matthew Y. Frei, Dan Pham, Adrian J. Praeger, Dan I. Lubman, Shalini Arunogiri","doi":"10.1111/dar.13885","DOIUrl":"10.1111/dar.13885","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Inducting buprenorphine from methadone has traditionally involved initial opioid withdrawal, with risk of mental state deterioration in patients with serious mental illness (SMI). Micro-dosing of buprenorphine, with small incremental doses, is a novel off-label approach to transitioning from methadone and does not require a period of methadone abstinence. Given the limited literature about buprenorphine microdosing, we aimed to evaluate the feasibility and safety of inducting buprenorphine in a series of patients on methadone with SMI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>For this retrospective case series, we reviewed the records of 16 patients with SMI at a Melbourne addiction treatment centre, from January 2021 to July 2022, who transitioned via micro-dosing, from high-dose methadone (>30 mg) to buprenorphine and depot-buprenorphine. Psychiatric diagnoses, mental state, other substance withdrawal, transfer success, transition time, opioid withdrawal symptoms and overall patient experience were collected via objective and subjective reporting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Methadone to buprenorphine transfer was completed by 88% of patients. Mental health measures remained stable with the exception of mildly increased anxiety. Median transfer time was 6.5 days for inpatients, 9 days for mixed setting and 10 days for outpatients. Most patients (93%) rated their experience ‘manageable’ reporting mild withdrawal symptoms. One patient met study criteria for precipitated withdrawal.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion and Conclusions</h3>\u0000 \u0000 <p>This retrospective case series provides evidence that the use of a micro-dosing buprenorphine induction for methadone to buprenorphine transitions, including to depot-buprenorphine, has negligible risk, is tolerated by patients with SMI and is unlikely to precipitate an exacerbation of their mental illness.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":"43 7","pages":"1829-1834"},"PeriodicalIF":3.0,"publicationDate":"2024-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dar.13885","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141418325","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}
Opioid agonist treatment (OAT) is an effective treatment for opioid dependence syndrome in adults. However, studies on effectiveness of OAT in adolescents are limited; existing studies show varying retention rates. The present study aimed to assess OAT retention rates in adolescent patients with opioid dependence syndrome registered in a community drug treatment clinic in Delhi, India, and to analyse factors associated with retention at 1 year.
Methods
Retrospective cohort study. All adolescents (n = 130) aged 10–19 years, started on OAT from January 2020 to July 2022 were included. Baseline and follow-up data was extracted from online record system maintained at the clinic. OAT retention rates at different timepoints were assessed. Multivariable logistic regression was used to discern factors associated with one-year retention.
Results
The participants' mean age was 16.9 (SD 1.4) years. Mean age of starting opioids was 14.9 (SD 2.2) years; 29.5% (n = 38) injected opioids. The 6-, 12-, 18- and 24-month retention rate on OAT was 64.4%, 45.6%, 38.7% and 29% respectively. The retention rates with buprenorphine and methadone were comparable. Multivariate logistic regression showed retention for less than 12 months to be significantly associated with younger age of starting heroin, involvement in illegal activities, absenteeism from school and substance use in family.
Discussion and Conclusions
The 12-month retention rates on OAT in adolescents is comparable to retention rates in adults. Various factors associated with early age of onset of opioid use are also associated with lower retention rates on OAT.
{"title":"Assessment of treatment retention rates and predictors of retention on opioid agonist treatment among adolescents","authors":"Pooja Shakya, Jaswant Jangra, Ravindra Rao, Ashwani Kumar Mishra, Roshan Bhad","doi":"10.1111/dar.13890","DOIUrl":"10.1111/dar.13890","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Opioid agonist treatment (OAT) is an effective treatment for opioid dependence syndrome in adults. However, studies on effectiveness of OAT in adolescents are limited; existing studies show varying retention rates. The present study aimed to assess OAT retention rates in adolescent patients with opioid dependence syndrome registered in a community drug treatment clinic in Delhi, India, and to analyse factors associated with retention at 1 year.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Retrospective cohort study. All adolescents (<i>n</i> = 130) aged 10–19 years, started on OAT from January 2020 to July 2022 were included. Baseline and follow-up data was extracted from online record system maintained at the clinic. OAT retention rates at different timepoints were assessed. Multivariable logistic regression was used to discern factors associated with one-year retention.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The participants' mean age was 16.9 (SD 1.4) years. Mean age of starting opioids was 14.9 (SD 2.2) years; 29.5% (<i>n</i> = 38) injected opioids. The 6-, 12-, 18- and 24-month retention rate on OAT was 64.4%, 45.6%, 38.7% and 29% respectively. The retention rates with buprenorphine and methadone were comparable. Multivariate logistic regression showed retention for less than 12 months to be significantly associated with younger age of starting heroin, involvement in illegal activities, absenteeism from school and substance use in family.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion and Conclusions</h3>\u0000 \u0000 <p>The 12-month retention rates on OAT in adolescents is comparable to retention rates in adults. Various factors associated with early age of onset of opioid use are also associated with lower retention rates on OAT.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":"43 7","pages":"1835-1844"},"PeriodicalIF":3.0,"publicationDate":"2024-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141330586","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}
Individuals with a substance use disorder (SUD) often face barriers to accessing health care, resulting in unmet needs and delayed care. Hospital-based services have the potential to engage individuals with a SUD in ongoing treatment, but there is limited literature characterising this population.
Methods
The Outcomes for Patients Accessing Addiction Care study was a prospective hospital-based cohort study conducted at St. Paul's Hospital in Vancouver, Canada. Participants were recruited from January 2018 to March 2020. Data were collected through an interviewer-administered questionnaire, including socio-demographic information, substance use history and mental health screening.
Results
The cohort included 536 participants, with 31% aged 30–39 years, 63% identifying as White and 74% reporting male sex at birth. Nearly half of the participants were either homeless or living in single room occupancy. Use of substances more than once per week was reported for tobacco/nicotine (86%), marijuana (43%), non-medical use of prescription drugs (29%), illicit stimulants (52%) and illicit opioids (61%).
Discussion and Conclusion
This preliminary report provides a description of a hospital-based cohort of individuals with a SUD accessing addiction care. The findings highlight demographic characteristics, mental health issues, substance use patterns and barriers to accessing services. Understanding these factors can inform the development of patient-centred interventions and improve engagement and retention in addiction care. Further research is needed to explore interventions and program effectiveness in this population.
{"title":"Characterising individuals with a substance use disorder accessing hospital-based addiction care: Preliminary description of the outcomes for patients accessing addiction care prospective cohort study","authors":"Hannah James, Jeffrey Morgan, Seonaid Nolan","doi":"10.1111/dar.13888","DOIUrl":"10.1111/dar.13888","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Individuals with a substance use disorder (SUD) often face barriers to accessing health care, resulting in unmet needs and delayed care. Hospital-based services have the potential to engage individuals with a SUD in ongoing treatment, but there is limited literature characterising this population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The Outcomes for Patients Accessing Addiction Care study was a prospective hospital-based cohort study conducted at St. Paul's Hospital in Vancouver, Canada. Participants were recruited from January 2018 to March 2020. Data were collected through an interviewer-administered questionnaire, including socio-demographic information, substance use history and mental health screening.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The cohort included 536 participants, with 31% aged 30–39 years, 63% identifying as White and 74% reporting male sex at birth. Nearly half of the participants were either homeless or living in single room occupancy. Use of substances more than once per week was reported for tobacco/nicotine (86%), marijuana (43%), non-medical use of prescription drugs (29%), illicit stimulants (52%) and illicit opioids (61%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion and Conclusion</h3>\u0000 \u0000 <p>This preliminary report provides a description of a hospital-based cohort of individuals with a SUD accessing addiction care. The findings highlight demographic characteristics, mental health issues, substance use patterns and barriers to accessing services. Understanding these factors can inform the development of patient-centred interventions and improve engagement and retention in addiction care. Further research is needed to explore interventions and program effectiveness in this population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":"43 7","pages":"1809-1816"},"PeriodicalIF":3.0,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dar.13888","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141310337","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}
Brienna N. Rutherford, Janni Leung, Daniel Stjepanović, Gary C. K. Chan
Introduction
There is growing concern over the lack of regulation of alcohol advertisements on social media platforms frequented by youths. This study aims to build upon existing literature by assessing the frequency with which young Australians (17–25) are shown advertisements promoting alcohol use and the themes utilised in these advertisements.
Methods
A total of 125 Australian youths (mean age 18.74 years; 74.40% female) were recruited in exchange for course credit to participate in an online study. Participants scrolled through Facebook or Instagram for a period of 30 min and screenshotted any alcohol advertisements encountered. Participants then identified the advertisement qualities (or ‘themes’) present in the advertisements, based on pre-identified categories. Demographic, social media usage and historical personal, peer or familial substance use behaviour data was also collected.
Results
Seventy-one university students were exposed to 796 alcohol advertisements across both platforms, and they encountered an advertisement every 2 min and 43 s on average. Most advertisements included call to action features on both Facebook (78.80%) and Instagram (71.17%). Advertisements relating to ease of access (promoting subscription/home delivery; 41.72% and 42.56%) and sales incentives (special offers, promotions, samples or bonuses with purchase; 43.70% and 46.84%) were most common across both platforms.
Discussion and Conclusions
Alcohol advertisements are highly prevalent online, particularly among Australian youth social media users. Future research should endeavour to identify whether temporal use of alcohol is a predictor of subsequent exposure to alcohol advertising on social media, and whether this exposure is likely to increase successive alcohol use behaviours.
{"title":"Through the looking glass: An alcohol advertisement every 3 minutes","authors":"Brienna N. Rutherford, Janni Leung, Daniel Stjepanović, Gary C. K. Chan","doi":"10.1111/dar.13886","DOIUrl":"10.1111/dar.13886","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>There is growing concern over the lack of regulation of alcohol advertisements on social media platforms frequented by youths. This study aims to build upon existing literature by assessing the frequency with which young Australians (17–25) are shown advertisements promoting alcohol use and the themes utilised in these advertisements.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 125 Australian youths (mean age 18.74 years; 74.40% female) were recruited in exchange for course credit to participate in an online study. Participants scrolled through Facebook or Instagram for a period of 30 min and screenshotted any alcohol advertisements encountered. Participants then identified the advertisement qualities (or ‘themes’) present in the advertisements, based on pre-identified categories. Demographic, social media usage and historical personal, peer or familial substance use behaviour data was also collected.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Seventy-one university students were exposed to 796 alcohol advertisements across both platforms, and they encountered an advertisement every 2 min and 43 s on average. Most advertisements included call to action features on both Facebook (78.80%) and Instagram (71.17%). Advertisements relating to ease of access (promoting subscription/home delivery; 41.72% and 42.56%) and sales incentives (special offers, promotions, samples or bonuses with purchase; 43.70% and 46.84%) were most common across both platforms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion and Conclusions</h3>\u0000 \u0000 <p>Alcohol advertisements are highly prevalent online, particularly among Australian youth social media users. Future research should endeavour to identify whether temporal use of alcohol is a predictor of subsequent exposure to alcohol advertising on social media, and whether this exposure is likely to increase successive alcohol use behaviours.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":"43 6","pages":"1426-1434"},"PeriodicalIF":3.0,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dar.13886","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141283208","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}
Jennifer Boyd, John Holmes, Naomi Gibbs, Charlotte Buckley, Robin Purshouse, Petra Meier
In recent years we have gained insight into the impact of minimum unit pricing (MUP)—a legal floor price below which a given volume of alcohol cannot be sold—on population-level reductions in alcohol sales, consumption and harm. However, several questions remain unanswered including how individual-level purchasing changes impact the local economy (e.g., balance between on-licence and off-licence outlets), lead to long-term population-level trends (e.g., youth drinking) and social harms (e.g., violence). Agent-based modelling captures heterogeneity, emergence, feedback loops and adaptive and dynamic features, which provides an opportunity to understand the nuanced effects of MUP. Agent-based models (ABM) simulate heterogeneous agents (e.g., individuals, organisations) often situated in space and time that interact with other agents and/or with their environment, allowing us to identify the mechanisms underlying social phenomena. ABMs are particularly useful for theory development, and testing and simulating the impacts of policies and interventions. We illustrate how ABMs could be applied to generate novel insights and provide best estimates of social network effects, and changes in purchasing behaviour and social harms, due to the implementation of MUP. ABMs like other modelling approaches can simulate alternative implementations of MUP (e.g., policy intensity [£0.50, £0.60] or spatial scales [local, national]) but can also provide an understanding of the potential impact of MUP on different population groups (e.g., alcohol exposure of young people who are not yet drinking). Using ABMs to understand the impact of MUP would provide new insights to complement those from traditional epidemiological and other modelling methods.
{"title":"How can agent-based modelling provide new insights into the impact of minimum unit pricing in Scotland?","authors":"Jennifer Boyd, John Holmes, Naomi Gibbs, Charlotte Buckley, Robin Purshouse, Petra Meier","doi":"10.1111/dar.13880","DOIUrl":"10.1111/dar.13880","url":null,"abstract":"<p>In recent years we have gained insight into the impact of minimum unit pricing (MUP)—a legal floor price below which a given volume of alcohol cannot be sold—on population-level reductions in alcohol sales, consumption and harm. However, several questions remain unanswered including how individual-level purchasing changes impact the local economy (e.g., balance between on-licence and off-licence outlets), lead to long-term population-level trends (e.g., youth drinking) and social harms (e.g., violence). Agent-based modelling captures heterogeneity, emergence, feedback loops and adaptive and dynamic features, which provides an opportunity to understand the nuanced effects of MUP. Agent-based models (ABM) simulate heterogeneous agents (e.g., individuals, organisations) often situated in space and time that interact with other agents and/or with their environment, allowing us to identify the mechanisms underlying social phenomena. ABMs are particularly useful for theory development, and testing and simulating the impacts of policies and interventions. We illustrate how ABMs could be applied to generate novel insights and provide best estimates of social network effects, and changes in purchasing behaviour and social harms, due to the implementation of MUP. ABMs like other modelling approaches can simulate alternative implementations of MUP (e.g., policy intensity [£0.50, £0.60] or spatial scales [local, national]) but can also provide an understanding of the potential impact of MUP on different population groups (e.g., alcohol exposure of young people who are not yet drinking). Using ABMs to understand the impact of MUP would provide new insights to complement those from traditional epidemiological and other modelling methods.</p>","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":"43 7","pages":"1657-1661"},"PeriodicalIF":3.0,"publicationDate":"2024-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dar.13880","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141261413","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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