Drug and alcohol review最新文献_第9页

Understanding the Determinants of Use of the Australian Guide to Diagnosis of Fetal Alcohol Spectrum Disorder: Informing the Review, Development and Dissemination of New National Clinical Practice Guidelines 了解使用澳大利亚胎儿酒精谱系障碍诊断指南的决定因素：为新的国家临床实践指南的审查、发展和传播提供信息

IF 2.6 3区医学 Q2 SUBSTANCE ABUSE

Drug and alcohol review

Pub Date : 2025-09-07 DOI: 10.1111/dar.70030

Natasha Reid, Jayden Logan, Yasmine Wong, Zachary Munn, Chelsea Vanderpeet, Nicole Hayes, the Australian FASD Guidelines Consortium

Introduction

The Australian Guide to the Diagnosis of fetal alcohol spectrum disorder (FASD), developed in 2016, is currently under review. This study aimed to understand how the Guide is used in practice and identify factors influencing its implementation.

Methods

A cross-sectional online survey was conducted with Australian health practitioners involved in the assessment and diagnosis of FASD. The Clinician Guideline Determinants Questionnaire was used. Quantitative data were summarised descriptively and content analysis was applied to open-ended questions.

Results

Of 333 survey sessions, 232 participants consented and 136 completed the survey. Most respondents were paediatricians (n = 54, 37%) or psychologists (n = 49, 33%). Although most clinicians felt confident using the Guide, only 44.1% agreed it clearly described the underlying evidence, and just 21% felt it adequately reflected patient preferences. Key enablers included clear, easy-to-follow guidance (n = 45, 36.3%); ease of access (n = 18, 14.5%) and familiarity with the Guide (n = 14, 11.3%). Common barriers were lack of access to appropriate clinicians, time and cost constraints (n = 25, 24.8%); concerns about the evidence base (n = 16, 15.8%); and lack of familiarity or skills (n = 8, 7.9%).

Discussion and Conclusions

Findings highlight strong clinician engagement with the 2016 Guide but also identify areas for improvement, particularly around evidence transparency and alignment with person-centred care. By engaging with stakeholders and improving guidelines based on clinician feedback, we can improve the quality of care and support for individuals with FASD and their families.

导读：澳大利亚胎儿酒精谱系障碍诊断指南（FASD）于2016年制定，目前正在审查中。本研究旨在了解《指南》在实践中的使用情况，并确定影响其实施的因素。方法：对参与FASD评估和诊断的澳大利亚卫生从业人员进行横断面在线调查。使用临床医生指南决定因素问卷。定量数据进行描述性总结，内容分析应用于开放式问题。结果：在333次调查中，232人同意，136人完成了调查。大多数回答者是儿科医生（n = 54, 37%）或心理学家（n = 49, 33%）。尽管大多数临床医生对使用指南有信心，但只有44.1%的临床医生认为指南清楚地描述了基础证据，只有21%的临床医生认为指南充分反映了患者的偏好。关键促成因素包括清晰、易于遵循的指导（n = 45, 36.3%）；易获取性（n = 18, 14.5%）和对指南的熟悉程度（n = 14, 11.3%）。常见的障碍是无法获得合适的临床医生、时间和成本限制（n = 25, 24.8%）；对证据基础的担忧（n = 16, 15.8%）；缺乏熟悉或技能（n = 8, 7.9%）。讨论和结论：调查结果强调了临床医生对2016年指南的积极参与，但也确定了需要改进的领域，特别是在证据透明度和与以人为本的护理相一致方面。通过与利益相关者合作，并根据临床医生的反馈改进指导方针，我们可以提高对FASD患者及其家庭的护理和支持质量。

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引用次数: 0

Factors Associated With Alcohol Use Among Individuals Commencing Treatment at Community-Based Outpatient Treatment Centres in Australia 在澳大利亚社区门诊治疗中心开始治疗的个体中与酒精使用相关的因素。

IF 2.6 3区医学 Q2 SUBSTANCE ABUSE

Drug and alcohol review

Pub Date : 2025-09-03 DOI: 10.1111/dar.70034

Jamie Bryant, Anthony Shakeshaft, Nicholas Lintzeris, Paul Haber, Michael Farrell, Joshua Dizon, Megan Freund

Introduction

Understanding the characteristics of individuals seeking treatment for alcohol use is essential for developing effective interventions. This study aimed to: (i) describe the characteristics of individuals accessing treatment at Australian outpatient alcohol and other drug (AOD) treatment centres; and (ii) identify characteristics associated with more harmful alcohol use at treatment commencement.

Methods

Clients from 34 community-based AOD centres completed surveys on demographic, substance use, health-related quality of life and social characteristics. A linear mixed model and two negative binomial models were used to examine factors associated with higher AUDIT scores (indicting more hazardous or harmful alcohol consumption), frequency of drinking days and heavy drinking days in the last 14 days.

Results

Participants (n = 1130) were predominantly male (65%), reported concurrent drug use (62%), self-referred for treatment (57%) and wanted to cease alcohol use completely (42%) or drink moderately (39%). Female gender, unemployment, being a victim or perpetrator of violence, poorer physical and mental health, self-referral and a goal to cease alcohol use were associated with higher AUDIT scores. Those reporting home duties, retirement, disability/carer pension, student or other employment had lower AUDIT scores. Older age, poorer physical and mental health, and treatment in Western Australia and Queensland were associated with more drinking and heavier drinking days. A goal to cease alcohol use was linked to 23% and 17% lower drinking days and heavy drinking days. Self-referral was associated with more heavy drinking days.

Discussion and Conclusion

Individuals seeking treatment for AOD use have diverse needs that should inform tailored and holistic treatment.

前言：了解寻求酒精使用治疗的个体的特征对于制定有效的干预措施至关重要。本研究旨在：(i)描述在澳大利亚门诊酒精和其他药物（AOD）治疗中心接受治疗的个人特征；（二）确定在治疗开始时与更有害的酒精使用有关的特征。方法：来自34个社区AOD中心的患者完成了人口统计、物质使用、健康相关生活质量和社会特征的调查。使用线性混合模型和两个负二项模型来检查与较高的AUDIT分数（表明更危险或有害的酒精消费）、最近14天内饮酒天数频率和重度饮酒天数相关的因素。结果：参与者（n = 1130）主要是男性（65%），报告同时使用药物（62%），自我推荐治疗（57%），希望完全停止饮酒（42%）或适度饮酒（39%）。女性性别、失业、成为暴力受害者或施暴者、较差的身心健康、自我转诊和戒酒目标与较高的审计得分有关。那些报告家务、退休、残疾/照顾者养老金、学生或其他就业的人的审计得分较低。在西澳大利亚州和昆士兰州，年龄较大、身心健康状况较差以及治疗与饮酒次数和饮酒天数有关。戒酒的目标与饮酒天数和重度饮酒天数分别减少23%和17%有关。自我推荐与更多的酗酒天数有关。讨论与结论：寻求AOD治疗的个体有不同的需求，应该为定制和整体治疗提供信息。

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引用次数: 0

Nitrous Oxide Sourcing, Use and Harms: Insights From Australians Who Use Ecstasy/MDMA and Other Illicit Stimulants 一氧化二氮的来源，使用和危害：从使用摇头丸/MDMA和其他非法兴奋剂的澳大利亚人的见解。

IF 2.6 3区医学 Q2 SUBSTANCE ABUSE

Drug and alcohol review

Pub Date : 2025-09-03 DOI: 10.1111/dar.70032

Jodie Grigg, Simon Lenton, Amy Peacock, Jessamine Soderstrom, Cate King, Natalie Thomas, Rachel Sutherland

Introduction

Increasing harms associated with nitrous oxide use have raised concerns, but limited evidence exists to inform harm reduction. This study aimed to identify how nitrous oxide is sourced, the products/forms used, awareness of health risks, engagement in harm reduction and experience of neurological symptoms.

Methods

Data were collected via annual interviews (2021–2023) with cross-sectional convenience samples of Australians who regularly used ecstasy/MDMA and/or other illicit stimulants and reported past 6-month use of nitrous oxide (2021 n = 379; 2022 n = 315; 2023 n = 284).

Results

The most commonly reported source of nitrous oxide in the past 6 months was convenience stores, followed by 24/7 delivery services. Sourcing from these retailers was also associated with heavier use. Reported use of larger cylinders (> 8 g) increased from 6% in 2021 to 26% in 2023. While most respondents demonstrated awareness of neurological risk (e.g., brain damage 63%; nerve damage 20%), only one-fifth identified the risk of Vitamin B12 depletion and 17% were unaware of any risks. Almost one-third (30%) reported limiting use per session, 36% limited frequency and 36% took no precautions. Reports of neurological symptoms rose from 5% in 2021 to 14% in 2023 among cross-sectional samples, with few (n ≤ 5) receiving treatment.

Discussion and Conclusions

Findings suggest increasing use of larger cylinders, alongside increasing neurological harms. Given the evolving regulatory and risk environment, close surveillance of usage and market trends is needed. The findings reinforce the need for balanced regulation and targeted education of retailers, clinicians and consumers to reduce harmful patterns of use and encourage early intervention.

导言：与使用一氧化二氮相关的危害日益增加引起了人们的关注，但现有的减少危害的证据有限。这项研究旨在确定一氧化二氮的来源、使用的产品/形式、对健康风险的认识、参与减少危害和神经系统症状的经历。方法：通过年度访谈（2021-2023）收集数据，这些横断面方便样本是经常使用摇头丸/MDMA和/或其他非法兴奋剂并报告过去6个月使用一氧化二氮的澳大利亚人（2021 n = 379; 2022 n = 315; 2023 n = 284）。结果：过去6个月报告的一氧化二氮最常见的来源是便利店，其次是24/7送货服务。从这些零售商那里采购也与更频繁的使用有关。据报道，大气缸（bbb80 g）的使用率从2021年的6%增加到2023年的26%。虽然大多数受访者表示意识到神经系统风险（例如，脑损伤63%；神经损伤20%），但只有五分之一的人认识到维生素B12缺乏的风险，17%的人不知道任何风险。近三分之一（30%）的人报告限制每次使用，36%的人限制频率，36%的人没有采取预防措施。在横断面样本中，神经系统症状的报告从2021年的5%上升到2023年的14%，接受治疗的病例很少（n≤5）。讨论和结论：研究结果表明越来越多地使用更大的钢瓶，同时增加神经损伤。鉴于不断变化的监管和风险环境，需要密切监测使用情况和市场趋势。研究结果表明，有必要对零售商、临床医生和消费者进行平衡的监管和有针对性的教育，以减少有害的使用模式，并鼓励早期干预。

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引用次数: 0

Normalisation of Non-Drinking and Implications for Psycho-Social Problems 不饮酒的正常化及其对心理社会问题的影响。

IF 2.6 3区医学 Q2 SUBSTANCE ABUSE

Drug and alcohol review

Pub Date : 2025-09-03 DOI: 10.1111/dar.70031

Elin K. Bye, Ingeborg Rossow, Inger Synnøve Moan

Introduction

A few decades ago, non-drinking was uncommon amongst young people in many countries, and non-drinkers typically reported more psycho-social problems than moderate drinkers. Since then, non-drinking has become common amongst Norwegian adolescents. Considering this normalisation of non-drinking, our study examined: (i) whether psycho-social problems still differ between non-drinkers, moderate drinkers and heavy drinkers; and (ii) whether psycho-social problems differ by parental drinking status amongst non-drinkers and moderate drinkers.

Methods

Data stem from the European School Survey Project on Alcohol and Other Drugs (ESPAD). The Norwegian 2024 subsample included 3471 15–16-year-olds. Psycho-social problems included anxiety and depressive symptoms and weak social support from friends and family. Parental drinking status distinguished between families with at least one non-drinking parent and families where both parents were drinkers. Mean values of non-drinkers (46% of the sample) were compared to mean values of moderate (42%) and heavy drinkers (12%) using analysis of variance and F-tests.

Results

Compared to moderate drinkers, non-drinkers reported significantly fewer anxiety and depressive symptoms, and significantly better social support from family and friends, whereas heavy drinkers reported significantly more psycho-social problems. Amongst non-drinkers, there was no significant difference in psycho-social problems by parental drinking status. Amongst moderate drinkers, those with non-drinking parents reported significantly poorer support from friends and family than others.

Discussion and Conclusions

This study lent empirical support to the hypothesis that in a context of normalised non-drinking amongst adolescents, psycho-social deviance amongst non-drinkers is not observed.

几十年前，不饮酒在许多国家的年轻人中并不常见，不饮酒者通常比适度饮酒者报告更多的心理社会问题。从那时起，不喝酒在挪威青少年中变得很普遍。考虑到这种不饮酒的正常化，我们的研究检验了：(i)不饮酒者、适度饮酒者和重度饮酒者之间的心理社会问题是否仍然不同；（ii）不饮酒者和适度饮酒者的心理社会问题是否因父母饮酒状况而不同。方法：数据来自欧洲学校酒精和其他药物调查项目（ESPAD）。挪威2024个子样本包括3471名15-16岁的年轻人。心理社会问题包括焦虑和抑郁症状以及来自朋友和家人的社会支持不足。父母饮酒状况区分了父母中至少有一方不饮酒的家庭和父母双方都饮酒的家庭。使用方差分析和f检验将不饮酒者（占样本的46%）的平均值与中度饮酒者（42%）和重度饮酒者（12%）的平均值进行比较。结果：与适度饮酒者相比，不饮酒者报告的焦虑和抑郁症状明显减少，家庭和朋友的社会支持明显更好，而重度饮酒者报告的心理社会问题明显更多。在非饮酒者中，父母饮酒状况对社会心理问题的影响无显著差异。在适度饮酒者中，那些父母不喝酒的人从朋友和家人那里得到的支持明显少于其他人。讨论和结论：本研究为以下假设提供了实证支持：在青少年戒酒正常化的背景下，不喝酒的人的社会心理偏差没有被观察到。

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引用次数: 0

Alcohol Promotion via User-Generated Content on Instagram and TikTok: A Content Analysis 通过Instagram和TikTok上的用户生成内容进行酒精促销：一项内容分析。

IF 2.6 3区医学 Q2 SUBSTANCE ABUSE

Drug and alcohol review

Pub Date : 2025-09-02 DOI: 10.1111/dar.70027

Alessandro Crocetti, Nichole Lister, Florentine Martino, Jennifer Browne, Kathryn Backholer, Peter Miller, Emma Jane Pristov, Matthew Dunn

Introduction

Alcohol-related user-generated content (UGC)—created by influencers and peers—appears to play a central role in shaping young people's alcohol-related attitudes and behaviours. However, the nature and extent to which UGC facilitates the promotion of alcohol remains under-examined. There is limited evidence on how alcohol companies utilise social media platforms to engage users and incentivise the promotion of their brands and products. Therefore, this study aimed to examine the nature and extent of alcohol promotion via UGC on Instagram and TikTok posts.

Methods

This content analysis examined 1848 public user-generated Instagram (n = 1148) and TikTok (n = 700) posts, focusing on major alcohol tags and hashtags over a 7-year period. Posts were systematically coded for account type, sentiment, product placement and indicators of marketing (e.g., sponsorship or undisclosed marketing).

Results

Of the posts analysed, 37% originated from influencers accounts. Five percent were identified as sponsored content, while 10% showed characteristics of undisclosed marketing. Half featured alcohol as the main focus, with 64% including branded products. Most posts (78%) expressed pro-brand sentiment, 53% showed positive drinking experiences and 20% portrayed camaraderie. Only 2% contained anti-brand sentiment or depicted negative consequences of alcohol consumption.

Discussion and Conclusions

The disparity between disclosed (5%) and suspected undisclosed promotional content (10%) highlights transparency and regulatory issues. UGC predominantly carried a celebratory tone, reinforcing a pro-alcohol narrative that influences young users' attitudes towards drinking. Stronger regulatory frameworks, independent monitoring and content transparency tools are urgently needed to mitigate young people's exposure to covert alcohol promotion.

导言：由影响者和同龄人创建的与酒精有关的用户生成内容（UGC）似乎在塑造年轻人与酒精有关的态度和行为方面发挥着核心作用。然而，教资会协助推广酒类的性质和程度，仍有待检讨。关于酒类公司如何利用社交媒体平台吸引用户并激励其品牌和产品的推广，证据有限。因此，本研究旨在研究通过Instagram和TikTok帖子上的UGC进行酒精促销的性质和程度。方法：该内容分析检查了1848个公共用户生成的Instagram （n = 1148）和TikTok （n = 700）帖子，重点关注7年期间的主要酒精标签和话题标签。帖子根据账户类型、情绪、产品位置和营销指标（如赞助或未披露的营销）进行系统编码。结果：在分析的帖子中，37%来自网红账户。其中5%被认定为赞助内容，而10%则表现出未公开营销的特征。一半的人主要关注酒精，64%的人关注品牌产品。大多数帖子（78%）表达了支持品牌的情绪，53%的帖子表达了积极的饮酒体验，20%的帖子描绘了同志情谊。只有2%包含反品牌情绪或描述酒精消费的负面后果。讨论与结论：已披露（5%）和疑似未披露的促销内容（10%）之间的差异凸显了透明度和监管问题。UGC主要带有庆祝的语气，强化了支持饮酒的叙事，影响了年轻用户对饮酒的态度。迫切需要更强有力的监管框架、独立监测和内容透明度工具，以减少年轻人接触隐蔽的酒精促销。

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引用次数: 0

Evaluation of a Residential Managed Alcohol Program for Aboriginal Peoples Experiencing Homelessness and Alcohol Dependence: Short-Term Impacts of an Australian Trial 对经历无家可归和酒精依赖的土著居民的住宅管理酒精计划的评估：澳大利亚试验的短期影响。

IF 2.6 3区医学 Q2 SUBSTANCE ABUSE

Drug and alcohol review

Pub Date : 2025-09-02 DOI: 10.1111/dar.70025

Kirrilly Thompson, Gianluca Di Censo, Jacqueline Bowden, Neophytos Georgiou, Mark Thompson, Victoria Cock, Blaire Brewerton, Courtney Ryder

Introduction

Homelessness and alcohol dependence can be barriers to accessing essential services such as health care, housing, and social supports. Managed alcohol programs (MAP) have emerged as an effective harm reduction strategy for people experiencing homelessness and alcohol dependence. The aim of the present study was to evaluate the short-term impacts of the first MAP run in South Australia outside of COVID-19 restrictions and the first in Australia to be conducted in a healthcare setting. It was designed to be culturally appropriate for Aboriginal and Torres Strait Islander clients.

Methods

Descriptive quantitative analysis and an inductive content analysis of case notes for 21 clients who stayed at least one night in the South Australian MAP.

Results

Clients were mostly Aboriginal, female, of middle age and managing multiple health conditions. The median stay was 15 nights per client. The MAP contributed to client wellbeing broadly across five interconnected areas: culture, housing, medical support, government system navigation, and the building of capacity, resilience, and social connectedness.

Discussion and Conclusions

The South Australian MAP provided various interconnected short-term benefits relevant to people experiencing homelessness and alcohol dependence in general and Aboriginal peoples additionally experiencing the on-going impacts of colonisation in particular. This evaluation supports international literature on the value of MAPs as an effective harm reduction approach to co-occurring homelessness and alcohol dependence and strengthens evidence for the feasibility, acceptability, and benefits of MAPs in Australia.

导言：无家可归和酒精依赖可能成为获得保健、住房和社会支持等基本服务的障碍。酒精管理方案（MAP）已成为无家可归和酒精依赖者减少伤害的有效策略。本研究的目的是评估南澳大利亚州首次在COVID-19限制之外运行的MAP的短期影响，以及澳大利亚首次在医疗保健环境中进行的MAP。它的设计是为了适应原住民和托雷斯海峡岛民的文化需求。方法：采用描述性定量分析和归纳性内容分析的方法，对21名在南澳大利亚州MAP住宿至少一晚的患者的病例记录进行分析。结果：患者以原住民、女性、中年、多种健康状况为主。每位客户的平均住宿时间为15晚。MAP在五个相互关联的领域为客户福祉做出了广泛贡献：文化、住房、医疗支持、政府系统导航，以及能力建设、复原力和社会联系。讨论和结论：南澳大利亚MAP提供了各种相互关联的短期福利，这些福利与无家可归和普遍酗酒的人以及特别受到殖民化持续影响的土著人民有关。这一评价支持了国际文献关于MAPs作为一种有效减少无家可归和酒精依赖同时发生的危害的方法的价值，并加强了澳大利亚MAPs的可行性、可接受性和效益的证据。

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引用次数: 0

Alcohol Excise Taxation, Tax Share and Revenue in the European Union and the United Kingdom in 2022: An Overview and Modelling Analysis 2022年欧盟和英国的酒精消费税、税收份额和收入：概述和建模分析。

IF 2.6 3区医学 Q2 SUBSTANCE ABUSE

Drug and alcohol review

Pub Date : 2025-08-28 DOI: 10.1111/dar.70028

Jürgen Rehm, Daniela Correia, Ahmed S. Hassan, Jakob Manthey, Pol Rovira, Kevin D. Shield, Carina Ferreira-Borges, Maria Neufeld, Mindaugas Štelemėkas

Introduction

Although increases in alcohol excise taxation have been identified as one of the ‘best buys’ of the World Health Organization to reduce alcohol consumption and attributable harm, excise tax shares—the proportion of excise tax included in retail prices of alcoholic beverages—remain low in Europe. Revenue derived from alcohol excise taxation, and how it is affected by changes in alcohol excise taxation, has not yet been widely explored.

Methods

We conducted a search for revenues generated from alcohol excise taxation in all European Union (EU) countries and the United Kingdom between 2017 and 2022. We then calculated the average excise tax share for alcoholic beverages for 2022. Using regression analysis, we predict tax revenue per capita from the tax share, type of alcohol excise taxation, recorded and unrecorded consumption and prevalence of past-year drinking. To illustrate the potential for revenue increases, we conducted a case study on Germany.

Results

In 2022, average revenue from alcohol excise taxation (119 euros per capita) and excise tax share (17.3%) were low in the EU countries and the United Kingdom, but showed sizable variation. The association between excise tax share and revenue from excise taxation was very high, with a Pearson correlation of 0.888 (0.720–0.958; df = 16; p < 0.0001). In regression analyses, only the excise tax share significantly predicted tax revenue.

Discussion and Conclusions

Marked revenue gains could be achieved in several countries having low tax shares by instituting increases in excise tax share, with only small effects on consumer prices.

导言：虽然增加酒精消费税已被世界卫生组织确定为减少酒精消费和可归因于的危害的“最合算”措施之一，但消费税份额——酒精饮料零售价格中包含的消费税比例——在欧洲仍然很低。酒精消费税产生的收入，以及它如何受到酒精消费税变化的影响，尚未得到广泛探讨。方法：我们对2017年至2022年间所有欧盟（EU）国家和英国的酒精消费税收入进行了搜索。然后，我们计算了2022年酒精饮料的平均消费税份额。使用回归分析，我们从税收份额、酒精消费税类型、记录和未记录的消费量以及过去一年饮酒的流行程度来预测人均税收收入。为了说明收入增长的潜力，我们对德国进行了一个案例研究。结果：2022年，欧盟国家和英国的酒精消费税平均收入（人均119欧元）和消费税份额（17.3%）都很低，但差异很大。消费税份额和消费税收入之间的关联非常高，皮尔逊相关性为0.888 （0.720-0.958;df = 16; p）。讨论和结论：在几个税收份额低的国家，通过提高消费税份额可以实现显著的收入增长，对消费者价格的影响很小。

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引用次数: 0

‘I Wanna Know What I'm Putting in My Body’: Perceptions of Drug Checking Services and Supply Information Among People Who Use Drugs in Rhode Island “我想知道我吃了什么”：罗德岛吸毒者对药物检查服务和供应信息的看法。

IF 2.6 3区医学 Q2 SUBSTANCE ABUSE

Drug and alcohol review

Pub Date : 2025-08-27 DOI: 10.1111/dar.70026

Katherine Dunham, E. Claire Macon, Raynald Joseph, Rachel S. Wightman, Alexandra B. Collins

Introduction

Drug checking services are emerging in the United States as a response to the rapidly changing drug supply. To inform the expansion of these services, it is critical to understand people who use drugs' perceptions of these programs and technologies. We explored perceptions of multiple drug checking technologies and supply communication among people who use drugs in Rhode Island.

Methods

Data were collected as part of a community-based, mixed-methods study assessing the local drug supply. This analysis focuses on follow-up qualitative interviews conducted from December 2022 to March 2023 with a subset (n = 25) of baseline participants. Data were analysed drawing on theories of situated rationality and the intersectional risk environment to examine implementation considerations for drug checking services and the communication of drug supply information.

Results

While participants described how varying degrees of structural vulnerability created barriers to using currently available drug checking technologies, many expressed an interest in learning more about the supply and utilising community-based drug checking programs. Importantly, despite this interest, participants described how structural constraints hinder the utility of these services, highlighting barriers to use like supply and time requirements, location and criminalisation. Participants further described existing efforts to communicate supply information through peer-to-peer dissemination and bidirectional communication between buyers and sellers.

Discussion and Conclusions

It is imperative that, beyond supporting and expanding drug checking services, we support interventions that address the structural constraints that impede the accessibility and utility of these services.

导言：药物检查服务正在美国出现，以应对快速变化的药物供应。为了为这些服务的扩展提供信息，了解吸毒者对这些项目和技术的看法至关重要。我们探索了对多种药物检查技术的看法，并在罗德岛州的吸毒者中进行了供应沟通。方法：收集数据作为一项以社区为基础的混合方法研究的一部分，评估当地药物供应。该分析侧重于2022年12月至2023年3月期间对基线参与者的子集（n = 25）进行的后续定性访谈。利用情境理性理论和交叉风险环境理论对数据进行分析，以考察药品检查服务和药品供应信息沟通的实施考虑。结果：虽然参与者描述了不同程度的结构脆弱性如何对使用现有的药物检查技术造成障碍，但许多人表示有兴趣更多地了解供应和利用基于社区的药物检查计划。重要的是，尽管有这种兴趣，与会者描述了结构性限制如何阻碍这些服务的利用，强调了使用的障碍，如供应和时间要求、地点和刑事定罪。与会者进一步描述了通过点对点传播和买卖双方双向沟通来沟通供应信息的现有努力。讨论和结论：除了支持和扩大药物检查服务之外，我们还必须支持解决阻碍这些服务可及性和效用的结构性限制的干预措施。

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引用次数: 0

Geographic Differences in Public Opinion on Drug Policy: Understanding Patterns of Support and ‘Don't Know’ Responses 毒品政策民意的地域差异：支持与“不知道”反应的理解模式

IF 2.6 3区医学 Q2 SUBSTANCE ABUSE

Drug and alcohol review

Pub Date : 2025-08-27 DOI: 10.1111/dar.70023

Paul Kelaita, Keelin O'Reilly, Alison Ritter

Introduction

Policymakers and advocates often rely on public opinion to support or oppose certain policies, with national surveys providing an important data source. Different geographic areas have socio-political specificity and are impacted by drug policies in different ways; yet there has been little analysis of public opinion accounting for geographic specificity. This study aimed to understand geographic differences in policy preferences using the case study of Greater Western Sydney (GWS), New South Wales (NSW), Australia.

Methods

Responses to two policy perception questions from Australia's 2022/23 National Drug Strategy Household Survey were analysed: preferred actions in response to possession and use of cannabis, ecstasy, heroin, methamphetamine, and hallucinogens (‘Action’ question), and the preferred criminal offence status of cannabis possession (‘Criminal’ question). Responses in GWS were compared to Rest of Sydney and Rest of NSW. Data were analysed by levels of support and proportions of respondents who did not register an opinion (not answered, ‘don't know’).

Results

Levels of support for different actions and policy settings varied by area, as did the proportions of respondents who do not register an opinion. The inclusion or exclusion of ‘don't know’/not answered responses influences interpretations of levels of public knowledge, engagement, and support.

Discussion and Conclusion

Public opinion as gauged through national surveys should be understood relative to specific geographies. Understanding whether geographic differences exist is important to understanding what drives support and ‘don't know’/not answered responses in relation to drug policy. Differences indicate sites for further analysis and attention in education, engagement and advocacy.

政策制定者和倡导者经常依靠公众舆论来支持或反对某些政策，全国调查提供了一个重要的数据来源。不同的地理区域具有社会政治特殊性，并以不同的方式受到毒品政策的影响；然而，很少有关于地理特殊性的民意分析。本研究旨在通过对澳大利亚新南威尔士州（NSW）大西悉尼（GWS）的案例研究，了解政策偏好的地理差异。方法：分析了澳大利亚2022/23年国家毒品战略家庭调查中对两个政策认知问题的回答：对拥有和使用大麻、摇头丸、海洛因、甲基苯丙胺和致幻剂的首选行动（“行动”问题），以及对拥有大麻的首选刑事犯罪状态（“刑事”问题）。GWS的反应与悉尼其他地区和新南威尔士州其他地区进行了比较。数据是通过支持程度和未发表意见（未回答，“不知道”）的受访者比例来分析的。结果：对不同行动和政策设置的支持程度因地区而异，不发表意见的受访者比例也是如此。包含或排除“不知道”/未回答的回答会影响对公众知识、参与和支持水平的解释。讨论和结论：通过国家调查衡量的民意应该相对于特定的地理位置来理解。了解地理差异是否存在，对于理解是什么推动了对毒品政策的支持和“不知道”/未回答的回应，是很重要的。差异表明在教育、参与和宣传方面需要进一步分析和关注的地方。

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引用次数: 0

Emergence of Medetomidine in the Unregulated Drug Supply and Its Association With Hallucinogenic Effects 美托咪定在非管制药品供应中的出现及其与致幻作用的关系。

IF 2.6 3区医学 Q2 SUBSTANCE ABUSE

Drug and alcohol review

Pub Date : 2025-08-22 DOI: 10.1111/dar.70024

Adams L. Sibley, Madigan L. Bedard, Samuel Tobias, Brooke A. Chidgey, Irina G. Phillips, Alice Bell, Nabarun Dasgupta

Introduction

The unregulated drug supply in the United States is rapidly evolving, and veterinary tranquillisers have emerged as adulterants of concern, especially in illicitly-manufactured fentanyl. Following the proliferation of xylazine, medetomidine, a more potent sedative, has recently appeared in multiple US states. This study describes the characteristics of medetomidine samples from a national mail-based drug checking program and aims to determine whether medetomidine is associated with hallucinogenic effects.

Methods

We conducted a retrospective analysis of 11,363 drug samples between December 2022 and April 2025. Samples were sent voluntarily by people who use drugs. Participant-reported sensations and sample characteristics (e.g., colour, texture) were gathered at point-of-contact. Composition was analysed using gas-chromatography mass spectrometry. We estimated adjusted prevalence ratios for hallucinations in medetomidine-containing samples using generalised estimating equations.

Results

Medetomidine was identified in 278 samples (2.4%), with pronounced growth beginning June 2024. Medetomidine commonly appeared with fentanyl (58.8%) and/or xylazine (55.9%). Most samples were powders (85.3%). Among all 11,363 samples, those containing medetomidine in primary abundance (n = 136) were more likely to be associated with reported hallucinations (17.6%) compared to all other samples (1.2%; adjusted prevalence ratio: 11.95, 95% confidence interval 6.36, 22.44).

Discussion and Conclusions

Medetomidine is an emerging adulterant, although its risk profile is under-described. Our findings suggest medetomidine may cause hallucinogenic effects, contradicting clinical use for preventing delirium in postsurgical settings. Unexpected hallucinations may serve as a sentinel signal for medetomidine's presence in local drug markets. Education is needed for people who use drugs and clinicians about novel adverse effects of medetomidine.

在美国，不受管制的药物供应正在迅速发展，兽医镇静剂已成为令人关注的掺假剂，特别是在非法制造的芬太尼中。继噻嗪大量使用后，美托咪定，一种更有效的镇静剂，最近在美国多个州出现。本研究描述了美托咪定样品的特点，从国家邮件为基础的药物检查程序，旨在确定美托咪定是否与致幻作用有关。方法：对2022年12月至2025年4月共11363份药品样品进行回顾性分析。样本是由吸毒者自愿送来的。参与者报告的感觉和样品特征（如颜色、质地）在接触点收集。采用气相色谱-质谱法分析成分。我们使用广义估计方程估计了含美托咪定样本中幻觉的校正患病率。结果：美托咪定在278份样本中检出（2.4%），从2024年6月开始显著增长。美托咪定常与芬太尼（58.8%）和/或噻嗪（55.9%）一起出现。样品以粉末状为主（85.3%）。在所有11,363个样本中，与所有其他样本（1.2%，校正患病率：11.95,95%可信区间6.36,22.44）相比，含有美托咪定初始丰度（n = 136）的样本更可能与报告的幻觉相关（17.6%）。讨论和结论：美托咪定是一种新兴的掺假剂，尽管其风险描述不足。我们的研究结果表明美托咪定可能引起致幻作用，这与临床上用于预防术后谵妄的应用相矛盾。意想不到的幻觉可能是美托咪定出现在当地毒品市场的哨兵信号。需要对药物使用者和临床医生进行有关美托咪定新不良反应的教育。

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引用次数: 0