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Weatherall TJ, Conigrave JH, Conigrave KM, Perry J, Wilson S, Room R, Chikritzhs T, Kylie Lee KS. Alcohol dependence in a community sample of Aboriginal and Torres Strait Islander Australians: harms, getting help and awareness of local treatments. Addict Sci Clin Pract 2021; 16:65. [PMID: 34715909 PMCID: PMC8555222 DOI: 10.1186/s13722-021-00274-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 10/21/2021] [Indexed: 11/10/2022] Open
Abstract
Background Few studies have examined links between current alcohol dependence and specific harms among Indigenous Australians. We investigated these associations as well as help seeking for drinking, awareness of local treatments and recommendations to help family or friends cut down or stop drinking in two Indigenous communities. Methods A representative sample of Indigenous Australians was surveyed in one urban and one remote community in South Australia. Data were collected via the Grog Survey App. Participants were dependent if they reported two or more symptoms of alcohol dependence (ICD-11). Pearson chi-square tests were used to describe relationships between employment by gender, and dependence by awareness of medicines and local treatment options. Multivariate logistic regressions were used to predict the odds of dependent drinkers experiencing harms and getting help for drinking, controlling for age, gender, schooling and income. Results A total of 775 Indigenous Australians took part in the study. After controlling for confounders, dependent drinkers were nearly eight times more likely to report a harm and nearly three times more likely to get help for their drinking—compared with non-dependent drinkers. Participants recommended accessing local support from an Aboriginal alcohol and other drugs worker, or a detoxification/ rehabilitation service. Discussion and conclusions More support and funding is needed for Indigenous Australians to ensure local treatment options for dependent drinkers are readily available, appropriate and accessible. Involvement of local Aboriginal or Torres Strait Islander health professionals in delivery of care can help ensure that it is appropriate to an individual’s culture and context.
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Affiliation(s)
- Teagan J Weatherall
- Faculty of Medicine and Health, Discipline of Addiction Medicine, NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, The University of Sydney, Sydney, NSW, Australia. .,The Edith Collins Centre (Translational Research in Alcohol Drugs and Toxicology), Sydney Local Health District, Sydney, NSW, Australia. .,Faculty of Medicine and Health, Discipline of Addiction Medicine, Indigenous Health and Substance Use, NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, The University of Sydney, King George V Building, 83-117 Missenden Road, Camperdown, NSW, 2050, Australia.
| | - James H Conigrave
- Faculty of Medicine and Health, Discipline of Addiction Medicine, NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, The University of Sydney, Sydney, NSW, Australia.,The Edith Collins Centre (Translational Research in Alcohol Drugs and Toxicology), Sydney Local Health District, Sydney, NSW, Australia
| | - Katherine M Conigrave
- Faculty of Medicine and Health, Discipline of Addiction Medicine, NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, The University of Sydney, Sydney, NSW, Australia.,The Edith Collins Centre (Translational Research in Alcohol Drugs and Toxicology), Sydney Local Health District, Sydney, NSW, Australia.,Drug Health Services, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| | - Jimmy Perry
- Aboriginal Drug and Alcohol Council South Australia, Underdale, SA, Australia
| | - Scott Wilson
- Faculty of Medicine and Health, Discipline of Addiction Medicine, NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, The University of Sydney, Sydney, NSW, Australia.,The Edith Collins Centre (Translational Research in Alcohol Drugs and Toxicology), Sydney Local Health District, Sydney, NSW, Australia.,Aboriginal Drug and Alcohol Council South Australia, Underdale, SA, Australia
| | - Robin Room
- Centre for Alcohol Policy Research, La Trobe University, Bundoora, VIC, Australia.,Department of Public Health Sciences, Centre for Social Research on Alcohol and Drugs, Stockholm University, Stockholm, Sweden
| | - Tanya Chikritzhs
- National Drug Research Institute, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
| | - K S Kylie Lee
- Faculty of Medicine and Health, Discipline of Addiction Medicine, NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, The University of Sydney, Sydney, NSW, Australia.,The Edith Collins Centre (Translational Research in Alcohol Drugs and Toxicology), Sydney Local Health District, Sydney, NSW, Australia.,Centre for Alcohol Policy Research, La Trobe University, Bundoora, VIC, Australia.,National Drug Research Institute, Faculty of Health Sciences, Curtin University, Perth, WA, Australia.,Burnet Institute, Melbourne, VIC, Australia
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Lee KSK, Conigrave JH, Wilson S, Perry J, Callinan S, Room R, Chikritzhs TN, Slade T, Hayman N, Leggat G, Conigrave KM. Short screening tools for risky drinking in Aboriginal and Torres Strait Islander Australians: modified AUDIT-C and a new approach. Addict Sci Clin Pract 2019; 14:22. [PMID: 31256762 PMCID: PMC6600888 DOI: 10.1186/s13722-019-0152-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 05/30/2019] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Alcohol consumption among Indigenous Australians can involve a stop-start pattern of drinking, with consumption well above recommended guidelines on each occasion. Such intermittent drinking patterns can make screening for risky drinking difficult. This study evaluates the ability of several short alcohol screening tools, contained in the Grog Survey Application, to detect short- or long-term risky drinking as defined by Australian guidelines. Tested tools include a modification of Alcohol Use Disorders Identification Test-Consumption (AUDIT-Cm). METHODS Alcohol consumption was assessed in current drinkers in the past year (n = 184) using AUDIT-Cm and using the last four drinking occasions (Finnish method). Sensitivity and specificity were assessed relative to the Finnish method, for how AUDIT-Cm score (3 + for women, 4 + for men), and how subsets of AUDIT-Cm questions (AUDIT-1m and AUDIT-2m; and AUDIT-3mV alone) were able to determine short- or long-term risk from drinking. Responses to AUDIT-Cm were used to calculate the average standard drinks consumed per day, and the frequency at which more than four standard drinks were consumed on single occasions. Finally, shorter versions of the Finnish method (1, 2, or 3 occasions of drinking) were compared to the full Finnish method, by examining the percentage of variance retained by shorter versions. RESULTS AUDIT-Cm has a high sensitivity in detecting at-risk drinking compared with the Finnish method (sensitivity = 99%, specificity = 67%). The combination of AUDIT-1m and AUDIT-2m was able to classify the drinking risk status for all but four individuals in the same way as the Finnish method did. For the Finnish method, two drinking sessions to calculate drinks per drinking occasion, and four to calculate frequency resulted in nearly identical estimates to data on all four of the most recent drinking occasions (r2 = 0.997). CONCLUSIONS The combination of AUDIT-1m and AUDIT-2m may offer advantages as a short screening tool, over AUDIT-3mV, in groups where intermittent and high per occasion drinking is common. As an alternative to the full Finnish method, the quantity consumed on the last two occasions and timing of the last four occasions may provide a practical short screening tool.
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Affiliation(s)
- K S Kylie Lee
- NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, Discipline of Addiction Medicine, Indigenous Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, King George V Building, Level 6, 83-117 Missenden Road, Camperdown, NSW, 2050, Australia. .,Centre for Alcohol Policy Research, La Trobe University, Bundoora, VIC, Australia.
| | - James H Conigrave
- NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, Discipline of Addiction Medicine, Indigenous Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, King George V Building, Level 6, 83-117 Missenden Road, Camperdown, NSW, 2050, Australia
| | - Scott Wilson
- NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, Discipline of Addiction Medicine, Indigenous Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, King George V Building, Level 6, 83-117 Missenden Road, Camperdown, NSW, 2050, Australia.,Aboriginal Drug and Alcohol Council (ADAC), Underdale, SA, Australia
| | - Jimmy Perry
- Aboriginal Drug and Alcohol Council (ADAC), Underdale, SA, Australia
| | - Sarah Callinan
- Centre for Alcohol Policy Research, La Trobe University, Bundoora, VIC, Australia
| | - Robin Room
- Centre for Alcohol Policy Research, La Trobe University, Bundoora, VIC, Australia
| | - Tanya N Chikritzhs
- Health Sciences, National Drug Research Institute, Curtin University, Perth, WA, Australia
| | - Tim Slade
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia
| | - Noel Hayman
- Southern Queensland Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care (Inala Indigenous Health Service), Inala, QLD, Australia.,School of Medicine, Griffith University, Brisbane, QLD, Australia.,School of Medicine, University of Queensland, Saint Lucia, QLD, Australia
| | - Geoffrey Leggat
- Centre for Alcohol Policy Research, La Trobe University, Bundoora, VIC, Australia
| | - Katherine M Conigrave
- NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, Discipline of Addiction Medicine, Indigenous Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, King George V Building, Level 6, 83-117 Missenden Road, Camperdown, NSW, 2050, Australia.,Sydney Local Health District, Royal Prince Alfred Hospital, Drug Health Services, Camperdown, NSW, Australia
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Examining the correlates of current smoking among off-reserve First Nations, Métis and Inuit youth: Evidence from the 2012 Aboriginal Peoples Survey. Addict Behav 2017; 69:93-97. [PMID: 28214709 DOI: 10.1016/j.addbeh.2017.02.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Revised: 02/05/2017] [Accepted: 02/09/2017] [Indexed: 11/23/2022]
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Noble N, Paul C, Conigrave K, Lee K, Blunden S, Turon H, Carey M, McElduff P. Does a retrospective seven-day alcohol diary reflect usual alcohol intake for a predominantly disadvantaged Australian Aboriginal population? Subst Use Misuse 2015; 50:308-19. [PMID: 25474728 DOI: 10.3109/10826084.2014.980951] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Alcohol disproportionately affects socially disadvantaged groups including Aboriginal and Torres Strait Islander Australians. METHODs to assess alcohol intake for disadvantaged communities need to be able to capture variable or episodic drinking. The ability of a seven-day diary to capture typical consumption for a predominantly Aboriginal sample has not been assessed. OBJECTIVE One aim of this paper was to examine agreement between a seven-day retrospective diary and 'usual' drinking assessed by a modified version of the Alcohol Use Disorders Identification Test question 3 (AUDIT-3m; two questions). Other aims were to describe drinking patterns as reported in the seven-day diary. METHOD In 2012, consecutive adults attending an Aboriginal Community Controlled Health Service completed a cross-sectional health risk survey on a touch screen laptop (n = 188). Alcohol consumption questions included the retrospective diary and AUDIT-3m. Agreement was assessed using weighted kappa analysis. RESULTS There was good agreement between the two measures of consumption; however, the AUDIT-3m questions identified more current drinkers. Respondents who were drinkers (54%) tended to consume large amounts per drinking occasion: almost half (46%) of diary completers reported nine or more standard drinks on at least one occasion in the last week. CONCLUSIONS The seven-day diary did not adequately capture variability in alcohol consumption common among this sample. Although the AUDIT-3m appeared acceptable, alternative approaches to assess usual or risky alcohol consumption, such as asking about specific drinking occasions, or allowing participants to respond in non-standard drink sizes, also need to be considered for indigenous and other disadvantaged communities.
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Affiliation(s)
- Natasha Noble
- 1School of Medicine and Public Health, HMRI Building, University of Newcastle, Callaghan, Newcastle, Australia
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Frydrych AM, Slack-Smith LM, Parsons R, Threlfall T. Oral cavity squamous cell carcinoma - characteristics and survival in aboriginal and non-aboriginal Western australians. Open Dent J 2014; 8:168-74. [PMID: 25328552 PMCID: PMC4200744 DOI: 10.2174/1874210601408010168] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2014] [Revised: 08/15/2014] [Accepted: 08/24/2014] [Indexed: 11/24/2022] Open
Abstract
Background: Squamous cell carcinoma (SCC) is the most common type of malignancy affecting the oral cavity. While exposures to main risk factors for oral SCC such as smoking and alcohol use are higher amongst the Aboriginal people, little is known about oral cancer in this population. This study aimed to describe characteristics and survival of oral SCC in Aboriginal and non-Aboriginal Western Australians. Methods: All primary oral SCC cases reported to the Western Australian Cancer Registry (WACR) between 1990 and 1999 were analysed with respect to person characteristics including: date of birth, sex and indigenous status; and disease characteristics including: date of biopsy, disease stage and site as well as date of recurrence and date of death. Exclusion criteria included diagnosis not based on incisional or excisional biopsy, diagnosis other than oral SCC or a history of another malignant neoplasm. Results: Aboriginal individuals were more likely to reside in rural areas. No statistically significant differences in oral SCC characteristics and survival were noted between Aboriginal and non-Aboriginal Western Australians. Conclusion: This study provides new information on person and disease characteristics of Aboriginal Western Australians diagnosed with oral SCC.
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Affiliation(s)
- A M Frydrych
- School of Dentistry M512, The University of Western Australia, Perth, Western Australia
| | - L M Slack-Smith
- School of Dentistry M512, The University of Western Australia, Perth, Western Australia
| | - R Parsons
- School of Occupational Therapy and Social Work, Curtin University, Perth, Western Australia
| | - T Threlfall
- Western Australian Cancer Registry, Department of Health (WA) Perth, Western Australia
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Lee KSK, Chikritzhs T, Wilson S, Wilkes Ao E, Gray D, Room R, Conigrave KM. Better methods to collect self-reported alcohol and other drug use data from Aboriginal and Torres Strait Islander Australians. Drug Alcohol Rev 2014; 33:466-72. [PMID: 24849378 DOI: 10.1111/dar.12159] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Kim San Kylie Lee
- Aboriginal and Torres Strait Health, Discipline of Addiction Medicine, Sydney Medical School, University of Sydney, Sydney, Australia.
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Lee KSK, Dawson A, Conigrave KM. The role of an Aboriginal women's group in meeting the high needs of clients attending outpatient alcohol and other drug treatment. Drug Alcohol Rev 2013; 32:618-26. [PMID: 23968311 DOI: 10.1111/dar.12068] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2013] [Accepted: 07/09/2013] [Indexed: 01/28/2023]
Abstract
INTRODUCTION AND AIMS Support groups are typically offered as part of specialist alcohol or other drug treatment. However, their usefulness with Indigenous Australians has not been examined. This paper provides a profile of Aboriginal women attending an inner city outpatient alcohol and other drug treatment service, insight into how effective women and staff perceive the support group to be at meeting their needs and suggestions for improvements. DESIGN AND METHODS Structured interviews were conducted with 24 Aboriginal female clients of an outpatient treatment service and with 21 staff from across that service and the local Aboriginal Medical Service. Client interviews also assessed alcohol consumption and mental health risk (Indigenous Risk Impact Screen). RESULTS Clients reported social and health indicators illustrating disadvantage and complex needs. Most clients and staff perceived the group to be useful and easily accessible. The participants discussed positive elements including opportunities for shared experience in a non-judgemental environment, practical support and health education. Staff reported how the safe, relaxed environment of the group helped with early identification of issues and user-friendly pathways for treatment access. Suggested improvements included greater involvement from Aboriginal staff and community members and enhanced communication with other staff. DISCUSSION AND CONCLUSIONS Clients and staff recognised the usefulness of the group, including the opportunities it provided for socialisation and early intervention. Comprehensive research is needed to determine the types and sources of support that best assist Aboriginal women with substance use disorders.
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Affiliation(s)
- Kim San Kylie Lee
- Discipline of Addiction Medicine, Sydney Medical School, University of Sydney, Sydney, Australia
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Elton-Marshall T, Leatherdale ST, Burkhalter R, Brown KS. Changes in tobacco use, susceptibility to future smoking, and quit attempts among Canadian youth over time: a comparison of off-reserve Aboriginal and non-Aboriginal youth. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2013; 10:729-41. [PMID: 23429753 PMCID: PMC3635174 DOI: 10.3390/ijerph10020729] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2012] [Revised: 01/17/2013] [Accepted: 01/29/2013] [Indexed: 11/16/2022]
Abstract
The purpose of this study was to determine whether there is a growing inequity in tobacco use, susceptibility to future smoking, and quit attempts among Off-Reserve Aboriginal (ORA) youth in Canada relative to Non-Aboriginal youth. Current smoking, susceptibility to future smoking and quit attempts were examined among a nationally representative sample of ORA and Non-Aboriginal Canadian youth. Data are from cross-sectional surveys of 88,661 respondents in Grades 6 to 9 across the 2004, 2006 and 2008 survey waves of the Youth Smoking Survey (YSS). At each wave, ORA youth were more likely to be current smokers (overall OR = 3.91, 95% CI 3.47 to 4.41), to be susceptible to future smoking (overall OR = 1.37, 95% CI 1.27 to 1.48), and less likely to have ever made a quit attempt compared to Non-Aboriginal youth (overall OR = 0.74, 95% CI 0.57 to 0.96). Although susceptibility to future smoking declined for Non-Aboriginal youth, the prevalence of susceptibility remained stable among ORA youth. The percentage of ORA youth reporting making a quit attempt increased, however, current smoking rates among ORA youth did not decline. These findings suggest that the disparity in susceptibility to future tobacco use among ORA and Non-Aboriginal youth has increased over time. Despite increased rates of quit attempts, current smoking rates remain significantly higher among ORA youth. Tobacco control programs for Aboriginal youth should be a public health priority.
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Affiliation(s)
- Tara Elton-Marshall
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON N2L 3G1, Canada; E-Mails: (T.E.-M.); (K.S.B.)
| | - Scott T. Leatherdale
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON N2L 3G1, Canada; E-Mails: (T.E.-M.); (K.S.B.)
- Author to whom correspondence should be addressed; E-Mail: ; Tel.: +1-519-888-4567 (ext. 37812); Fax: +1-519-746-8171
| | - Robin Burkhalter
- Propel Centre for Population Health Impact, University of Waterloo, Waterloo, ON N2L 3G1, Canada; E-Mail:
| | - K. Stephen Brown
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON N2L 3G1, Canada; E-Mails: (T.E.-M.); (K.S.B.)
- Propel Centre for Population Health Impact, University of Waterloo, Waterloo, ON N2L 3G1, Canada; E-Mail:
- Department of Statistics and Actuarial Sciences, University of Waterloo, Waterloo, ON N2L 3G1, Canada
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