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Kershaw S, Sunderland M, Grager A, Birrell L, Deen H, Newton NC, Stapinski LA, Champion KE, Kay-Lambkin F, Teesson M, Chapman C. Perceived barriers to help-seeking for people who use crystal methamphetamine: Perspectives of people with lived experience, family members and health workers. Drug Alcohol Rev 2024. [PMID: 38965840 DOI: 10.1111/dar.13897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 05/16/2024] [Accepted: 06/20/2024] [Indexed: 07/06/2024]
Abstract
INTRODUCTION Barriers to help-seeking for illicit drug use cross psychosocial (e.g., knowledge of where to seek help, attitudinal beliefs like being afraid of what people will think) and structural (e.g., service availability) domains. Along with people who use illicit drugs, it is important to consider the perspectives of other key groups who are often involved in the help-seeking and recovery process. This study aimed to examine the perceived barriers to help-seeking for people who use crystal methamphetamine ('ice') among key groups (people who use crystal methamphetamine, families and friends, health workers) as well as the general community. METHODS A cross-sectional online survey open to all Australian residents (aged ≥18 years) was conducted November 2018-March 2019. Four key groups of interest were recruited to examine and compare perceived barriers to help-seeking for crystal methamphetamine use. RESULTS Participants (n = 2108) included: people who use/have used crystal methamphetamine (n = 564, 39%), health workers (n = 288, 26.8%), affected family/friends (n = 434, 13.7%) and general community (n = 822, 20.6%). People who used crystal methamphetamine demonstrated increased odds of reporting attitudinal (OR 1.35; 1.02-1.80) or structural (OR 1.89; 1.09-3.27) barriers, or a previous negative help-seeking experience (OR 2.27; 1.41-3.66) compared to knowledge barriers. Health workers demonstrated decreased odds of reporting attitudinal compared to knowledge barriers (OR 0.69; 0.50-0.95). DISCUSSION AND CONCLUSIONS Perceived barriers to seeking help for crystal methamphetamine use differed among key groups involved in treatment and recovery. Acknowledging and addressing the mismatches between key groups, through targeted interventions may better support people to seek help for crystal methamphetamine use.
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Affiliation(s)
- Steph Kershaw
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Matthew Sunderland
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Anna Grager
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Louise Birrell
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Hannah Deen
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Nicola C Newton
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Lexine A Stapinski
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Katrina E Champion
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | | | - Maree Teesson
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Cath Chapman
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
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Siefried KJ, Bascombe F, Clifford B, Liu Z, Middleton P, Kay-Lambkin F, Freestone J, Herman D, Millard M, Steele M, Acheson L, Moller C, Bath N, Ezard N. Effect of a Smartphone App (S-Check) on Actual and Intended Help-Seeking and Motivation to Change Methamphetamine Use Among Adult Consumers of Methamphetamine in Australia: Randomized Waitlist-Controlled Trial. JMIR Mhealth Uhealth 2024; 12:e55663. [PMID: 38959499 PMCID: PMC11255525 DOI: 10.2196/55663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 01/23/2024] [Accepted: 05/10/2024] [Indexed: 07/05/2024] Open
Abstract
BACKGROUND Interventions are required that address delays in treatment-seeking and low treatment coverage among people consuming methamphetamine. OBJECTIVE We aim to determine whether a self-administered smartphone-based intervention, the "S-Check app" can increase help-seeking and motivation to change methamphetamine use, and determine factors associated with app engagement. METHODS This study is a randomized, 28-day waitlist-controlled trial. Consenting adults residing in Australia who reported using methamphetamine at least once in the last month were eligible to download the app for free from Android or iOS app stores. Those randomized to the intervention group had immediate access to the S-Check app, the control group was wait-listed for 28 days before gaining access, and then all had access until day 56. Actual help-seeking and intention to seek help were assessed by the modified Actual Help Seeking Questionnaire (mAHSQ), modified General Help Seeking Questionnaire, and motivation to change methamphetamine use by the modified readiness ruler. χ2 comparisons of the proportion of positive responses to the mAHSQ, modified General Help Seeking Questionnaire, and modified readiness ruler were conducted between the 2 groups. Logistic regression models compared the odds of actual help-seeking, intention to seek help, and motivation to change at day 28 between the 2 groups. Secondary outcomes were the most commonly accessed features of the app, methamphetamine use, feasibility and acceptability of the app, and associations between S-Check app engagement and participant demographic and methamphetamine use characteristics. RESULTS In total, 560 participants downloaded the app; 259 (46.3%) completed eConsent and baseline; and 84 (32.4%) provided data on day 28. Participants in the immediate access group were more likely to seek professional help (mAHSQ) at day 28 than those in the control group (n=15, 45.5% vs n=12, 23.5%; χ21=4.42, P=.04). There was no significant difference in the odds of actual help-seeking, intention to seek help, or motivation to change methamphetamine use between the 2 groups on the primary logistic regression analyses, while in the ancillary analyses, the imputed data set showed a significant difference in the odds of seeking professional help between participants in the immediate access group compared to the waitlist control group (adjusted odds ratio 2.64, 95% CI 1.19-5.83, P=.02). For participants not seeking help at baseline, each minute in the app increased the likelihood of seeking professional help by day 28 by 8% (ratio 1.08, 95% CI 1.02-1.22, P=.04). Among the intervention group, a 10-minute increase in app engagement time was associated with a decrease in days of methamphetamine use by 0.4 days (regression coefficient [β] -0.04, P=.02). CONCLUSIONS The S-Check app is a feasible low-resource self-administered intervention for adults in Australia who consume methamphetamine. Study attrition was high and, while common in mobile health interventions, warrants larger studies of the S-Check app. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry ACTRN12619000534189; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=377288&isReview=true.
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Affiliation(s)
- Krista J Siefried
- The National Centre for Clinical Research on Emerging Drugs, University of New South Wales, Randwick, Australia
- St Vincent's Hospital Alcohol and Drug Service, Sydney, Australia
- The National Drug and Alcohol Research Centre, The University of New South Wales, Sydney, Australia
| | - Florence Bascombe
- The National Centre for Clinical Research on Emerging Drugs, University of New South Wales, Randwick, Australia
- Institute for Global Health, University College London, London, United Kingdom
- Central and North-West London NHS Foundation Trust, London, United Kingdom
- University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - Brendan Clifford
- The National Centre for Clinical Research on Emerging Drugs, University of New South Wales, Randwick, Australia
- St Vincent's Hospital Alcohol and Drug Service, Sydney, Australia
- The National Drug and Alcohol Research Centre, The University of New South Wales, Sydney, Australia
- New South Wales Drug and Alcohol Clinical Research and Improvement Network, New South Wales Ministry of Health, Sydney, Australia
| | - Zhixin Liu
- Healthdirect Australia, Sydney, Australia
| | - Peter Middleton
- St Vincent's Hospital Alcohol and Drug Service, Sydney, Australia
- New South Wales Drug and Alcohol Clinical Research and Improvement Network, New South Wales Ministry of Health, Sydney, Australia
| | - Frances Kay-Lambkin
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, Australia
| | - Jack Freestone
- ACON, Sydney, Australia
- The Kirby Institute, University of New South Wales, Sydney, Australia
| | | | - Michael Millard
- Clinical Research Unit for Anxiety and Depression, St Vincent's Hospital, Sydney, Australia
| | - Maureen Steele
- St Vincent's Hospital Alcohol and Drug Service, Sydney, Australia
| | - Liam Acheson
- The National Centre for Clinical Research on Emerging Drugs, University of New South Wales, Randwick, Australia
- St Vincent's Hospital Alcohol and Drug Service, Sydney, Australia
- The National Drug and Alcohol Research Centre, The University of New South Wales, Sydney, Australia
| | - Carl Moller
- The National Centre for Clinical Research on Emerging Drugs, University of New South Wales, Randwick, Australia
| | - Nicky Bath
- LGBTIQ+ Health Australia, Sydney, Australia
| | - Nadine Ezard
- The National Centre for Clinical Research on Emerging Drugs, University of New South Wales, Randwick, Australia
- St Vincent's Hospital Alcohol and Drug Service, Sydney, Australia
- The National Drug and Alcohol Research Centre, The University of New South Wales, Sydney, Australia
- New South Wales Drug and Alcohol Clinical Research and Improvement Network, New South Wales Ministry of Health, Sydney, Australia
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Duncan Z, Ward B, Kippen R, Dietze P, Sutton K. A narrative systematic review of associations and temporality between use of methamphetamine, ecstasy/MDMA, or cocaine with anxiety or depressive symptoms. Addict Behav 2024; 153:107988. [PMID: 38394960 DOI: 10.1016/j.addbeh.2024.107988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 02/06/2024] [Accepted: 02/15/2024] [Indexed: 02/25/2024]
Abstract
OBJECTIVE Anxiety and depression are prevalent mental health problems in people who use illicit stimulants. Improved understanding of the temporal relationship between methamphetamine, ecstasy/MDMA, or cocaine use with anxiety or depression informs public health interventions and treatment options for those experiencing this co-occurrence. This narrative systematic review sought to examine associations and temporality between the use of methamphetamine, ecstasy/MDMA, or cocaine, with anxiety or depressive symptoms. Method Systematic searches of 4 electronic databases were conducted up to August 2023. Study eligibility included the measurement of anxiety and/or depressive symptoms, and frequency of illicit stimulant use (methamphetamine, cocaine, or ecstasy/MDMA) at two separate time points, with data analysis of the association between these variables. The Joanna Briggs Critical Appraisal Checklist was utilised to assess quality. Data was extracted, and a narrative synthesis incorporating an eight-criteria framework to assess associations was conducted. Results 4432 studies were screened for eligibility; 11 studies (3 RCTs and 8 prospective cohort studies) were included. Evidence for an association between depressive symptoms and methamphetamine use was demonstrated in six studies, with temporal evidence in three studies supporting methamphetamine use preceding depressive symptoms. Three studies reported an association between cocaine use and depressive symptoms. Evidence for associations with any of the illicit stimulants and anxiety symptoms was lacking. CONCLUSIONS There was some evidence to support a case for temporality, particularly for methamphetamine use and depressive symptoms. Investing in longitudinal studies is pivotal to understanding the dynamic and reciprocal relationship between illicit stimulant use and anxiety or depressive symptoms. A limitation of the study was the variation in the measurement and analysis of outcomes.
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Affiliation(s)
- Zoe Duncan
- Monash Rural Health, Monash University, Melbourne, Australia.
| | - Bernadette Ward
- Monash Rural Health, Monash University, Melbourne, Australia; Behaviours and Health Risks Program, Burnet Institute, Melbourne, Victoria, Australia
| | - Rebecca Kippen
- Monash Rural Health, Monash University, Melbourne, Australia
| | - Paul Dietze
- Behaviours and Health Risks Program, Burnet Institute, Melbourne, Victoria, Australia; National Drug Research Institute, Curtin University, Melbourne, Victoria, Australia; School of Public Health and Preventive Medicine, Monash University, Victoria, Australia
| | - Keith Sutton
- Monash Rural Health, Monash University, Melbourne, Australia; National Drug Research Institute, Curtin University, Melbourne, Victoria, Australia
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Clifford B, Van Gordon K, Magee F, Malone V, Siefried KJ, Graham D, Ezard N. "There's a big tag on my head": exploring barriers to treatment seeking with women who use methamphetamine in Sydney, Australia. BMC Health Serv Res 2023; 23:162. [PMID: 36793060 PMCID: PMC9933255 DOI: 10.1186/s12913-023-09125-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 01/30/2023] [Indexed: 02/17/2023] Open
Abstract
BACKGROUND Australia has a high prevalence of regular use of methamphetamine. While half of people who use methamphetamine regularly are women, they make up only one third of people seeking treatment for methamphetamine use disorder. There is a lack of qualitative research into the facilitators and barriers to treatment for women who use methamphetamine regularly. The study seeks a better understanding of the experiences and treatment preferences of women who use methamphetamine, to inform person-centred changes in practice and policy that break down barriers to treatment. METHODS We conducted semi-structured interviews with 11 women who frequently use methamphetamine (at least once a week), and who are not engaged in treatment. Women were recruited from health services surrounding a stimulant treatment centre at an inner-city hospital. Participants were asked about their methapmhetamine use and health service needs and preferences. Thematic analysis was completed using Nvivo® software. RESULTS Three themes were developed from participants' responses around experiences of regular methamphetamine use and treatment needs: 1. Resistance of stigmatised identity including dependence; 2. Interpersonal violence; 3. Institutionalised stigma. A fourth set of themes on service delivery preferences were also elicited, including continuity of care, integrated health care, and provision of non-judgmental services. CONCLUSION Gender-inclusive health care services for people who use methamphetamine should actively work to address stigma, support a relational approach to assessment and treatment, and seek to provide structurally competent health care that is trauma and violence informed, and integrated with other services. Findings may also have application for substance use disorders other than methamphetamine.
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Affiliation(s)
- Brendan Clifford
- Alcohol & Drug Service, St Vincent's Hospital Sydney, Sydney, New South Wales, Australia.
- National Centre for Clinical Research on Emerging Drugs of Concern, Sydney, New South Wales, Australia.
- Drug and Alcohol Clinical Research and Improvement Network, Sydney, New South Wales, Australia.
- National Drug and Alcohol Research Centre, University of New South Wales Sydney, Sydney, Australia.
| | - Kate Van Gordon
- Victor Medical Centre, Victor Harbor, South Australia, Australia
| | - Fiona Magee
- South Eastern Sydney Local Health District, Sydney, New South Wales, Australia
| | - Victoria Malone
- Alcohol & Drug Service, St Vincent's Hospital Sydney, Sydney, New South Wales, Australia
| | - Krista J Siefried
- Alcohol & Drug Service, St Vincent's Hospital Sydney, Sydney, New South Wales, Australia
- National Centre for Clinical Research on Emerging Drugs of Concern, Sydney, New South Wales, Australia
- National Drug and Alcohol Research Centre, University of New South Wales Sydney, Sydney, Australia
| | - Duncan Graham
- National Centre for Clinical Research on Emerging Drugs of Concern, Sydney, New South Wales, Australia
| | - Nadine Ezard
- Alcohol & Drug Service, St Vincent's Hospital Sydney, Sydney, New South Wales, Australia
- National Centre for Clinical Research on Emerging Drugs of Concern, Sydney, New South Wales, Australia
- Drug and Alcohol Clinical Research and Improvement Network, Sydney, New South Wales, Australia
- National Drug and Alcohol Research Centre, University of New South Wales Sydney, Sydney, Australia
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Black E, Mammen K, Deacon RM, Ezard N, Mills L, Dunlop AJ, Montebello M, Reid D, Childs S, Bruno R, Shakeshaft A, Siefried KJ, Farrell M, Holmes J, Lintzeris N. Health and social characteristics of clients reporting amphetamine type substance use at entry to public alcohol and other drug services in New South Wales, Australia, 2016-2019. Drug Alcohol Rev 2023; 42:389-400. [PMID: 36524444 PMCID: PMC10107800 DOI: 10.1111/dar.13588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 11/09/2022] [Accepted: 11/11/2022] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Amphetamine type substances (ATS) are commonly used by Australian alcohol and other drug service entrants. We describe demographic characteristics, patterns of ATS and other substance use, health and social conditions among clients entering New South Wales (NSW) public alcohol and other drug services. METHODS Retrospective cohort of 13,864 records across six health districts (2016-2019) for clients seeking substance use treatment. These districts service approximately 44% of the NSW population aged 15 years and over. Multivariate analysis was conducted on a subsample for whom full data were available (N = 9981). Data included NSW Minimum Data Set for drug and alcohol treatment services and Australian Treatment Outcomes Profile items. RESULTS Over the preceding 4 weeks, 77% (n = 10,610) of clients (N = 13,864) reported no recent ATS use, 15% (n = 2109) reported 'low frequency' (1-12 days) and 8% (n = 1145) 'high frequency' (13-28 days) use. ATS use was most common among people attending for ATS or opioids as primary drug of concern. A multinomial regression (N = 9981) identified that clients reporting recent arrest (aOR 1.74, 95% CI 1.36, 2.24), higher cannabis use frequency (aOR 1.01, 95% CI 1.00, 1.02), lower opioid use frequency (aOR 0.98, 95% CI 0.97, 0.99) and poorer quality of life (aOR 0.91, 95% CI 0.86, 0.97) were more likely to report 'high frequency' rather than 'low frequency' ATS use. DISCUSSION AND CONCLUSIONS People who use ATS experience health and social issues that may require targeted responses. These should be integrated across all services, not only for clients with ATS as principal drug of concern.
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Affiliation(s)
- Emma Black
- Drug and Alcohol Services, South Eastern Sydney Local Health DistrictSydneyAustralia
- Specialty of Addiction MedicineThe University of SydneySydneyAustralia
- National Drug and Alcohol Research Centre, UNSW SydneySydneyAustralia
| | - Kristie Mammen
- Drug and Alcohol Services, South Eastern Sydney Local Health DistrictSydneyAustralia
| | - Rachel M. Deacon
- Drug and Alcohol Services, South Eastern Sydney Local Health DistrictSydneyAustralia
- Specialty of Addiction MedicineThe University of SydneySydneyAustralia
| | - Nadine Ezard
- National Drug and Alcohol Research Centre, UNSW SydneySydneyAustralia
- Alcohol and Drug Service, St Vincent's HospitalSydneyAustralia
- National Centre for Clinical Research on Emerging DrugsSydneyAustralia
- NSW Drug and Alcohol Clinical Research and Improvement Network, NSW Ministry of HealthSydneyAustralia
| | - Llewellyn Mills
- Drug and Alcohol Services, South Eastern Sydney Local Health DistrictSydneyAustralia
- Specialty of Addiction MedicineThe University of SydneySydneyAustralia
- National Drug and Alcohol Research Centre, UNSW SydneySydneyAustralia
| | - Adrian J. Dunlop
- NSW Drug and Alcohol Clinical Research and Improvement Network, NSW Ministry of HealthSydneyAustralia
- Drug and Alcohol Clinical Services, Hunter New England Local Health DistrictNewcastleAustralia
- School of Medicine and Public HealthCollege of Health & Wellbeing, University of NewcastleNewcastleAustralia
- HMRI Healthcare Transformation Research ProgramNewcastleAustralia
| | - Mark Montebello
- Specialty of Addiction MedicineThe University of SydneySydneyAustralia
- National Drug and Alcohol Research Centre, UNSW SydneySydneyAustralia
- NSW Drug and Alcohol Clinical Research and Improvement Network, NSW Ministry of HealthSydneyAustralia
- Drug and Alcohol Services, North Sydney Local Health DistrictSydneyAustralia
| | - David Reid
- NSW Drug and Alcohol Clinical Research and Improvement Network, NSW Ministry of HealthSydneyAustralia
- Drug and Alcohol Services, Illawarra and Shoalhaven Local Health DistrictWollongongAustralia
| | - Steven Childs
- NSW Drug and Alcohol Clinical Research and Improvement Network, NSW Ministry of HealthSydneyAustralia
- Drug and Alcohol Services, Central Coast Local Health DistrictGosfordAustralia
| | - Raimondo Bruno
- National Drug and Alcohol Research Centre, UNSW SydneySydneyAustralia
- School of Psychological SciencesUniversity of TasmaniaHobartAustralia
| | | | - Krista J. Siefried
- National Drug and Alcohol Research Centre, UNSW SydneySydneyAustralia
- Alcohol and Drug Service, St Vincent's HospitalSydneyAustralia
- National Centre for Clinical Research on Emerging DrugsSydneyAustralia
| | - Michael Farrell
- National Drug and Alcohol Research Centre, UNSW SydneySydneyAustralia
| | - Jennifer Holmes
- Centre for Alcohol and other Drugs, NSW Ministry of HealthSydneyAustralia
| | - Nicholas Lintzeris
- Drug and Alcohol Services, South Eastern Sydney Local Health DistrictSydneyAustralia
- Specialty of Addiction MedicineThe University of SydneySydneyAustralia
- Drug and Alcohol Services, Illawarra and Shoalhaven Local Health DistrictWollongongAustralia
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Duncan Z, Kippen R, Sutton K, Ward B, Agius PA, Quinn B, Dietze P. Correlates of anxiety and depression in a community cohort of people who smoke methamphetamine. Aust N Z J Psychiatry 2022; 56:964-973. [PMID: 34558302 DOI: 10.1177/00048674211048152] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
OBJECTIVE Anxiety and depression are the most common mental health disorders experienced by Australians. These disorders are commonly found in people who use methamphetamine; however, much of this research has involved participants recruited from treatment settings who inject methamphetamine. We therefore explored (1) the prevalence of moderate to severe anxiety and depression in a community-recruited cohort who smoked methamphetamine and (2) examined potential factors associated with moderate to severe anxiety or depression in this cohort. METHOD Data were derived from baseline surveys of 725 participants of the prospective 'VMAX' study, recruited from metropolitan and non-metropolitan areas of Victoria, Australia, via snowball and respondent-driven sampling. Anxiety and depression were measured using the Generalized Anxiety Disorder-7 and the Patient Health Questionnaire-9 instruments. Independent associations between moderate to severe scores on these measures and demographic, socio-economic, substance use and other health and social characteristics were examined using multivariable logistic regression. RESULTS More than half (60%) of the participants were classified as experiencing moderate to severe anxiety and/or depression. In the multivariable models, having poor/very poor self-rated health, methamphetamine dependence and being unemployed were associated with higher odds of experiencing both moderate to severe depression and moderate to severe anxiety. Living in a large rural town, identifying as Aboriginal and Torres Strait Islander and smoking methamphetamine were associated with lower odds of experiencing moderate to severe depression. Being female was associated with higher odds of experiencing moderate to severe anxiety. CONCLUSION The high rates of anxiety and/or depression found in the VMAX cohort were associated with demographic, socio-economic, substance use and other health and social factors. The prevalence of moderate to severe anxiety is a novel finding that warrants further study. Further work is needed to determine how anxiety and depression change over time among people who smoke methamphetamine, to help identify key intervention points.
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Affiliation(s)
- Zoe Duncan
- School of Rural Health, Faculty of Medicine, Nursing, and Health Sciences, Monash University, Melbourne, VIC, Australia
| | - Rebecca Kippen
- School of Rural Health, Faculty of Medicine, Nursing, and Health Sciences, Monash University, Melbourne, VIC, Australia
| | - Keith Sutton
- School of Rural Health, Faculty of Medicine, Nursing, and Health Sciences, Monash University, Melbourne, VIC, Australia.,Behaviours and Health Risks Program, Burnet Institute, Melbourne, VIC, Australia
| | - Bernadette Ward
- School of Rural Health, Faculty of Medicine, Nursing, and Health Sciences, Monash University, Melbourne, VIC, Australia.,Behaviours and Health Risks Program, Burnet Institute, Melbourne, VIC, Australia
| | - Paul A Agius
- Behaviours and Health Risks Program, Burnet Institute, Melbourne, VIC, Australia.,School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing, and Health Sciences, Monash University, VIC, Australia
| | - Brendan Quinn
- Behaviours and Health Risks Program, Burnet Institute, Melbourne, VIC, Australia.,School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing, and Health Sciences, Monash University, VIC, Australia
| | - Paul Dietze
- Behaviours and Health Risks Program, Burnet Institute, Melbourne, VIC, Australia.,School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing, and Health Sciences, Monash University, VIC, Australia.,National Drug Research Institute, Curtin University, Melbourne, VIC, Australia
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Duncan Z, Kippen R, Sutton K, Ward B, Quinn B, Dietze P. Health Service Use for Mental Health Reasons in a Cohort of People Who Use Methamphetamine Experiencing Moderate to Severe Anxiety or Depression. Int J Ment Health Addict 2022. [DOI: 10.1007/s11469-022-00889-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Abstract
This study examined health service use for mental health reasons in a cohort of people who use methamphetamine and experience anxiety or depression. Data were derived from baseline surveys of a subset of 429 participants from the ‘VMAX’ study. Anxiety and depression were measured using the Generalized Anxiety Disorder-7 instruments and the Patient Health Questionnaire-9. Sequential logistic regression determined correlates of health service use for mental health reasons. Lower odds of health service use for mental health reasons were evident for those living in a medium/small rural town (aOR = 0.27, CI = 0.12, 0.62), ≥ weekly methamphetamine use (aOR = 0.51, CI = 0.27, 0.99), and not utilising professional support for methamphetamine use in the 12 months prior (aOR = 0.19, CI = 0.12, 0.30). People who use methamphetamine frequently use health services for mental health issues. Further work is needed to determine the effectiveness of these services for this population.
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Spencer LP, Addison M, Alderson H, McGovern W, McGovern R, Kaner E, O'Donnell A. 'The Drugs Did For Me What I Couldn't Do For Myself': A Qualitative Exploration of the Relationship Between Mental Health and Amphetamine-Type Stimulant (ATS) Use. Subst Abuse 2021; 15:11782218211060852. [PMID: 34898985 PMCID: PMC8655440 DOI: 10.1177/11782218211060852] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Accepted: 10/27/2021] [Indexed: 12/11/2022]
Abstract
Substance use and mental ill health constitute a major public health burden, and a key global policy priority is to reduce illicit and other harmful substance use. Amphetamine-type stimulants (ATS) are the second most used class of illicit drugs and a range of mental health issues have been documented amongst users. This paper explores the relationship between mental health and ATS use, through a thematic analysis of qualitative interviews with n = 18 current and former ATS users in England. The findings are presented by trajectory point of; (1) Initiation of ATS use; (2) continued and increased ATS use and (3) decreased and remitted ATS use. This work helps to develop understanding around the complex and bi-directional relationship between ATS use and mental health. Many ATS users lead chaotic lives and engage in multiple risk behaviours, however there is a need to better understand and conceptualise the dynamic interaction between different individual, social, environment and cultural factors that determine individuals’ mental health and substance use. There is no ‘one size fits all’ approach to prevention and treatment, and these findings highlight the need for more joined-up, tailored and holistic approaches to intervention development.
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Affiliation(s)
- Liam Patrick Spencer
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | | | - Hayley Alderson
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - William McGovern
- Department of Social Work, Education and Community Wellbeing, Northumbria University, Newcastle upon Tyne, UK
| | - Ruth McGovern
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Eileen Kaner
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Amy O'Donnell
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
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Thoradeniya MR, Wessel EL, Pourmarzi D, Najman JM, Smirnov A. The prevalence of mental health disorders among young adults who use amphetamine-type stimulants, compared to young adults who do not. Drug Alcohol Rev 2020; 40:557-566. [PMID: 33073466 DOI: 10.1111/dar.13196] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 09/19/2020] [Accepted: 09/21/2020] [Indexed: 11/27/2022]
Abstract
INTRODUCTION AND AIMS There is a lack of evidence regarding mental health disorder prevalence in people who use amphetamine-type stimulants (ATS). This study compares prevalence in Australian young adults who used ATS and young adults who had never used, and examines potential predictors. DESIGN AND METHODS Population-based sampling was used to recruit young adults who used ATS (n = 224) and young adults who had never used ATS (n = 125). Thirty-day prevalence of major depressive disorder (MDD), generalised anxiety disorder (GAD), panic disorder (PD), post-traumatic stress disorder (PTSD) and mania/hypomania were assessed using the Composite International Diagnostic Interview Short Scale. Adjusted prevalence ratios (APR) of mental disorders in people who used ATS and the comparison group were examined, and a prediction model was developed for people who used ATS. RESULTS We found higher prevalence of PD (APR 4.67, 95% confidence interval [CI] 1.14-19.07, P = 0.032) and PTSD (APR 1.68, 95% CI 1.10-2.55, P = 0.016) in people who used ATS, compared to the comparison group, adjusting for sociodemographic variables. Baseline methamphetamine use was positively associated with MDD (ARR 6.45, 95% CI 1.51-27.59, P = 0.012) and GAD (ARR 2.76, 95% CI 1.52-5.02, P = 0.001). Baseline ecstasy use was negatively associated with GAD (ARR 0.52, 95% CI 0.30-0.92, P = 0.025) and PD (ARR 0.15, 95% CI 0.05-0.48, P = 0.001). DISCUSSION AND CONCLUSION PTSD and PD appear to be more common in young adults who use ATS. However, the relationship between ATS use and mental disorders is complex, with divergent patterns of association for ecstasy and methamphetamine use. Mental health screening in people using ATS may improve treatment outcomes.
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Affiliation(s)
| | - Ellen L Wessel
- Queensland Alcohol and Drug Research and Education Centre, School of Public Health, The University of Queensland, Brisbane, Australia
| | - Davoud Pourmarzi
- School of Social Science, The University of Queensland, Brisbane, Australia
| | - Jake M Najman
- Queensland Alcohol and Drug Research and Education Centre, School of Public Health, The University of Queensland, Brisbane, Australia.,School of Social Science, The University of Queensland, Brisbane, Australia
| | - Andrew Smirnov
- Queensland Alcohol and Drug Research and Education Centre, School of Public Health, The University of Queensland, Brisbane, Australia
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From initiating injecting drug use to regular injecting: Retrospective survival analysis of injecting progression within a sample of people who inject drugs regularly. Drug Alcohol Depend 2016; 158:177-80. [PMID: 26652894 DOI: 10.1016/j.drugalcdep.2015.11.022] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Revised: 11/08/2015] [Accepted: 11/17/2015] [Indexed: 11/22/2022]
Abstract
BACKGROUND The initiation of injecting drug use and the commencement of a pattern of regular injecting are key milestones in injecting careers. The progression from initiation to regular injecting is a poorly understood period in these careers. METHODS Cross-sectional baseline data from a sample of people who inject drugs regularly (N=691), recorded the age at which participants initiated injecting drug use and the age they became regular (at least once per month) injectors. Survival analysis compared the rapidity of progression to regular injecting across sub-groups within the sample using bivariate log-rank testing and multivariable Cox regression. RESULTS Half of all participants progressed to regular injecting within 1 year of initiation and by the fourth year post-initiation, 91% had progressed. In bivariate analysis, there were significant differences in equality of hazards by sex (X(2)=7.75, p<0.01), from whom participants learnt to inject (X(2)=22.32, p<0.01) and the drug of injection initiation (X(2)=18.36; p<0.01). In the multivariable Cox model, only initiating injecting with heroin (HR=1.28; 95% CI: 1.09-1.50) compared with other drugs (predominantly methamphetamine) showed a significantly greater hazard, suggesting a faster progression to regular injecting. CONCLUSION This study showed that among our sample of eventual regular injectors, progression from initiation to regular injecting was rapid. By gaining a greater understanding of the dynamics of this progression, the ability to appropriately target interventions and future research is subsequently informed.
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Abstract
PURPOSE OF REVIEW To summarize the recent literature (1st January 2014-1st February 2015) on stimulant treatment programme evaluations, and highlight key areas for future programme development. RECENT FINDINGS Advances have been made in addressing both sexual risks and stimulant use among gay and bisexual men in the United States, and in adapting evidence-based resource-intense interventions to real-world settings. Programme outcome measures increasingly include changes in substance use as well as health and wellbeing indicators and measures of risk. SUMMARY Future programme directions include: expansion of the psychosocial repertoire to include narrative and mindfulness-based therapies; web-based programme delivery; sex-sensitive programming to attract and retain women; comprehensive programming to address coexisting mental and physical illness and polysubstance use (including tobacco smoking); and improving accessibility to promote early intervention. Comparability of evaluation data can be improved by developing standardized tools particularly for measuring change in sexual-risk behavior. The use of new statistical techniques can address the lack of comparison populations.
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