1
|
McKetin R, Degan TJ, Saunders L, Nguyen L, Dore G, Shoptaw S, Farrell M, Degenhardt L, Kelly PJ, Turner A, Clare PJ, Dean OM, Arunogiri S, Colledge-Frisby S, Koeijers J, Goodman-Meza D, Sinclair B, Reid D, Hill H, Hayllar J, Christmass M, Cordaro F, Lundin R, Liaw W, Liu D, Holyoak E, Wu BTF, Keygan J, Kontogiannis A, Palmer L, Morrison C, Wrobel A, Hyland B, Byrne M, Russell S, Zahra E, Berk M. A phase 3 randomised double-blind placebo-controlled trial of mirtazapine as a pharmacotherapy for methamphetamine use disorder: a study protocol for the Tina Trial. Trials 2024; 25:408. [PMID: 38907288 PMCID: PMC11193254 DOI: 10.1186/s13063-024-08238-y] [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: 03/01/2024] [Accepted: 06/10/2024] [Indexed: 06/23/2024] Open
Abstract
BACKGROUND There are no approved pharmacotherapies for methamphetamine use disorder. Two preliminary phase 2 randomised controlled trials have found mirtazapine, a tetracyclic antidepressant, to be effective in reducing methamphetamine use. The proposed Tina Trial is the first phase 3 placebo-controlled randomised trial to examine the effectiveness and safety of mirtazapine as an outpatient pharmacotherapy for methamphetamine use disorder. METHODS This is a multi-site phase 3 randomised, double-blind, placebo-controlled parallel trial. Participants are randomly allocated (1:1) to receive either mirtazapine (30 mg/day for 12 weeks) or matched placebo, delivered as a take-home medication. The target population is 340 people aged 18-65 years who have moderate to severe methamphetamine use disorder. The trial is being conducted through outpatient alcohol and other drug treatment clinics in Australia. The primary outcome is measured as self-reported days of methamphetamine use in the past 4 weeks at week 12. Secondary outcomes are methamphetamine-negative oral fluid samples, depressive symptoms, sleep quality, HIV risk behaviour and quality of life. Other outcomes include safety (adverse events), tolerability, and health service use. Medication adherence is being monitored using MEMS® Smart Caps fitted to medication bottles. DISCUSSION This trial will provide information on the safety and effectiveness of mirtazapine as a pharmacotherapy for methamphetamine use disorder when delivered as an outpatient medication in routine clinical practice. If found to be safe and effective, this trial will support an application for methamphetamine use disorder to be included as a therapeutic indication for the prescription of mirtazapine. TRIAL REGISTRATION Australian and New Zealand Clinical Trials Registry ACTRN12622000235707. Registered on February 9, 2022.
Collapse
Affiliation(s)
- Rebecca McKetin
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia.
| | - Tayla J Degan
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Lucy Saunders
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | | | - Gregory Dore
- Kirby Institute, University of New South Wales, Sydney, Australia
| | - Steven Shoptaw
- Department of Family Medicine, David Geffen School of Medicine, Los Angeles, USA
| | - Michael Farrell
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Louisa Degenhardt
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Peter J Kelly
- School of Psychology, Faculty of Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, Australia
| | - Alyna Turner
- IMPACT, School of Medicine, Deakin University, Geelong, Australia
| | - Philip J Clare
- Prevention Research Collaboration, The University of Sydney, Sydney, Australia
| | - Olivia M Dean
- IMPACT, School of Medicine, Deakin University, Geelong, Australia
| | - Shalini Arunogiri
- Alfred Psychiatry Research Centre (MAPrc), Central Clinical School, Monash University, Melbourne, Australia
| | - Samantha Colledge-Frisby
- Burnet Institute, Melbourne, Australia
- National Drug Research Institute, Curtin University, Perth, Australia
| | - Juanita Koeijers
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - David Goodman-Meza
- Center for HIV Identification, Prevention, and Treatment Services, Los Angeles, USA
| | - Barbara Sinclair
- Illawarra Drug and Alcohol Service, Illawarra Shoalhaven Local Health District, NSW Health, Wollongong, Australia
| | - David Reid
- Illawarra Drug and Alcohol Service, Illawarra Shoalhaven Local Health District, NSW Health, Wollongong, Australia
| | - Harry Hill
- Drug and Alcohol Services, Barwon Health, Geelong, Australia
| | - Jeremy Hayllar
- Biala City Community Health Centre, Metro North Health, Brisbane, Australia
| | - Michael Christmass
- Next Step Community Alcohol and Drug Service East Perth, East Perth, Australia
| | - Frank Cordaro
- Illawarra Drug and Alcohol Service, Illawarra Shoalhaven Local Health District, NSW Health, Wollongong, Australia
| | - Robert Lundin
- Drug and Alcohol Services, Barwon Health, Geelong, Australia
| | - Willy Liaw
- Drug and Alcohol Services of South Australia, Adelaide, Australia
| | - Danica Liu
- Drug and Alcohol Services of South Australia, Adelaide, Australia
| | - Ellie Holyoak
- Alcohol, Tobacco & Other Drug Services, Townsville, Australia
| | | | - Joel Keygan
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Ava Kontogiannis
- School of Psychology, Faculty of Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, Australia
| | - Lily Palmer
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Caity Morrison
- IMPACT, School of Medicine, Deakin University, Geelong, Australia
| | - Anna Wrobel
- IMPACT, School of Medicine, Deakin University, Geelong, Australia
| | - Bec Hyland
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Marianne Byrne
- Kirby Institute, University of New South Wales, Sydney, Australia
| | - Samantha Russell
- IMPACT, School of Medicine, Deakin University, Geelong, Australia
- Grampians Health, Ballarat, Australia
| | - Emma Zahra
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Michael Berk
- IMPACT, School of Medicine, Deakin University, Geelong, Australia
- Drug and Alcohol Services, Barwon Health, Geelong, Australia
- Florey Institute for Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia
| |
Collapse
|
2
|
Jaehne EJ, Semaan H, Grosman A, Xu X, Schwarz Q, van den Buuse M. Enhanced methamphetamine sensitisation in a rat model of the brain-derived neurotrophic factor Val66Met variant: Sex differences and dopamine receptor gene expression. Neuropharmacology 2023; 240:109719. [PMID: 37742717 DOI: 10.1016/j.neuropharm.2023.109719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 08/29/2023] [Accepted: 09/17/2023] [Indexed: 09/26/2023]
Abstract
Brain-derived neurotrophic factor (BDNF) and the Val66Met polymorphism may play a role in the development of psychosis and schizophrenia. The aim of this study was to investigate long-term effects of methamphetamine (Meth) on psychosis-like behaviour and dopamine receptor and dopamine transporter gene expression in a novel rat model of the BDNF Val66Met polymorphism. At the end of a 7-day subchronic Meth treatment, female rats with the Met/Met genotype selectively showed locomotor hyperactivity sensitisation to the acute effect of Meth. Male rats showed tolerance to Meth irrespective of Val66Met genotype. Two weeks later, female Met/Met rats showed increased locomotor activity following both saline treatment or a low dose of Meth, a hyperactivity which was not observed in other genotypes or in males. Baseline PPI did not differ between the groups but the disruption of PPI by acute treatment with apomorphine was absent in Meth-pretreated Met/Met rats. Female Met/Met rats selectively showed down-regulation of dopamine D2 receptor gene expression in striatum. Behavioural effects of MK-801 or its locomotor sensitisation by prior Meth pretreatment were not influenced by genotype. These data suggest a selective vulnerability of female Met/Met rats to short-term and long-term effects of Meth, which could model increased vulnerability to psychosis development associated with the BDNF Val66Met polymorphism.
Collapse
Affiliation(s)
- Emily J Jaehne
- Department of Psychology and Counselling, School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Hayette Semaan
- Department of Psychology and Counselling, School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Adam Grosman
- Department of Psychology and Counselling, School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Xiangjun Xu
- Centre for Cancer Biology, SA Pathology and University of South Australia, Adelaide, Australia
| | - Quenten Schwarz
- Centre for Cancer Biology, SA Pathology and University of South Australia, Adelaide, Australia
| | - Maarten van den Buuse
- Department of Psychology and Counselling, School of Psychology and Public Health, La Trobe University, Melbourne, Australia; Department of Pharmacology, University of Melbourne, Melbourne, Australia.
| |
Collapse
|
3
|
Bascombe F, Siefried KJ, Clifford B, Child S, Loos R, Sgouras H, Stevens L, Wilson H, Ezard N. Methamphetamine and emerging drugs of concern: A training needs analysis of Australian alcohol and other drug helplines. Drug Alcohol Rev 2023; 42:1744-1753. [PMID: 37452757 DOI: 10.1111/dar.13719] [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: 10/06/2022] [Revised: 04/25/2023] [Accepted: 06/26/2023] [Indexed: 07/18/2023]
Abstract
INTRODUCTION Fielding greater than 100,000 calls annually, telephone helplines are an important point of entry to alcohol and other drug (AOD) support and services in Australia. Methamphetamine and emerging drugs can present a particular challenge for this workforce. We sought to identify training needs for these services, so that appropriate targeted resources can be developed. METHODS We distributed an anonymous, online, cross-sectional survey to helpline staff from New South Wales, Queensland, South Australia, Victoria and Western Australia. Based on the WHO Hennessy-Hicks training needs analysis tool, participants were asked: to rate on a 7-point likert scale the importance of a topic to their practice and how well they perform in relation to the topic; open-ended questions specifying their own self-perceived training needs; and demographic data. RESULTS Of 50 participants, 29 completed the full survey (median age 49 [IQR 30-57.5]; median time working in AOD sector 6 years [IQR 1-20]). The results identified a need for: practical community-informed population relevant information for culturally and linguistically diverse populations and Aboriginal and Torres Strait Islander peoples for calls relating to methamphetamine and emerging drugs of concern; training and resources with a particular focus on families and friends of people who use methamphetamine and emerging drugs; and readily accessible up-to-date information on new and emerging drugs and treatment of related disorders. DISCUSSION AND CONCLUSIONS This training needs analysis provides a structured approach to supporting the first-line AOD counsellors to provide up-to-date and accurate information to assist Australians seeking information, support and advice.
Collapse
Affiliation(s)
- Florence Bascombe
- The National Centre for Clinical Research on Emerging Drugs, Sydney, Australia
- St Vincent's Hospital Alcohol and Drug Service, Sydney, Australia
- The National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Krista J Siefried
- The National Centre for Clinical Research on Emerging Drugs, Sydney, Australia
- St Vincent's Hospital Alcohol and Drug Service, Sydney, Australia
- The National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Brendan Clifford
- The National Centre for Clinical Research on Emerging Drugs, Sydney, Australia
- St Vincent's Hospital Alcohol and Drug Service, Sydney, Australia
- The National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Stacey Child
- Alcohol and Drug Support Service, Mental Health Commission, Perth, Australia
| | - Rick Loos
- Telephone and Online Services, Turning Point, Eastern Health, Melbourne, Australia
| | - Hazel Sgouras
- St Vincent's Hospital Alcohol and Drug Service, Sydney, Australia
| | - Lynn Stevens
- Alcohol and Drug Information Service, Drug and Alcohol Service SA, Adelaide, Australia
| | - Hollie Wilson
- Adis 24/7 Alcohol and Drug Support, Queensland Health, Brisbane, Australia
| | - Nadine Ezard
- The National Centre for Clinical Research on Emerging Drugs, Sydney, Australia
- St Vincent's Hospital Alcohol and Drug Service, Sydney, Australia
- The National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| |
Collapse
|
4
|
Brazel M. Patients languishing in emergency departments: A descriptive analysis of mental health-related emergency department presentations in Australia between 2016-17 and 2020-21. Australas Psychiatry 2023; 31:646-651. [PMID: 37583264 PMCID: PMC10566215 DOI: 10.1177/10398562231195438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/17/2023]
Abstract
OBJECTIVE In the context of concerns regarding hospital access block, this paper provides a descriptive longitudinal analysis of mental health-related ED episodes in Australian public hospitals between 2016-17 and 2020-21. METHOD We descriptively analysed Australian Institute of Health and Welfare data for mental health-related ED presentations, outcomes and 5-year trends for Australian public hospitals. RESULTS There were more than 300,000 Australian mental health-related ED presentations in 2020-21. Presentations increased by an average annual rate of 2.8% between 2016-17 and 2020-21, commonly involving first responder (police, paramedic) attendance. From 2016-17 to 2020-21, the average annual rate of mental health-related ED presentations receiving a triage category of resuscitation increased by 13.7%, emergency by 9.4% and urgent by 4.7%. 90% of MH-related ED presentations were completed within 14 h, which was longer than the 90th percentile for all ED presentations (up to 8 h). CONCLUSIONS Current mental health policies have not stemmed the rising tide of ED presentations. Mental health-related ED presentations are increasing in number and severity, likely due to health systemic and societal factors. Psychiatry patients stay longer in EDs than other patients. Healthcare reforms should be targeted to provide the best outcome based on principles of equity of access.
Collapse
Affiliation(s)
- Matthew Brazel
- Matthew Brazel, Academic Unit of Psychiatry and Addiction Medicine, School of Medicine and Psychology, The Australian National University, Building 4, Level 2, The Canberra Hospital, PO Box 11, Garran 2605, ACT, Australia.
| |
Collapse
|
5
|
Fang SC, Hung CC, Huang CY, Huang SM, Shao YHJ. Influence of Baseline Psychiatric Disorders on Mortality and Suicide and Their Associations with Gender and Age in Patients with Methamphetamine Use Disorder. Int J Ment Health Addict 2023. [DOI: 10.1007/s11469-023-01025-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/15/2023] Open
|
6
|
Mills L, Freeman J, Davey J. A study into the nature and extent of drug driving recidivism in Queensland (Australia). JOURNAL OF SAFETY RESEARCH 2022; 81:116-122. [PMID: 35589282 DOI: 10.1016/j.jsr.2022.02.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 09/14/2021] [Accepted: 02/04/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION While research has reported on overall prevalence rates of drug driving, the extent of recidivist offending has yet to be explored. The objective of this research was to examine recidivistic behaviors detected through Roadside Drug Testing (RDT) in Queensland (between December 2007 and June 2020), with a focus on: Delta-9-tetrahydrocannabinol (THC), 3,4-Methylenedioxymethylamphetamine (MDMA), and methamphetamine (MA). METHOD Data were provided by the Queensland Police Service, and contained information on positive drug detections that were confirmed via laboratory analysis. RESULTS The analyses revealed 50,442 unique offenders with a total of 67,727 offenses, as 25% (N = 12,490) of all offenders had been apprehended more than once (ranging from 2 to 11 offences). MA use was more common among recidivist offenders, whereas THC was more common for those with one offense. On average, the days between offenses decreased with increases in offense number. CONCLUSIONS The findings provide evidence for the extent of drug driving recidivism on Queensland roads. PRACTICAL APPLICATIONS To deter recidivists and the greater motorist population from drug driving, there is need for greater resources dedicated to RDT to increase both the perceived and real likelihood of detection.
Collapse
Affiliation(s)
- Laura Mills
- Road Safety Research Collaboration, University of the Sunshine Coast, 90 Sippy Downs Dr, Sippy Downs, Queensland 4556, Australia.
| | - James Freeman
- Road Safety Research Collaboration, University of the Sunshine Coast, 90 Sippy Downs Dr, Sippy Downs, Queensland 4556, Australia
| | - Jeremy Davey
- Road Safety Research Collaboration, University of the Sunshine Coast, 90 Sippy Downs Dr, Sippy Downs, Queensland 4556, Australia
| |
Collapse
|
7
|
Man N, Sisson SA, McKetin R, Chrzanowska A, Bruno R, Dietze PM, Price O, Degenhardt L, Gibbs D, Salom C, Peacock A. Trends in methamphetamine use, markets and harms in Australia, 2003-2019. Drug Alcohol Rev 2022; 41:1041-1052. [PMID: 35604870 DOI: 10.1111/dar.13468] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 01/18/2022] [Accepted: 03/10/2022] [Indexed: 12/19/2022]
Abstract
INTRODUCTION To describe trends in methamphetamine use, markets and harms in Australia from 2003 to 2019. METHODS Data comprised patterns of use and price from sentinel samples of people who inject drugs and who use MDMA/other illicit stimulants and population-level amphetamine-related police seizures, arrests, hospitalisations, treatment episodes and deaths from approximately 2003 to 2019. Bayesian autoregressive time-series models were analysed for: no change; constant rate of change; and change over time differing in rate after one to three changepoints. Related indicators were analysed post hoc with identical changepoints. RESULTS The percentage of people who inject drugs reporting weekly use increased from 2010 to 2013 onwards, while use among samples of people who regularly use ecstasy and other illicit stimulants decreased. Seizures and arrests rose steeply from around 2009/10 to 2014/15 and subsequently plateaued. Price increased ($15.9 [95% credible interval, CrI $9.9, $28.9] per point of crystal per year) from around 2009 to 2011, plateauing and then declining from around 2017. Hospitalisation rates increased steeply from around 2009/10 until 2015/16, with a small subsequent decline. Treatment also increased (19.8 episodes [95% CrI 13.2, 27.6] with amphetamines as the principal drug of concern per 100 000 persons per year) from 2010/11 onwards. Deaths involving amphetamines increased (0.285 per 100 000 persons per year) from 2012 until 2016. DISCUSSION AND CONCLUSIONS These findings suggest that problematic methamphetamine use and harms escalated from 2010 to 2012 in Australia, with continued demand and a sustained market for methamphetamine.
Collapse
Affiliation(s)
- Nicola Man
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Scott A Sisson
- School of Mathematics and Statistics, UNSW Sydney, Sydney, Australia.,UNSW Data Science Hub, UNSW Sydney, Sydney, Australia
| | - Rebecca McKetin
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Agata Chrzanowska
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Raimondo Bruno
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia.,School of Psychological Sciences, University of Tasmania, Hobart, Australia
| | - Paul M Dietze
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia.,Behaviours and Health Risks, Burnet Institute, Melbourne, Australia.,National Drug Research Institute, Curtin University, Melbourne, Australia
| | - Olivia Price
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Louisa Degenhardt
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Daisy Gibbs
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Caroline Salom
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia.,Institute for Social Science Research, University of Queensland, Brisbane, Australia
| | - Amy Peacock
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| |
Collapse
|
8
|
Brookfield S, Selvey L, Maher L, Fitzgerald L. ‘Making Ground’: An Ethnography of ‘Living With’ Harmful Methamphetamine Use and the Plurality of Recovery. JOURNAL OF DRUG ISSUES 2022. [DOI: 10.1177/00220426211073911] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The trajectories of people attempting to reduce harmful methamphetamine use are frequently understood within a binary framework of transitioning between states of health and disease. This framework can often be reinforced by service interactions informed by these dominant narratives of recovery and addiction. In this paper, we draw on a critical interactionist analysis of ethnographic fieldwork conducted with people who use methamphetamine, to examine how their experiences could undermine this binary, observing the ways participants experienced growth, change, and progress, without necessarily maintaining abstinence. These findings support a more diverse understanding of drug use trajectories, and we explore the concept of ‘living with drug use’, similar to how people live with other chronic conditions by finding ‘health in illness’. Participant experiences are also interpreted within the context of counter public health, arguing for the recognition and integration of values and goals which are divergent from the implicit aims of public health practice.
Collapse
Affiliation(s)
- Samuel Brookfield
- School of Public Health, The University of Queensland, Brisbane, Australia
| | - Linda Selvey
- School of Public Health, The University of Queensland, Brisbane, Australia
| | - Lisa Maher
- Kirby Institute for Infection and Immunity, University of New South Wales, Sydney, Australia
| | - Lisa Fitzgerald
- School of Public Health, The University of Queensland, Brisbane, Australia
| |
Collapse
|
9
|
Mills L, Freeman J, Parkes A, Davey J. Do they need to be tested to be deterred? Exploring the impact of exposure to roadside drug testing on drug driving. JOURNAL OF SAFETY RESEARCH 2022; 80:362-370. [PMID: 35249616 DOI: 10.1016/j.jsr.2021.12.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 08/09/2021] [Accepted: 12/15/2021] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Maximizing the deterrent effects of Roadside Drug Testing (RDT) operations remains critical for improving road safety. While preliminary research has explored the impact of being tested at RDT sites, there is yet to be an investigation of different types of exposure (e.g., seeing an operation, being tested) and the subsequent relationship(s) with perceptions of certainty of apprehension and future intentions to offend. The overall objective of this research was to explore these relationships with a sample of drug takers. METHOD A total of 803 Queensland motorists aged between 16 and 75 (M = 27.12, SD = 13.09) completed an online-based survey, and all reported consuming marijuana, MDMA, and/or methamphetamine at least once in the previous 12 months. A convenience sampling method was utilized (via Facebook). RESULTS The drug driving proportion of the sample (58%) reported a total of 30,858 instances of drug driving, or 66 instances on average. Seeing RDT in the previous 12 months (26% of sample) was more common than being tested at RDT (7%). The results indicated that seeing RDT two or more times was related to increased certainty of apprehension (compared to those who had seen it only once or never), although the increase was relatively small. Correlational analyses suggest there were some positive (albeit weak relationships) between exposure to RDT (seen and tested) and past and future offending. However, only three significant predictors of future offending emerged: older age, lower perceptions of apprehension certainty, and greater use of marijuana. Practical Applications: The results illuminate the extent of the drug driving problem and the need for greater resourcing to increase the real threat of detection. While the effect of exposure to enforcement was small, it was positive, incremental and supportive of increased roadside police enforcement as well as further research to quantify such deterrent processes.
Collapse
Affiliation(s)
- Laura Mills
- Road Safety Research Collaboration, University of the Sunshine Coast, 90 Sippy Downs Dr, Sippy Downs, Queensland 4556, Australia.
| | - James Freeman
- Road Safety Research Collaboration, University of the Sunshine Coast, 90 Sippy Downs Dr, Sippy Downs, Queensland 4556, Australia
| | - Alexander Parkes
- Road Safety Research Collaboration, University of the Sunshine Coast, 90 Sippy Downs Dr, Sippy Downs, Queensland 4556, Australia
| | - Jeremy Davey
- Road Safety Research Collaboration, University of the Sunshine Coast, 90 Sippy Downs Dr, Sippy Downs, Queensland 4556, Australia
| |
Collapse
|
10
|
Lewis D, van den Heuvel C, Kenneally M, Byard RW. Methamphetamine use and the risk of diabetic ketoacidosis. MEDICINE, SCIENCE, AND THE LAW 2022; 62:39-42. [PMID: 34102917 DOI: 10.1177/00258024211020936] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Diabetic ketoacidosis (DKA) is a life-threatening condition arising in individuals with insulin-dependent diabetes mellitus, associated with hyperglycaemia and hyperketonaemia. While drugs such as methadone, cocaine and certain prescription medications may precipitate DKA, the potential effect of methamphetamine is unclear. Analysis of autopsy and toxicology case files at Forensic Science SA, Adelaide, South Australia, was therefore undertaken from 1 January to 31 December 2019 of all cases where methamphetamine was detected in post-mortem blood samples. There were 94 cases with 11 diabetics (n = 6 type 1 and n = 5 type 2). Four of the six decedents with type 1 diabetes had lethal DKA (66.7%; age range 30-54 years; average age 44.6 ± 10.5 years; M:F ratio 1:1). This incidence of DKA was higher than that of the general insulin-dependent diabetic population (6%) and also significantly higher than in medico-legal cases (13%; p < 0.05). The clinical and autopsy assessment of insulin-dependent diabetics presenting with DKA should therefore include specific screening for methamphetamine. The increase in both insulin-dependent diabetes and methamphetamine abuse in the community may lead to increases in such cases in medico-legal and health contexts.
Collapse
Affiliation(s)
- Daniel Lewis
- Adelaide Medical School, The University of Adelaide, Australia
| | | | | | - Roger W Byard
- Adelaide Medical School, The University of Adelaide, Australia
- Forensic Science SA, Australia
| |
Collapse
|
11
|
Cullity ER, Guerin AA, Perry CJ, Kim JH. Examining Sex Differences in Conditioned Place Preference or Aversion to Methamphetamine in Adolescent and Adult Mice. Front Pharmacol 2021; 12:770614. [PMID: 34916945 PMCID: PMC8670007 DOI: 10.3389/fphar.2021.770614] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Accepted: 10/28/2021] [Indexed: 12/28/2022] Open
Abstract
Adolescence marks a particularly vulnerable period to developing substance use disorders. Human and rodent studies suggest that hypersensitivity to reward may contribute towards such vulnerability when adolescents are exposed to casual drug use. Methamphetamine is a popular illicit substance used by male and female youths. However, age- and sex-specific research in methamphetamine is scarce. The present study therefore aimed to examine potential sex differences in methamphetamine-conditioned place preference in adolescent and adult mice. Mice (n = 16–24/group) were conditioned to methamphetamine (0.1 mg/kg). We observed that regardless of age, females were more hyperactive compared to males. Individually normalized score against baseline preference indicated that on average, adolescents formed stronger preference compared to adults in both sexes. This suggests that adolescents are more sensitive to the rewarding effects of methamphetamine compared to adults. Surprisingly, individual data showed that some mice formed a conditioned place aversion instead of preference, with females less likely to form an aversion compared to males. These results suggest that adolescents may be hypersensitive to methamphetamine’s rewarding effects. In addition, female resistance to the aversive effects of methamphetamine may relate to the sex-specific findings in humans, including quicker transition to regular methamphetamine use observed in females compared to males.
Collapse
Affiliation(s)
- Ellen R Cullity
- Mental Health Theme, The Florey Institute of Neuroscience and Mental Health, Parkville, VIC, Australia.,Florey Department of Neuroscience and Mental Health, University of Melbourne, Parkville, VIC, Australia
| | - Alexandre A Guerin
- Mental Health Theme, The Florey Institute of Neuroscience and Mental Health, Parkville, VIC, Australia.,Florey Department of Neuroscience and Mental Health, University of Melbourne, Parkville, VIC, Australia
| | - Christina J Perry
- Mental Health Theme, The Florey Institute of Neuroscience and Mental Health, Parkville, VIC, Australia.,Florey Department of Neuroscience and Mental Health, University of Melbourne, Parkville, VIC, Australia
| | - Jee Hyun Kim
- Mental Health Theme, The Florey Institute of Neuroscience and Mental Health, Parkville, VIC, Australia.,Florey Department of Neuroscience and Mental Health, University of Melbourne, Parkville, VIC, Australia.,School of Medicine, IMPACT-The Institute for Mental and Physical Health and Clinical Translation, Deakin University, Geelong, VIC, Australia
| |
Collapse
|
12
|
Shortened leukocyte telomere length in young adults who use methamphetamine. Transl Psychiatry 2021; 11:519. [PMID: 34628468 PMCID: PMC8502172 DOI: 10.1038/s41398-021-01640-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 04/08/2021] [Accepted: 04/16/2021] [Indexed: 12/23/2022] Open
Abstract
Methamphetamine (METH) use, most prevalent in young adults, has been associated with high rates of morbidity and mortality. The relationship between METH use and accelerated biological aging, which can be measured using leukocyte telomere length (LTL), remains unclear. We examined whether young adult METH users have shorter LTL and explored the relationship between characteristics of METH use and LTL by using Mendelian randomization (MR) analysis. We compared the LTL for 187 METH users and 159 healthy individuals aged between 25 and 34 years and examined the relationship of LTL with METH use variables (onset age, duration, and maximum frequency of METH use) by using regression analyses. In addition, 2-stage-least-squares (2SLS) MR was also performed to possibly avoid uncontrolled confounding between characteristics of METH use and LTL. We found METH users had significantly shorter LTL compared to controls. Multivariate regression analysis showed METH use was negatively associated with LTL (β = -0.36, P < .001). Among METH users, duration of METH use was negatively associated with LTL after adjustment (β = -0.002, P = .01). We identified a single nucleotide polymorphism (SNP) rs6585206 genome-wide associated with duration of METH use. This SNP was used as an instrumental variable to avoid uncontrolled confounding for the relationship between the use duration and LTL shortening. In conclusion, we show that young adult METH users may have shorter LTL compared with controls and longer duration of METH use was significantly associated with telomere shortening. These observations suggest that METH use may accelerate biological senescence.
Collapse
|
13
|
Mills L, Freeman J, Davey J, Davey B. The who, what and when of drug driving in Queensland: Analysing the results of roadside drug testing, 2015-2020. ACCIDENT; ANALYSIS AND PREVENTION 2021; 159:106231. [PMID: 34130055 DOI: 10.1016/j.aap.2021.106231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 05/30/2021] [Accepted: 05/31/2021] [Indexed: 06/12/2023]
Abstract
Roadside Drug Testing (RDT) is the primary strategy utilised in Australia to detect and deter drug driving. RDT operations have been expanding and evolving in Queensland since their introduction in 2007, with the number of tests increasing by 5.63 times between 2009 and 2019. The objective of this paper was to explore trends and characteristics of the 60,551 positive results detected in Queensland's RDT program (from January 2015 to June 2020), which focuses on the detection of Delta-9-tetrahydrocannabinol (THC), Methylenedioxymethylamphetamine (MDMA) and methamphetamine (MA). The analysis indicated that (over the entire testing period) MA was the most common drug detected in isolation (39.4%), followed by THC (34%) and the combination of MA and THC (21.9%). When considering detections with two or more drugs, MA was present in 64% of detections, THC in 59% and MDMA in 1.8%. THC was most commonly detected among younger drivers (e.g., aged 16 to 24), while MA was most commonly detected with drivers aged 25 and 59 years. Analysis of sociodemographic and contextual factors revealed that positive roadside tests were most commonly associated with males who had consumed methamphetamines, aged between 30 and 39 who were driving a car on a Friday or Saturday between 2:00 pm and 6:00 pm. The findings provide some indication as to the extent of drug driving within Queensland (and growing use of MA) and have clear implications for enforcement activities, not least, directing sufficient resources to address the burgeoning problem.
Collapse
Affiliation(s)
- Laura Mills
- Road Safety Research Collaboration, University of the Sunshine Coast, 90 Sippy Downs Dr, Sippy Downs, Queensland 4556, Australia.
| | - James Freeman
- Road Safety Research Collaboration, University of the Sunshine Coast, 90 Sippy Downs Dr, Sippy Downs, Queensland 4556, Australia.
| | - Jeremy Davey
- Road Safety Research Collaboration, University of the Sunshine Coast, 90 Sippy Downs Dr, Sippy Downs, Queensland 4556, Australia.
| | - Benjamin Davey
- Road Safety Research Collaboration, University of the Sunshine Coast, 90 Sippy Downs Dr, Sippy Downs, Queensland 4556, Australia.
| |
Collapse
|
14
|
Cullity ER, Guérin AA, Madsen HB, Perry CJ, Kim JH. Insular cortex dopamine 1 and 2 receptors in methamphetamine conditioned place preference and aversion: Age and sex differences. NEUROANATOMY AND BEHAVIOUR 2021. [DOI: 10.35430/nab.2021.e24] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Rodent studies have proposed that adolescent susceptibility to substance use is at least partly due to adolescents experiencing reduced aversive effects of drugs compared to adults. We thus investigated methamphetamine (meth) conditioned place preference/aversion (CPP/CPA) in adolescent and adult mice in both sexes using a high dose of meth (3 mg/kg) or saline as controls. Mice tagged with green-fluorescent protein (GFP) at Drd1a or Drd2 were used so that dopamine receptor 1 (D1) and 2 (D2) expression within the insular cortex (insula) could be quantified. There are sex differences in how the density of D1+ and D2+ cells in the insula changes across adolescence that may be related to drug-seeking behaviors. Immunohistochemistry followed by stereology were used to quantify the density of cells with c-Fos and/or GFP in the insula. Unexpectedly, mice showed huge variability in behaviors including CPA, CPP, or no preference or aversion. Females were less likely to show CPP compared to males, but no age differences in behavior were observed. Conditioning with meth increased the number of D2 + cells co-labelled with c-Fos in adults but not in adolescents. D1:D2 ratio also sex- and age-dependently changed due to meth compared to saline. These findings suggest that reduced aversion to meth is unlikely an explanation for adolescent vulnerability to meth use. Sex- and age-specific expressions of insula D1 and D2 are changed by meth injections, which has implications for subsequent meth use.
Collapse
Affiliation(s)
- Ellen Rose Cullity
- Mental Health Theme, Florey Institute of Neuroscience and Mental Health, Melbourne, Victoria, Australia
- The Florey Department of Neuroscience and Mental Health, The University of Melbourne, Melbourne, Australia
| | - Alexandre Arthur Guérin
- Mental Health Theme, Florey Institute of Neuroscience and Mental Health, Melbourne, Victoria, Australia
- The Florey Department of Neuroscience and Mental Health, The University of Melbourne, Melbourne, Australia
| | - Heather Bronwyn Madsen
- Mental Health Theme, Florey Institute of Neuroscience and Mental Health, Melbourne, Victoria, Australia
| | - Christina Jennifer Perry
- Mental Health Theme, Florey Institute of Neuroscience and Mental Health, Melbourne, Victoria, Australia
- The Florey Department of Neuroscience and Mental Health, The University of Melbourne, Melbourne, Australia
| | - Jee Hyun Kim
- Mental Health Theme, Florey Institute of Neuroscience and Mental Health, Melbourne, Victoria, Australia
- The Florey Department of Neuroscience and Mental Health, The University of Melbourne, Melbourne, Australia
- IMPACT – the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, VIC, Australia
| |
Collapse
|
15
|
Lappin JM, Darke S. Methamphetamine and heightened risk for early-onset stroke and Parkinson's disease: A review. Exp Neurol 2021; 343:113793. [PMID: 34166684 DOI: 10.1016/j.expneurol.2021.113793] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 06/09/2021] [Accepted: 06/19/2021] [Indexed: 01/10/2023]
Abstract
INTRODUCTION Methamphetamine users are typically young adults, placing them at risk for significant drug-related harms. Neurological harms include stroke and Parkinson's disease, both of which may develop prematurely in the context of methamphetamine use. MATERIAL AND METHODS We conducted a narrative review examining the evidence first, for stroke under 45 years and second, early onset of Parkinson's disease (PD) and parkinsonism related to methamphetamine use. We summarise epidemiological factors and common clinical features, before examining in detail the underlying pathology and causal mechanisms. RESULTS AND DISCUSSION Methamphetamine use among young people (<45 years) is associated with heightened risk for haemorrhagic stroke. Compared to age-matched all-cause fatal stroke, haemorrhage secondary to aneurysmal rupture is more common among young people with methamphetamine-related stroke and is associated with significantly poorer prognosis. Aetiology is related primarily to both acute and chronic hypertension associated with methamphetamine's sympathomimetic action. Evidence from a variety of sources supports a link between methamphetamine use and increased risk for the development of PD and parkinsonism, and with their early onset in a subset of individuals. Despite this, direct evidence of degeneration of dopaminergic neurons in methamphetamine users has not been demonstrated to date. CONCLUSIONS Stroke and Parkinson's Disease/parkinsonism are neurological harms observed prematurely in methamphetamine users.
Collapse
Affiliation(s)
- Julia M Lappin
- National Drug & Alcohol Research Centre, University of New South Wales, NSW, Australia; School of Psychiatry, University of New South Wales, NSW, Australia.
| | - Shane Darke
- National Drug & Alcohol Research Centre, University of New South Wales, NSW, Australia
| |
Collapse
|
16
|
Weatherburn D, Yeong S. Does correctional supervision of amphetamine users reduce the risk of re-offending? Addiction 2021; 116:1472-1481. [PMID: 33067834 DOI: 10.1111/add.15298] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 02/21/2020] [Accepted: 10/13/2020] [Indexed: 11/30/2022]
Abstract
AIM To examine the specific deterrent effect of offender supervision on the risk of a further offence by persons convicted of amphetamine use and/or possession. DESIGN Observational study of two groups matched on a wide range of factors using augmented inverse probability of treatment weighting. SETTING New South Wales (NSW), Australia. PARTICIPANTS A total of 2099 persons convicted of amphetamine use and/or possession and placed on either a supervised good behaviour bond (1004) or a bond without supervision (1096). MEASUREMENTS Conviction for another amphetamine use/possession offence, any drug offence, assault or theft within 48 months free time after the index court appearance. FINDINGS Only two of the treatment estimates were consistent with a deterrent effect. Where the outcome was an assault offence, the estimated reduction in risk of re-offending was 1%. Where the outcome was a theft offence, the estimated reduction in the risk of reoffending was 0.07%. Neither result was statistically significant. The coefficients measuring the effect of supervision on the remaining two outcomes (use/possess amphetamine and use/possess any drug) were both positive and not statistically significant. CONCLUSION Correctional supervision does not appear to have been effective in New South Wales, Australia, in reducing the risk of reoffending among people convicted of amphetamine use/possession.
Collapse
Affiliation(s)
- Don Weatherburn
- National Drug and Alcohol Research Centre, University of New South Wales, Australia
| | - Steve Yeong
- Principal evaluator, New South Wales Bureau of Crime Statistics and Research, Sydney, New South Wales, Australia
| |
Collapse
|
17
|
Pisarski K. A Narrative Review of the Recent 'Ice' Epidemic: An Australian Perspective. SUBSTANCE ABUSE-RESEARCH AND TREATMENT 2021; 15:11782218211010502. [PMID: 33958872 PMCID: PMC8064659 DOI: 10.1177/11782218211010502] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 03/14/2021] [Indexed: 11/25/2022]
Abstract
Background: The use of methamphetamine or amphetamine stimulant drugs has been identified by authoritative public health bodies as a global health issue, with a worrying trend towards production and consumption of a higher purity crystalline form methamphetamine (ice) over the past decade. This trend has been well documented within Australia, resulting in a public perception of there being an ‘ice’ epidemic in regional/rural areas. Considering the illicit nature of ice, monitoring it is challenging and as such little information is available regarding the actual extent of methamphetamine use, harms and patterns in regional/remote Australia. Aim: To collate the available literature regarding methamphetamine use in regional/rural Australia and identify gaps in the literature. Methods: A literature search was conducted by searching 6 databases (PUBMED, Medline, CINAHL, EMBASE, PsycINFO and SCOPUS) following which exclusion/inclusion criteria were applied. Included papers were appraised with the Joanna Briggs Institute Critical appraisal tools and synthesised in light of the sociocultural, ethnic and geographic differences in methamphetamine use in Australia. Results: Regarding rural/regional Australia there is a significant lack of research into methamphetamine use, patterns and epidemiology since the rise of crystalline methamphetamine in 2013. The existing literature available suggests great variability in methamphetamine harms in rural communities. This can be a double-edged sword however, as the introduction of ice into a remote/rural community may result in greater harms if it becomes ingrained in local customs. Similarly, there is a lack of research into the specific factors within Indigenous communities leading to an increased rate of methamphetamine use amongst members. Recommendation: Future research should address the causes of variance in methamphetamine harms in rural/remote regions. Although the scope of this paper was the Australian context, a wider international approach may yield useful information.
Collapse
Affiliation(s)
- Konrad Pisarski
- Division of Tropical Health & Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD, Australia.,Faculty of Medicine, University of Queensland, Herston, St Lucia, QLD, Australia
| |
Collapse
|
18
|
Drysdale K, Bryant J, Dowsett GW, Lea T, Treloar C, Aggleton P, Holt M. Priorities and practices of risk reduction among gay and bisexual men in Australia who use crystal methamphetamine for sex. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2021; 93:103163. [PMID: 33601217 DOI: 10.1016/j.drugpo.2021.103163] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Revised: 02/04/2021] [Accepted: 02/05/2021] [Indexed: 02/07/2023]
Abstract
Crystal methamphetamine (hereafter crystal) is associated with deleterious health outcomes, such as drug dependence and physical and mental health disorders. While some harms from crystal use can affect all users, there may be additional risks for people who combine the use of drug with sex. Compared with the broader population, gay and bisexual men in Australia report a higher prevalence of methamphetamine use, and crystal is the most commonly injected illicit drug among this population. The Crystal, Pleasures and Sex between Men research project was conducted between 2017 and 2019 and examined gay and bisexual men's crystal use in four capital cities in Australia, with the aim of identifying how to best support men who use crystal for sex. In this article, we examine how risk is understood and prioritised by gay and bisexual men who combine crystal use and sex and identify the range of risk reduction practices that they used. We classified these risks as those associated with the transmission of HIV, HCV and STIs, and those associated with dependence on either crystal or the sex it facilitated. Gay and bisexual men overwhelmingly prioritised the risk of dependence over any other risks associated with crystal-enhanced sex, and this prioritization was reflected in the risk reduction practices they employed. While some of the strategies that gay and bisexual men have adopted may contradict anticipated public health principles, they derive from a carefully considered and shared approaches to the generation of pleasure, the maintenance of a controlled form of feeling "out of control", and the negotiated reduction of risk. The consolidation of these strategies effectively constitutes a "counterpublic health" underpinned by forms of "sex-based sociality", which gives primacy to the priorities and practices of gay and bisexual men in Australia who combine crystal and sex.
Collapse
Affiliation(s)
- Kerryn Drysdale
- Centre for Social Research in Health, UNSW Sydney, Sydney, NSW, 2054, Australia; Health Equity Research and Development Unit, Sydney Local Health District & UNSW Sydney, Sydney, NSW, 2054, Australia.
| | - Joanne Bryant
- Centre for Social Research in Health, UNSW Sydney, Sydney, NSW, 2054, Australia
| | - Gary W Dowsett
- Centre for Social Research in Health, UNSW Sydney, Sydney, NSW, 2054, Australia; Australian Research Centre for Sex, Health and Society, La Trobe University, Bundoora, VIC, 3086, Australia
| | - Toby Lea
- Centre for Social Research in Health, UNSW Sydney, Sydney, NSW, 2054, Australia
| | - Carla Treloar
- Centre for Social Research in Health, UNSW Sydney, Sydney, NSW, 2054, Australia
| | - Peter Aggleton
- Centre for Social Research in Health, UNSW Sydney, Sydney, NSW, 2054, Australia
| | - Martin Holt
- Centre for Social Research in Health, UNSW Sydney, Sydney, NSW, 2054, Australia
| |
Collapse
|
19
|
Khan SI, Khan MNM, Irfan SD, Rumayan Hasan AM, Ross AG, Horng LMS, Lachowsky N, Knudson G, Azim T. The Effects of Methamphetamine Use on the Sexual Lives of Gender and Sexually Diverse People in Dhaka, Bangladesh: A Qualitative Study. ARCHIVES OF SEXUAL BEHAVIOR 2021; 50:479-493. [PMID: 32239362 PMCID: PMC7529687 DOI: 10.1007/s10508-020-01674-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 02/26/2020] [Accepted: 02/27/2020] [Indexed: 06/11/2023]
Abstract
Methamphetamine use has increased among gender and sexually diverse people in several countries, including Bangladesh. This study aimed to explore the effects of methamphetamine on the sexual lives of these people in Dhaka, Bangladesh. An exploratory qualitative study was conducted, comprising 30 in-depth interviews with gender and sexually diverse people including males having sex with males, male sex workers, and transgender women (hijra) under HIV intervention coverage. Ten key informant interviews were also conducted with individuals who have expertise in relevant disciplines such as drug use, harm reduction, and HIV and AIDS. Digitally recorded data were manually analyzed under the thematic analysis framework. Findings indicated that many participants reported that methamphetamine brought changes in their sexual lives such as increased sexual drive, engagement in group sex, the increased ability to perform serial sex, transactional sex, impulsive and coercive sex, initiation and switching of male-to-male sexual practices, and limited condom use. Key informants noted that there is a dearth of methamphetamine-related services in Bangladesh. Methamphetamine use was found to lead to diverse effects on the sexual lives of gender and sexually diverse people, thus making it a driving force for shaping sexual practices and, hence, sexual risks. Therefore, it is essential for policy-level stakeholders and program managers to consider the risks of methamphetamine use due to their negative ramifications on sexual health, including HIV risks.
Collapse
Affiliation(s)
- Sharful Islam Khan
- Programme for HIV and AIDS, Infectious Diseases Division, International Centre for Diarrhoeal Diseases Research, Bangladesh (icddr,b), 68 Shaheed Tajuddin Ahmed Avenue, Mohakhali, Dhaka, Bangladesh.
| | - Mohammad Niaz Morshed Khan
- Programme for HIV and AIDS, Infectious Diseases Division, International Centre for Diarrhoeal Diseases Research, Bangladesh (icddr,b), 68 Shaheed Tajuddin Ahmed Avenue, Mohakhali, Dhaka, Bangladesh
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Samira Dishti Irfan
- Programme for HIV and AIDS, Infectious Diseases Division, International Centre for Diarrhoeal Diseases Research, Bangladesh (icddr,b), 68 Shaheed Tajuddin Ahmed Avenue, Mohakhali, Dhaka, Bangladesh
| | - A M Rumayan Hasan
- Programme for HIV and AIDS, Infectious Diseases Division, International Centre for Diarrhoeal Diseases Research, Bangladesh (icddr,b), 68 Shaheed Tajuddin Ahmed Avenue, Mohakhali, Dhaka, Bangladesh
| | - Allen G Ross
- Infectious Diseases Division, International Centre for Diarrhoeal Diseases Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Lily Ming-Sha Horng
- Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University, Palo Alto, CA, USA
| | - Nathan Lachowsky
- Faculty of Human and Social Development, School of Public Health and Social Policy, University of Victoria, Victoria, BC, Canada
| | - Gail Knudson
- Department of Psychiatry, The University of British Columbia, Vancouver, BC, Canada
| | - Tasnim Azim
- International Centre for Diarrhoeal Diseases Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| |
Collapse
|
20
|
Garfield JBB, Piercy H, Arunogiri S, Lubman DI, Campbell SC, Sanfilippo PG, Gavin J, Hopwood M, Kotler E, George S, Okedara G, Piccoli LR, Manning V. Protocol for the methamphetamine approach-avoidance training (MAAT) trial, a randomised controlled trial of personalised approach bias modification for methamphetamine use disorder. Trials 2021; 22:21. [PMID: 33407781 PMCID: PMC7788914 DOI: 10.1186/s13063-020-04927-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 11/21/2020] [Indexed: 01/23/2023] Open
Abstract
Background Globally, methamphetamine use has increased in prevalence in recent years. In Australia, there has been a dramatic increase in numbers of people seeking treatment, including residential rehabilitation, for methamphetamine use disorder (MUD). While residential rehabilitation is more effective for MUD than withdrawal treatment (i.e. “detoxification”) alone, relapse rates remain high, with approximately half of rehabilitation clients using methamphetamine within 3 months of rehabilitation. “Approach bias modification” (ABM) is a computerised cognitive training approach that aims to dampen automatically triggered impulses to approach drugs and drug-related stimuli. ABM has been demonstrated to reduce alcohol relapse rates, but no randomised controlled trials of ABM for MUD have yet been conducted. We aim to test whether a novel “personalised” form of ABM, delivered during rehabilitation, reduces post-treatment methamphetamine use, relative to a sham-training control condition. Secondary outcomes will include dependence symptoms, cravings, and approach bias. Methods We aim to recruit 100 participants attending residential rehabilitation for MUD at 3 sites in the Melbourne metropolitan area. Participants will complete baseline measures of methamphetamine use, craving, dependence severity, and approach bias before being randomised to receiving 6 sessions of ABM or “sham” training. In the active condition, ABM will be personalised for each participant, using those methamphetamine images that they rate as most relevant to their recent methods of methamphetamine use as “avoidance” images and using positive images representing their goals or healthy sources of pleasure as “approach” images. Approach bias and craving will be re-assessed following completion of training, and methamphetamine use, dependence, and craving will be assessed 4 weeks and 3 months following discharge from residential treatment. Discussion This study is the first randomised controlled trial of ABM for MUD and also the first ABM study to test using a personalised set of both approach and avoid images for ABM training. If effective, the low cost and easy implementation of ABM means it could be widely implemented as a standard part of MUD treatment. Trial registration Australian New Zealand Clinical Trials Registry ACTRN12620000072910. Registered on 30 January 2020 (prospectively registered): https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=378804&isReview=true
Collapse
Affiliation(s)
- Joshua B B Garfield
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, Australia. .,Turning Point, Eastern Health, 110 Church Street, Richmond, Melbourne, Victoria, 3121, Australia.
| | - Hugh Piercy
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, Australia.,Turning Point, Eastern Health, 110 Church Street, Richmond, Melbourne, Victoria, 3121, Australia
| | - Shalini Arunogiri
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, Australia.,Turning Point, Eastern Health, 110 Church Street, Richmond, Melbourne, Victoria, 3121, Australia
| | - Dan I Lubman
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, Australia.,Turning Point, Eastern Health, 110 Church Street, Richmond, Melbourne, Victoria, 3121, Australia
| | - Samuel C Campbell
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, Australia.,Turning Point, Eastern Health, 110 Church Street, Richmond, Melbourne, Victoria, 3121, Australia
| | - Paul G Sanfilippo
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, Australia.,Turning Point, Eastern Health, 110 Church Street, Richmond, Melbourne, Victoria, 3121, Australia
| | - Jeff Gavin
- Association of Participating Service Users (APSU), Self Help Addiction Resource Centre (SHARC), 140 Grange Road, Carnegie, Melbourne, Victoria, 3163, Australia
| | - Malcolm Hopwood
- Department of Psychiatry, University of Melbourne, Melbourne, Australia.,Albert Road Clinic, Ramsay Health, 31-33 Albert Road, Melbourne, Victoria, 3004, Australia
| | - Eli Kotler
- Malvern Private Hospital, 5 Wilton Vale Crescent, Malvern East, Melbourne, Victoria, 3145, Australia.,Monash Alfred Psychiatry Research Centre, Monash University, Melbourne, Australia
| | - Suzanne George
- Malvern Private Hospital, 5 Wilton Vale Crescent, Malvern East, Melbourne, Victoria, 3145, Australia
| | - Goke Okedara
- Albert Road Clinic, Ramsay Health, 31-33 Albert Road, Melbourne, Victoria, 3004, Australia
| | - Lara R Piccoli
- School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Victoria Manning
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, Australia.,Turning Point, Eastern Health, 110 Church Street, Richmond, Melbourne, Victoria, 3121, Australia
| |
Collapse
|
21
|
Jones HE, Harris RJ, Downing BC, Pierce M, Millar T, Ades AE, Welton NJ, Presanis AM, Angelis DD, Hickman M. Estimating the prevalence of problem drug use from drug-related mortality data. Addiction 2020; 115:2393-2404. [PMID: 32392631 PMCID: PMC7613965 DOI: 10.1111/add.15111] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 11/05/2019] [Accepted: 05/04/2020] [Indexed: 01/07/2023]
Abstract
BACKGROUND AND AIMS Indirect estimation methods are required for estimating the size of populations where only a proportion of individuals are observed directly, such as problem drug users (PDUs). Capture-recapture and multiplier methods are widely used, but have been criticized as subject to bias. We propose a new approach to estimating prevalence of PDU from numbers of fatal drug-related poisonings (fDRPs) using linked databases, addressing the key limitations of simplistic 'mortality multipliers'. METHODS Our approach requires linkage of data on a large cohort of known PDUs to mortality registers and summary information concerning additional fDRPs observed outside this cohort. We model fDRP rates among the cohort and assume that rates in unobserved PDUs are equal to rates in the cohort during periods out of treatment. Prevalence is estimated in a Bayesian statistical framework, in which we simultaneously fit regression models to fDRP rates and prevalence, allowing both to vary by demographic factors and the former also by treatment status. RESULTS We report a case study analysis, estimating the prevalence of opioid dependence in England in 2008/09, by gender, age group and geographical region. Overall prevalence was estimated as 0.82% (95% credible interval = 0.74-0.94%) of 15-64-year-olds, which is similar to a published estimate based on capture-recapture analysis. CONCLUSIONS Our modelling approach estimates prevalence from drug-related mortality data, while addressing the main limitations of simplistic multipliers. This offers an alternative approach for the common situation where available data sources do not meet the strong assumptions required for valid capture-recapture estimation. In a case study analysis, prevalence estimates based on our approach were surprisingly similar to existing capture-recapture estimates but, we argue, are based on a much more objective and justifiable modelling approach.
Collapse
Affiliation(s)
- Hayley E. Jones
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Ross J. Harris
- Centre for Infectious Disease Surveillance and Control, Public Health England, London, UK
| | - Beatrice C. Downing
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Matthias Pierce
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Manchester, UK
| | - Tim Millar
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Manchester, UK
| | - A. E. Ades
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Nicky J. Welton
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | | | - Daniela De Angelis
- Centre for Infectious Disease Surveillance and Control, Public Health England, London, UK,MRC Biostatistics Unit, University of Cambridge, Cambridge, UK
| | - Matthew Hickman
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| |
Collapse
|
22
|
Soo JY, Wiese MD, Dyson RM, Gray CL, Clarkson AN, Morrison JL, Berry MJ. Methamphetamine administration increases hepatic CYP1A2 but not CYP3A activity in female guinea pigs. PLoS One 2020; 15:e0233010. [PMID: 32396581 PMCID: PMC7217439 DOI: 10.1371/journal.pone.0233010] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 04/28/2020] [Indexed: 11/18/2022] Open
Abstract
Methamphetamine use has increased over the past decade and the first use of methamphetamine is most often when women are of reproductive age. Methamphetamine accumulates in the liver; however, little is known about the effect of methamphetamine use on hepatic drug metabolism. Methamphetamine was administered on 3 occassions to female Dunkin Hartley guinea pigs of reproductive age, mimicking recreational drug use. Low doses of test drugs caffeine and midazolam were administered after the third dose of methamphetamine to assess the functional activity of cytochrome P450 1A2 and 3A, respectively. Real-time quantitative polymerase chain reaction was used to quantify the mRNA expression of factors involved in glucocorticoid signalling, inflammation, oxidative stress and drug transporters. This study showed that methamphetamine administration decreased hepatic CYP1A2 mRNA expression, but increased CYP1A2 enzyme activity. Methamphetamine had no effect on CYP3A enzyme activity. In addition, we found that methamphetamine may also result in changes in glucocorticoid bioavailability, as we found a decrease in 11β-hydroxysteroid dehydrogenase 1 mRNA expression, which converts inactive cortisone into active cortisol. This study has shown that methamphetamine administration has the potential to alter drug metabolism via the CYP1A2 metabolic pathway in female guinea pigs. This may have clinical implications for drug dosing in female methamphetamine users of reproductive age.
Collapse
Affiliation(s)
- Jia Yin Soo
- Early Origins of Adult Health Research Group, University of South Australia, Adelaide, Australia
- Health and Biomedical Innovation, University of South Australia, Adelaide, Australia
| | - Michael D. Wiese
- Health and Biomedical Innovation, University of South Australia, Adelaide, Australia
| | - Rebecca M. Dyson
- Department of Paediatrics and Child Health, Brain Health Research Centre and Brain Research New Zealand, University of Otago, Dunedin, New Zealand
| | - Clint L. Gray
- Department of Paediatrics and Child Health, Brain Health Research Centre and Brain Research New Zealand, University of Otago, Dunedin, New Zealand
| | - Andrew N. Clarkson
- Department of Anatomy, Brain Health Research Centre and Brain Research New Zealand, University of Otago, Dunedin, New Zealand
| | - Janna L. Morrison
- Early Origins of Adult Health Research Group, University of South Australia, Adelaide, Australia
- Health and Biomedical Innovation, University of South Australia, Adelaide, Australia
- * E-mail: (JLM); (MJB)
| | - Mary J. Berry
- Department of Paediatrics and Child Health, Brain Health Research Centre and Brain Research New Zealand, University of Otago, Dunedin, New Zealand
- * E-mail: (JLM); (MJB)
| |
Collapse
|
23
|
O'Connor A, Harris E, Seeber C, Hamilton D, Fisher C, Sachmann M. Methamphetamine use in pregnancy, child protection, and removal of infants: Tertiary centre experience from Western Australia. Midwifery 2020; 83:102641. [DOI: 10.1016/j.midw.2020.102641] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 01/06/2020] [Accepted: 01/17/2020] [Indexed: 10/25/2022]
|
24
|
Kenneally M, Byard RW. Increasing Methamphetamine Detection in Cases of Early Childhood Fatalities. J Forensic Sci 2020; 65:1376-1378. [PMID: 32202648 DOI: 10.1111/1556-4029.14321] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 03/04/2020] [Accepted: 03/06/2020] [Indexed: 12/01/2022]
Abstract
Age and organ maturity can influence drug toxicity in children; however, most clinical data and literature are based on drug concentrations in adults. Therefore, the interpretation of drugs detected in children is often difficult or not possible. Retrospective reviewing of pathology and toxicology information from postmortem cases may assist in future interpretations or identify drug trends. A search of the Forensic Science SA case files was undertaken over 15 years from January 2002 to December 2016 for all children (<13 years). Of the 412 pediatric coronial cases, toxicological information was available on 373. At least one drug was detected in 94 cases with paracetamol, ibuprofen, codeine and hospital-administrated lignocaine and morphine among the most commonly detected agents. Methamphetamine, one of the most commonly abused illicit drugs in Australia, was found in seven cases. In the methamphetamine cases, deaths were associated with shared sleeping in three, pneumonia in one, and stillbirth in one. Methamphetamine was considered potentially contributory to death in two cases. The causes of death in the remaining two cases were undetermined. As six of the seven positive cases occurred in the 2012-2016 (n = 106) timeframe, an increase has occurred over recent years in the number of infants and young children presenting to forensic autopsy in South Australia who have detectable concentrations of methamphetamine. If this is an indication of a more generalized increased childhood exposure in the community there may be significant long-term physical and psychological effects.
Collapse
Affiliation(s)
- Michaela Kenneally
- Forensic Science SA, GPO Box 2790, Adelaide, 5001, South Australia, Australia
| | - Roger W Byard
- Forensic Science SA, GPO Box 2790, Adelaide, 5001, South Australia, Australia
| |
Collapse
|
25
|
Arunogiri S, Moayeri F, Crossin R, Killian JJ, Smith K, Scott D, Lubman DI. Trends in gamma-hydroxybutyrate-related harms based on ambulance attendances from 2012 to 2018 in Victoria, Australia. Addiction 2020; 115:473-479. [PMID: 31618793 DOI: 10.1111/add.14848] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 07/30/2019] [Accepted: 09/29/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND AIMS Although the prevalence of gamma-hydroxybutyrate (GHB) use is relatively low globally, harms related to the drug appear to be increasing. Few existing studies present reliable, representative, population-level data on GHB-related harms. The aim of this study was to investigate trends in acute GHB-related harms within an ambulance database in Australia. DESIGN, SETTING AND PARTICIPANTS Cross-sectional, retrospective analysis of data on all GHB-related ambulance attendances in the state of Victoria, Australia during a 7-year period (January 2012-December 2018) MEASUREMENTS: Presentations were characterized based on patient demographics, transport to hospital, co-occurring substance use (i.e. GHB only, alcohol, methamphetamine, heroin, benzodiazepine and cannabis) and clinical presentation (e.g. symptoms of anxiety, psychosis, depression). FINDINGS There were 5866 GHB-related ambulance attendances between 2012 and 2018, with the prevalence rate increasing from 8.8 per 100 000 population in 2012 to a maximum of 21.7 per 100 000 population in 2017. Methamphetamine [odds ratio (OR) = 6.23, P < 0.001] and benzodiazepine-related (OR = 1.43, P < 0.001) co-occurrences; ages between 18-29 (OR = 6.58, P < 0.001) and 30-39 years (OR = 2.02, P < 0.001); and male gender (OR = 1.23, P < 0.001) were significant predictors of GHB-related attendances. CONCLUSIONS There has been a 147% increase in the prevalence of GHB-related ambulance attendances in Victoria, Australia between 2012 and 2019, largely attributable to a growth in the proportions of people using gamma-hydroxybutyrate alone or concurrently with methamphetamine.
Collapse
Affiliation(s)
- Shalini Arunogiri
- Monash Addiction Research Centre and Eastern Health Clinical School, Monash University, Box Hill, VIC, Australia.,Turning Point, Eastern Health, Richmond, VIC, Australia
| | | | - Rose Crossin
- Monash Addiction Research Centre and Eastern Health Clinical School, Monash University, Box Hill, VIC, Australia.,Turning Point, Eastern Health, Richmond, VIC, Australia
| | - Jessica J Killian
- Monash Addiction Research Centre and Eastern Health Clinical School, Monash University, Box Hill, VIC, Australia.,Turning Point, Eastern Health, Richmond, VIC, Australia
| | - Karen Smith
- Ambulance Victoria, Doncaster, VIC, Australia.,Department of Community Emergency Health and Paramedic Practice, Monash University, Frankston, VIC, Australia.,Department of Epidemiology and Preventive Medicine, Monash University, Richmond, VIC, Australia
| | - Debbie Scott
- Monash Addiction Research Centre and Eastern Health Clinical School, Monash University, Box Hill, VIC, Australia.,Turning Point, Eastern Health, Richmond, VIC, Australia
| | - Dan I Lubman
- Monash Addiction Research Centre and Eastern Health Clinical School, Monash University, Box Hill, VIC, Australia.,Turning Point, Eastern Health, Richmond, VIC, Australia
| |
Collapse
|
26
|
Davey JD, Armstrong KA, Freeman JE, Parkes A. Alcohol and illicit substances associated with fatal crashes in Queensland: An examination of the 2011 to 2015 Coroner's findings. Forensic Sci Int 2020; 312:110190. [PMID: 32413687 DOI: 10.1016/j.forsciint.2020.110190] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 12/31/2019] [Accepted: 02/07/2020] [Indexed: 11/15/2022]
Abstract
PROBLEM The problem of impaired driving is well documented in the literature but is heavily dependent upon self-report studies and/or databases that do not include in-depth information about the contributing origins of fatalities. AIM This study aimed to conduct an in-depth analysis of Coroner's findings for all fatally injured drivers in the state of Queensland in order to explore the prevalence of alcohol and different types of illicit substances (including drug combinations) in fatal crash reports. METHOD A total of 701 Coroner's reports related to drivers or controllers of vehicles involved in traffic related fatalities for the period of 2011-2015 were analysed, revealing 306 controllers (43.6%) were detected with either alcohol or illegal drugs (e.g., methylamphetamine, Δ9-tetrahydrocannabinol, cocaine or MDMA) RESULTS: Alcohol was the most commonly detected substance identified with 223 cases (72.9% of the drug and alcohol sample). Illicit drug detections totalled 147 cases (48% of the drug and alcohol sample) with Δ9-tetrahydrocannabinol the most commonly detected illicit substance (109 cases; 35.6% of the drug and alcohol sample) followed by methylamphetamine (total of 63 cases; 20.6% of the drug and alcohol sample). An important theme to emerge was the prevalence of polysubstance use among fatally injured drivers, not just for alcohol and one drug type, but also multiple drug combinations. Fatality trends revealed a decrease in both non-substance and alcohol-related fatalities across the study period. However, road fatalities where an illicit substance was detected increased by approximately 57%. Males were overrepresented as a proportion of total fatalities (82.4%) and there were no significant sex or age differences regarding illicit substance related deaths. Drivers of passenger vehicles were most commonly identified in the data (66.2%), but motorcycle operators were disproportionately represented (28.1% of the total controller sample compared to 4% of vehicle registrations in Queensland) CONCLUSION: This case study analysis of fatal crashes not only confirms the ongoing problem of alcohol and driving, but also illuminates the emerging (and escalating) issue of illicit substances detected in fatally injured drivers.
Collapse
Affiliation(s)
- Jeremy D Davey
- Road Safety Research Collaboration, University of the Sunshine Coast, Sippy Downs, Queensland, 4556 QLD, Australia.
| | - Kerry A Armstrong
- Road Safety Research Collaboration, University of the Sunshine Coast, Sippy Downs, Queensland, 4556 QLD, Australia
| | - James E Freeman
- Road Safety Research Collaboration, University of the Sunshine Coast, Sippy Downs, Queensland, 4556 QLD, Australia
| | - Alexander Parkes
- Road Safety Research Collaboration, University of the Sunshine Coast, Sippy Downs, Queensland, 4556 QLD, Australia
| |
Collapse
|
27
|
Power J, Mikołajczak G, Bourne A, Brown G, Leonard W, Lyons A, Dowsett GW, Lucke J. Sex, drugs and social connectedness: wellbeing among HIV-positive gay and bisexual men who use party-and-play drugs. Sex Health 2019; 15:135-143. [PMID: 29544599 DOI: 10.1071/sh17151] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Accepted: 12/05/2017] [Indexed: 11/23/2022]
Abstract
Background This paper explores associations between use of party-and-play drugs, including crystal methamphetamine, and wellbeing among HIV positive gay and bisexual men (GBM) in Australia. This study considers whether use of drugs in a social or sex-based setting facilitates access to social and support networks, which may in turn support wellbeing. METHODS A cross-sectional survey of Australian people living with HIV (PLHIV) was conducted. There were 714 participants (79.7%) who identified as GBM. Differences between party-and-play drug users and non-users were examined using bivariate and multinomial logistic regressions. Mediation analysis examined the indirect effect of drug use on wellbeing via social connectedness and support. RESULTS One in three participants (29.7%) reported party-and-play drug use within the past 12 months. Only 5% reported regular use. There were no differences between users and non-users on self-reported measures of general health, wellbeing or general social support. Compared with non-users, party-and-play drug users reported higher levels of resilience and lower levels of perceived HIV-related stigma. This was associated with spending more time with other people living with HIV and friends in the gay and lesbian community. CONCLUSIONS While party-and-play drug use poses risks to the health of GBM, the social contexts in which these drugs are used may provide wellbeing benefits, particularly for HIV-positive GBM who may be subject to HIV-related stigma in other settings. Further research is needed to determine whether drug-use facilitates access to social networks or if people with more active social ties are more likely to engage in drug use.
Collapse
Affiliation(s)
- Jennifer Power
- Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Vic. 3086, Australia
| | - Gosia Mikołajczak
- Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Vic. 3086, Australia
| | - Adam Bourne
- Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Vic. 3086, Australia
| | - Graham Brown
- Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Vic. 3086, Australia
| | - William Leonard
- Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Vic. 3086, Australia
| | - Anthony Lyons
- Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Vic. 3086, Australia
| | - Gary W Dowsett
- Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Vic. 3086, Australia
| | - Jayne Lucke
- Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Vic. 3086, Australia
| |
Collapse
|
28
|
Mann A, Wagstaff C. Psychosocial treatment for methamphetamine use and the associated mental health symptoms. ADVANCES IN DUAL DIAGNOSIS 2019. [DOI: 10.1108/add-11-2018-0022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
Methamphetamine users commonly experience induced methamphetamine associated mental health symptoms. Currently, psychosocial treatment is implemented to reduce use; however, to date, the effectiveness of psychosocial treatment in methamphetamine use and the associated mental health symptoms has not been reviewed. The paper aims to discuss this issue.
Design/methodology/approach
A systematic literature review was performed by searching databases (PubMed, Embase, Ovid MEDLINE, PsychINFO and CINAHL) and following clear inclusion/exclusion criteria.
Findings
In total, 12 studies met the inclusion/exclusion criteria, measuring a variety of psychosocial interventions and measuring a variety of different mental health outcomes. Decreased methamphetamine use was observed in the five studies which recorded this.
Research limitations/implications
Most studies in this review were preliminary trials and only three were RCTs. Additionally, methamphetamine use is a particular problem in Japan and is becoming more prevalent in Europe, yet neither primary nor secondary searching identified papers from these regions.
Practical implications
While the findings may not provide sufficient supporting evidence to instigate changes in clinical practice, this work should be developed further, as it is clear that psychosocial interventions can be successful in treating this population.
Social implications
This review demonstrates that psychosocial treatments can improve symptoms associated with methamphetamine use. Reduction in mental health symptoms has been shown to attract individuals to drug use treatment and thus indirectly reducing methamphetamine use.
Originality/value
Given the consequences of methamphetamine for individuals and communities treatment options must be explored. A review of psychosocial interventions in the treatment of methamphetamine use and associated mental health symptoms had not been done previously. This review provides a foundation for further research.
Collapse
|
29
|
Chivaurah BM, Lienert D, Coates D. Amphetamine-type-substance-related presentations to the Emergency Department Mental Health Team of a local health district in Australia. Australas Psychiatry 2019; 27:369-373. [PMID: 31081337 DOI: 10.1177/1039856219848836] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To identify the prevalence and profile of amphetamine-type-substance-related presentations to the Emergency Department Mental Health Team of a local health district in Australia. METHODS Data was collected from medical records of all amphetamine-type-substance presentations to the Emergency Department Mental Health Team over a 1-year period, between 1 January 2015 and 31 December 2015. RESULTS Of all presentations referred to the Emergency Department Mental Health Team, 0.15% (N = 189) were amphetamine-type-substance related. Of these, the majority were male, the average age was 32, 19.0% engaged in intravenous drug use, some were aggressive and 15.9% required tranquilisation. The most common presenting issues were psychosis and suicidal threats, intent and behaviour (including intentional overdose). Multiple comorbid conditions were identified. On discharge, 34.4% were admitted into a psychiatric hospital and 32.8% were referred to Community Mental health teams. CONCLUSIONS Amphetamine-type-substance users suffer from multiple comorbidities and pose a significant burden on emergency services.
Collapse
Affiliation(s)
- Bernard M Chivaurah
- Psychiatry Registrar, Emergency Department Mental Health Team, Wyong Hospital, NSW, Australia
| | - David Lienert
- Consultant Psychiatrist and Clinical Director, Central Coast Local Health District, NSW, Australia
| | - Dominiek Coates
- Senior Research Fellow, University of Technology, Sydney, NSW, Australia
| |
Collapse
|
30
|
McInnis P, Lee A. Methamphetamine use in an early psychosis service: a cross-sectional retrospective cohort study. Australas Psychiatry 2019; 27:383-387. [PMID: 31264898 DOI: 10.1177/1039856219859811] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Methamphetamine-associated psychotic symptoms are common among regular users, and can overlap with the emergence of a primary psychotic disorder. In contrast to previous research, this retrospective observational study aims to describe the characteristics of young people experiencing early psychosis who use methamphetamine regularly. We also aimed to investigate associations between regular methamphetamine use and markers of psychosocial functioning, psychosis outcomes and substance use. METHOD This study involved 116 young people (19 using methamphetamine regularly) referred to the Camperdown Early Intervention in Psychosis Service from January 2015 to January 2016. Variables including demographic information, psychosocial functioning and psychosis outcomes were collected on referral to the service, updated throughout treatment and at discharge. RESULTS There were significant associations found between regular methamphetamine use and a criminal history (p<0.001), regular cannabis use (p=0.002) and regular nicotine use (p<0.001). CONCLUSION This study suggests that in early psychosis, regular methamphetamine use could signify a subgroup of young people who use multiple substances and may engage in criminal activity. Addressing substance use in early psychosis may be an important treatment target for this vulnerable group of young people.
Collapse
Affiliation(s)
- Peter McInnis
- Rivendell Child Adolescent and Family Mental Health Service, Sydney Local Health District, Concord West, NSW, Australia
| | - Anna Lee
- Early Intervention in Psychosis Service, Sydney Local Health District, Camperdown, NSW, Australia
| |
Collapse
|
31
|
|
32
|
Turning points, identity, and social capital: A meta-ethnography of methamphetamine recovery. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2019; 67:79-90. [PMID: 30970290 DOI: 10.1016/j.drugpo.2019.02.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 01/30/2019] [Accepted: 02/27/2019] [Indexed: 01/09/2023]
Abstract
BACKGROUND Despite the increasing prevalence and distinct nature of methamphetamine-related harms, treatment models are limited, and relapse is common. Meta-ethnography has been increasingly used to synthesise qualitative health research and develop new concepts or theories. This meta-ethnography aimed to explore methamphetamine users' experiences of cessation, recovery, and relapse, to better understand how to tailor support for this population. METHODS A systematic review was conducted of six electronic databases, supported by hand searches of leading journals and reviews of reference lists. Reports were included that used naturalistic participant observation to examine methamphetamine cessation, recovery, and relapse with at least 50% of their sample. The life course approach to drug use was used to inform the process of data analysis and interpretation. The final sample was synthesised using Reciprocal Translation supported by open and axial coding. RESULTS Nineteen sources were selected, thirteen of which were conducted in the United States. Two themes were identified: methamphetamine users are exposed to a range of relapse triggers, but also triggers for recovery, and their susceptibility to these triggers is largely determined by their social environment; and the process of recovery requires changes in personal and social identity which can be a barrier to recovery for some users. CONCLUSION These findings present the concept of recovery triggers and highlight the role of wider risk environments in determining methamphetamine recovery, and the negative potential of social capital. These themes also address the ongoing debate regarding the agency of drug users, and the impact of this debate on drug user's experiences of recovery.
Collapse
|
33
|
Allan J, Ip RHL, Kemp M, Snowdon N. Increased demand for amphetamine treatment in rural Australia. Addict Sci Clin Pract 2019; 14:13. [PMID: 30929641 PMCID: PMC6442410 DOI: 10.1186/s13722-019-0144-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Accepted: 03/14/2019] [Indexed: 11/19/2022] Open
Abstract
Background A substantial increase in substance treatment episodes for methamphetamine problems suggests characteristics of the treatment population could have changed and that targeted treatment programs are required. To determine who methamphetamine treatment should be designed for this study has two aims. First, to empirically describe changes in amphetamine treatment presentations to a rural NSW drug and alcohol treatment agency over time. Second, to examine how these characteristics may affect the likelihood of being treated for amphetamines compared to other drugs. Method The Australian Alcohol and Other Drug Treatment Services National Minimum Data Set (AODTS-NMDS) containing closed treatment episodes from a single agency from three time periods was used. Characteristics of people receiving amphetamine treatments in these three periods were compared and the effects of these characteristics on the odds of being treated for amphetamine were estimated using a logistic regression model. The characteristics utilised in the analysis include age, sex, Indigenous status, usual accommodation, living arrangement, source of referral and source of income. Results The proportion of amphetamine treatment episodes doubled from 2006/2007 to 2015/2016 and overtook alcohol as the most commonly treated principal drug of concern. The estimated proportion of amphetamine treatments showed an increment across all ages and for men and women. It was found that younger people, women, people in temporary accommodation or homeless, people who were self-referred and people whose main source of income was not through employment are more likely to be treated for amphetamine use. Conclusion Significant changes over time in the age, sex and Indigenous status of people receiving treatment for amphetamine as the principal drug of concern requires service delivery to match demand from younger people, particularly women; and Indigenous people. The needs and preferences for treatment of younger women who use amphetamine will be important factors in treatment planning service providers who are more used to providing treatment for young men who use cannabis and older men who use alcohol. Further research on women’s experiences in treatment and outcomes would be useful for informing treatment practices. Electronic supplementary material The online version of this article (10.1186/s13722-019-0144-6) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Julaine Allan
- Lives Lived Well, Orange, NSW, Australia. .,Conjoint Academic, National Drug and Alcohol Research Centre, UNSW, P.O. Box 9374, Orange East, NSW, 2800, Australia.
| | - Ryan H L Ip
- Charles Sturt University, Wagga Wagga, NSW, Australia
| | - Michael Kemp
- Charles Sturt University, Orange, NSW, Australia
| | | |
Collapse
|
34
|
Jacka B, Kemp R, Degenhardt L, Peacock A, Clare P, Bruno R, Dev A, Sotade O, Larance B. Trends in methamphetamine and opioid use among clients of needle-syringe programs in Queensland, Australia: 2007-2015. Drug Alcohol Rev 2019; 38:159-168. [PMID: 30761653 DOI: 10.1111/dar.12908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Revised: 01/08/2019] [Accepted: 01/09/2019] [Indexed: 11/28/2022]
Abstract
INTRODUCTION AND AIMS Needle-syringe programs (NSP) are an underutilized source of data on drug injection trends; these data are essential for informing public health interventions. We examine trends in NSP service occasions from 2007-2015. DESIGN AND METHODS Using standardised data from 26 NSP outlets through the Queensland NSP Minimum Data Set (QNSPMDS), trends in service occasions among clients intending to inject methamphetamine, heroin, opioid substitution therapy (OST) medications and other pharmaceutical opioids were assessed using multilevel mixed-effects negative binomial regression, adjusting for month, year, age and clustering by site. RESULTS Over 1.5 million service occasions were recorded in 2007-2015. Methamphetamine was the main 'drug intended to inject' (33.7%), however cf. 2007, the incidence rate ratio decreased to 0.64 (95% CI: 0.62, 0.66) in 2009, remaining low until 2015. Among clients reporting methamphetamine injection, there was a shift in the form from base to the higher-potency crystal methamphetamine since 2012. Heroin injection (22.5% service occasions) initially increased (cf. 2007), followed by a decline to 0.77 (95% CI: 0.75, 0.79) in 2015. Significant and sustained increases in OST and other pharmaceutical opioids injection were observed throughout the study period, accounting for 7.2% and 19.8% of total visits, respectively. DISCUSSION AND CONCLUSIONS The QNSPMDS provides unique, routinely collected, jurisdiction-wide and standardised data on the demographics of people who inject drugs, types of drugs injected and regional variations; these data are essential in informing policy, planning and program implementation. There remains significant opportunity to enhance engagement and linkage to care alongside needle-syringe provision.
Collapse
Affiliation(s)
- Brendan Jacka
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia.,Kirby Institute, UNSW Sydney, Sydney, Australia
| | - Robert Kemp
- Communicable Diseases Branch, Queensland Health, Brisbane, Australia
| | - Louisa Degenhardt
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Amy Peacock
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia.,School of Medicine (Psychology), University of Tasmania, Hobart, Australia
| | - Philip Clare
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Raimondo Bruno
- School of Medicine (Psychology), University of Tasmania, Hobart, Australia
| | - Abhilash Dev
- Chief Medical Officer and Healthcare Regulation Branch, Queensland Health, Brisbane, Australia
| | | | - Briony Larance
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia.,School of Psychology, University of Wollongong, Wollongong, Australia
| |
Collapse
|
35
|
Darke S, Kaye S, Duflou J, Lappin J. Completed Suicide Among Methamphetamine Users: A National Study. Suicide Life Threat Behav 2019; 49:328-337. [PMID: 29444345 DOI: 10.1111/sltb.12442] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2017] [Accepted: 10/30/2017] [Indexed: 11/28/2022]
Abstract
All Australian cases of methamphetamine-related suicide (2009-2015) retrieved from the National Coronial Information System were examined to determine crude mortality rates, characteristics and circumstances of death, and blood toxicology. There were 300 cases, 18.2% of all methamphetamine-related deaths, and 1.6% of all completed suicides. The mean age was 33.1 years, and 77.0% were male. The crude mortality rate was 1.9 per 106 , with males having a significantly higher rate than females (2.9 vs. 0.9 per 106 ). A quarter were known to have previous suicide attempts, and a history of psychosis was noted in 12.3%. In 40.7% of cases, witnesses described the decedent as having been agitated and/or aggressive immediately prior to the incident. The vast majority (85.3%), and of both sexes (males 87.0%, females 79.7%), used violent methods. Hanging (70.3%) was overwhelmingly the most frequent method among both males (70.1%) and females (71.0%). Prescription medications were frequently present: hypnosedatives (23.6%), antidepressants (19.5%), and antipsychotics (8.4%). Self-poisoning cases were significantly more likely to have antidepressants (odds ratio: 4.2) and opioids (4.9) present, but less likely to have cannabis (0.3). Methamphetamine-related suicide makes a large contribution to methamphetamine-related death and represents a substantial clinical and public health problem.
Collapse
Affiliation(s)
- Shane Darke
- National Drug & Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia
| | - Sharlene Kaye
- National Drug & Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia.,Justice Health and Forensic Mental Health Network, NSW Health, Sydney, NSW, Australia
| | - Johan Duflou
- National Drug & Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia.,Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - Julia Lappin
- National Drug & Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia.,School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| |
Collapse
|
36
|
Cartwright K, Tait RJ. Service providers' experience of methamphetamine and the portrayal of the 'ice epidemic' in remote Australia. Aust J Rural Health 2019; 27:83-87. [PMID: 30693985 DOI: 10.1111/ajr.12483] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/17/2018] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To contrast service providers' perceptions about crystalline methamphetamine (henceforth, ice) use and harm with information communicated in media reports and politicians' statements. DESIGN In-depth semi structured interviews with service providers about the nature and extent of ice use in the local community and its impact on individual services, clients and town life. Interviews were transcribed verbatim, manually analysed and coded around key themes, interpreted and independently cross-checked for context and accuracy. SETTING Two remote towns located in different states and territories operating as service hubs to very remote communities. PARTICIPANTS Twenty-seven key service providers representing local organisations that engage with ice users and/or their families. RESULTS First, compared with alcohol, ice use and ice-related harm were insignificant at the two sites. Ice users were primarily high-earning and -functioning non-Australian Aboriginal tradesmen, and to a lesser extent, professionals and secondary school students. There were few Australian Aboriginal users. Ice was used to 'party', keep alert, and escape psychological distress. Second, the 'Ice Destroys Lives' campaign and references to an 'ice epidemic' amplified public anxiety about ice and ice-related harm in the surveyed communities. Third, the attention on ice distracted from the more extensive harm arising from alcohol use in their communities. CONCLUSION The respondents questioned the notion of an 'ice epidemic' and the use of federal funding for ice-related initiatives in remote communities, especially while general alcohol and other drug services were under-resourced.
Collapse
Affiliation(s)
- Kimberly Cartwright
- National Drug Research Institute, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Robert J Tait
- National Drug Research Institute, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| |
Collapse
|
37
|
Rubenis AJ, Fitzpatrick RE, Lubman DI, Verdejo‐Garcia A. Working memory predicts methamphetamine hair concentration over the course of treatment: moderating effect of impulsivity and implications for dual-systems model. Addict Biol 2019; 24:145-153. [PMID: 29114992 DOI: 10.1111/adb.12575] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Revised: 09/22/2017] [Accepted: 10/03/2017] [Indexed: 01/08/2023]
Abstract
High impulsivity and poor executive function are characteristic of methamphetamine use disorder. High arousal in the impulsive system has been proposed to compromise the executive system's regulating ability (i.e. the dual-systems model). While interaction between these variables may partly explain poor treatment outcomes associated with methamphetamine use disorder, previous research has tended to examine each factor separately. We investigated whether high impulsivity (measured with an impulsive choice task) and poor executive function (measured with a working memory task) predict methamphetamine use (determined by hair sample) in the 6 weeks following treatment commencement. We also investigated whether impulsive choice moderates the relationship between working memory and methamphetamine use. One hundred and eight individuals with methamphetamine use disorder (75 percent male) were tested within 3 weeks of commencing treatment; 80 (74 percent) were followed up 6 weeks following baseline testing. Cognitive measures significantly predicted drug use after controlling for nuisance variables. Working memory was a significant predictor, while impulsive choice was not. The interaction model included working memory as a predictor and impulsive choice as a moderator. This model was significant, as was the interaction term. Working memory significantly predicted levels of methamphetamine use in early treatment, and impulsive choice moderated this relationship. Those with working memory deficits are particularly vulnerable to using greater amounts of methamphetamine. As working memory increased methamphetamine use decreased among individuals with low/medium delay discounting. Pre-treatment cognitive testing may identify patients at high risk, while remediation of working memory function may be a treatment target for reducing methamphetamine use.
Collapse
Affiliation(s)
- Adam J. Rubenis
- Monash Institute of Cognitive and Clinical Neurosciences Monash University Clayton VIC 3800 Australia
| | - Rebecca E. Fitzpatrick
- Monash Institute of Cognitive and Clinical Neurosciences Monash University Clayton VIC 3800 Australia
| | - Dan I. Lubman
- Turning Point Eastern Health Fitzroy VIC 3065 Australia
- Eastern Health Clinical School Monash University Fitzroy VIC 3065 Australia
| | - Antonio Verdejo‐Garcia
- Monash Institute of Cognitive and Clinical Neurosciences Monash University Clayton VIC 3800 Australia
| |
Collapse
|
38
|
Longitudinal patterns of amphetamine use from adolescence to adulthood: A latent class analysis of a 20-year prospective study of Australians. Drug Alcohol Depend 2019; 194:121-127. [PMID: 30419406 DOI: 10.1016/j.drugalcdep.2018.08.042] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Revised: 08/22/2018] [Accepted: 08/25/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND To examine the longitudinal patterns of amphetamine use over twenty years from adolescence to the mid-thirties; and identify adolescent antecedents of future problematic patterns of use. DESIGN Ten-wave longitudinal study following participants from age 15 to age 35 in Victoria, Australia. Participants (N = 1755; 47% males) first enrolled in the Victoria Adolescent Health Cohort Study in 1992. MEASUREMENTS Outcome: Self-reported frequency of amphetamine use. PREDICTORS Gender, depression and anxiety, peer alcohol and tobacco use; self-reported alcohol, tobacco and cannabis use, self-reported adolescent antisocial behavior. FINDINGS Three different longitudinal patterns were identified: Non-user (83.7%); Occasional user (14.5%); Regular user (1.8%). Among the two user patterns, amphetamine use was commonly initiated in late teenage years or early 20s, peaked at mid-20s, and declined substantially by mid-30s. Participants who used cannabis and had smoking peers during adolescence were at significantly more likely to become an occasional or regular user (p < .05). CONCLUSION Regular cannabis use and peer tobacco use during adolescence were the two strongest predictors of a longitudinal pattern of regular amphetamine use in the mid-30s. This suggests that prevention programs could be implemented around or before mid-adolescence and interventions to reduce amphetamine harms focus on high-risk individuals in their 20s when amphetamine use was at its peak.
Collapse
|
39
|
“A more accurate understanding of drug use”: A critical analysis of wastewater analysis technology for drug policy. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2019; 63:47-55. [DOI: 10.1016/j.drugpo.2018.10.011] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 10/29/2018] [Accepted: 10/29/2018] [Indexed: 11/21/2022]
|
40
|
Chapman C, Champion KE, Birrell L, Deen H, Brierley ME, Stapinski LA, Kay-Lambkin F, Newton NC, Teesson M. Smartphone Apps About Crystal Methamphetamine ("Ice"): Systematic Search in App Stores and Assessment of Composition and Quality. JMIR Mhealth Uhealth 2018; 6:e10442. [PMID: 30463834 PMCID: PMC6282015 DOI: 10.2196/10442] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 07/01/2018] [Accepted: 08/10/2018] [Indexed: 01/23/2023] Open
Abstract
Background Amid considerable community concern about the prevalence and harms associated with the use of crystal methamphetamine (“ice”), the increased use of smartphones to access health information and a growing number of available smartphone apps related to crystal methamphetamine, no previous reviews have examined the content and quality of these apps. Objective This study aims to systematically review existing apps in the iTunes and Google Play Stores to determine the existence, composition, and quality of educational smartphone apps about methamphetamines, including ice. Methods The iTunes and Google Play Stores were systematically searched in April 2017 for iOS Apple and Android apps, respectively. English-language apps that provided educational content or information about methamphetamine were eligible for inclusion. Eligible apps were downloaded and independently evaluated for quality by 2 reviewers using the Mobile Application Rating Scale (MARS). Results A total of 2205 apps were initially identified, of which 18 were eligible and rated using the MARS. The mean MARS quality total score for all rated apps was 3.0 (SD 0.6), indicating poor to acceptable quality. Overall, mean scores were the highest for functionality (mean 4.0, SD 0.5) and lowest for engagement (mean 2.3, SD 0.7). Conclusions This study demonstrates a shortage of high-quality educational and engaging smartphone apps specifically related to methamphetamine. The findings from this review highlight a need for further development of engaging and evidence-based apps that provide educational information about crystal methamphetamine.
Collapse
Affiliation(s)
- Cath Chapman
- National Health and Medical Research Council Centre of Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Katrina Elizabeth Champion
- National Health and Medical Research Council Centre of Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia.,Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Louise Birrell
- National Health and Medical Research Council Centre of Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Hannah Deen
- National Health and Medical Research Council Centre of Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Mary-Ellen Brierley
- National Health and Medical Research Council Centre of Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Lexine A Stapinski
- National Health and Medical Research Council Centre of Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Frances Kay-Lambkin
- National Health and Medical Research Council Centre of Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia.,Priority Research Centre for Brain and Mental Health, The University of Newcastle, Newcastle, Australia
| | - Nicola C Newton
- National Health and Medical Research Council Centre of Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Maree Teesson
- National Health and Medical Research Council Centre of Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| |
Collapse
|
41
|
Tait RJ, Whetton S, Shanahan M, Cartwright K, Ferrante A, Gray D, Kaye S, McKetin R, Pidd K, Ritter A, Roche A, Allsop S. Quantifying the societal cost of methamphetamine use to Australia. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2018; 62:30-36. [PMID: 30352332 DOI: 10.1016/j.drugpo.2018.08.015] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Revised: 08/23/2018] [Accepted: 08/27/2018] [Indexed: 11/30/2022]
Abstract
Globally, there are increasing concerns about the harms associated with methamphetamine use. This paper i) reports on the results of a cost-of-illness (CoI) study that quantified the social costs associated with methamphetamine use in Australia and, ii) drawing on examples from this study, critically examines the general applicability of CoI studies for the alcohol and other drug field. A prevalence approach was used to estimate costs in 2013/2014, the most recent year for which reasonably comprehensive data were available. The value selected for a statistical life-year in our central estimate was AUD 281,798. Other costs were estimated from diverse sources. Total cost was estimated at AUD 5023.8 million in 2013/14 (range, AUD 2502.3 to AUD 7016.8 million). The greatest cost areas were crime including costs related to policing, courts, corrections and victims of crime (AUD 3244.5 million); followed by premature death (AUD 781.8 million); and, workplace costs (AUD 289.4 million). The social costs of methamphetamine use in Australia in 2013/14 are high, and the identification of crime and premature mortality as the largest cost areas is similar to USA findings and represents important areas for prevention and cost remediation. However, caution is required in interpreting the findings of any CoI study, as there is uncertainty associated with estimates owing to data limitations. Moreover, CoI estimates on their own do not identify which, if any, of the costs are avoidable (with drug substitution being a particular problem) nor do they shed light on the effectiveness of any potential interventions. We also recognise that data limitations prevent some costs from being estimated at all.
Collapse
Affiliation(s)
- Robert J Tait
- National Drug Research Institute, Faculty of Health Sciences, Curtin University, Perth, WA, Australia.
| | - Steve Whetton
- South Australian Centre for Economic Studies, University of Adelaide, Adelaide, SA, Australia
| | - Marian Shanahan
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia; Drug Policy Modelling Program, University of New South Wales, Sydney, NSW, Australia
| | - Kimberly Cartwright
- National Drug Research Institute, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
| | - Anna Ferrante
- School of Public Health, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
| | - Dennis Gray
- National Drug Research Institute, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
| | - Sharlene Kaye
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia
| | - Rebecca McKetin
- National Drug Research Institute, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
| | - Ken Pidd
- National Centre for Education and Training on Addiction, Flinders University, Adelaide, SA, Australia
| | - Alison Ritter
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia; Drug Policy Modelling Program, University of New South Wales, Sydney, NSW, Australia
| | - Ann Roche
- National Centre for Education and Training on Addiction, Flinders University, Adelaide, SA, Australia
| | - Steve Allsop
- National Drug Research Institute, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
| |
Collapse
|
42
|
Pilla M, van den Heuvel C, Musgrave I, Byard RW. Increasing incidence of nonlethal inflicted injuries in paediatric homicides: A 45-year study. J Forensic Leg Med 2018; 59:4-7. [PMID: 30036763 DOI: 10.1016/j.jflm.2018.07.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2018] [Revised: 07/06/2018] [Accepted: 07/13/2018] [Indexed: 11/30/2022]
Abstract
A retrospective study was undertaken at Forensic Science South Australia of all homicides in individuals aged <18 years from January 1970 to December 2014. 166 cases were identified (M:F = 1.5:1). The number of cases steadily declined, with the highest numbers and death rate occurring between 1970 and 1974 (N = 26; 0.37/100,000 population), and the lowest between 2010 and 2014 (N = 8; 0.1/100,000) (p < 0.01). Deaths were due to blunt force trauma (37%), gunshot wounds (19%), asphyxiation (18%), sharp force trauma (8%), poisoning (8%), burns (3%) and neglect (1%), or were undetermined (6%). There was a significant increase in numbers of accompanying nonfatal injuries (3.46 per case for 1970 and 1974, compared to 18.88 per case for 2010 and 2014). Thus, while both the absolute numbers and the rates of paediatric homicides declined significantly, numbers of nonlethal injuries increased. Whatever the underlying reason(s) for the increase in nonlethal injuries, fatal attacks on children in South Australia appear to be becoming more violent.
Collapse
Affiliation(s)
- Mark Pilla
- Adelaide Medical School, The University of Adelaide, Frome Rd, Adelaide, Australia; Forensic Science SA, 21 Divett Place, Adelaide, Australia
| | | | - Ian Musgrave
- Adelaide Medical School, The University of Adelaide, Frome Rd, Adelaide, Australia
| | - Roger W Byard
- Adelaide Medical School, The University of Adelaide, Frome Rd, Adelaide, Australia; Forensic Science SA, 21 Divett Place, Adelaide, Australia.
| |
Collapse
|
43
|
Wright CM, Norman R, Varhol R, Davis J, Wilson-Taylor E, Dorigo J, Robinson S. Exploring the costs and effectiveness of the Drug and Alcohol Withdrawal Network: a home-based alcohol and other drug withdrawal service. Aust J Prim Health 2018; 24:385-390. [PMID: 30032738 DOI: 10.1071/py17110] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Accepted: 03/24/2018] [Indexed: 11/23/2022]
Abstract
The Drug and Alcohol Withdrawal Network (DAWN) is a home-based withdrawal service based in Perth, Western Australia. Literature on outcomes, costs and client attitudes towards this type of home-based detoxification in Australia is sparse. Therefore, this study assessed these factors for clients enrolled over a 5-year period (July 2011-June 2016). Client experience was explored through semi-structured interviews with 10 clients. Over the study period, 1800 clients (54% male, mean age 38 years) were assessed, and there were 2045 episodes of care. Although most first-episode clients (52%) listed alcohol as the primary drug of concern, the proportion listing methamphetamine increased from 4% in 2011-12 to 23% in 2015-16. In 94% (n=639) of withdrawal detoxification episodes with completed surveys, clients used their 'drug of primary concern' most days or more often at baseline; this had reduced to 23% (n=149) at the conclusion of detoxification. Five-year direct costs were A$4.8million. Clients valued the person-centred holistic approach to care, including linking with other health providers. Barriers included low awareness of the program and difficulties finding an appropriate support person. Further exploration of cost-effectiveness would substantiate the apparently lower per client cost, assuming medical suitability for both programs, for home-based relative to inpatient withdrawal.
Collapse
Affiliation(s)
- Cameron M Wright
- Health Systems and Health Economics, School of Public Health, Curtin University, GPO Box U1987, Bentley, WA 6845, Australia
| | - Richard Norman
- Health Systems and Health Economics, School of Public Health, Curtin University, GPO Box U1987, Bentley, WA 6845, Australia
| | - Richard Varhol
- Health Systems and Health Economics, School of Public Health, Curtin University, GPO Box U1987, Bentley, WA 6845, Australia
| | - Jacqueline Davis
- Health Systems and Health Economics, School of Public Health, Curtin University, GPO Box U1987, Bentley, WA 6845, Australia
| | - Elizabeth Wilson-Taylor
- Drug and Alcohol Withdrawal Network, St John of God Healthcare, 12 Salvado Road, Subiaco, WA 6008, Australia
| | - Justin Dorigo
- Drug and Alcohol Withdrawal Network, St John of God Healthcare, 12 Salvado Road, Subiaco, WA 6008, Australia
| | - Suzanne Robinson
- Health Systems and Health Economics, School of Public Health, Curtin University, GPO Box U1987, Bentley, WA 6845, Australia
| |
Collapse
|
44
|
Been F, O'Brien J, Lai FY, Morelato M, Vallely P, McGowan J, van Nuijs ALN, Covaci A, Mueller JF. Analysis of N,N-dimethylamphetamine in wastewater - a pyrolysis marker and synthesis impurity of methamphetamine. Drug Test Anal 2018; 10:1590-1598. [PMID: 29877063 DOI: 10.1002/dta.2419] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Revised: 05/22/2018] [Accepted: 05/29/2018] [Indexed: 11/09/2022]
Abstract
The increased availability of high purity crystalline methamphetamine (MA) in Australia raised concerns because of high dosages and its potential consumption through inhalation. The present work investigates the possibility of using wastewater levels of N,N-dimethylamphetamine (DMA), a pyrolysis by-product, as an indirect indicator of MA smoking. A dedicated liquid chromatography quadrupole-time-of-flight mass spectrometry (LC-QToF-MS) method was set up to detect and quantify DMA in wastewater samples. Wastewater samples were collected from 8 locations across Australia during the period 2011-2016. Data about the abundance of DMA in MA seizures as well as in residues from drug paraphernalia were obtained from forensic laboratories in Australia. DMA/MA ratios measured in wastewater ranged from 0.0001 to 0.09 (median 0.007). DMA/MA ratios in bulk seizures are generally below 0.0025, with a median value of 0.0004, whilst residues in paraphernalia ranged from 0.031 to 3.37. DMA/MA ratios in wastewater decreased between 2011 and 2016, in parallel to an increase in MA loads. Furthermore, wastewater analyses highlighted a strong positive correlation between DMA/MA ratios and per capita MA use (Pearson's correlation ρ= 0.61, p-value <0.001). Nonetheless, geographical specificities could be highlighted between the investigated locations. The obtained data could help authorities detect hot spots of drug use as well as to plan specific intervention campaigns to tackle the issue. In future, simultaneous analysis of DMA and MA in both wastewater and seizures could improve our understanding about MA use and its consumption patterns.
Collapse
Affiliation(s)
- Frederic Been
- Toxicological Centre, University of Antwerp, Belgium
| | - Jake O'Brien
- Queensland Alliance for Environmental Health Sciences, The University of Queensland, Coopers Plains, Australia
| | - Foon Yin Lai
- Toxicological Centre, University of Antwerp, Belgium
| | - Marie Morelato
- Centre for Forensic Science, University of Technology Sydney, Australia
| | - Peter Vallely
- Australian Criminal Intelligence Commission, Canberra, Australia
| | - Jenny McGowan
- Forensic and Scientific Services, Queensland Health, Coopers Plains, Australia
| | | | - Adrian Covaci
- Toxicological Centre, University of Antwerp, Belgium
| | - Jochen F Mueller
- Queensland Alliance for Environmental Health Sciences, The University of Queensland, Coopers Plains, Australia
| |
Collapse
|
45
|
Ezard N, Dunlop A, Hall M, Ali R, McKetin R, Bruno R, Phung N, Carr A, White J, Clifford B, Liu Z, Shanahan M, Dolan K, Baker AL, Lintzeris N. LiMA: a study protocol for a randomised, double-blind, placebo controlled trial of lisdexamfetamine for the treatment of methamphetamine dependence. BMJ Open 2018; 8:e020723. [PMID: 30030312 PMCID: PMC6059315 DOI: 10.1136/bmjopen-2017-020723] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
INTRODUCTION Methamphetamine dependence is a growing public health concern. There is currently no pharmacotherapy approved for methamphetamine dependence. Lisdexamfetamine (LDX) dimesylate, used in the treatment of attention-deficit hyperactivity disorder and binge eating disorder, has potential as an agonist therapy for methamphetamine dependence, and possible benefits of reduced risk of aberrant use due to its novel formulation. METHODS AND ANALYSIS A double-blind randomised controlled trial will be used to evaluate the efficacy of LDX in reducing methamphetamine use. The target sample is 180 participants with methamphetamine dependence of ≥2 years, using ≥14 days out of the previous 28, who have previously attempted but not responded to treatment for methamphetamine use. Participants will be randomly assigned to receive either a 15-week intervention consisting of induction (1 week of 150 mg LDX or placebo), maintenance (12 weeks of 250 mg LDX or placebo) and reduction (1 week of 150 mg LDX or placebo and 1 week of 50 mg LDX or placebo). All participants will be given access to four sessions of cognitive-behavioural therapy as treatment as usual and receive a 4-week follow-up appointment. The primary outcomes are efficacy (change from baseline in days of methamphetamine use by self-report for the last 28 days at week 13 and urinalyses confirmation of methamphetamine use) and safety (treatment-related adverse events). Secondary outcomes are total number of days of self-report methamphetamine use over the 12-week active treatment, longest period of abstinence during treatment period, percentage of achieving ≥21 days abstinence, craving, withdrawal, dependence, retention, bloodborne virus transmission risk behaviour, criminal behaviour, as well measures of abuse liability, physical and mental health, other substance use, cognitive performance, psychosocial functioning, treatment retention and satisfaction. Additionally, the study will assess the cost-effectiveness of LDX relative to the placebo control. ETHICS AND DISSEMINATION The study has been approved by the Human Research Ethics Committee of St. Vincent's Hospital, Sydney, Australia (HREC/16/SVH/222). Contact the corresponding author for the full trial protocol. TRIAL REGISTRATION NUMBER ACTRN12617000657325; Pre-results.
Collapse
Affiliation(s)
- Nadine Ezard
- Alcohol and Drug Service, St Vincents Hospital, Sydney, New South Wales, Australia
- University of New South Wales, Randwick, New South Wales, Australia
| | - Adrian Dunlop
- Drug and Alcohol Clinical Services, Hunter New England, Newcastle, New South Wales, Australia
- School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
| | - Michelle Hall
- Drug and Alcohol Clinical Services, Hunter New England, Newcastle, New South Wales, Australia
| | - Robert Ali
- University of New South Wales, Randwick, New South Wales, Australia
- University of Adelaide, Adelaide, South Australia, Australia
| | | | - Raimondo Bruno
- University of South Australia, Adelaide, South Australia, Australia
- University of Tasmania, Hobart, Tasmania, Australia
| | - Nghi Phung
- Western Sydney Local Health District, Sydney, New South Wales, Australia
| | - Andrew Carr
- Alcohol and Drug Service, St Vincents Hospital, Sydney, New South Wales, Australia
- University of New South Wales, Randwick, New South Wales, Australia
| | - Jason White
- University of South Australia, Adelaide, South Australia, Australia
| | - Brendan Clifford
- Alcohol and Drug Service, St Vincents Hospital, Sydney, New South Wales, Australia
- University of Sydney, Sydney, New South Wales, Australia
| | - Zhixin Liu
- University of New South Wales, Randwick, New South Wales, Australia
| | - Marian Shanahan
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, New South Wales, Australia
| | - Kate Dolan
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, New South Wales, Australia
| | - Amanda L Baker
- School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
| | - Nicholas Lintzeris
- University of Sydney, Sydney, New South Wales, Australia
- South East Sydney Local Health District, Sydney, New South Wales, Australia
| |
Collapse
|
46
|
Butterworth P, Becker D, Degenhardt L, Hall WD, Patton GC. Amphetamine use in the fourth decade of life: Social profiles from a population-based Australian cohort. Drug Alcohol Rev 2018; 37:743-751. [PMID: 29998467 DOI: 10.1111/dar.12840] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Revised: 05/21/2018] [Accepted: 06/12/2018] [Indexed: 11/30/2022]
Abstract
INTRODUCTION AND AIMS To estimate the prevalence and frequency of amphetamine use in a cohort of Australians aged in their mid-30s. DESIGN AND METHODS Cross-sectional analysis of wave 10 data collected in 2014 from the Victorian Adolescent Health Cohort Study: a sample of 1435 persons originally selected in a stratified, random community survey of secondary school students from the state of Victoria that commenced in 1992. Weighted multinomial regression models were used to evaluate the social, health and other substance-use correlates of lifetime and current (12-month) amphetamine use and current frequency of use. RESULTS Lifetime amphetamine use was reported by 23.2% (95% confidence interval 21.0-25.5%) of respondents, and 6.5% (95% confidence interval 5.2-7.8%) reported current (12-month) use. A quarter (26%) of those currently using amphetamines, 1.7% (95% confidence interval 1.0-2.4%) of all respondents, reported frequent (at least weekly) use. Men reported greater amphetamine use than women. Current amphetamine use was associated with disrupted family circumstances, socioeconomic adversity, polydrug use and high levels of drug use within the social and familial environment. Frequent use was associated with greater likelihood of multiple adversity, unemployment, anxiety disorders and use of mental health services. DISCUSSION AND CONCLUSIONS The current results show that lifetime, current and frequent amphetamine use was common amongst adults in the fourth decade of life in this cohort, and associated with the experience of social disadvantage, poor mental health and living in a social context in which drug use is the norm.
Collapse
Affiliation(s)
- Peter Butterworth
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.,Melbourne Institute of Applied Economic and Social Research, University of Melbourne, Melbourne, Australia
| | - Denise Becker
- Centre for Adolescent Health, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia
| | - Louisa Degenhardt
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Wayne D Hall
- Centre for Youth Substance Abuse, University of Queensland, Brisbane, Australia
| | - George C Patton
- Centre for Adolescent Health, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia
| |
Collapse
|
47
|
Bryant J, Hopwood M, Dowsett GW, Aggleton P, Holt M, Lea T, Drysdale K, Treloar C. The rush to risk when interrogating the relationship between methamphetamine use and sexual practice among gay and bisexual men. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2018; 55:242-248. [DOI: 10.1016/j.drugpo.2017.12.010] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 12/01/2017] [Accepted: 12/08/2017] [Indexed: 10/18/2022]
|
48
|
Crouse JJ, Lee RSC, White D, Moustafa AA, Hickie IB, Hermens DF. Distress and sleep quality in young amphetamine-type stimulant users with an affective or psychotic illness. Psychiatry Res 2018; 262:254-261. [PMID: 29475104 DOI: 10.1016/j.psychres.2018.02.033] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Revised: 02/02/2018] [Accepted: 02/14/2018] [Indexed: 01/30/2023]
Abstract
Misuse of amphetamine-type stimulant (ATS) drugs may disrupt key neurodevelopmental processes in young people and confer protracted neurocognitive and psychopathological harm. ATS users with a co-occurring psychiatric illness are typically excluded from research, reducing generalisability of findings. Accordingly, we conducted a cross-sectional examination of key clinical, sleep, socio-occupational and neurocognitive measures in current, past and never users of ATS drugs who were accessing a youth mental health service (headspace) for affective- or psychotic-spectrum illnesses. Contrary to hypotheses, groups did not differ in psychotic symptomology, socio-occupational functioning or neurocognitive performance. Current ATS users were however significantly more distressed and reported poorer subjective sleep quality and greater subjective sleep disturbances than never users, with a trend toward greater depressive symptomology in current users. Regression analyses revealed that depressive symptoms, daily ATS use and socio-occupational functioning predicted distress, and depressive symptoms and distress predicted subjective sleep quality. Our findings suggest that distress and poor sleep quality reflect a particular pathophysiology among ATS-using patients, which may negatively impact treatment engagement. Delineating the factors that disrupt social and neurobiological development in young people (such as substance use) warrants further investigation, including longitudinal study.
Collapse
Affiliation(s)
- Jacob J Crouse
- Youth Mental Health Team, Brain and Mind Centre, University of Sydney, NSW, Australia.
| | - Rico S C Lee
- Youth Mental Health Team, Brain and Mind Centre, University of Sydney, NSW, Australia; Brain and Mental Health Laboratory, Monash University, VIC, Australia
| | - Django White
- Youth Mental Health Team, Brain and Mind Centre, University of Sydney, NSW, Australia
| | - Ahmed A Moustafa
- School of Social Sciences and Psychology, Western Sydney University, NSW, Australia
| | - Ian B Hickie
- Youth Mental Health Team, Brain and Mind Centre, University of Sydney, NSW, Australia
| | - Daniel F Hermens
- Youth Mental Health Team, Brain and Mind Centre, University of Sydney, NSW, Australia; Sunshine Coast Mind and Neuroscience Thompson Institute, University of the Sunshine Coast, QLD, Australia
| |
Collapse
|
49
|
Champion KE, Chapman C, Newton NC, Brierley ME, Stapinski L, Kay-Lambkin F, Nagle J, Teesson M. A Web-Based Toolkit to Provide Evidence-Based Resources About Crystal Methamphetamine for the Australian Community: Collaborative Development of Cracks in the Ice. JMIR Ment Health 2018; 5:e21. [PMID: 29559427 PMCID: PMC5883077 DOI: 10.2196/mental.8891] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 11/22/2017] [Accepted: 01/09/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The use of crystal methamphetamine (ice) and the associated harms for individuals, families, and communities across Australia has been the subject of growing concern in recent years. The provision of easily accessible, evidence-based, and up-to-date information and resources about crystal methamphetamine for the community is a critical component of an effective public health response. OBJECTIVE This paper aims to describe the codevelopment process of the Web-based Cracks in the Ice Community Toolkit, which was developed to improve access to evidence-based information and resources about crystal methamphetamine for the Australian community. METHODS Development of the Cracks in the Ice Community Toolkit was conducted in collaboration with community members across Australia and with experts working in the addiction field. The iterative process involved the following: (1) consultation with end users, including community members, crystal methamphetamine users, families and friends of someone using crystal methamphetamine, health professionals, and teachers (n=451) via a cross-sectional Web-based survey to understand information needs; (2) content and Web development; and (3) user testing of a beta version of the Web-based toolkit among end users (n=41) and experts (n=10) to evaluate the toolkit's acceptability, relevance, and appeal. RESULTS Initial end user consultation indicated that the most commonly endorsed reasons for visiting a website about crystal methamphetamine were "to get information for myself" (185/451, 41.0%) and "to find out how to help a friend or a family member" (136/451, 30.2%). Community consultation also revealed the need for simple information about crystal methamphetamine, including what it is, its effects, and when and where to seek help or support. Feedback on a beta version of the toolkit was positive in terms of content, readability, layout, look, and feel. Commonly identified areas for improvement related to increasing the level of engagement and personal connection, improving the ease of navigation, and balancing a "low prevalence of use, yet high impact" message. A total of 9138 users visited the website in the 3 months immediately post launch, and over 25,000 hard-copy Cracks in the Ice booklets and flyers were distributed across Australia. Of these resources, 60.93% (15,525/25,480) were distributed to relevant organizations and mailing list subscribers, and 39.07% (9955/25,480) were ordered directly by individuals, services, and community groups via the Cracks in the Ice website. CONCLUSIONS The codevelopment process resulted in an engaging Web-based resource for the Australian community to access up-to-date and evidence-based resources about crystal methamphetamine. The Cracks in the Ice Community Toolkit provides much-needed information and support for individuals, families, and communities.
Collapse
Affiliation(s)
- Katrina Elizabeth Champion
- National Health and Medical Research Council Centre of Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia.,Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Cath Chapman
- National Health and Medical Research Council Centre of Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Nicola Clare Newton
- National Health and Medical Research Council Centre of Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Mary-Ellen Brierley
- National Health and Medical Research Council Centre of Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Lexine Stapinski
- National Health and Medical Research Council Centre of Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Frances Kay-Lambkin
- National Health and Medical Research Council Centre of Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia.,Priority Research Centre for Brain and Mental Health, The University of Newcastle, Callaghan, Australia
| | - Jack Nagle
- The Real Drug Talk, Melbourne, Australia
| | - Maree Teesson
- National Health and Medical Research Council Centre of Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| |
Collapse
|
50
|
Dixson G, Woolfenden S, Jayasinha R, Rawstorne P, Palmer K, Nathan S. Characteristics of Australian adolescent females in residential treatment who report using methamphetamines. Drug Alcohol Rev 2017; 37 Suppl 1:S384-S393. [PMID: 29266457 DOI: 10.1111/dar.12641] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Revised: 10/12/2017] [Accepted: 11/08/2017] [Indexed: 11/30/2022]
Abstract
INTRODUCTION AND AIMS To investigate factors associated with methamphetamine use in adolescent females referred to an Australian residential treatment service. DESIGN AND METHODS A mixed-methods explanatory sequential design was undertaken. Cross-sectional analysis of existing pre-treatment data for adolescent females aged 13-18 years (median 16.48 years) attending a treatment program between 2009 and 2015 (n = 267) was undertaken, followed by a focus group and in-depth interviews of key staff. RESULTS Female methamphetamine-users (n = 127, 47.6%) were significantly more likely than non-methamphetamine-users at pre-treatment to be in unstable living arrangements, where they moved frequently (P = 0.025), lived in more unstable (not rented or privately owned) accommodation (P = 0.012) and had problematic family situations (P = 0.004). They were more likely than non-methamphetamine-users to be to be poly-drug users (P < 0.001) and to have ever attempted suicide (P = 0.029). Cumulative trauma by someone known to the adolescent was the main predictor for female methamphetamine use (odds ratio 3.077). Qualitative data provided context and depth to quantitative findings, with an emphasis on trauma as a precursor to methamphetamine use. The qualitative interviews also highlighted changes made in service provision, given the increasing rates of methamphetamine use. DISCUSSION AND CONCLUSIONS High levels of trauma and mental health problems in this population support the notion that traumatic childhood experiences are strongly associated with problematic alcohol and other drug use, particularly, methamphetamine use, at a young age. Increased attention to decreasing family violence, abuse and neglect is required and in clinical practice, a trauma-informed model of care is recommended.
Collapse
Affiliation(s)
- Georgina Dixson
- School of Public Health & Community Medicine, UNSW Sydney, Sydney, Australia
| | - Susan Woolfenden
- School of Public Health & Community Medicine, UNSW Sydney, Sydney, Australia.,Sydney Children's Hospital Network, Sydney, Australia
| | - Ranmalie Jayasinha
- School of Public Health & Community Medicine, UNSW Sydney, Sydney, Australia
| | - Patrick Rawstorne
- School of Public Health & Community Medicine, UNSW Sydney, Sydney, Australia
| | | | - Sally Nathan
- School of Public Health & Community Medicine, UNSW Sydney, Sydney, Australia
| |
Collapse
|