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• Latent class analyses identify 15 types of drinking in Great Britain in 2019. • Alcohol consumption varies substantially across types of occasion. • Occasions that span the off-trade and on-trade involve particularly heavy drinking. • Heavy drinking is common across most occasion types, but so is moderate drinking. • Most heavy drinking takes place in off-trade only drinking occasions. This paper aimed to (i) update a previous typology of British alcohol drinking occasions using a more recent and expanded dataset and revised modelling procedure, and (ii) estimate the average consumption level, prevalence of heavy drinking, and distribution of all alcohol consumption and heavy drinking within and across occasion types. The paper uses a cross-sectional latent class analysis of event-level diary data that includes characteristics of 43,089 drinking occasions in 2019 reported by 17,821 adult drinkers in Great Britain. The latent class indicators are characteristics of off-trade only (e.g. home), on-trade only (e.g. bar) and mixed trade (e.g. home and bar) drinking occasions. These describe companions, locations, purpose, motivation, accompanying activities, timings, consumption volume in units (1 UK unit = 8g ethanol) and beverages consumed. The analysis identified four off-trade only, eight on-trade only and three mixed-trade occasion types (i.e. latent classes). Mean consumption per occasion varied between 4.4 units in Family meals to 17.7 units in Big nights out with pre-loading. It exceeded ten units in all mixed-trade occasion types and in Off-trade get togethers, Big nights out and Male friends at the pub. Three off-trade types accounted for 50.8% of all alcohol consumed and 51.8% of heavy drinking occasions: Quiet drink at home alone, Evening at home with partner and Off-trade get togethers. For thirteen out of fifteen occasion types, more than 25% of occasions involved heavy drinking. Conversely, 41.7% of Big nights out and 16.4% of Big nights out with preloading were not heavy drinking occasions. Alcohol consumption varies substantially across and within fifteen types of drinking occasion in Great Britain. Heavy drinking is common in most occasion types. However, moderate drinking is also common in occasion types often characterised as heavy drinking practices. Mixed-trade drinking occasions are particularly likely to involve heavy drinking. [ABSTRACT FROM AUTHOR]

Introduction: 'New recovery' can be conceptualised as both a social movement and a broader policy agenda to restructure treatment service systems towards 'recovery-oriented systems of care'. Emerging initially out of the United States, new recovery has gained currency as a policy agenda in other jurisdictions - perhaps most distinctly in the United Kingdom. In 2012, the ideas behind 'new recovery' were debated in the Australian alcohol and other drug field as the Victorian government sought to incorporate recovery principles into policy and service design. This paper uses the policy transfer and policy translation literature to understand how international policy ideas about 'new recovery' were negotiated in the Australian context, focusing specifically on the role of non-government actors in the process.Methods: This paper draws on an analysis of policy documents, organisational documents and interviews with representatives from the Australian non-government alcohol and other drug sector to consider how new recovery was translated into Victorian drug policy.Results: The interactions between organisations and actors - including bureaucrats, governmental agencies and policy entrepreneurs - facilitated the circulation and translation of policy ideas in the Victorian context. Despite this, the analysis suggests that policy transfer was largely a symbolic exercise: overall, some of the key features of new recovery policy from the United States and the United Kingdom, such as encouraging peer-led recovery and mutual aid, were not incorporated in the Victorian policy. NGOs resisted what they considered to be some of the more problematic elements of 'new recovery', and informed the local translation of the policy.Discussion: The results have implications for understandings of the relationship between social movements, non-government organisations and the state, as well as the dynamics of knowledge transfer in drug policy. [ABSTRACT FROM AUTHOR]

Recent years have seen an expanding 'no and low alcohol' (NoLo) drinks market in the United Kingdom and other high-income countries. With the UK government pledging to increase the availability of NoLos and encourage their consumption, further research is required to underpin policy and explore the potential for NoLos to ease – or exacerbate – alcohol-related harm. This paper draws on original primary research on NoLo marketing and consumption in the UK; analysis of two NoLo marketing campaigns and semi-structured interviews with both drinkers and non-drinkers who consume NoLos. Addition marketing was identified in the promotion of NoLo products, encouraging consumers to incorporate NoLo consumption into new spatial and temporal contexts on top of their typical weekly drinking patterns. However, there was resistance towards these practices from consumers, who stressed they were more likely to drink NoLos in place of alcohol and incorporate them into their existing drinking routines. This paper expands a currently very limited evidence base and contributes directly to ongoing debates around 'addition' versus 'substitution' (i.e. whether NoLo products are being used on top of or in place of alcohol). Findings highlight both some of the challenges and opportunities of the expanding market, pointing towards the problematic presence of 'addition marketing' but also highlighting the ways consumers might challenge this and use NoLos flexibly to reduce consumption. As a result, NoLo promotion could function as one tool amongst many to help at least some consumers drink in moderation, alongside a broader package of measures such as education and wider social change. [ABSTRACT FROM AUTHOR]

Recent surveys have found a strong decrease in alcohol consumption among young people and this trend has been identified in European countries, Australia and North America. Previous research suggests that the decline in alcohol consumption may be explained by changes in parenting style, increased use of social media, changes in gender identities or a health and fitness trend. We use qualitative interviews with drinking and non-drinking young people from Sweden (N = 49) to explore in what way and in what kinds of contexts these explanations may hold true and how they alone or together may explain declining alcohol consumption among young people. By using the pragmatist approach, we pay attention to what kinds of concerns, habits, practices, situations and meanings our interviewees relate to adolescents' low alcohol consumption or decline in drinking. By analyzing these matters, we aim to specify the social mechanisms that have reduced adolescents' drinking. Our paper discovers social mechanisms similar to previous studies but also a few that have previously been overlooked. We propose that the cultural position of drinking may have changed among young people so that drinking has lost its unquestioned symbolic power as a rite of passage into adulthood. There is less peer pressure to drink and more room for competing activities. This opening of a homogeneous drinking culture to the acceptance of differences may function as a social mechanism that increases the success of other social mechanisms to reduce adolescents' drinking. Furthermore, the results of the paper suggest a hypothesis of the early maturation of young people as more individualized, responsible, reflective, and adult-like actors than in earlier generations. Overall, the paper provides hypotheses for future quantitative studies to examine the prevalence and distribution of the identified social mechanisms, as well as recommends directions for developing effective interventions to support young people's healthy lifestyle choices. [ABSTRACT FROM AUTHOR]

Background: In the United States (U.S.), higher levels of acculturation have been associated with higher rates of heavy alcohol use more consistently among Latino women than among Latino men. This paper explores mechanisms underlying the link between acculturation and alcohol use among Latino/as in the U.S. We examine alcohol use expectancies and motives from the perspectives of the social cognitive theory of gender development.Methods: Qualitative narratives data from six focus groups of individuals (total n = 37), who met criteria for heavy drinking (4/5 drinks/occasion for females/males), were examined separately by gender (18 females; 19 males). Coded narratives data were analyzed using a framework that compared lives in Latin America and in the U.S. Emergent themes were analyzed for their consistency across genders. Gender-specific themes were identified.Results: Changes in family structure and the loss of social networks prompted divergent patterns of drinking among men and women, such that relative to patterns in their countries of origin, drinking among Latino women increased while it decreased among Latino men. Men and women reported drinking to replace missing social bonds, a motive not frequently reported in the literature on drinking motives. Women who engaged in heavy-drinking nonetheless described traditional gender role expectations after U.S. arrival. Only men endorsed positive alcohol expectancies in Latin America. Women reported drinking to alleviate psychological distress in the U.S.Conclusions: Pre and post-immigration comparisons revealed different drinking trajectories among men and women after immigration to the U.S. These patterns appeared to be influenced by new social contexts and changes in familial expectations regarding women's roles. Future inquiry that examines gender-specific themes in alcohol expectancies and motives unique to the experience of immigration, is warranted. [ABSTRACT FROM AUTHOR]

Background: This paper evaluates the impact of the AU$83 million introduction of 24-h public transport (PT) in Melbourne, Australia on Friday and Saturday nights on a sample of nightlife venues and venue patrons. This sample was selected because a primary reason for the introduction of 24 h PT was to provide a safe means of travel home for nightlife attendees.Methods: Covert venue observations (pre-post) and a convenience sample of nightlife patron interviews (post-only) were conducted to measure the impact of 24-h PT on venues and venue patrons. Specifically, the impact of 24-h PT on the proportion of people observed within venues (as rated on a 0-100% scale of venue capacity), patrons in venues showing any sign of intoxication, those who were observed to be too intoxicated to remain in the venue, patron drinking or drug taking behavior, train use, and the time and money spent in the night time economy were assessed.Results: After 24-h PT was introduced there were no significant differences overall in the proportion of people observed within venues, or significant associations with the proportion of patrons showing any sign of intoxication or proportions who were observed to be too intoxicated to remain in the venue. However, when accounting for seasonality (matching-months), observed patron intoxication increased significantly after the introduction of 24-h PT. The majority of nightlife patrons did not report a change in their pre-drinking or drug taking behavior after 24-public transport, but 44% indicated spending more time in the night time economy, 27% reported spending more money, and 56% reported increasing their train use.Conclusion: Patron reports suggest that 24-h public transport has increased the amount of time people spend in nightlife settings without obviously impacting on drinking behavior. However, supplying 24-h public transport has resulted in greater self-reported use of public transport. [ABSTRACT FROM AUTHOR]

Alcohol misuse contributes substantially to the global morbidity and mortality burden. Unrecorded alcohol, alcohol that is purchased by means which precludes regulation, represents a substantial proportion of the alcohol consumed in East Africa. In Kenya, homebrew also known as traditional brew, has been linked to several fatalities and hospitalizations. Previously banned, the Kenyan government recently legalized homebrew in an effort to regulate and reduce its harm. Despite legalization, however, homebrew continues to be endemic. In this paper, we examine the scope and harm associated with unrecorded alcohol in Kenya, and discuss current policies and interventions aimed at reducing production and consumption of unrecorded alcohol in the Kenyan context that reflect its culture, politics, environment and resources. [ABSTRACT FROM AUTHOR]

Research suggests young women view drinking as a pleasurable aspect of their social lives but that they face challenges in engaging in a traditionally 'masculine' behaviour whilst maintaining a desirable 'femininity'. Social network sites such as Facebook make socialising visible to a wide audience. This paper explores how young people discuss young women's drinking practices, and how young women construct their identities through alcohol consumption and its display on social media. We conducted 21 friendship-based focus groups (both mixed and single sex) with young adults aged 18-29 years and 13 individual interviews with a subset of focus group respondents centred on their Facebook practices. We recruited a purposive sample in Glasgow, Scotland (UK) which included 'middle class' (defined as students and those in professional jobs) and 'working class' respondents (employed in manual/service sector jobs), who participated in a range of venues in the night time economy. Young women's discussions revealed a difficult 'balancing act' between demonstrating an 'up for it' sexy (but not too sexy) femininity through their drinking and appearance, while still retaining control and respectability. This 'balancing act' was particularly precarious for working class women, who appeared to be judged more harshly than middle class women both online and offline. While a gendered double standard around appearance and alcohol consumption is not new, a wider online audience can now observe and comment on how women look and behave. Social structures such as gender and social class remain central to the construction of identity both online and offline. [ABSTRACT FROM AUTHOR]

Alcohol is a recognized global risk factor for many diseases and injury types and a major contributor to disability and death. While cost-effective interventions do exist, many countries lack a comprehensive national alcohol harm reduction policy. The Arab world includes 22 diverse countries stretching from North Africa to Western Asia having varying dispositions with regards to alcohol sale and consumption. Epidemiological data is scattered and the picture on alcohol consumption remains blurry. This paper presents the findings of an extensive review conducted on all 22 Arab countries, specifically describing: (1) the density and methodology of alcohol-related peer-reviewed publications over the last two decades (1993-2013); (2) the epidemiology of alcohol consumption given all available data; and (3) the current status of policies in the region. Our search revealed a strikingly low number of alcohol-related peer-reviewed published studies - a total of 81 publications across 22 countries and two decades. Most studies are based on clinical or student samples. Where data is available, age of onset is low and drinking is frequent, in the absence of any available or enforced harm reduction policies. We submit that countries in the Arab region can be divided into four categories by alcohol ban and published data. One category includes countries where alcohol is not banned but data is absent, suggesting an ostrich-like response to a controversial behavior, or reflecting a weak research infrastructure and/or policy landscape. Evidence-informed recommendations and future directions for policy and research are discussed and tailored to countries' current stance on alcohol legislation and consumption. Given the particular vulnerability of youth to uptake of alcohol as well as the resulting short and long term consequences, the paper concludes by focusing on the implications of the findings for youth alcohol harm reduction. [ABSTRACT FROM AUTHOR]

Background: Hello Sunday Morning (HSM) is an online program that encourages people to commit to a period of non-drinking and blog about their experiences. The purpose of this paper is to explore how HSM members negotiated their periods of abstention, with a focus on how not drinking influenced their narratives of selfhood.Methods: Thematic analysis was undertaken of 2844 blog posts from 154 Victorians who signed up to HSM in 2013 or 2014.Results: Analysis revealed three key narratives of selfhood offered by participants: (1) abstinence resulting in a disrupted sense of self, (2) non-consumption facilitating the development of a new healthy self, and (3) anti-consumption facilitating the development of a resistant self.Conclusion: Individuals construct and maintain their sense of self through consumption (or non-consumption) activities, and this occurs within the broader context of the relationship between selfhood, consumption and culture. HSM members developed narratives of self by drawing on a range of wider discursive structures concerning pleasure, healthism and resistance. The typologies of non-drinking selves identified in this paper could be disseminated through platforms such as HSM to support people who are new to non-drinking in choosing how they might construct and enact alternative selfhoods in contexts where alcohol consumption is deeply embedded. [ABSTRACT FROM AUTHOR]

The term "harm per litre" has been increasingly used in alcohol research in recent years as a concept and a comparative measure of alcohol-attributable harm in comparisons between environments, circumstances, and patterns of drinking. This essay discusses the origins of the term in connection with analyses in terms of patterns as well as levels of drinking and with concerns about differential harms from drinking different beverage types. Also discussed is the term's current primary usage, in the context of epidemiological concerns about differentially severe harms for poorer persons who drink. It is noted that these same concerns have been discussed, particularly in Britain, using the phrase "alcohol harm paradox". "Harm per litre" was initially most often used in comparisons between rates of alcohol-attributable harm by beverage type. After 2010, the expression was applied more broadly, particularly after its use in various World Health Organization-related discussions and documents. In addition, and especially from 2018 onwards when most of the papers using this term were published, it has been used in comparisons by socioeconomic status at the individual level, and by level of socioeconomic development at the country level. Almost all the findings indicate that people with lower socioeconomic status, and countries with lower average income, e.g., low income and lower-middle income countries, incur considerably higher harm per litre (with harm being expressed in disease burden and mortality) than upper middle-income and high-income countries. "Harm per litre" is a practicable and easy-to-understand concept to compare groups of individuals or countries, and to quantify health inequalities. The next important step will need to be elucidating a better causal understanding of the processes underlying these inequalities, with an emphasis on factors which can be most easily changed by interventions. [ABSTRACT FROM AUTHOR]

Background: Pre-drinking is often defined as an economically-minded set of drinking practices engaged in prior to attending public entertainment areas, such as licensed venues. This paper explores motivations and practical considerations that a sample of teenagers describes as significant to 'pre-drinking', despite not attending licensed premises during their most recent risky drinking session.Methods: Data were derived from the mixed-methods Young Australians Alcohol Reporting System (YAARS) project. 16 participants aged 16-19 were identified as pre-drinking on their most recent risky drinking session, followed by subsequent alcohol consumption in non-licensed venues. 4 members of this subsample also undertook qualitative interviews.Results: These data expand on existing understandings of pre-drinking by emphasising the breadth of motivations and practical considerations understood to shape both pre-drinking practices, and subsequent drinking in other public entertainment areas. These primarily included desires for personal enhancement and experiencing freedom over restriction, the dynamics of accessing alcohol and private space, the necessity of opportunism, and concerns regarding parents and other authority figures.Conclusions: Analyses of groups obscured by dominant definitions of what constitutes 'pre-drinking' illuminate a broader range of motivations and concerns facing young people who drink. Such findings enhance our understanding of young people's drinking practices, the terminology used to describe them, and the development of relevant policies and interventions. [ABSTRACT FROM AUTHOR]

In June 2012 DMAA (1,3-dimethylamylamine), an ephedrine-like vasoconstricting substance which had been included in many popular sports supplements, became a scheduled substance in Australia, following bans in several other countries. The underlying rationale for this ban was that DMAA use is unsafe. This paper aimed to critically review the available evidence on the acute and/or long-term harms of DMAA. Using five research databases (PubMed, Embase, ProQuest Health and Medical Complete, and Web of Science) and the key terms 'methylhexaneamine', 'DMAA', 'dimethylamylamine', '1,3-dimethylpentylamine' and '2-amino-4-methylhexane', 842 articles were identified once duplicates removed. Sixteen studies met the inclusion criteria and were included in the review. Of the included studies, eight were case studies, which reported on eight patients who presented to emergence departments. All were retrospective in their reporting. The patients displayed various outcomes; while the patients were presenting with serious problems, in most patients conditions subsided on cessation of supplement use. The remaining eight experimental studies were low powered, with a number of studies conducted by a single research group with industry ties, and broadly investigated the effects of DMAA on physiological outcomes. Mixed findings were apparent, although escalations of blood pressure were present on acute dosing, as well as decreases in measures of body weight and body fat. There is a shallow evidence base describing the adverse effects of DMAA and the dose above which such effects may occur. The scheduling of DMAA in many countries may now impede research efforts to determine whether there are safe doses at which DMAA can be consumed. [ABSTRACT FROM AUTHOR]

Background: Environmental factors inside licensed venues have been found to influence the intoxication levels and consumption practices of patrons. The consumption of alcohol mixed with energy drinks (AmED) occurs primarily at or prior to attending licensed venues, however there is a lack of in situ research investigating AmED use in these contexts. Given that AmED use has been linked with increased alcohol consumption, intoxication, illicit substance use, and risk taking behaviours, this paper explores the environmental correlates and levels of intoxication associated with AmED use in licensed venues.Methods: Structured observations were undertaken in five Australian cities on Friday and Saturday nights. Covert teams spent 4-5h in venues and recorded hourly observations on patron, venue, and staff characteristics, alcohol, illicit drug and AmED consumption patterns and intoxication levels.Results: 898 hourly observations were recorded across 68 venues. All but one venue served energy drinks, and patron AmED use was observed during 34.9% of hourly records. AmED use was more prevalent after 12am and in nightclub venues compared to bars and pubs, and was positively associated with high intoxication levels, illicit drug use, and younger crowds. After controlling for environmental factors (i.e. venue crowding, service practices, venue characteristics, patron demographics and behaviour) AmED use did not predict high intoxication at a venue level in multivariable models.Conclusion: AmED consumption is ubiquitous in the licensed venues of Australian night-time entertainment districts, particularly busy nightclub venues where intoxication and risky consumption are heightened. However, AmED use was not associated with high patron intoxication when environmental factors were considered. [ABSTRACT FROM AUTHOR]

Background: Unrecorded homemade alcohol consumption has been less examined in the literature. Previous studies of homemade alcohol in Russia have almost entirely focused upon the use of samogon (moonshine) attributed to the northern style of drinking. No systematic analysis is available regarding the production and consumption of homemade wine. This paper explores the drinking patterns demonstrated by consumers of samogon and homemade wine in Russia. The main factors affecting the consumption of these beverages are investigated.Methods: Data were collected from a 2014 nationwide survey of 14,986 respondents aged 15+ years. Beverage preferences, volume of consumed alcohol, drinking habits, and alcohol availability were the main measures reported. Demographic, socio-economic, spatial, and policy-related factors affecting homemade alcohol consumption are examined using logistic regression.Results: The percentages of samogon and homemade wine consumers were similar, although a greater volume of samogon in pure alcohol was consumed compared to homemade wine. The groups of samogon and homemade wine consumers showed very little overlap. Unlike homemade wine consumers, samogon drinkers consumed larger amounts of alcohol and were more engaged in frequent and excessive drinking, drinking without meals and drinking in marginal public settings. Gender, education, regional affiliation, and type of residence showed opposite associations with regard to the consumption of samogon and homemade wine. Availability of homemade alcohol in the neighbourhood was the most influential predictor due to respondents' own production, presence of homemade alcohol in friendship networks and at illegal market. The prices of manufactured alcohol and the consumption of homemade alcohol did not show significant relationships.Conclusion: Consumers of samogon and homemade wine demonstrate contrasting drinking patterns that are largely driven by different factors. Samogon is consumed in a more hazardous manner, whereas homemade wine is consumed in a more moderate and law-abiding way. Illegal commercial samogon should be a special concern for alcohol policy. [ABSTRACT FROM AUTHOR]

Background: The Covid-19 restrictions - as they made young people's practices in their everyday life visible for reflection and reformation - provide a productive opportunity to study how changing conditions affected young people's well-being and drinking practices.Methods: The data is based on qualitative interviews with 18- to 24-year-old Swedes (n=33) collected in the Autumn 2021. By drawing on the socio-material approach, the paper traces actants, assemblages and trajectories that moved the participants towards increased or decreased well-being during the lockdown.Results: The Covid-19 restrictions made the participants reorganize their everyday life practices emphatically around the home and communication technologies. The restrictions gave rise to both worsened and improved well-being trajectories. In the worsened well-being trajectories, the pandemic restrictions moved the participants towards loneliness, loss of routines, passivity, physical barriers, self-centered thoughts, negative effects of digital technology, sleep deficit, identity crisis, anxiety, depression, and stress. In the improved well-being trajectories, the Covid-19 restrictions brought about freedom to study from a distance, more time for significant others, oneself and for one's own hobbies, new productive practices at home and a better understanding of what kind of person one is. Both worsened and improved well-being trajectories were related to the aim to perform well, and in them drinking practices either diminished or increased the participants' capacities and competencies for well-being.Conclusions: The results suggest that material domestic spaces, communication technologies and performance are important actants both for alcohol consumption and well-being among young people. These actants may increase or decrease young people's drinking and well-being depending on what kinds of relations become assembled. [ABSTRACT FROM AUTHOR]

Background: Harmful alcohol consumption contributes to poorer health for all people. For Indigenous Peoples of Australia, Canada, and New Zealand alcohol impacts their wellbeing significantly, this is partially explained by both their experiences of colonisation and the resulting impact on structural and social determinants of health. Indigenous Peoples have a recognised right to self-determination, which includes their right to contribute to policy decisions that affect them. This right is based on international recognition and principles, and acknowledgement of historical culture and law. The aim of this narrative review is to examine the processes of inclusion of Indigenous Peoples in policy development processes for evidence of self-determination to inform alcohol policy development.Methods: Ninety-eight peer-reviewed journal articles were identified through four databases. Twenty papers describing the inclusion of Indigenous Peoples in policy development processes were included; one focusing on alcohol. Two authors reviewed and coded the papers by four domains of Indigenous inclusion in policy processes: Indigenous representation; method of inclusion; reasons for inclusion; and stage of inclusion.Results: There is no single model for the integration of self-determination into policy. However, the nature of participation is key in ensuring that Indigenous Peoples' self-determination is recognised. While all the papers reported Indigenous Peoples being included in processes, there was little evidence of self-determination.Conclusions: Self-determination is a right, and critical to effective policy and action. The inclusion of Indigenous Peoples in policy development alone is not self-determination; however, creating the conditions that ensures Indigenous Peoples have influence throughout policy processes is one integral component of self-determination. [ABSTRACT FROM AUTHOR]

Background and Aims: There is little information on consumption patterns across the diverse range of cannabis product types. This paper examines trends in consumption patterns in Canada and the United States (US) between 2018-2020.Design: Repeat cross-sectional surveys were conducted as part of the International Cannabis Policy Study online survey in 2018 (n=27,024), 2019 (n=45,426), and 2020 (n=45,180).Setting: Respondents were recruited from commercial panels in Canada and US states that had and had not legalized non-medical cannabis (US 'legal' and 'illegal' states, respectively).Participants: Respondents were male and female participants aged 16-65 years.Measurements: Data on frequency and consumption amounts were collected for nine types of cannabis products, including dried flower and processed products (e.g., oils and concentrates). Consumers were also asked about mixing cannabis with tobacco. Socio-demographic information was collected.Findings: Dried flower was the most commonly used product, although use in the past 12 months declined between 2018 and 2020 in Canada (81% to 73%), US legal (78% to 72%) and illegal states (81% to 76%; p<0.05 for all). Prevalence of past 12-month use increased for virtually all other product forms, although prevalence of daily use remained stable across years. In 2020, edibles and vape oils were the most commonly used products after flower. Use of non-flower products was highest in US legal states, although similar trends were observed in all jurisdictions. Males were more likely to report using processed products, and vape oils were the most commonly processed product among 16-20-year-olds. Daily use of cannabis flower increased in US legal and illegal states, and average joint size increased across all jurisdictions over time.Conclusions: Dried flower remains the dominant product in Canada and the US; however, use of processed cannabis products has increased, with the largest increases observed in legal cannabis markets. [ABSTRACT FROM AUTHOR]

Background Homeless people who use drugs and alcohol have been described as one of the most marginalised groups in society. In this paper, we explore the relationships of homeless drug and alcohol users who live in hostels in order to ascertain the nature and extent of their social and recovery capital. Methods Data were collected during 2013 and 2014 from three hostels. Each hostel was in a different English city and varied in size and organisational structure. Semi-structured interviews were conducted with 30 residents (21 men; 9 women) who self-reported current drink and/or drug problems. Follow-up interviews were completed after 4–6 weeks with 22 residents (16 men; 6 women). Audio recordings of all interviews were transcribed verbatim, systematically coded and analysed using Framework. Results Participants’ main relationships involved family members, professionals, other hostel residents, friends outside of hostels, current and former partners, and enemies. Social networks were relatively small, but based on diverse forms of, often reciprocal, practical and emotional support, encompassing protection, companionship, and love. The extent to which participants’ contacts provided a stable source of social capital over time was, nonetheless, uncertain. Hostel residents who used drugs and alcohol welcomed and valued interaction with, and assistance from, hostel staff; women appeared to have larger social networks than men; and hostels varied in the level of enmity between residents and antipathy towards staff. Conclusion Homeless hostel residents who use drugs and alcohol have various opportunities for building social capital that can in turn foster recovery capital. Therapies that focus on promoting positive social networks amongst people experiencing addiction seem to offer a valuable way of working with homeless hostel residents who use drugs and alcohol. Gains are, however, likely to be maximised where hostel management and staff are supportive of, and actively engage with, therapy delivery. [ABSTRACT FROM AUTHOR]

Background: People who drink alcohol often seek to manage their intake in order to maximise the pleasurable effects, such as feelings of sociability and relaxation, without reaching their 'tipping point', where they feel out of control, or unwell. This paper aimed to explore three stages of intoxication; feeling the effects; being as drunk as you would like to be; and reaching the tipping point (feeling more drunk than you want to be) in a large international sample.Methods: The Global Drug Survey (GDS) is an annual, cross-sectional, online survey of drug use. This paper draws on data from 61,043 respondents (63.7% male) from 21 countries who took part in GDS2015 collected in November 2014 to January 2015. Respondents reported their usual type of drink; how many drinks they would require to reach each stage of intoxication and how frequently they reached each stage. Alongside socio-demographic measures, they also completed the Alcohol Use Disorders Identification Test (AUDIT).Results: Male respondents reported consuming 87.55 gm to be as drunk as they want to be and female respondents reported 70.16 gm, on average. The tipping point was reached at 138.65 gm for male respondents and 106.54 gm for female respondents. Overall 20.3% reported reaching their tipping point at least once a month. Being male, aged under 25 and at higher risk for alcohol use disorder was associated with reporting reaching the tipping point more frequently.Conclusions: The amount of alcohol being consumed to reach a desired point of intoxication is much higher than the maximum daily, and sometimes weekly, amount recommended by country guidelines. Encouraging people to avoid reaching their tipping point may be a useful intervention point alongside better communication of low risk drinking guidelines. [ABSTRACT FROM AUTHOR]

Background: By creating a dichotomy between those who are 'out-of-control' 'binge drinkers' and those for whom alcohol contributes to friendship fun, academic and alcohol policy literature often fail to acknowledge the nuances in the diverse drinking practices of men.Methods: This paper engages with findings from a multiple qualitative method research project (comprising of individual and friendship group interviews; diaries; and participant observation), conducted with 16 young men, aged 15-24: eight living in the middle-class area of Chorlton, and eight living in the working-class area of Wythenshawe, Manchester, United Kingdom.Results: This paper provides fine-grained insights into the doings, complexities and contradictions of masculinity in the context of drinking. Young men are shown to tap into different co-existing versions of masculinity, one of which is based on the exclusion of femininity (i.e. they act as tough guys), while another version is more inclusive (i.e. it allows for displays of care).Conclusion: This paper shows a much more complex image of young men's drinking practices than has hitherto been conceptualised in the existing literature, and brings to the fore doings of alternative masculinities. This has important implications for alcohol policy interventions targeting men, in that the complexities and contradictions of masculinity in relation to drinking must be taken seriously. [ABSTRACT FROM AUTHOR]

The Botswana government has recently ramped up efforts to control alcohol consumption through various measures. These include the alcohol tax levy, reduction in trading hours for bars and other licenced premises and increased penalties for alcohol-related road offenses. Whilst these efforts have recently received considerable attention, the processes of alcohol policy development remain unknown and understudied. In this paper, I examine the alcohol policy processes in Botswana using What's the Problem Represented to be (WPR), a poststructural analytic approach that emphasises problematisations in policies. Drawing on alcohol-associated policy documents, I identify two key problematisations that relate to, (1) an emphasis on an "undisciplined" drinker, and (2) an appeal to an internationally-endorsed multi-sectoralism. I explore these problematisations as political formations and periodise them to the year 2008 when they were canonised. I argue that "undisciplined drinking" and an internationally-endorsed multi-sectoralism neglect the social and cultural contexts of drinking, pathologise drinking and do not consider other forms of knowledge. Unmaking current alcohol policy representations is needed to allow for the 'emergence' of alternative conceptualisations of the alcohol 'problem' in Botswana. [ABSTRACT FROM AUTHOR]

Background and Aims: Danish youth drinking culture is characterized by a very high level of alcohol consumption and a focus on intoxication. Young people with Muslim backgrounds drink markedly less, but their experiences with drinking and partying have been overlooked in research concerned with youth drinking. The aim of this paper is to investigate how young Danish Muslim women experience being part of a youth culture of intoxication and how they navigate through processes of exclusion related to drinking and partying. Special attention is paid to the intersections of different social positions relevant to these processes of exclusion in drinking and partying contexts.Methods: Twenty-five in-depth qualitative interviews were conducted with 32 young Danish Muslim women (mean age 23 years) residing mainly in big cities and surrounding areas. An intersectional case study design approach was applied to investigate how certain identities become salient at particular moments or within particular contexts.Results: The Danish normalized youth culture of intoxication had various consequences for our participants, of which two stand out. First, this culture of intoxication was excluding for young Muslim women and, furthermore, seemed to enhance exclusion based on ethnicity and religion, regardless of whether our participants drank alcohol or abstained. Second, the culture of intoxication actualized gendered ideals within the young women's families, and the potential for conflicts pertaining to drinking and partying could call into doubt their experiences of belonging to a local ethno-religious community.Discussion: Due to the Danish normalized youth culture of intoxication, young Muslim women are at risk of several exclusions: exclusion from central Danish youth contexts and, potentially, from their religious and cultural roots. We discuss the importance of including agency and strategic manoeuvring in intersectional approaches because these contribute to a better understanding of the complexity found in the results and, furthermore, they help to avoid the pitfalls of determinism and essentialism in studies of minorities. We also discuss how binge drinking prevention initiatives could focus not only on health warnings but also on the social consequences of exclusion. [ABSTRACT FROM AUTHOR]

Background: Evidence details how cannabis can influence the use of other psychoactive substances, including prescription medications, alcohol, tobacco and illicit drugs, but very little research has examined the factors associated with these changes in substance use patterns. This paper explores the self-reported use of cannabis as a substitute for alcohol among a Canadian medical cannabis patient population.Methods: Data was derived from a survey of 2102 people enrolled in the Canadian medical cannabis program. We included 973 (44%) respondents who reported using alcohol on at least 10 occasions over a 12 month period prior to initiating medical cannabis, and then used retrospective data on the frequency and amount of alcohol use pre-and post medical cannabis initiation to determine which participant characteristics and other variables were associated with reductions and/or cessation of alcohol use.Results: Overall, 419 (44%) participants reported decreases in alcohol usage frequency over 30 days, 323 (34%) decreased the number of standard drinks they had per week, and 76 (8%) reported no alcohol use at all in the 30 days prior to the survey. Being below 55 years of age and reporting higher rates of alcohol use in the pre-period were both associated with greater odds of reducing alcohol use, and an intention to use medical cannabis to reduce alcohol consumption was associated with significantly greater odds of both reducing and ceasing alcohol use altogether.Conclusions: Our findings suggest that medical cannabis initiation may be associated with self-reported reductions and cessation of alcohol use among medical cannabis patients. Since alcohol is the most prevalent recreational substance in North America, and its use results in significant rates of criminality, morbidity and mortality, these findings may result in improved health outcomes for medical cannabis patients, as well as overall improvements in public health and safety. [ABSTRACT FROM AUTHOR]

Background: Price-based policies are effective alcohol harm minimisation policy options. This paper examines public support for price-based policies based on patterns of consumption and expenditure, to determine if the extent to which an individual may be affected by a policy influences their support.Methods: The current study included 1,684 Australian residents (59.8% male, Mage 43.8 [SD=16.7]). Respondents who purchased and consumed alcohol in the past six months were asked about their support for potential changes in a series of price-based policies.Results: Increasing price was less likely to be supported than either implementing a minimum price or a tax-increase earmarked to pay for alcohol harms. Increasing price and taxing drinkers were more likely to be supported by older people and women. We found no relationship between income or perceived impact of price increases on purchasing and level of support.Conclusion: Contrary to the idea that public support might be partly influenced by ability to pay for alcohol, support for a minimum unit price was not related to price paid per drink or income, only amount consumed. Thus, heavier drinkers may be inherently unlikely to support price-based policies even when these policies would have little impact on their actual purchasing. [ABSTRACT FROM AUTHOR]

Background: In this paper, we explore how Danish youth legitimize and negotiate abstaining from drinking alcohol. While most literature on abstinence focuses either on abstainers or non-drinkers, we focus on young peoples' reasons for abstaining either for shorter or longer periods of time.Methods: The article draws on narrative data from in-depth qualitative interviews with 140 young Danes between 18 and 25 years of age, all of whom had used alcohol in the past three months before the interview. In the analyses we identify different ways in which young Danes explain, justify and legitimize shorter or longer periods of abstinence, while still participating in friendship groups where consuming alcohol is a central part of being together.Results: We employ two concepts that identify what we mean when talking about abstaining from drinking alcohol. The first is 'situational abstinence' which covers abstaining from drinking alcohol in certain situations and for particular reasons while nevertheless consuming in other situations. The second concept, 'long term abstinence', covers taking a break from drinking for longer periods of time. We thus focus on young people, who participate in the Danish youth drinking cultures, but choose to abstain from drinking in certain situations and for a certain period of time. One important finding to emerge from our analysis is that while other studies show some of the same reasons for not drinking, our study shows that timing, negotiation and legitimization also play important roles. Furthermore, these roles are modified by gender.Conclusion: Friendship and peer groups are central relationships for young people and are important arenas for feelings of comfort, a sense of belonging and a source of identity. If policy and/or prevention initiatives focus solely on abstaining as an individual choice or an individual concern, as for example in the 'just say no' campaigns, then these initiatives fail to emphasize important aspects of young people's lives. [ABSTRACT FROM AUTHOR]

Background: Although young women's friendships remain understudied in drinking contexts, some researchers have pointed to how young women can make use of each other to manage sexual advances when drinking. In this paper, we explore how young women make use of friends to negotiate their sexual boundaries, and construct the meaning of sexual experiences in a context of heavy alcohol use.Methods: The data stems from a large scale research project at the Centre for Alcohol and Drug Research, Aarhus University, which included 140 interviews with young Danes between the ages of 18-25. In the present study, we primarily use narratives from 33 in-depth interviews with young women, who recall their personal sexual experiences with men in the context of heavy alcohol use.Results: We find that these young women make meaning of their sexual experiences in relation to friends through a negotiation of their emotional response as well as dominant gender norms. We argue that friends may serve to prevent sexual regret and offer support in instances where young women feel regret after engaging in sex when drinking heavily. However, we also argue that friends may encourage a more humorous approach in recounting sexual encounters in the context of heavy alcohol use, which may contradict their initial feelings of the encounter and gloss over issues of sexual consent.Conclusion: With this article we point to how young women's ability to negotiate the meaning of their sexual experiences as well as that of sexual consent more generally, are interlinked with prevalent gender norms that play out in the context of friendships. The young women in our study narrated friends as more central to negotiations of sexual boundaries than sexual partners when in a context of heavy alcohol use. On this basis, we develop the term 'social consent', which we suggest that future studies and preventive efforts should take into account in order to challenge the gender norms that can serve to normalize sexual violence in drinking contexts. [ABSTRACT FROM AUTHOR]

Whilst women's excessive alcohol consumption has traditionally been regarded as a potential threat to health, safety and even femininity, recent research highlights the important role that alcohol plays in many young women's lives. Drawing on data from semi-structured interviews with women aged 18-25 in Newcastle, UK, this paper will consider the role that alcohol can play in the negotiation of female friendships in the Night Time Economy, highlighting the ways in which young women may regard alcohol as a tool to enhance socialising, trust and intimacy (both when pre-drinking and in bars, pubs and clubs). The role of alcohol in 'doing' gender and femininity will also be explored, as young women collectively display feminine identities through particular drinking choices and practices that may include heavy drinking and drunkenness. Finally, I will consider the implications for young women who do not engage in these collective practices of alcohol consumption and suggest avenues for future work on the under-researched topic of the experiences of non-drinkers. [ABSTRACT FROM AUTHOR]

Background: The aim of this paper is to examine the relationship between youthful drinking practices and gender within the domestic pre-party (prior to a night out), an arena, which has been relatively ignored in existing qualitative research on youthful alcohol use. An examination of the relationships between gender and drinking practices in this context is important for three reasons. First, pre-parties are associated with heavy drinking, which has traditionally been associated with masculinity. Second, because pre-drinking takes place in the private sphere of the home, it is therefore 'controlled' in terms of who can participate and hence what precisely is the gender composition. Third, whilst being located in the private sphere of the home, pre-party practices are nevertheless informed by the (hyper) gendered environments of public drinking spaces in the Night-Time Economy (NTE), most dominantly mainstream clubs and bars. We suggest that such characteristics allow for the emergence of specific gendered relationships, activities and affectivities, thereby demarcating the pre-party as a particular gendered drinking space.Methods: We draw on narrative data from 140 in-depth face-to-face interviews with young Danish alcohol users between 18-25 years of age. The interviews were part of a large-scale research project on the gendered aspects of youthful alcohol use and intoxication. Theoretically, we draw on a combination of the 'doing gender' paradigm (West & Zimmerman, 1987) and affect theoretical notions on (un)comfortability (Ahmed, 2014). We propose that these perspectives mark out the pre-party as a particularly gendered drinking space.Results: While our analysis supports the observation of existing qualitative studies, that pre-partying is not merely motivated by the possibility of becoming intoxicated in a cheap and un-surveilled way before going out, we especially argue that pre-partying is fueled by a desire for 'comfortability', which seems almost impossible to disassemble from the gendering that pre-partying also entails. Our analysis therefore contributes to the ongoing academic discussion around the relationship between 'intoxicated femininity' and 'intoxicated masculinity' by suggesting that we need to take the affective implications of young people's (gendered) drinking practices into account in a thorough discussion of the relationship between youthful alcohol use and gender. [ABSTRACT FROM AUTHOR]

Background: Men are more likely than women to perpetrate serious violence when they have consumed alcohol, but alcohol does not affect all men in the same way. This paper considers young adults' attribution about agency (the capacity to act) in men's drunken violence.Methods: Interviews about alcohol use in night-time venues, streets or private parties were conducted with 60 young adults aged 18-24 in Melbourne, Australia, and analysed thematically. Participants included seven men who identified as having initiated violence when drunk.Results: Some interviewees stated that men chose to be violent, or that men's violence when they were drunk was purposeful and therefore involved some component of choice. However, much alcohol-related violence enacted by young men was understood (both by men who reported violence and by other young adults) as impelled by forces outside their control. These forces were: diffusely defined effects of drinking alcohol; proclivities of men and masculinity, and the interaction of alcohol and men's bodies to override capacity for judgement and produce an irresistible urge to fight. The latter was at times explained as caused by the mutually reinforcing actions of alcohol and testosterone, providing a particularly persuasive account of men's violence as biologically-determined.Conclusion: These categories encapsulate a set of discursive resources that contribute to the rationalisation, naturalisation and production of men's violence. Participants tended to regard alcohol, masculinities and testosterone as inciting violence predictably and consistently, suggesting that men themselves had relatively little agency over its occurrence. In contrast, research evidence indicates that these actors do not cause violence in any uniform way and that their effects are contingent on changing configurations of factors. Highlighting discrepancies between young adults' understandings of responsibility for men's drunken violence, and those expressed in research, presents additional opportunities for intervention. [ABSTRACT FROM AUTHOR]

Background: Alcohol is a leading risk factor for death and disability globally. Due to the Islamic prohibition of alcohol consumption, alcohol policy is an under-studied and sensitive topic in Muslim majority countries (MMCs). In addition, drinkers in these countries may face barriers to treatment access due to stigma or the legal status of alcohol. Using Iran as a case study this paper explores how alcohol treatment is planned and delivered in the complex environment of an MMC.Method: We searched academic and grey literature, clinical manuals, guidelines and policy documents for information on the development and implementation of alcohol treatment policy in Iran. The search was conducted in English, Persian and Arabic. We conducted 6 consultations to verify information obtained. We analysed information based on the Walt & Gilson health policy analysis triangle, which identifies context, process, actors and content as key factors for understanding policy.Results: Iran initiated an alcohol-specific national strategy in 2011-2012 that aims to prevent, reduce and treat alcohol use disorders. This strategy has been designed to be implemented on a multi-sectoral level. Screening and prevention are mainly initiated in primary health care and cases are referred accordingly. Alcohol treatment is provided in specialised outpatient and inpatient settings. Due to contextual factors such as stigma, feasibility and affordability, alcohol outpatient units are planned to be integrated into existing public/ private drug addiction treatment facilities. However, the Ministry of Health has faced many challenges in implementing this pilot project. To date only small numbers of outpatient and inpatient units have formally commenced offering alcohol treatment.Conclusion: Implementing alcohol treatment has been challenging for Iran. Approval of new treatment programs may not be seen as a priority because of the low prevalence of alcohol use disorders in the country. Also, policy makers are implementing treatment services with caution due to the existing alcohol prohibition for the country's Muslim majority population. Barriers to treatment seeking need to be addressed at the micro and macro levels. Support from international agencies such as the WHO could assist MMCs to develop appropriate services that are feasible for their unique alcohol policy environment. [ABSTRACT FROM AUTHOR]