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Introduction: The aim of this paper was to examine the client and psychosocial characteristics associated with polydrug use in patients with alcohol misuse as their primary drug of concern (PDC) seeking treatment from substance use treatment centres. Methods: Self‐report surveys were undertaken with clients attending 1 of 34 community‐based substance use treatment centres across Australia with alcohol as their PDC. Survey items included client's socio‐demographic characteristics, level of alcohol dependence, use of other drugs including tobacco, health and wellbeing factors including health‐related quality of life. The factors associated with polydrug use (alcohol use concurrent with at least one other drug) were examined. Results: In a sample of 1130 clients seeking treatment primarily for alcohol problems, 71% reported also using another drug. The most frequently used drug was tobacco (50%) followed by cannabis (21%) and benzodiazepines (15%). Excluding tobacco use, 35% of participants reported polydrug use. Factors associated with any polydrug use were younger age, lower education levels, lower levels of mental health related quality of life and housing risk (i.e., risk of eviction or experienced homelessness in past 4 weeks). When tobacco was excluded, factors associated with polydrug use were age, lower physical and mental health‐related quality of life, and housing risk. Discussion and Conclusions: Most adults seeking treatment for alcohol misuse as their PDC reported using another drug in addition to alcohol. Treatment services should be designed accordingly to maximise the likelihood of treatment engagement and success. [ABSTRACT FROM AUTHOR]

Issues: Alcohol use disorder (AUD) causes the highest harms around the world. Many people use alcohol to reduce stress and anxiety, considered as risk factors for AUD. Chronic alcohol use leads to changes in the reward system and the high level of stress may exacerbate neuroendocrine responses. Electroencephalographic (EEG) neurofeedback shows reduction of stress, anxiety and alcohol abuse and it could be an important tool for reducing harm and risk associated with AUD. The aim of this paper is to review the studies that investigated the effects of EEG neurofeedback in subjects with AUD and it proposes to discuss this intervention as a tool for reducing harm and risk in AUD. Approach: Medline, PsycINFO and LILACS databases were searched and appropriated terms were used. Inclusion criterion was adopted. The year of publication was not limited because of the scarce number of studies. Eighty‐two papers returned and eight were included. A critical review was conducted. Key Findings: Most of the papers analysed used the alpha/theta protocol to reduce the 'hyperexcitation' of the nervous system. This protocol provides relaxation, decreases anxiety or stress, prevents alcohol relapse, maintains abstinence and increases the feeling of well‐being. Implications: EEG neurofeedback has important effects on AUD and anxiety or stress. Studies reinforce the use of EEG neurofeedback as an alternative tool for reducing harm and risk in AUD. Conclusion: EEG neurofeedback is an intervention to treat AUD, specifically, to reduce harm and risk. However, more randomised studies are necessary to consolidate the effectiveness of the technique. [ABSTRACT FROM AUTHOR]

Introduction: The aim of this paper is to describe the context of alcohol use and problems in Latin America and the Caribbean (LAC), the environmental context for alcohol‐related policy, drinking trends, harm and policy and to systematically review policies implemented to reduce alcohol‐related burden. Methods: LAC‐based studies relating to the existence and effects of public health‐oriented alcohol policies are described. The review is informed by a literature search of alcohol policies in LAC in English and in Spanish in several platforms, and in publications of international organisations, including grey and scientific literature. Results: Only 30 documents measuring policy impact were identified for the policy analysis. Most of the policies are focused on brief interventions, and most have little evidence on their effectiveness. Alcohol taxation and drink‐driving policies appear to have the highest impact if enforcement is adequately performed. Discussion and Conclusions: The studies reviewed indicate a pattern of modelling policy interventions but implementing only a few, and a paucity of sustained or systematic evaluations. Although patterns of use indicate alcohol use should be a major public health priority, only a few countries in LAC have a national policy or plan dedicated to alcohol, representing a low political commitment to considering alcohol as a public health priority. [ABSTRACT FROM AUTHOR]

The present text comments on Stockwell and colleagues' paper documenting the high burden of alcohol use in COVID-19 related mortality in the USA and Canada in North America and the absence of a control policy in several countries of the world. This comment adds information about the third country in North America, Mexico. It describes alcohol use during the COVID lockdown and its consequences, highlighting the control efforts through public health policies and ponders the weaknesses of the current response to the health crisis and opportunities in the aftermath. [ABSTRACT FROM AUTHOR]

Introduction and Aims: Globally, there is growing concern regarding workers' alcohol use and its implications for health, wellbeing and workplace safety. Male-dominated industries are more susceptible to risky alcohol consumption and its associated harms. This paper investigated the patterns, prevalence and predictors of risky drinking among construction workers.Design and Methods: Male construction workers (n = 511) completed a survey measuring alcohol-related measures including Alcohol Use Disorders Identification Test - Concise (AUDIT-C), which was compared with population data. Hierarchical multiple regression examined alcohol-related knowledge, perception of risk to workplace safety, psychological distress, job stress, general health, quality of life and workplace alcohol culture variables as predictors of risky drinking.Results: Prevalence of risky drinking was higher than the national average, particularly for younger (<25 years) and mid-aged (45-54 years) workers. One in six construction workers reported workmates being visibly affected by alcohol in the workplace. Key predictors of risky drinking were perception of alcohol-related risks to workplace safety, general health, alcohol knowledge and descriptive norms regarding workmates' alcohol use.Discussion and Conclusions: These findings provide useful insights into the patterns and predictors of risky drinking in construction and can inform future preventive programs and interventions in high-risk workplaces. In addition to tailoring programs to both young and mid-aged workers, this work highlights the importance of implementing strategies to increase awareness of risks to workplace safety; and the adoption of norms that inhibit the social acceptability of risky drinking behaviour in the wider workplace. [ABSTRACT FROM AUTHOR]

Responding to the commentaries on a recent paper on the elusiveness of representativeness in general population alcohol surveys, we can summarise that there is agreement that the status quo of current alcohol surveys is scientifically no longer defensible. Current surveys cannot per se be assumed to yield representative results for the general populations of countries based on a probabilistic sampling alone. Alternatives are discussed and-as for any survey-creative ideas on validating key results on indicators or hypotheses need to be developed and used. This will inevitably lead away from omnibus surveys to more focused studies requiring more complex methodological tools. While there may not be obvious solutions for every problem related to alcohol use prevention and policy or treatment use disorders, and it may take years to find solutions for some of the issues, continued use of the methodology of the status quo will surely fail to answer the questions posed by modern societies concerning these issues. [ABSTRACT FROM AUTHOR]

Alcohol is the only substance commonly used for intoxication that is not subject to an international agreement regulating its trade in the interest of public health and welfare [1]. In the 1990s, the focus of discussions of global governance of international trade would have been primarily on multilateral agreements on trade in commodities under the World Trade Organization (WTO) umbrella. These three papers are a timely contribution concerning issues in the global governance of alcohol, applying in the specific area of alcohol problems considerations that also arise more generally concerning how trade agreements may deter governments from pursuing public health and welfare interests [24]. [Extracted from the article]

In 2011, the Australian National Health and Medical Research Council (NHMRC) initiated an inquiry to determine whether there is a need for expanded ethical guidance in the form of a discrete guidance document for alcohol and other drug (AOD) research. An issues paper was developed to frame the inquiry. AOD researchers, Human Research Ethics Committees and others were invited to discuss whether there are distinctive ethical issues facing researchers and Human Research Ethics Committees in the AOD setting. Based on the public submissions, the NHMRC recommended that no AOD research-specific guidance is required. The inquiry and the NHMRC decision were not widely publicized, and we feel there is a need for further discussion. In order to do so, we have analysed the public inquiry submissions and described the central themes. Few submissions in the inquiry explicitly agreed AOD research warrants a specific guidance framework. Most were concerned that the NHMRC issues paper unfairly targeted people who use drugs as complex research participants. The inquiry highlights tensions around research governance and ethics review boards dealing with illicit and stigmatised behaviours. While we agree that a specific guidance framework for AOD research is not needed and could potentially be harmful and restrictive, we are concerned that the wholesale rejection of a guidance framework has closed the door to much needed debate. There remains, we argue, a need for alternative strategies and tools to support ethical research, inform and streamline institutional ethics approval, and engage and protect participants. [ABSTRACT FROM AUTHOR]

Introduction and Aims: People with severe alcohol dependence and unstable housing are vulnerable to multiple harms related to drinking and homelessness. Managed Alcohol Programs (MAP) aim to reduce harms of severe alcohol use without expecting cessation of use. There is promising evidence that MAPs reduce acute and social harms associated with alcohol dependence. The aim of this paper is to describe MAPs in Canada including key dimensions and implementation issues.Design and Methods: Thirteen Canadian MAPs were identified through the Canadian Managed Alcohol Program Study. Nine key informant interviews were conducted and analysed alongside program documents and reports to create individual case reports. Inductive content analysis and cross case comparisons were employed to identify six key dimensions of MAPs.Results: Community based MAPs have a common goal of preserving dignity and reducing harms of drinking while increasing access to housing, health and social services. MAPs are offered as both residential and day programs with differences in six key dimensions including program goals and eligibility, food and accomodation, alcohol dispensing and administration, funding and money management, primary care services and clinical monitoring, and social and cultural connections.Discussion and Conclusions: MAPs consist of four pillars with the alcohol intervention provided alongside housing interventions, primary care services, social and cultural interventions. Availability of permanent housing and re-establishing social and cultural connections are central to recovery and healing goals of MAPs. Additional research regarding Indigenous and gendered approaches to program development as well as outcomes related to chronic harms and differences in alcohol management are needed. [ABSTRACT FROM AUTHOR]

Introduction and Aims: The relationship between alcohol intoxication and harm is well known, and many community-based interventions have been introduced in an attempt to reduce the rates of alcohol-related harm. The current paper uses two metropolitan and two regional Australian cities as sites to investigate the impact of community-based interventions on the reduction of alcohol-related harms.Design and Methods: Data for injury-related emergency department (ED) presentations and police attended assaults during high-alcohol hours (i.e. 20:00-06:00 h, Friday and Saturday nights) were obtained for each site from 2000 to 2015 for ED presentations and from 2000 to 2016 for police assaults. Autoregressive integrated moving average time series analyses were conducted to determine the impact of the community-based interventions introduced at each site for reducing these rates of ED injury presentations and police attended assaults.Results: None of the community-level interventions that were introduced across the four sites resulted in a reduction in ED presentation rates or assault rates.Discussion and Conclusions: The majority of interventions introduced across the four sites were proposed and implemented by local liquor accords. Given none of the interventions demonstrated a reduction in ED injury presentation rates or police attended assault rates, it is argued that local liquor accords may not be best placed to propose alcohol-related harm reduction measures, and instead, there should be a focus on the implementation of evidence-based regulatory strategies, such as restricted trading hours. [Curtis A, Coomber K, Droste N, Hyder S, Palmer D, Miller PG. Effectiveness of community-based interventions for reducing alcohol-related harm in two metropolitan and two regional sites in Victoria, Australia. Drug Alcohol Rev 2017;36:359-368]. [ABSTRACT FROM AUTHOR]

Introduction and Aims: There is a growing interest in measuring alcohol's harms to people other than the drinker themselves. 'Children of alcoholics' and foetal alcohol spectrum disorder have received widespread attention. Less is known about how children are affected by post-natal exposure to parental drinking other than alcohol abuse/dependence. In this scoping review, we aim to assemble and map existing evidence from cohort studies on the consequences of parental alcohol use for children, and to identify limitations and gaps in this literature.Design and Methods: Systematic review methods were used. Electronic databases were searched (1980 to October 2013) and a total of 3215 abstracts were screened, 326 full text papers examined and 99 eligible for inclusion according to selection criteria including separation of exposure and outcome measurement in time and report of a quantitative effect size.Results: The main finding is the large literature available. Adolescent drinking behaviour was the most common outcome measure and outcomes other than substance use were rarely analysed. In almost two of every three published associations, parental drinking was found to be statistically significantly associated with a child harm outcome measure. Several limitations in the literature are noted regarding its potential to address a possible causal role of parental drinking in children's adverse outcomes.Discussion and Conclusions: This study identifies targets for further study and provides a platform for more targeted analytic investigations which ascertain risk of bias, and which are capable of considering the appropriateness of causal inferences for the observed associations. [Rossow I, Felix L, Keating P, McCambridge J. Parental drinking and adverse outcomes in children: A scoping review of cohort studies. Drug Alcohol Rev 2016;35:397-405]. [ABSTRACT FROM AUTHOR]

Introduction and Aims: Cognitive enhancers (CE) such as methylphenidate, amphetamines and modafinil are becoming more commonly used in non-medical situations. This study explored the prevalence and motivations for CE use in a New Zealand university.Design and Methods: Students from the Schools of Pharmacy, Nursing, Medicine, Law and Accounting at a university in New Zealand were invited to complete a paper-based questionnaire that elicited their views on the prevalence, reasons for use and attitudes towards use of CEs. Questionnaires were distributed at the end of a third-year lecture (August-October 2012). Reasons for use and attitudes towards use was measured using a 7-point Likert scale from strongly agree (1) to strongly disagree (7). Descriptive and prevalence statistics were calculated. Inferential statistics were generated to explore the overall associations between CE use and how the respondents had first learnt about CEs, and to investigate reasons for CE use.Results: The response fraction was 88.6 % (442/499) and the prevalence of CE use was 6.6% (95% confidence interval 4.5-9.0). Commonly cited reasons for use were to get high [M = 4.43, standard deviation (SD) 2.36], experimentation (M = 4.17, SD 2.36), increase alertness (M = 3.55, SD 2.48), to help concentrate (M = 3.48, SD 2.42), to help stay awake (M = 3.20, SD 2.33), to help study (M = 3.10, SD 2.47) and to concentrate better while studying (M = 3.00, SD 2.43).Discussion and Conclusions: Use of CEs was uncommon in contrast to the prevalence reported in the USA. The reasons for use also varied depending on which CE was used. Students who use CEs have differing attitudes towards their acceptability, which warrants further research about how these attitudes influence their use and attitudes towards academic performance. [Ram S(S), Hussainy S, Henning M, Jensen M, Russell B. Prevalence of cognitive enhancer use among New Zealand tertiary students. Drug Alcohol Rev 2016;35:245-351]. [ABSTRACT FROM AUTHOR]

Several abstracts of research papers presented at the Australasian Professional Society on Alcohol & other Drugs Conference 2015 are presneted including Losing Your License to drink: Insights From Rand Evaluations of 24/7 Sobriety Programs, Impact of alcohol use on suicidal behaviors: Research and Prevention and Utilizing technology to address substance use and violence in fast paced clinical settings. [ABSTRACT FROM AUTHOR]

Introduction and Aims: The harms associated with non-medical use of pharmaceutical opioid analgesics are well established; however, less is known about the characteristics and drug-use patterns of the growing and hidden populations of people using pharmaceutical opioids illicitly, including the frequency of pharmaceutical opioid injection. This paper aimed to undertake a detailed examination of jurisdictional differences in patterns of opioid use among a cohort of people who regularly tamper with pharmaceutical opioids in Australia.Design and Methods: Data were drawn from the National Opioid Medications Abuse Deterrence study. The cohort was recruited from New South Wales (NSW; n = 303), South Australia (SA; n = 150) and Tasmania (TAS; n = 153) to participate in face-to-face structured interviews collecting data on use of pharmaceutical opioids, benzodiazepines, other sedative drugs and illicit substances, as well as the harms associated with substance use.Results: TAS participants reported greater use and injection of certain pharmaceutical opioids (particularly morphine and methadone tablets), and limited heroin use, with lower rates of engagement in opioid substitution treatment, compared with NSW participants. NSW participants were more socially disadvantaged and more likely to report risky injecting behaviours and injecting-related injuries and diseases compared with SA and TAS participants. SA participants reported greater rates of pain conditions, greater use of pain-based services, as well as broader use of pharmaceutical opioids in regards to forms and route of administration, compared with NSW participants.Discussion and Conclusions: Distinct jurisdictional profiles were evident for people who tamper with pharmaceutical opioids, potentially reflecting jurisdictional differences in prescribing regulatory mechanisms and addiction treatment models. [ABSTRACT FROM AUTHOR]

Introduction: Over the past two decades, alcohol consumption of Icelandic adolescents has decreased dramatically. The aim of this study was to quantify the extent of this reduction and compare it with the trend in cannabis use over a 20 year period and to identify possible explanations.Methods: We used data from the Icelandic participants to the European School Survey Project on Alcohol and Other Drugs study (collected via paper-and-pencil questionnaires in classrooms). The sample included all students in the 10th grade (54-89% response rate).Results: The percentage of participants who had never used alcohol during their lifetime rose from 20.8% in 1995 to 65.5% in 2015. Similarly, there was a decline in the proportion of students who had consumed alcohol 40 times or more, from 13.7% to 2.8%. During the same period, the number of students who had never used cannabis rose from 90.2% to 92.0%. In contrast, we found a small, but statistically significant, increase in the prevalence of those who had used cannabis 40 times or more, from 0.7% in 1995 to 2.3% in 2015. Parental monitoring increased markedly between 1995 and 2015, but availability of alcohol decreased. Perceived access to cannabis and youth attitudes towards substance use remained unchanged.Discussion: Although Iceland has enjoyed success in lowering alcohol use among adolescents over the past decades, and somewhat fewer claim to have ever tried cannabis, there has been a threefold increase among heavy users of cannabis. Increased parental monitoring and decreased availability of alcohol explain some of the changes seen. [ABSTRACT FROM AUTHOR]