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Introduction: People who inject drugs experience stigma across multiple settings, including when accessing health‐care services, however, comparatively little is known about experiences of stigma towards other groups of people who use illegal drugs. This paper examines experience of, and factors associated with, stigma among two samples of people who use illegal drugs when visiting both specialist alcohol and other drug (AOD) and general health‐care services. Methods: Australians who regularly (i.e., ≥monthly) inject drugs (n = 879; illicit drug reporting system [IDRS]) or use ecstasy and/or other illegal stimulants (n = 700; ecstasy and related drugs reporting system [EDRS]) were surveyed between April and July 2022 about past 6‐month experience of stigma in the above services. Multi‐variable regression analyses were performed to determine the socio‐demographic, drug use and health factors associated with stigma. Results: Experiences of stigma in general health‐care services were more common among IDRS (40%) than EDRS (24%; p < 0.001) participants, however, experiences were comparable in specialist AOD health‐care settings (22% and 20%, respectively; p = 0.687). Gender identity and experiencing high psychological distress were associated with experiencing stigma across both samples. Past‐year overdose was associated with experiencing stigma among the IDRS sample, while unstable housing and incomplete high school education were associated with experiencing stigma in the EDRS sample. Discussion and Conclusions: Experiences of stigma when accessing health‐care services are relatively common across different populations of people who use illegal drugs. Our findings highlight the multiple and intersecting dimensions of stigma and provide further support for recent calls for a universal precautions approach to stigma in health care. [ABSTRACT FROM AUTHOR]

Introduction: There is concern around non‐prescribed benzodiazepine use, particularly with increasing detections of counterfeit products containing high‐risk novel compounds. The aims of this study were to investigate how and which non‐prescribed benzodiazepines are being sourced; forms, appearance and packaging; and awareness of risks associated with non‐prescribed benzodiazepines. Methods: Data were collected from a sample of Australians who inject drugs or use ecstasy and/or other illicit stimulants on a monthly or more frequent basis, and who reported past 6‐month use of non‐prescribed benzodiazepines (n = 235 and n = 250, respectively). Data were collected on source, diversion from a known/trusted prescription, product name and aesthetic characteristics for the last non‐prescribed benzodiazepine obtained. Results: Amongst participants who injected drugs, 71% reported that their last non‐prescribed benzodiazepines were diverted from a known/trusted prescription, compared to 59% of participants who used ecstasy/other stimulants. Sourcing via cryptomarkets was rare. Across both samples, the majority reported last obtaining substances sold/marketed as diazepam or alprazolam. Participants sourcing via non‐diverted means were twice as likely to obtain alprazolam. Known sourcing of novel compounds was rare. Amongst participants who used ecstasy/other stimulants, 36% reported confidence in the content/dose of non‐prescribed benzodiazepines even when the source is unknown. Discussion and Conclusions: Most participants obtained substances sold as classic/registered benzodiazepines, mostly via diverted prescriptions, with a substantial minority potentially unaware of counterfeits circulating. While diverted use undeniably presents risks, tightening of prescriptions in Australia could inadvertently lead to greater supply of novel benzodiazepines as seen internationally, reinforcing prioritisation of demand and harm reduction strategies. [ABSTRACT FROM AUTHOR]

Introduction: We aimed to describe COVID‐19 vaccination attitudes and identify potential facilitators for vaccine uptake among people who inject drugs. Methods: People who inject drugs were recruited from all eight Australian capital cities (N = 884; 65% male, mean age 44 years) and interviewed face‐to‐face or via telephone in June–July 2021. COVID‐19 and broader vaccination attitudes were used to model latent classes. Correlates of class membership were assessed through multinomial logistic regression. Probability of endorsing potential vaccination facilitators were reported by class. Results: Three classes of participants were identified: 'vaccine acceptant' (39%), 'vaccine hesitant' (34%) and 'vaccine resistant' (27%). Those in the hesitant and resistant groups were younger, more likely to be unstably housed and less likely to have received the current season influenza vaccine than the acceptant group. In addition, hesitant participants were less likely to report a chronic medical condition than acceptant participants. Compared to vaccine acceptant and hesitant participants, vaccine‐resistant participants were more likely to predominantly inject methamphetamine and to inject drugs more frequently in the past month. Both vaccine‐hesitant and resistant participants endorsed financial incentives for vaccination and hesitant participants also endorsed facilitators related to vaccine trust. Discussion and Conclusion: People who inject drugs who are unstably housed or predominantly inject methamphetamine are subgroups that require targeted interventions to increase COVID‐19 vaccination uptake. Vaccine‐hesitant people may benefit from interventions that build trust in vaccine safety and utility. Financial incentives may improve vaccine uptake among both hesitant and resistant people. [ABSTRACT FROM AUTHOR]

Background: Perinatal depression is often underdiagnosed; consequently, many women suffer perinatal depression without follow-up care. Screening for depressive symptoms during the perinatal period has been recommended in Australia to increase detection and follow-up of women suffering from depressive symptoms. Screening rates have gradually increased over the last decades in Australia. Objective: To explore trends in referrals of women to community mental health services during the perinatal period, and prenatal and postnatal admissions to psychiatric units, among those who gave birth in Queensland between 2009 and 2015. Method: Retrospective analyses of data from three linked state-wide administrative data collections. Trend analyses using adjusted Poisson regression models examined 426,242 births. Outcome variables included referrals to specialised mental health services; women admitted with a mood disorder during the second half of their pregnancy and during the first 3 months of the postnatal period; and women admitted with non-affective psychosis disorders during the second half of their pregnancy and during the first 3 months of the postnatal period. Results: We found an increase in mental health referrals during the perinatal period over time (adjusted incidence rate ratio, 1.07; 95% confidence interval, [1.06, 1.08]) and a decrease in admissions with mood disorders during the first 3 months of the postnatal period (adjusted incidence rate ratio, 0.95; 95% confidence interval, [0.94, 0.98]). We did not find any changes in rates of admission for other outcomes. Conclusion: Since the introduction of universal screening in Queensland, referrals for mental health care during the perinatal period have increased, while admissions for mood disorders in the first 3 months after delivery decreased. [ABSTRACT FROM AUTHOR]

Background: Evidence shows that depressive symptoms during pregnancy increase the risk of an intervention during delivery (induction, the use of forceps or vacuum, and caesarean sections (CS)). Many women with depression during pregnancy are not identified and therefore will not receive appropriate follow up of their symptoms. We hypothesised that routine screening for depressive symptoms during pregnancy could reduce detrimental consequences of depressive symptoms on delivery outcomes. Aim: We explored the association between screening for depressive symptoms during pregnancy and delivery outcomes. Materials and Methods: A cross‐sectional analysis of state‐wide administrative data sets. The population included all women who delivered a singleton in Queensland between the July and December of 2015. Logistic regression analyses were run in 27 501 women (93.1% of the total population) with information in all variables. The following were the main outcomes: onset of labour, CS, instrumental vaginal delivery, and all operative deliveries (including both CS and instrumental vaginal deliveries). Results: Women who completed the screening had increased odds of a spontaneous onset of labour (adjusted odds ratio (aOR) 1.18; 95% CI 1.09–1.27) and decreased odds of an operative delivery (instrumental or CS) (aOR 0.88; 95% CI 0.81–0.96). Among women who had a vaginal delivery, those who completed the screening had decreased odds of having an instrumental delivery (aOR 0.84; 95% CI 0.74–0.97). Sensitivity analyses in women who did not have a formal diagnosis of depression showed similar results. Conclusion: Our findings suggest that screening may decrease interventions during delivery in women with depressive symptoms. [ABSTRACT FROM AUTHOR]

Background Overdoses and poisonings are among the most common causes of death in young adults. Adolescent problem drinking has been associated with psychiatric morbidity in young adulthood as well as with elevated risk for suicide attempts. There is limited knowledge on adolescent alcohol use as a risk factor for alcohol and/or drug overdoses in later life. Methods Here, data from The Northern Finland Birth Cohort 1986 study with a follow-up from adolescence to early adulthood were used to assess the associations between adolescent alcohol use and subsequent alcohol or drug overdose. Three predictors were used: age of first intoxication, self-reported alcohol tolerance and frequency of alcohol intoxication in adolescence. ICD-10-coded overdose diagnoses were obtained from nationwide registers. Use of illicit drugs or misuse of medication, Youth Self Report total score, family structure and mother's education in adolescence were used as covariates. Results In multivariate analyses, early age of first alcohol intoxication [hazard ratios (HR) 4.5, 95% confidence intervals (CI) 2.2–9.2, P  < 0.001], high alcohol tolerance (HR 3.1, 95% CI 1.6–6.0, P  = 0.001) and frequent alcohol intoxication (HR 1.9, 95% CI 1.0–3.4, P  = 0.035) all associated with the risk of overdoses. Early age of first intoxication (HR 5.2, 95% CI 1.9–14.7, P  = 0.002) and high alcohol tolerance (HR 4.4, 95% CI 1.7–11.5, P  = 0.002) also associated with intentional overdoses. Conclusions Alcohol use in adolescence associated prospectively with increased risk of overdose in later life. Early age of first intoxication, high alcohol tolerance and frequent alcohol intoxication are all predictors of overdoses. [ABSTRACT FROM AUTHOR]

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 onwards in Australia, with continued demand and a sustained market for methamphetamine. [Correction added on 30 May 2022, after first online publication: In the Abstract under 'Discussion and Conclusions' 'onwards' has been added after ... 2010 to 2012]. [ABSTRACT FROM AUTHOR]

Background To study the associations between maternal smoking during pregnancy and paternal smoking before pregnancy and adult offspring psychiatric disorders. Methods Prospective general population cohort study in Northern Finland, with people from the Northern Finland Birth Cohort 1986: 7259 subjects (77% of the original sample). Data on parental smoking were collected from parents during pregnancy using questionnaires. Outcomes were offspring's register-based diagnoses: any psychiatric disorder, any non-organic psychosis, mood disorder, anxiety disorder and substance use disorder (SUD) until the age of 29–30 years. Maternal smoking during pregnancy and paternal smoking before pregnancy were pooled to three-class variables: (i) none; (ii) 1–9 and (iii) ≥10 cigarettes/day. Information regarding both parents' alcohol use during pregnancy and at offspring age 15–16 years, maternal education level, family structure, parental psychiatric diagnoses and offspring gender, smoking, intoxication frequency and illicit substance use at the age of 15–16 years were investigated as covariates. Results In the multivariable analyses, maternal smoking during pregnancy did not associate with the studied outcomes after adjusting for offspring smoking and other substance use at offspring age 15–16 years and parental psychiatric disorders. However, paternal smoking ≥10 cigarettes/day before pregnancy [hazard ratio (HR) = 5.5, 95% confidence interval (CI) 2.7–11.2, P  <   0.001] and paternal psychiatric disorders (HR = 1.7, 95% CI 1.1–2.8, P  =   0.028) associated with offspring SUD after adjustments. Conclusions Information across the offspring life course is essential in exploring the association between parental smoking and offspring psychiatric disorders. Paternal smoking before pregnancy and paternal psychiatric disorders may act as modifiers in elevating the risk of substance-use-related problems among offspring. [ABSTRACT FROM AUTHOR]

Objective: Longitudinal studies examining the association between adolescent cannabis use and self‐harm are rare, heterogeneous and mixed in their conclusions. We study this association utilizing a large general population‐based sample with prospective data. Methods: The Northern Finland Birth Cohort 1986 (n = 6582) with linkage to nationwide register data was used to study the association of self‐reported cannabis use at age 15–16 years and self‐harm and suicide death until age 33 (until year 2018), based on register information. Cox regression analysis with Hazard Ratios (HR) and 95% confidence intervals (CI) was used. Psychiatric disorders, parental psychiatric disorders and other substance use were considered as confounders. Results: In all, 6582 (49.2% male) were included in the analysis, and 377 adolescents (5.7%) reported any cannabis use until the age of 15–16 years. Based on register information, 79 (55.7% male) had visited in health care services due to self‐harm, and 22 (90.1% male) had died by suicide. In crude analyses, adolescent cannabis use was associated with self‐harm (HR = 3.93; 95% CI 2.24–6.90). The association between cannabis use and self‐harm remained statistically significant after adjusting for sex, psychiatric disorders at baseline, frequent alcohol intoxications, other illicit drug use, and parental psychiatric disorders (HR 2.06; 95% CI 1.07–3.95). In contrast, the association of cannabis use with suicide did not reach statistical significance even in crude analysis (HR 2.60; 95% CI 0.77–8.78). Conclusion: Cannabis use in adolescence may increase risk of self‐harm independent of adolescent psychopathology and other substance use. [ABSTRACT FROM AUTHOR]

Introduction: The extant Alcohol's Harms to Others (AHTO) literature is largely comprised of reports from victims. We investigated AHTO from perpetrators' perspectives, including how harms were associated with individual characteristics, and alcohol quantities consumed during the perpetration incident. Methods: Participants (N = 2932) were 14–19 years old, recruited primarily through social media and screened as risky drinkers. They completed face‐to‐face (n = 594) or self‐administered (n = 2338) surveys. They self‐reported whether during their last risky drinking session (LRDS) they had perpetrated any verbal abuse, physical abuse or property damage. A multinomial logistic regression examined whether nine factors were associated with perpetrating zero, one or 2+ categories of AHTO. Results: Eleven percent (n = 323) reported perpetrating at least one form of AHTO (7.5% verbal, 1.9% physical and 4.6% property). Perpetration of AHTO at LRDS was uniquely associated with: younger age, male gender, experiences of childhood physical punishment, greater perpetration incident‐specific drinking, concurrent illicit drug use, and less frequent use of safety strategies while drinking in the past 12 months. Controlling for the other variables, an increase of six Australian standard drinks (60 g of alcohol) increased the odds of perpetration by 15% [95% confidence interval (CI) adjusted odds ratio (AOR) 1.08, 1.23], and an increase of 15 Australian standard drinks increased the odds by 42% (95% CI AOR 1.20, 1.69). Discussion and Conclusions: Individual characteristics, larger quantities of alcohol consumed, and a disinclination to practice harm reduction amplified risk of AHTO perpetration. This has implications for health promotion and risk prevention/reduction strategies. [ABSTRACT FROM AUTHOR]

Aims: To describe (i) self‐reported changes in drug use and (ii) trends in price, perceived availability, and perceived purity of illicit drugs, among people who regularly use ecstasy/ 3,4‐methylenedioxymethamphetamine (MDMA) and other illicit stimulants in Australia following COVID‐19 and associated restrictions. Design Annual interviews with cross‐sectional sentinel samples conducted face‐to‐face in 2016–19 and via video conferencing or telephone in 2020. Data were collected via an interviewer‐administered structured questionnaire. Setting: Australian capital cities. Participants: Australians aged 16 years or older who used ecstasy/MDMA and other illicit stimulants on a monthly or more frequent basis and resided in a capital city, recruited via social media and word‐of‐mouth (n ~ 800 each year). Measurements: Key outcome measures were self‐reported illicit drug market indicators (price, purity and availability) and, in 2020 only, perceived change in drug use (including alcohol and tobacco) since March 2020 and reasons for this change. Findings For most drugs, participants reported either no change or a reduction in their use since COVID‐19 restrictions were introduced. Ecstasy/MDMA was the drug most frequently cited as reduced in use (n = 552, 70% of those reporting recent use), mainly due to reduced opportunities for socialization. While market indicators were largely stable across most drugs, the odds of perceiving MDMA capsules as 'high' in purity decreased compared with 2016–19 [adjusted odds ratio (aOR) = 0.72, 95% confidence interval (CI) = 0.53–0.99], as did perceiving them as 'easy' to obtain (aOR = 0.42, CI = 0.26–0.67). The odds of perceiving cocaine and methamphetamine crystal as 'easy' to obtain also decreased (aOR = 0.67, CI = 0.46–0.96 and aOR = 0.12, CI = 0.04–0.41, respectively). Conclusions: After COVID‐19‐related restrictions were introduced in Australia, use of ecstasy/MDMA, related stimulants and other licit and illicit drugs mainly appeared to remain stable or decrease, primarily due to impediments to socialization. [ABSTRACT FROM AUTHOR]

Background: Alcohol and other drug (AOD) use patterns have altered as a result of the coronavirus (COVID-19) pandemic restrictions. This study aimed to: (i) determine the impact of the pandemic on patterns of AOD use among individuals seeking treatment, (ii) identify which mental health and resilience factors were associated with changes in patterns of AOD use and (iii) evaluate changes in the contextual factors (eg, motivations) associated with use. Methods: Cross-sectional surveys were completed by clients (n = 325) who had sought AOD treatment from January 2020 onwards. We measured quantity and frequency of AOD use now compared to before the pandemic, mental health (depression, anxiety, trauma exposure), resilience and contextual factors related to AOD use. Results: Quantity of tobacco and cannabis use increased post-pandemic, while methamphetamine and alcohol did not change. Depression was associated with more frequent alcohol use now compared to before the pandemic, while anxiety and lower resilience were associated with less frequent cannabis use now. Lower resilience was associated changes in methamphetamine use. Depression was associated with using more frequently for enjoyment and to alleviate loneliness following the pandemic, and anxiety was associated with using earlier in the day and to alleviate boredom. Conclusions: The pandemic has led to increased frequency of AOD use for a subset of individuals seeking treatment. Depression, anxiety and resilience are important factors associated with altered AOD use, and changes in the motivations and control surrounding use. Special consideration of this should be considered during AOD treatment through the pandemic. [ABSTRACT FROM AUTHOR]

Introduction: This paper aims to describe cocaine use, markets and harms in Australia from 2003 to 2019. Methods: Outcome indicators comprised prevalence of use from triennial household surveys; patterns of use from annual surveys of sentinel samples who use stimulants; and cocaine‐related seizures, arrests, hospitalisations, deaths and treatment episodes. Bayesian autoregressive time‐series analyses were conducted to estimate trend over time: Model 1, no change; Model 2, constant rate of change; and Model 3, change over time differing in rate after one change point. Results: Past‐year population prevalence of use increased over time. The percentage reporting recent use in sentinel samples increased by 6.1% (95% credible interval [CrI95%] 1.2%,16.9%; Model 3) per year from around 2017 (48%) until the end of the series (2019: 67%). There was a constant annual increase in number of seizures (count ratio: 1.1, CrI95% 1.1,1.2) and arrests (1.2, CrI95% 1.1,1.2), and percentage reporting cocaine as easy to obtain in the sentinel samples (percent increase 1.2%, CrI95% 0.5%,1.8%; Model 2). Cocaine‐related hospitalisation rate increased from 5.1 to 15.6 per 100 000 people from around 2011–2012 to 2017–2018: an annual increase of 1.3 per 100 000 people (CrI95% 0.8,1.8; Model 3). While the death rate was low (0.23 cocaine‐related deaths per 100 000 people in 2018; Model 2), treatment episodes increased from 3.2 to 5.9 per 100 000 people from around 2016–2017 to 2017–2018: an annual increase of 2.9 per 100 000 people (CrI95% 1.6,3.7; Model 3). Discussion and Conclusions: Cocaine use, availability and harm have increased, concentrated in recent years, and accompanied by increased treatment engagement. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has posed a great challenge for the existing health systems. The restrictions imposed across countries on the movement of people and the realignment of health care services in response to the pandemic are likely to negatively affect the health status and delivery of mental health services to persons with dual disorders (PWDD). Methods: An online survey was conducted among mental health professionals involved in providing care to PWDD to better understand the problems encountered and identify potential solutions in providing continued treatment for PWDD during the COVID-19 pandemic. Results: The findings confirmed significant disruption in the delivery of treatment services for PWDD during the COVID-19 pandemic. Dissatisfaction with personal protective equipment, inadequate COVID-19 testing services at treatment facility, and lack of guidelines on providing continued treatment services to PWDD by national authorities or professional bodies were identified as the likely reasons for this disruption. Conclusions: These concerns in turn need to be addressed by the policy-makers, hospital management staff, and other stakeholders. Specifically, there should be a focus on developing and disseminating guidelines to assist mental health professionals in setting-up and providing continued treatment services to PWDD via tele-psychiatry and other novel digital strategies. [ABSTRACT FROM AUTHOR]

Aims Understanding contexts in which social harms from drinking occur can help develop context-based harm reduction efforts. However, there is little knowledge of specific drinking contexts where such harms occur and whether these are gender or age specific. We aimed to investigate associations of a range of drinking contexts and social harms from drinking among young adults at age 30. Methods We used data from 2187 30-year-old adults. Latent constructs of gender-specific drinking contexts were created using factor analysis. We performed multivariate logistic regression between drinking contexts and a range of social harms from drinking, separately by gender. Results After accounting for social roles and binge drinking, gender-specific solitary drinking contexts ('home drinking' for men and 'daytime drinking' for women) were positively associated with marital problems and problems with other family members and friends. Conversely, 'social drinking' was not. Work-related drinking among men was associated with marital/intimate relationship problems and friendship problems. After accounting for mental health symptoms, women's home drinking was associated with marital problems. Conclusion We found that experiences of social harms from drinking at 30 years differ depending on the drinker's gender and context. Our findings suggest that risky contexts and associated harms are still significant among 30-year-old adults, indicating that a range of gender-specific drinking contexts should be represented in harm reduction campaigns. The current findings also highlight the need to consider gender to inform context-based harm reduction measures and to widen the age target for these beyond emerging adults. [ABSTRACT FROM AUTHOR]

Background: Despite the growing interest in investigating social harms from drinking, little is known about drinkers' reports of these harms and their gender differences among Australian young adults at age 30. We aimed to examine gender differences of social harms from drinking as reported by drinkers. Methods: 2,200 young adults at age 30 with complete data on social harms from drinking were drawn from the 30-year follow-up of the Mater-University of Queensland Study of Pregnancy. Measures included percentages of 11 past-year drinkers' self-reported social harms stratified by gender. Logistic regression was used to examine associations between gender and each social harm, accounting for relevant confounding. Results: More than one in five young adults (22%) reported at least one social harm in the past year. Among binge drinkers, 44% reported at least one social harm. After adjustments for social roles and binge drinking, we found no gender differences on several self-reported social harms: friendship problems, people criticizing drinking, non-marital family problems, employment problems, and alcohol-fuelled fights. However, men were more likely to report spousal threats to leave, drink-driving legal problems and financial problems. Conclusions: Our findings demonstrate that young adults are still vulnerable to risky drinking at age 30 and the social harm resulting from drinking. Thus, alcohol prevention campaigns should target this age group and include women in their focus. Strategies aiming to reduce alcohol-related harms, such as screening in clinical settings for risky drinking and alcohol-related harms, followed by motivational behavior interventions, could be beneficial among these vulnerable groups. [ABSTRACT FROM AUTHOR]

To systematically review the quality of evidence regarding the effectiveness of supports for people affected by suicide. EMBASE, MEDLINE, and PsychINFO were searched for evaluations of community-based supports for people affected by suicide. Outcomes included suicide-related behavior, depression, grief, quality of life, caring ability, and qualitative experiences. Fifteen studies evaluated 15 supports of various modalities. Study quality was generally poor; most studies examined bereaved individuals with mixed findings. Few reduced suicide-related behavior, half improved depression, and grief, while studies of caring ability, quality of life, or qualitative experiences reported positive effects. Supports associated with better outcomes connected peers with similar experiences, were provided over a period of months, and involved veteran rather than novice facilitators. Supports for people affected by suicide may be effective for improving suicide-related behavior, psychological adjustment, quality of life and caregiving, but require further evaluation. [ABSTRACT FROM AUTHOR]

Aims: Understanding the social contexts in which problematic drinking occurs can inform prevention strategies. In this article, we investigate gender-specific social contexts associated with problematic drinking and depression among adults aged 30 years. Because depression has been consistently linked with harmful alcohol consumption, we will also examine its association with drinking contexts. Methods: We used data from 2490 young adults who completed the 30-year follow-up phase of the Mater-University of Queensland Study of Pregnancy and its Outcomes, a prospective study commenced in 1981. Exploratory and confirmatory factor analyses were used to identify latent constructs of drinking contexts stratified by gender, with subsequent regression analysis to assess the role of these contexts in problematic drinking (measured using the Alcohol Use Disorders Identification Test). Results: Six distinct drinking contexts were identified, which differed by gender, three for men and three for women. For both men and women, "social drinking", was associated with problematic drinking. "Home drinking" was also common to men and women but associations with problematic drinking differed, being risky only among men. "Daytime drinking" (women) was associated with risk but "work-related drinking" (men) was not. Both "home drinking" (men) and "daytime drinking" (women) were linked to depression symptoms. Conclusion: Specific contexts appeared to be associated with problematic drinking for both sexes. Among both men and women, "social drinking" was associated with problematic drinking. Both "home drinking" (men) and "daytime drinking" (women) contexts, were associated with problematic drinking and depressive symptoms. Targeted alcohol-focused interventions need to address co-occurring mental health issues. [ABSTRACT FROM AUTHOR]

Background: Evidence suggests that externalizing and internalizing symptoms are expressed early in life and are associated with problematic drinking in young adulthood. However, few studies have examined their role during childhood and adolescence in predicting alcohol problems later in life. Objectives: To examine the role of childhood and adolescent externalizing and internalizing symptoms in predicting alcohol use disorders in young adulthood. Methods: We searched five electronic databases (PubMed, Scopus, PsycINFO, Web of Sciences and Embase) for studies which diagnosed alcohol use disorders through either the International Classification of Diseases or American Psychiatric Association – Diagnostic and Statistical Manual of Mental Disorders criteria and followed up children or adolescents into the transition to young adulthood. We performed a meta-analysis and obtained pooled odds ratio estimates with 95% confidence intervals using random-effects models. Results: A total of 12 longitudinal studies met eligibility criteria and were included in the meta-analysis. All measured the outcome using Diagnostic and Statistical Manual of Mental Disorders criteria. The majority were of good quality and were conducted in the United States. A total of 19,407 participants (50% female) were included in this meta-analysis. Of these, n = 2337 (12%) had diagnoses of alcohol use disorders/alcohol dependence. Participant ages ranged from birth to 36 years. Internalizing symptoms increased the risk of young adult alcohol use disorders by 21% (odds ratio = 1.21; 95% confidence interval = [1.05, 1.39]), with no strong evidence of publication bias. Subgroup analysis suggested significantly lower heterogeneity than for externalizing studies. Externalizing symptoms increased the risk of alcohol use disorders by 62% (odds ratio = 1.62, 95% confidence interval = [1.39, 1.90]). We found some evidence of publication bias and significant heterogeneity in the studies. Conclusion: Our findings highlight the contribution of early behavioural problems to the development of alcohol use disorders in young adulthood and the need for timely scrutiny of and intervention on early behavioural problems. [ABSTRACT FROM AUTHOR]

Objective: People bereaved by suicide, people who make suicide attempts and people who care for someone at risk of suicide may experience negative psychosocial and physical health outcomes. Provision of support to these populations is an important component of suicide prevention and postvention in Australia, including the Queensland Suicide Prevention Action Plan 2015–2017. This study aimed to identify, classify and review resources available in Queensland for people affected by suicide using an innovative classification framework. Method: Searches of the grey literature were completed in Google Chrome in August/September 2016 using seven search terms relevant to Queensland. The first three pages of results were recorded, assessed for suitability, and analysed using a classification framework created by the authors. Results: The study found 24 resources for people affected by suicide in Queensland. The majority of resources (n = 14, 58%) targeted the bereaved, four (17%) addressed carers of people affected by suicide, and six (25%) were general suicide prevention resources. None of the resources specifically targeted people who have made a suicide attempt. The quality of the resources varied and only two had been evaluated. Discussion: Using the classification framework the study identified several gaps, such as relative lack of resources for specific vulnerable populations, including minority subgroups, older adults and men. There is also space for improvement in both the implementation of rigorous evaluation and quality assurance mechanisms for the development of suicide prevention and postvention resources, and in their co-creation with consumers. [ABSTRACT FROM AUTHOR]

Aims Alcohol use disorders (AUDs) are highly disabling neuropsychiatric conditions. Although evidence suggests a high burden of AUDs in young adults, few studies have investigated their life course predictors. It is crucial to assess factors that may influence these disorders from early life through adolescence to deter AUDs in early adulthood by tailoring prevention and intervention strategies. This review aims to assess temporal links between childhood and adolescent predictors of clinically diagnosed AUDs in young adults. Methods We systematically searched PubMed, Scopus, PsycINFO and Embase databases for longitudinally assessed predictors of AUDs in young adults. Data were extracted and assessed for quality using the Newcastle-Ottawa quality assessment tool for cohort studies. We performed our analysis by grouping predictors under six main domains. Results and Conclusion Twenty two studies met the eligibility criteria. The outcome in all studies was measured according to the Diagnostic Statistical Manual of Mental Disorders. Our review suggests strong links between externalizing symptoms in adolescence and AUDs in young adulthood, as well as when externalizing symptoms co-occur with illicit drug use. Findings on the role of internalizing symptoms and early drinking onset were inconclusive. Environmental factors were influential but changed over time. In earlier years, maternal drinking predicted early adult AUD while parental monitoring and school engagement were protective. Both peer and parental influences waned in adulthood. Further high-quality large longitudinal studies that identify distinctive developmental pathways on the aetiology of AUDs and assess the role of early internalizing symptoms and early drinking onset are warranted. [ABSTRACT FROM AUTHOR]

Objective: The perception that people who use illicit drugs are deviant has contributed to the stigmatization of this population. The primary aim of this review is to examine the links among injection-related discrimination, mental health, physical health, and quality of life in people who inject drugs. We also identify settings, perpetrators of discrimination, and coping strategies developed by people who inject drugs to deal with the issue.Method: Online databases MEDLINE (PubMed), EMBASE, CINAHL (EbscoHost), and PsycINFO (APA PsycNET) were searched for articles focusing on injection-related discrimination against people who inject drugs. Findings were compared for consistency. Qualitative and quantitative articles were evaluated separately.Results: Eleven articles were included in the final review. Several links between discrimination and negative health outcomes were identified. Discrimination was associated with engagement in risky injecting behavior as well as psychological distress. The perpetrators of discrimination against people who inject drugs included general community members and service providers. Attempts to hide addiction was the main strategy used to cope with discrimination.Conclusions: Injection-related discrimination was associated with higher psychological distress levels, unhealthy behaviors, and low quality of life in people who inject drugs. By addressing the stigma of deviance, discrimination and associated negative health outcomes may be reduced. [ABSTRACT FROM AUTHOR]

Primary Health Networks (PHNs) are a new institution for health systems management in the Australian healthcare system. PHNs will play a key role in mental health reform through planning and commissioning primary mental health services at a regional level, specifically adopting a stepped care approach. Selected PHNs are also trialling a healthcare homes approach. Little isknown about the systems levers that could be applied byPHNsto achieve these aims. Arapid review of academic and grey literature published between 2006 and 2016 was undertaken to describe the use of systems levers in commissioning primary care services. Fifty-six documents met the inclusion criteria, including twelve specific to primary mental healthcare. Twenty-six levers were identified. Referral management, contracts and tendering processes, and health information systems were identified as useful levers for implementing stepped care approaches. Location, enrolment, capitation and health information systems were identified as useful in implementing a healthcare homes approach. Other levers were relevant to overall health system functioning. Further work is needed to develop a robust evidence-base for systems levers. PHNs can facilitate this by documenting and evaluating the levers that they deploy, and making their findings available to researchers and other commissioning bodies. [ABSTRACT FROM AUTHOR]

Introduction and Aims: Alcohol misuse and depressed mood are common during early adolescence, and comorbidity of these conditions in adulthood is associated with poorer health and social outcomes, yet little research has examined the co-occurrence of these problems at early adolescence. This study assessed risky and protective characteristics of pre-teens with concurrent depressed mood/early alcohol use in a large school-based sample.Design and Methods: School children aged 10-14 years (n = 7289) from late primary and early secondary school classes in government, Catholic and independent sectors participated with parental consent in the cross-sectional Healthy Neighbourhoods Study. Key measures included depressed mood, recent alcohol use, school mobility, family relationship quality, school engagement and coping style. Multinomial logistic regression analyses were used to identify school and family-related factors that distinguished those with co-occurring drinking and depressive symptoms from those with either single condition. Gender and school-level interactions for each factor were evaluated.Results: Co-occurring conditions were reported by 5.7% of students [confidence interval (CI)95 5.19, 6.19]. Recent drinkers were more likely than non-drinkers to have symptoms consistent with depression (odds ratio 1.80; CI95 1.58, 2.03). Low school commitment was associated with co-occurring drinking/depressive symptoms (odds ratio 2.86; CI95 2.25, 3.65 compared with null condition). This association appeared to be weaker in the presence of adaptive stress-coping skills (odds ratio 0.18; CI95 0.14, 0.23).Conclusions: We have identified factors that distinguish pre-teens with very early co-occurrence of drinking and depressed mood, and protective factors with potential utility for school-based prevention programmes targeting these conditions. [Salom CL, Kelly AB, Alati R, Williams GM, Patton GC, Williams JW. Individual, school-related and family characteristics distinguish co-occurrence of drinking and depressive symptoms in very young adolescents. Drug Alcohol Rev 2016;35:387-396]. [ABSTRACT FROM AUTHOR]