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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]

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]

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]

Introduction. Misuse of pharmaceutical drugs, particularly by young people, is an issue of rising concern. Poly-substance use is common among regular psychostimulant users (RPU), and mental health problems are associated with pharmaceutical misuse, but RPU do not generally acknowledge their use as problematic. Objective. To examine links between mental health and misuse of non-prescription pharmaceuticals in a group of regular users of illicit psychostimulants. Method. Face to face structured interviews were conducted in April 2015 with 763 regular users of illicit psychostimulants as part of the Annual Ecstasy and Related Drugs Reporting System study in Australia. Results. At least half of the RPU in this study reported extra-medical or misuse of pharmaceuticals in the last six months in addition to regular use of illicit psychostimulants. Higher levels of psychological distress were recorded for RPU who also reported recent illicit use of opioids, antidepressants, benzodiazepines, or over-the-counter (OTC) codeine. Recent misuse of benzodiazepines or OTC codeine was associated with self-reported mental health problems and having attended a mental health professional. Those reporting recent misuse of opioids were at increased risk of mental health problems and more likely to record high levels of psychological distress, but less likely to have received prescription medications for their mental health problem. Discussion and conclusion. Regular users of illicit psychostimulants who also misuse pharmaceuticals are at increased risk of mental health problems, even after accounting for their use of illicit psychostimulants. Screening of this group for mental health problems is recommended. [ABSTRACT FROM AUTHOR]