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Little is known about the extent of non-medical use of prescription drugs among European adolescents with substance use disorders. This cross-sectional study examined non-medical use of seven categories of psychotropic prescription drugs (opioid analgesics, ADHD stimulant, sleeping, sedative/anxiolytic, antipsychotic, antidepressant, and anabolic steroid medications) in a clinical sample of Irish adolescents with substance use disorders. Of the 85 adolescents (aged 13-18 years) invited to participate, 65 adolescents (M = 16.3 years, SD = 1.3) took part (response: 74%). Among respondents, 68% reported lifetime non-medical use of any of the prescription drugs; sedative/anxiolytic (62%) and sleeping medications (43%) were more commonly abused. The most frequently reported motives for abuse were "seeking high or buzz" (79%), "having good time" (63%), and "relief from boredom" (56%). Sharing among friends and street-level drug markets were the most readily available sources. Innovative solutions of control measures and intervention are required to address the abuse of prescription drugs.

Objectives: Cocaine abuse is widespread in Europe, and Ireland ranks among the leading countries for prevalence of cocaine use among adolescents. This study aimed to examine demographic and substance use correlates of lifetime cocaine use among adolescents with substance use disorder, and to explore the relationship between alcohol intoxication and cocaine initiation., Methods: Data from a cross-sectional study of 171 adolescents presenting to an outpatient substance abuse treatment program in the Dublin metropolitan area were analyzed. Bivariate and multivariate analyses were conducted., Results: Approximately 64% of the participants reported ever used cocaine: 70% reported the first use of cocaine was while alcohol intoxicated and 96% reported the onset of cocaine use was preceded by cannabis use. Later age at treatment entry, unstable accommodation, non engagement in educational/vocational functions, and greater frequency of alcohol and cannabis use had robust associations with lifetime cocaine use. Male gender was significantly associated with first use of cocaine while alcohol intoxicated., Conclusions: Alcohol frequently plays a central role in cocaine initiation in Irish adolescents. Efforts to delay, avoid, or reduce adolescent drinking may yield benefits in terms of reducing cocaine use initiation in this population.

There is no agreed definition of a mental health crisis; however, a useful one is 'a situation where mental health has deteriorated to an extent that the user is likely to be at risk of harm to self or others and is in need of urgent intensive specialist support and treatment' (Minghella et al , 1998). Community-based care is the primary model of specialist mental healthcare in Ireland (Government of Ireland, 2006 a ). When clinically indicated, a patient with mental health crisis is referred to the community mental health team (CMHT) for an urgent assessment.

Objectives: Despite the clinical guidelines regarding the use of combined antipsychotics and the limited evidence for its benefits, use remains high in psychiatric practice. The aim of this study was to examine prescribing practices and investigate reasons for initiating and continuing combined antipsychotics in stable psychiatric illnesses., Method: A cross-sectional case record survey of antipsychotic prescribing practices in a community psychiatric rehabilitation service. A total sample (n = 75) of patients with chronic and enduring psychiatric illnesses was studied. The age, gender, diagnosis and prescribed antipsychotics were examined. The proportional prevalence and documented reasons for combined antipsychotic prescribing were analysed., Results: Seventy-three of the 75 patients were prescribed antipsychotic mediations. Of these, 44 (60%) received a combination of two or more antipsychotics. The most common reason for combined prescribing was a switch of antipsychotic (n = 18; 41%). No reason was documented in 19 cases (43%)., Conclusions: In this study, slow cross-tapering or incomplete switch process of antipsychotics contributed to the prolonged period of combined antipsychotics treatment. Adequate documentation regarding indication and review of medications cannot be overemphasized.