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Common depictions of buying and selling illicit drugs online centre on how drug market actors engage in dark web drug cryptomarkets, but the supply of illicit drugs also takes place in 'plain site' on the surface web. Drawing on netnographic observations and qualitative interviews with hard-to-reach buyers and vendors (n = 20), this paper explores LeafedOut, a specific, popular surface web platform, that provides a conduit for local cannabis exchanges. We found that the platform enabled easy access and supply at the local level but increased some specific risks to those involved. Actors neutralised the perceived risks of drug supply over this surface web platform through the broader societal normalisation of cannabis use/supply, adopting encrypted messaging applications to cover 'digital traces', and developing various methods to establish trust with an exchange partner (e.g. review systems, sending selfies with drug paraphernalia, selectively choosing meet-up locations). This paper expands our understanding of the growing number of online illicit drug markets by shifting attention from dark web cryptomarkets to the much more widely accessed surface/clear web. Theoretical implications for the study of trust and risk in online illicit drug market exchanges are also considered. [ABSTRACT FROM AUTHOR]

Aims: The current study assesses the impact of youth drug treatment on substance use, offending and wellbeing in a sample of young people recruited from specialist youth alcohol and drug treatment. The paper examines the impact of treatment engagement on the size and substance use profile of the young person's social network and hypothesises that the best treatment outcomes are associated with maintaining the size of the young person's social network but changing its composition to reduce the representation of substance use in social networks. Methods: A cohort study of 112 young people (aged 16–21) engaged in specialist youth alcohol and drug treatment services in Victoria, Australia, were recruited at the beginning of treatment and re-interviewed six months later using a structured questionnaire. Findings: There were improvements in substance use, social functioning, mental health and life satisfaction from baseline to follow-up. While network size was associated with mental health and quality of life markers, only having a lower proportion of substance users in the social network was associated with lower substance use and offending at follow-up. Conclusions: Social networks are a key component of wellbeing in adolescence. This study suggests that through independent analysis of network size and network composition, both the size and the composition of social networks have an important role to play in developing interventions for adolescent substance users that will sustain behaviour changes achieved in specialist treatment. [ABSTRACT FROM AUTHOR]

Aims: Across the globe law enforcement agencies frequently link trafficking in illicit drugs to serious and organised crime such as terrorism and gun trafficking. However, there remain few systematic academic analyses of the extent and nature of links. This paper explored the extent of concordance between trends in high-level drug trafficking and seven other serious and organised crimes in Australia: and which crimes (and crime subtypes) most and least correlated with drug trafficking. Methods: Official crime data from the Commonwealth Director of Public Prosecutions was obtained on criminal prosecutions on drug trafficking, money laundering, fraud, weapons trafficking, people trafficking, sex trafficking, terrorism and corruption and trends examined over a decade: 2005-2006 to 2014-2015. Results: Analysis revealed a positive correlation between drug trafficking and money laundering and subcategories of corruption, fraud and people trafficking. No positive correlation was found between drug trafficking and sex trafficking, weapon trafficking or terrorism. Differences were found by type of drug-trafficking offence. Conclusions: These findings suggest that in Australia, high-level drug trafficking is most likely related to money laundering, fraud, corruption and people trafficking. It also suggests that drug trafficking and other serious and organised crime linkages may be more complex than often asserted. [ABSTRACT FROM AUTHOR]

Aims: Knowledge of public opinion towards drug policy is often limited to analyses of individual survey questions. There has been less thought given to the underlying structure of public opinion, and how attitudes towards different facets of drug policy, for example, law enforcement and harm reduction, might align into ideological positions. This paper aims to assess the extent to which distinct ideologies are present among the general public in Australia in relation to drug policy. Method: The study involved a Latent Class Analysis of data taken from the 2010 National Drug Strategy Household Survey. The analysis categorized individuals into mutually exclusive groups (classes), according to their responses to 15 attitudinal items. Findings: Six classes of individuals were identified, and were labelled as: uninformed, ambivalent, detached prohibitionists, committed prohibitionists, harm reductionists and legalizers. Conclusions: The unique analysis presented in this paper demonstrates the existence of six distinct classes of opinions towards drug policy in an Australian sample. Whilst there were a large proportion of respondents in support of both drug legalization and harm reduction, there were also many who opposed drug legalization, yet supported harm reduction. Any assumption that supporting harm reduction automatically equates with support for legalization, is erroneous. [ABSTRACT FROM AUTHOR]

The papers in this series are presented by Australia's National Research Centre on Workforce development, or as it is formally known as the National Centre for Education and Training on Addiction (NCETA), at Flinders University in Australia. NCETA is recognized nationally and internationally as a research centre that works as a catalyst for change in the alcohol and other drugs (AOD) sector. NCETA is one of the three national research Centres in Australia funded under the National Drug Strategy, and the only Centre briefed to specifically address issues related to workforce development. In this guise, the Centre's mission is to advance the capacity of human services organizations and workers to respond to alcohol and other drug related problems. NCETA's role is not restricted to the area of workforce development. The Centre also undertakes an important programme of work in relation to the workplace, law enforcement, complex data analyses on a range of topics and has an innovative programme of social research on issues such as young people and alcohol. The focus of attention selected for this issue however provides a sample of our work in the area of workforce development. [ABSTRACT FROM AUTHOR]

Aims: Schools have emerged as a key site for prevention and early intervention strategies for antisocial behaviour. This paper examines teacher perspectives of the scope within their day-to-day practice for the implementation of monitoring and management of student risk status for substance misuse. Methods: Teacher perspectives of early intervention for young secondary school students aged 12-14 are examined. Case studies are presented of five non-metropolitan Australian schools located in a low socioeconomic area. Findings: The study identifies a diverse range of early intervention practice in school settings; reports that teachers are pragmatic in their identification of students at risk, and use an under-theorised construct of engagement to manage risk. A number of tensions centring on the perceived purpose of school emerge when early intervention policy is operationalised in the classroom. Conclusion: The student wellbeing policy currently in use in Victorian schools needs to be refined. These revisions should provide schools with a clear and understandable early intervention framework that allows local translation. Any further policy development should be based on teacher understandings and capacity for early intervention. [ABSTRACT FROM AUTHOR]

The paper reports the findings of survey research recently completed in Melbourne, Australia, among a sample of 455 club and rave festival patrons. This research aims to provide a clearer account of the prevalence of drug driving within such settings in Melbourne, as well as identifying relevant ‘predictors’ of this drug driving. Just under half of the sample (48%) indicated that they had driven a motor vehicle within four hours of consuming an illicit substance at least once in the past year; 22% of respondents reported driving while ‘knowingly intoxicated’ in the previous year. Fifteen percent reported such behaviour ‘several times’ or more in this time. Relatively permissive attitudes towards drug driving, coupled with higher than average prevalence of drug driving in one's peer group, were found to be significant predictors of drug driving. So too was the reported frequency of the use of cannabis and ecstasy, and the propensity to use these substances in ‘rave’ and ‘party’ settings. Given the levels of drug driving revealed in this study, the paper closes with a series of recommendations regarding the design and delivery of more effective anti-drug-driving strategies within rave and club settings. [ABSTRACT FROM AUTHOR]

Aims: This paper explores the complex and dynamic relationship between pleasure and harm as experienced by a group of young people during and after “party drug” use.Methods: Fourteen months of ethnographic fieldwork was undertaken among regular recreational users of ecstasy and methamphetamine. Weekly participant observation took place in licensed venues and private homes. In-depth interviews were conducted with 25 core participants.Findings: There were four primary domains of both pleasure and harm experienced by participants that included: (a) elevated and lowered mood, (b) heightened and impaired cognition, (c) economic availability and unavailability and (d) enhanced and troubled friendships. This analysis suggests that it is unhelpful to discuss the harms of drug use without an appreciation of pleasure, as one is not typically experienced without the other.Conclusions: A more nuanced understanding of the relationship between pleasure and harm is needed, as the two concepts are not in opposition, as they are so commonly used. Appreciating the way in which individuals experience the dynamics between pleasure and harm will enable the development of more appropriate harm reduction measures that resonate with individuals. [ABSTRACT FROM PUBLISHER]

Ethnic Vietnamese heroin users in Australia typically experience high rates of blood-borne virus infection, opioid overdose, criminal justice system involvement and poor retention in substance use treatment, particularly methadone maintenance treatment. This paper explores the experiences of twenty ethnic Vietnamese heroin users and examines the specific role of families in treatment from the perspective of the person going through treatment. What emerged from this study was a picture of a young, ethnically distinct subgroup of opiate-dependent people struggling to engage in treatment in an environment where heroin was easily accessible. The relational dynamics between participants and their family appears as a key mediator of the experience of treatment: it can be a source of motivation, grounding and connectedness; or it can be alienating and fragmenting. The extended nature of Vietnamese family systems meant that these relationships had implications for family members geographically and relationally close and distant. I think it is just like the worst thing when your parents find out because it feels like they have to suffer for like no reason, you know. It is too hard for them, they know but they never want to admit it. I would say the family stuff is the hardest. (Lien My [1], female 19 years) [ABSTRACT FROM AUTHOR]

Hepatitis C-related discrimination is reportedly common, however few studies have investigated this phenomenon. This paper presents findings from a cross-sectional study of people with self-reported hepatitis C virus (HCV) infection ( N ?=?504) conducted in New South Wales (NSW), Australia throughout 2001 and 2002. Participants completed a self-administered questionnaire enquiring into their experience of living with HCV. Over a half of the participants (57.5%, n ?=?290) reported that they had acquired their infection from injecting drug use. Discrimination was reported by 64.7% ( n ?=?326) of participants and healthcare was the most commonly reported site where discrimination occurred. A logistic regression identified the predictors of any discrimination as: knowing many other people with HCV infection; feeling tired due to HCV symptoms; and being younger ( [ABSTRACT FROM AUTHOR]

Increasing public participation has the potential to inform better alcohol policy. One method for increasing participation is the citizens' jury – a strategy that has been both touted as a panacea for issues of democratic representation and dismissed as ineffective in impacting policy. Seeking to look past both hype and cynicism, we reflect on two Australian juries with an aim to identify both the potentials and pitfalls of the use of citizens' juries in alcohol policy. Using public documentation, we analyse two alcohol-related citizens' jury processes – one in Adelaide, SA, and one in Sydney, NSW – with respect to their implications for alcohol policy development. We reflect on matters of participation, deliberation, authority, remit, and impact of recommendations. The case studies indicate the importance of clear aims; whether these are instrumental and focussed on developing specific alcohol policy recommendations or focussed on broader epistemic democratic effects. Jury composition, the notion of vested interests, and the extent of juries' authorising power are key considerations for juries deliberating on alcohol policy. Due to the nature of policy-making, no single strategy can be a democratic panacea. However, we find that carefully considered and situationally aware elements of citizens' juries may be useful in alcohol policy development. [ABSTRACT FROM AUTHOR]

The alcohol and other drugs (AOD) sector has shown strong progress with regard to recognition, professionalism and international programs of training and credentialing. Yet little is known regarding the professional development (PD) needs of AOD workers, nor how these needs differ across career stages. Australian AOD workers (N = 812) from the government and non-government sectors completed an online survey. Early career workers (≤3 years' AOD experience) were more likely than mid/late career workers to be non-government employed and earn less than the national average and were less likely to be AOD qualified and have permanent employment. Early career workers were more likely to nominate a need for PD in advanced clinical skills (86.3%, p ≤.05), dual diagnoses/mental health (72.6%, p ≤.001) and service delivery/partnerships/teamwork (66.4%, p ≤.01). These findings highlight an urgent need for advanced skill development to accord with increasing complexity in AOD presentations. High quality care is founded on a skilled and experienced workforce; addressing the ubiquitous PD barriers of time, cost and access is a crucial workforce development priority best addressed through reform to systems of organisational funding, professional accreditation and curriculum development in AOD specialist and generalist health areas. [ABSTRACT FROM AUTHOR]

This study aimed to assess the accuracy and factors influencing blood alcohol concentration self-estimation during voluntary breath testing. It also aimed to assess whether intended drinking behaviour changed after reviewing blood alcohol concentration and factors influencing this. A total of 462 Australian music festival patrons aged 18–40 years completed a survey exploring factors likely to affect estimation accuracy and provided an estimation of their blood alcohol concentration. A breathalyser reading was taken and participants were asked whether reviewing this reading changed their drinking intentions. Most respondents (58.4%) were accurate within 0.02% range, while 11.4% underestimated and 29.1% overestimated. Machine-read blood alcohol concentration was the most significant estimation accuracy predictor. Reviewing their readings changed the intention to drink in one-third of participants, indicating that voluntary breath testing may influence future drinking behaviour. Underestimation was associated with intention to drink less, whilst completing the survey earlier and <1 h since last drink was associated with intention to drink more. [ABSTRACT FROM AUTHOR]

In Australia there have been calls for volumetric alcohol taxation, or some variant of this, to eliminate the complexities and inequalities of the existing system. While the arguments have been made on economic rationality and evidence-based public health grounds, this article examines the historical drivers of alcoholic beverage excise tax changes in order to facilitate a more informed debate about how to achieve alcohol taxation reform. Excise taxation on spirits and beer (wine has almost never been taxed through excise taxes in Australia) was examined in greater detail using primary data sourced from national excise taxation schedules from 1902 to 2012. Interpretation of this data was based on primary sources such as Hansard speeches and Government reports, and secondary sources provided by historians. Australia had a long history of not taxing spirits more heavily than beer except in the early part of the twentieth century; this changed after 1988. Setting alcohol excise taxes in Australia has been a balancing exercise between industry protection, revenue raising and political expediency, as well as public health. The historical instances examined in this article support the conclusion that while public health has been a driving force for some excise taxation changes, it has not been the only driver. These findings should inform policy making on excise taxation on alcoholic beverages in Australia. [ABSTRACT FROM AUTHOR]

Evidence based strategies are needed to enhance the ability of the Alcohol and Other Drugs (AOD) sector to prevent prenatal alcohol exposure (PAE) and harms including Fetal Alcohol Spectrum Disorder (FASD). In Australia FASD prevention research has largely focused on primary care and child development sectors, while little research has been conducted with AOD services providing comprehensive support to high risk women. This study interviewed 26 staff from 18 organizations involved in referral and co-ordination, case management, or treatment and support services for women with (or at high risk of) PAE in the Greater Newcastle region in Australia. Interviews with service workers indicated a significant appreciation of the psychosocial complexities related to substance misuse in pregnancy, a highly skilled approach to harm reduction, and a sector going to extraordinary lengths to overcome the disadvantages faced by women including gaps in service provision. These results are discussed in light of recommendations to support AOD services to reduce the harms of PAE. [ABSTRACT FROM AUTHOR]

Employee drug use poses a serious risk to health and safety in male-dominated industries yet patterns and determinants of drug use in construction are not well understood. This study assessed prevalence rates and predictors of Australian construction workers' use of cannabis, cocaine and meth/amphetamine. Workers (N = 511) completed a survey that assessed use of the three drug types; alcohol use; general health and mental health; job stress and the workplace cultural norms for each drug. Hierarchical binary logistic regressions examined predictors. Use of each drug over the past 12 months was two–five times higher than the national averages. Higher alcohol consumption was a consistent predictor across drug types and younger age and poorer general health were predictive of cannabis and cocaine use. Higher psychological distress was associated only with cannabis use. Workplace availability, descriptive and injunctive norms were significant predictors of cocaine use. The findings highlight concerning patterns of drug use in construction, particularly high levels of cocaine, with serious implications. The influence of cocaine workplace availability and norms highlight the importance of the workplace culture. Multi-component approaches involving culture change and individual-level responses that target vulnerable workers are required to minimize risk from drug-related harm. [ABSTRACT FROM AUTHOR]

Media and politicians both influence public opinion and policy responses to illicit drug issues. This study examines the contribution each may have made in Australia in 2015 to the problem and politics streams of the policy process, as outlined in Kingdon's 'multiple streams' heuristic, when a National Ice Taskforce responded to increased public, political and media concern about methamphetamine use. A retrospective content analysis compared the frequency and content of articles about methamphetamine in print media (N = 639) and federal parliament speeches (N = 158) in 2015. Peaks in the number of media articles and debates in parliament followed the establishment and interim findings of the Ice Taskforce. The findings showed that politicians more frequently framed methamphetamine use as a crisis or epidemic than the media. Both frequently portrayed cost to society as the consequence of methamphetamine use and often cited law enforcement sources. The media most frequently positioned methamphetamine users as criminal or deviant compared to politicians who did not position the user or positioned them as an addict or victim. This analysis highlights the convergence of the problem and politics streams and suggests they are not independent as first posited by Kingdon. [ABSTRACT FROM AUTHOR]

Recent trends in Australia show a decline in youth drinking, but alcohol-related harms and the number of heavy drinkers remains high. This suggests a polarised drinking culture with subgroups of heavier drinkers continuing to reinforce heavy drinking norms. It is important to recognise the role peer networks in setting drinking norms despite cultural change. In a society collectively moving towards a more moderate drinking culture, recognising the segmented and homogenous heavier drinking subgroups that get left behind is vital. Encouraging greater integration of abstainers and moderate drinkers within social networks rather than letting heavy drinkers remain isolated and self-reinforcing might be one way to disrupt perceived heavy drinking norms. Harnessing this decline in youth drinking at the population level and translating it to the peer-to-peer level could be an important step for the future of alcohol-related harm reduction. [ABSTRACT FROM AUTHOR]

Aims: To review existing evidence on effectiveness of community-based diversion programmes for Class A drug-using offenders. Methods: 31 databases were searched for studies published 1985-2012 (update search 2012-2016) involving community-based Criminal Justice System diversion of Class A drug users via voluntary or court-mandated treatment. Findings: 16 studies were initially included (US, 10; UK, 4; Canada, 1; Australia, 1). There was evidence for a small impact of diversion to treatment on drug use reduction (primary Class A drug use: OR 1.68, CI 1.12-2.53; other drug use: OR 2.60, 1.70-3.98). Class A drug users were less likely to complete treatment (OR 0.90, 0.87-0.94) than users of other drugs. There was uncertainty surrounding results for offending, which were not pooled due to lack of outcome measure comparability and heterogeneity. Individual studies pointed to a minor effect of diversion on offending. Findings remained unchanged following an update review (evidence up to March 2016: US, 3; Australia, 1). Conclusions: Treatment accessed via community-based diversion is effective at reducing drug use in Class A drug-using offenders. Evidence of a reduction in offending amongst this group as a result of diversion is uncertain. Poor methodological quality and data largely limited to US methamphetamine users limits available evidence. [ABSTRACT FROM AUTHOR]

Aims: The Drug Education in Victorian Schools (DEVS) programme taught about licit and illicit drugs over two years (2010–2011), with follow up in the third year (2012). It focussed on minimising harm and employed participatory, critical-thinking and skill-focussed pedagogy. This study evaluated the programme’s residual effectiveness at follow up in reducing alcohol-related risk and harm.Methods: A cluster-randomised, controlled trial was conducted with a student cohort during years eight (13–14 years old), nine (14–15 years old) and 10 (15–16 years old). Schools were randomly allocated to the DEVS programme (14 schools,n = 1163), or their usual drug education (7 schools,n = 589). Multi-level models were fitted to the data, which were analysed on an intent-to-treat basis.Statistically significant findings: Over the 3 years, there was a greater increase in intervention students’ knowledge about drugs, including alcohol. Their alcohol consumption did not increase as much as controls. Their alcohol-related harms decreased, while increasing for controls. There were fewer intervention group risky drinkers, and they reduced their consumption compared to controls. Similarly, harms decreased for intervention group risky drinkers, while increasing for controls.Conclusions: Skill-focussed, harm minimisation drug education can remain effective, subsequent to programme completion, in reducing students’ alcohol consumption and harm, even with risky drinkers. [ABSTRACT FROM PUBLISHER]

Over the past two decades, there has been a major paradigm shift in the conceptualisation of workforce development for the alcohol and other drugs (AOD) sector. Foremost, in this regard, is the shift towards a systems approach. Unlike more traditional approaches, which predominantly address the immediate education and training needs of individual workers, a systems approach is broad and comprehensive and targets individual, organisational and structural factors. It also incorporates issues such as innovation dissemination and systems redesign. This paradigm shift and its implications for workers, services and sectors are outlined. Then, an overview of the background, historical and contextual factors impacting current approaches to workforce development is provided. This is followed by a description of changes in the theoretical understandings of effective workforce development which prompted the paradigm shift. A range of factors impacting at the global and individual worker level are then described, such as the impacts of changes to AOD prevention and intervention approaches. Then, a number of aspects of contemporary approaches to workforce development are described, specifically: worker well-being; workforce planning; leadership and management; worker recruitment and retention; effective learning environments; and training. Finally, an example of the application of a systems approach to workforce development is provided in the form of Australia’s National Alcohol and other Drug Workforce Development Strategy 2015–2018. [ABSTRACT FROM PUBLISHER]

Aims: Currently, efforts to prevent hepatitis C virus (HCV) focus on the message that all sharing of injecting equipment is risky. This obscures the strategies undertaken by people who inject drugs (PWID) to reduce risk of transmission to themselves and others.Methods: Self-complete survey of clients of Needle and Syringe Programs (NSPs) in a metropolitan area of Sydney, Australia. Among those who reported sharing injecting equipment, two categories of risk were constructed based on self-perceived HCV status and self-reported distributive and receptive sharing of injecting equipment. The “higher risk” category contained participants who reported being either HCV-positive and distributive sharing or HCV-negative and receptive sharing. The “lower risk” category contained participants who reported being either HCV-positive and receptive sharing or HCV-negative and distributive sharing.Findings: Around a third of the total sample were categorised as “higher risk”. In multivariate analysis, being in the higher risk category was associated with perceived difficultly in managing drug use (adjusted odds ratio (AOR) = 2.37; 95% CI 1.34–4.18;p = 0.003) and having less trust in drug and alcohol workers (AOR = 0.68; 95% CI 0.52–0.90;p = 0.007).Conclusions: This exploratory study highlights gaps in the way that the HCV prevention sector understands and addresses risk. Further research is required to guide prevention efforts that are meaningful and relate to the strategies that PWID undertake to reduce HCV risk. [ABSTRACT FROM PUBLISHER]

Aims: To investigate the perspectives and experiences of service providers regarding provision of take-home naloxone to people who use opioids in Victoria, Australia. Methods: Content analysis of qualitative semi-structured interviews with 15 service providers who are either involved with take-home naloxone programs or whose work brings them in contact with people who use opioids. Findings: Statements about take-home naloxone were universally positive. Both direct and indirect benefits of take-home naloxone were described. Alongside potential reductions in opioid overdose-related harms, service providers highlighted the empowering effects of providing people who use opioids with take-home naloxone. No significant risks were described. Service providers supported the expansion of naloxone availability, but also identified several intertwined barriers to doing so. Key among these were costs, current regulations and scheduling, availability of prescribers and stigma related to illicit and injecting drug use. Conclusions: Expanding the availability of naloxone is a key component of strategies to reduce harms associated with opioid overdose. Our article provides Australian evidence of the successful operational implementation of peer-to-peer THN delivery within a range of drug primary health services and needle syringe programs. Further research is required to better understand the implications of and impediments to scale-up of this potentially life-saving public health intervention. [ABSTRACT FROM AUTHOR]

Background: While survey data can provide information on alcohol products favoured by those who drink to intoxication, it is more difficult to get information on what they drink when they are consuming at a level which places them at high risk of harm. Objectives: To use complementary quantitative and qualitative data to investigate what young risky drinkers drink, and what they drink when they are drinking heavily. Methods: Three thousand, two hundred and twenty-six respondents aged 18–24 from the Australian state of Victoria answered questions in the Victorian youth alcohol and drug survey on their drinking habits and usual drinking choice. Sixty qualitative interviews were also conducted with Victorian 18–24-year olds. In each study, regular drinkers to acute intoxication (RDAIs), those who drank more than 10 Australian standard drinks in a session and drank to the point of forgetting afterwards, were compared to those who did not meet both of these criteria. Results: RDAIs were more likely to drink beer, cask wine, spirits and ready to drink spirits; however, they also consumed more drink types than non-RDAIs. Qualitative interviews highlighted spirits, particularly shots, as a popular drink of choice when intoxication was the aim and or/outcome. Conclusion: Young people appear to prefer spirits when intending to get drunk, however, there is also evidence to show that RDAIs will drink whatever is to hand. Motives behind drink choice for RDAIs include the value for money, where the value is gauged by the amount of alcohol per drink or by the speed of intoxication. [ABSTRACT FROM AUTHOR]

Despite the predominantly masculine nature of drinking cultures within Australian community sporting clubs, masculinities have received little attention in the associated research and policy arenas. Focusing on the Good Sports Program, which is designed to change the drinking culture of sporting clubs, this article presents a case study of drinking cultures in a football club. My analysis of interview and field observation material traces interrelations between Program interventions, demographic and social changes, gender hierarchies, drinking settings and norms governing alcohol consumption within the club. I demonstrate that the changes in the drinking culture of the clubrooms have occurred, and that the Good Sports Program played a role in this change. However, “bad behaviour”, “drink” and “trouble” remain features of other club settings. I conclude that opportunities exist for further engagements with masculinities, and the socio-material networks that hold them in place, and that these engagements might open the way for more significant changes in the drinking cultures of male sporting clubs. [ABSTRACT FROM PUBLISHER]

Aims: Positioned by work of normalisation researchers, this article examines how “recreational” styles of drug use were negotiated by young adults in relation to emerging “adult” identities.Methods: Ethnographic fieldwork was conducted in Perth, Western Australia. This involved 18 months of field observations within a network of approximately 60 non-service-engaged 18–31 year olds among whom amphetamine-type stimulant use was a common activity and 25 in-depth interviews with a sub-sample (average age, 25 years) who used illicit drugs at least monthly.Findings: While most participants began to “age out” of drug use by their mid-twenties, the process was uneven and individualised. Some did not perceive a need to “quit” using drugs at all. While health and wellbeing and work-related responsibilities informed decisions by many to use less frequently of “quit”, negotiation of non-stigmatised and “normal” identities – especially among friends and partners – appeared to most strongly inform decision-making.Conclusions: Values associated with “ageing out” of illicit drug use are more nuanced and contested than have been depicted within typical accounts of “normalised” drug use. This study found that they are complicated by uncertain and protracted transitions into adulthood in contemporary society but also by the continued stigmatisation of drug users. [ABSTRACT FROM PUBLISHER]

In recent years, several studies have suggested that the use of performance and image enhancing drugs via injection is increasing in Australia, with anabolic steroids appearing to be the most commonly used of these drugs. Traditionally the domain of elite athletes and recreational bodybuilders, steroid use may be extending to other groups, including adolescents, gym attendees, professionals and students. Like other forms of injecting drug use, steroid injecting can allow transmission of blood-borne viruses, especially hepatitis C, but little is known about how steroid injecting takes place and how such transmission might occur. Crucially, Australia’s existing harm reduction framework appears ill-equipped to deal with this emerging trend, and is underprepared to meet the challenges that it may pose. In this commentary, we outline key areas where more research into steroid use in Australia is needed. Improved understandings of the practices and experiences of individuals, who inject steroids, and the possibilities for targeted harm reduction responses, are needed if Australia is to respond to the increase in steroid use effectively. [ABSTRACT FROM PUBLISHER]

Expansion of Needle and Syringe Programs (NSPs) to non-specialised sites requires an NSP workforce with skills in engaging stakeholders who may have different opinions of NSP. This study examined the strategies used by NSP workers to develop and maintain NSP services and the emotional labour involved in performing this work. Qualitative interviews were undertaken with 12 staff of a NSP network in metropolitan Sydney, Australia. Participants had undertaken a range of activities to expand NSP sites, often in unwelcoming environments in which NSP was viewed as a “cowboy” service. Participants’ strategies included building positive, ongoing inter-group contact, being visible in external services, and maintaining their professionalism to promote NSP as a legitimate service and themselves as legitimate health workers. Some participants employed strategies which were at odds with their personal and professional values. Participants relied on cohesion within the NSP team to support and encourage each other. Dealing with external services to establish and maintain NSPs was a source of significant emotional labour for NSP workers and was grounded in the stigma attached to injecting drug use. NSP policies and procedures should account for this additional work undertaken by NSP staff and leadership is required to address stigmatisation of NSPs. [ABSTRACT FROM PUBLISHER]

Aims:Workforce entry is a key transition period. It offers an ideal, but under-utilised opportunity to implement intervention strategies to prevent mental health and substance use problems among young people. A brief psychological wellbeing and substance use intervention targeting a high-risk group – apprentice chefs – was undertaken to explore this opportunity.Method:A RCT design (N = 71) was used. The intervention group received two face-to-face sessions, and controls received five related information sheets during the first 2 weeks of training, with 4-month follow-up.Results:These apprentices were a high-risk group for alcohol and other drug harm and poor psychological wellbeing. At T1, 70% of the participants had AUDIT scores indicating problem drinking; 28% had used cannabis and 18% had used amphetamines in the last 12 months; and 24% had high K10 scores. At T2, the intervention group had significantly reduced risky alcohol use (p = 0.008), improved psychological distress (p = 0.045) and ability to talk with supervisors about work issues (p = 0.001) and cope with work stress (p = 0.001) and verbal abuse (p = 0.005), compared to the control group.Conclusions:Brief tailored interventions, delivered in an occupational training environment, have potential to reduce substance use risk and enhance young workers’ psychological wellbeing. [ABSTRACT FROM PUBLISHER]

Aims: This article describes the characteristics and attendance patterns of clients of a co-located fixed-site needle and syringe program (NSP) and syringe vending machine (SVM) to assess the utilisation and benefits of providing access to multiple distribution services. Methods: Data were collected through cross-sectional surveys with a convenience sample of NSP ( n = 98) and SVM ( n = 91) recruited attendees in Sydney, Australia. Surveys collected demographic data, self-reported injecting patterns, self-reported receptive equipment sharing, knowledge of hepatitis C and utilisation of the fixed-site NSP and SVM services. Findings: The demographic profile and characteristics of these NSP and SVM groups were similar; no differences were evident in knowledge about hepatitis C risk practices or type of drug used, frequency of injecting, sharing of injecting equipment and place of injecting. Both fixed-site NSP- and SVM-recruited attendees primarily accessed equipment from the fixed-site NSP in the last month. The SVM was usually accessed outside the opening hours of the fixed-site NSP, between 8 pm and 4 am, or in circumstances where equipment could not be obtained from the NSP. Conclusions: Findings support the argument that SVMs act as a complementary service alongside fixed-site NSP services and indicate that providing 24-h access to syringes through multiple mechanisms has benefits for provision of sterile equipment to people who inject drugs. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to investigate whether there is heterogeneity of opinion about drug policies amongst people with different experiences of drug use, so as to stimulate discussion about how the diverse perspectives of people who use drugs can be meaningfully included in policy deliberation. Methods: The views of people who inject drugs were compared with the views of people who regularly use 3,4-methylendioxymethamphetamine (MDMA), using data obtained from two Australian surveys (the Ecstasy and Related Drugs Reporting System and the Illicit Drug Reporting System). Support for drug-related policies (including treatment, harm reduction and drug legalisation) was examined using questions from the National Drug Strategy Household Survey. The extent to which demographic variables and/or drug use experience accounted for differences of opinion amongst the two samples was also explored. Findings: There were significant differences between the views of IDRS and EDRS participants, about legalisation, and a range of harm reduction and treatment interventions. The heterogeneity in support for the legalisation of different drugs could be accounted for by recent experience of use, over and above demographic differences between people who inject drugs and people who regularly use MDMA. Conclusions: These findings speak to the diversity of attitudes and experiences amongst people who use drugs, and reinforce the need to better represent a diversity of opinion in drug policy deliberation and challenge stereotypical perceptions which stigmatise people who use drugs. [ABSTRACT FROM AUTHOR]

Aims: The purpose of this article is to review community-based evaluations of street drinking bans, with a view to understanding the effectiveness of these laws in reducing alcohol-related harm and benefiting the community. Methods: Sixteen evaluations across 13 locations (in the UK, New Zealand and Australia) were identified. Nine themes were drawn out of the content and thematic analysis. Findings: Street drinking bans often: (1) negatively impact marginalized groups; (2) result in displacement; (3) improve perceptions of safety; (4) are enforced inconsistently; (5) improve perceptions of environment/amenity; and (6) are supported by police, traders and older people. It is unclear whether street drinking bans: (7) reduce public drinking; (8) reduce alcohol-related crime or harm; and (9) are understood and adhered to. Conclusions: There is no evidence that street drinking bans reduce alcohol-related harm or benefit the community in the other ways (aside from perceptions of safety and improvement to amenity). However, the methodological limitations of the evaluations reviewed make it difficult to draw conclusions about the effectiveness or otherwise of street drinking bans. More rigorous evaluations of the effectiveness and impacts of street drinking laws need to be undertaken given their continued proliferation across Australia and other Western countries. [ABSTRACT FROM AUTHOR]

Aim: This pilot study investigated what alcohol prevention benefits could be achieved by a harm reduction focused school drug education intervention that addressed all drug use, both licit and illicit. Method: The study population comprised a cohort of 225 students in three intervention secondary schools and 93 students in a matched control school in Victoria, Australia. A classroom drug education programme, derived from evidence of effective practice and designed to reduce alcohol and other drug harm, was provided to the intervention students during years eight (13-14 year olds) and nine (14-15 year olds) by teachers trained in its delivery. The control students received the drug education programme normally provided by their school. Findings: The students, who received the intervention, were more knowledgeable about drug use issues, communicated more with their parents about alcohol, drank less, got drunk less, and experienced fewer alcohol related harms. They also remembered receiving more alcohol lessons. They were, however, no less likely to have tried alcohol. Conclusions: The findings are consistent with other studies that have demonstrated school alcohol education that focuses on harm reduction can be effective in reducing consumption, risk and harm. In this study, this was achieved even though the students were not persuaded against taking up drinking, and the intervention did not focus solely on alcohol. These findings have implications for both the goals and coverage of future school drug education programmes. [ABSTRACT FROM AUTHOR]

Aim: This study explored the motivations behind illicit tobacco use in Australia. A key focus was to investigate the hypothesis that the primary motivation for illicit tobacco use is its low cost in comparison to the price of legal tobacco. Methods: An Australian tobacco usage telephone survey was conducted in 2007. Illicit tobacco smokers completed a longer version of the questionnaire, with questions relating to illicit tobacco usage and perceptions. Findings: Of the current smokers of illicit tobacco surveyed, almost half would consider increasing illicit tobacco consumption if the cost of legal tobacco were to increase to four times the price of illicit tobacco, although others stated consumption would remain the same regardless of such a price change. Almost all former smokers of illicit tobacco claimed that price did not influence the decision to stop smoking illicit tobacco. Conclusions: Some illicit tobacco smokers appear to be sensitive to the price of tobacco products, but price is not always an underlying motivator. Personal preference and supply also influence illicit tobacco consumption. The findings suggest that reducing the availability of illicit tobacco would be a useful strategy for combating the growing illicit tobacco problem. [ABSTRACT FROM AUTHOR]

Dutch drug policy has received a great deal of attention all over the world and many have judged this policy to be (too) liberal and (too) tolerant. This article describes the highlights in The Netherlands with regard to the use of illegal drugs and the use of tobacco and alcohol, the policies towards these substances, recent discussions and expected changes in the near future. A tendency towards a more repressive policy can be detected. Rational arguments do not seem to play the dominant role in the public acceptance of a substance, nor in regard to the public acceptance of possible policy options. [ABSTRACT FROM AUTHOR]

Aim: Perspectives on rural alcohol and other drug (AOD) service provision were explored. Methods: A mixed methods approach included a document review, service monitoring data, regional group fora with AOD and other health providers (109), semi-structured interviews with stakeholders from health, policy and research (53), and interviews with rural AOD services users (21). Findings: Alcohol is the main drug used by people in rural Victoria, followed by cannabis and then heroin. Services are allocated within a unit cost funding model and distributed on a regional or statewide basis. AOD treatment is dominated by outpatient therapy, outreach and rural withdrawal. Pharmacotherapy and residential rehabilitation are in short supply. Distance, stigma, and confidentiality concerns are barriers to treatment. Recruiting and retaining workers is difficult. The system continues to develop; secondary consultations and networking strategies increase capacity in other care systems. Hospital involvement in AOD treatment varies according to other health demands. Conclusions: Many aspects of the rural AOD service provider's role enhance service delivery by extending reach and capacity. This occurs through AOD models, such as outreach, as well as strategies for working with other systems that include networking and secondary consultation. While there is task diffusion beyond traditional understandings of AOD treatment, the service delivery role may be understood as specialist in its own right. Recognition of this role as specialist may support staff recruitment and retention, while building potential for career pathways. [ABSTRACT FROM AUTHOR]

Aims: This study investigates the knowledge and attitudes towards alcohol related harm minimization initiatives in Kalgoorlie-Boulder, Western Australia, as part of a community project aimed at reducing harms associated with excessive drinking. Methods: Baseline data were collected from a stratified, community sample, using a purpose designed instrument. The community's readiness was determined by interviewing key stakeholders and community leaders, using the ‘Readiness for Change’ interview instrument. Findings: There were substantial levels of binge drinking accompanied by low awareness of alcohol as a local problem and lack of knowledge about interventions that are currently operating in the community. Support for measures designed to reduce problems associated with excessive use of alcohol was polarized. Community readiness to tackle alcohol related issues was low indicating a need for awareness raising. Conclusions: These findings are critical to informing the development of interventions to ensure they are tailored to this community's needs and abilities. Since knowledge and awareness of alcohol related issues are low in Kalgoorlie-Boulder, the first step in changing community attitudes is to create greater awareness of these issues and their consequences, and provide information on potential interventions to address the current problems. [ABSTRACT FROM AUTHOR]

Many parents support the ‘supervised introduction’ of alcohol to children. While initiation to regular alcohol consumption in early adolescence has been linked with alcohol-related problems in adult life, the findings from these studies cannot be extrapolated to early childhood. The definition of initiation to alcohol in early childhood is often not reliable and there is a dearth of research regarding the impact of the broader social and cultural context where initiation may occur. Whilst parents need to be supported to make decisions that are informed by ‘evidence’, policymakers need to be mindful of the role of ideology in policy development and the potential differences in risk factors for initiation to alcohol and the misuse of alcohol. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the effect of restricting hours of sale for take-away alcohol, container sizes for beverages linked to risky consumption and advertising and promotion of certain high-strength beverages on community attitudes, consumption and proxy measures of related harm in a small remote community with high levels of problematic use. Methods: Community surveys were undertaken in the intervention community and an adjacent control community immediately prior to the introduction of the mandated restrictions and again 12 months later. Pre and post interviews were conducted with key informants in the intervention community at approximately the same times. Serial consumption and proxy harm data were collected from both intervention and control communities and changes measured over the period that voluntary and then mandatory restrictions were introduced. Findings: There was recognition of a substantial community alcohol problem. This was accompanied by good knowledge of, and support for, the nominated restrictions prior to their mandated introduction. Subsequently, there was little opposition to their ongoing operation. Consumption of the most problematic beverage, cask wine, has reduced. Proxy measures of alcohol harm: night-time hospital accident and emergency occasions of service; trauma-related ambulance call outs; and police-attended disturbances, also declined. Much of this change was associated with earlier, voluntary restrictions. Conclusions: The restrictions have had a beneficial effect, but most of this occurred prior to their mandated introduction. Continuing to mandate compliance is, however, important because it validates community action, crystallizes structural change and provides a basis for further local initiatives. [ABSTRACT FROM AUTHOR]

Approximately 10% of the global population is left-handed. Much research has been directed at handedness and health, with reports of left-handers suffering higher rates of numerous health conditions, accidents, injuries and ultimately, significantly reduced lifespans. Most previous research focused on 'well' or general-population samples; no previous investigations of the effects of handedness on injecting drug users' (IDUs) health are known. Aim: To investigate associations between handedness and health outcomes among IDUs-a marginalized population subgroup with significantly worse health than average. Methods: A total of 346 self-identified left- (9.5%) or right-handed current IDUs were recruited in the Australian states of Queensland, New South Wales and Victoria in late 2006 and interviewed about their health and behaviour. Findings: Many socio-demographic, health status and injury occurrence variables were evaluated univariately, but only two were significantly associated with handedness. Left-handers were significantly less likely to report recent scarring or bruising, and significantly more likely to report accidentally penetrating an artery; these variables were also significantly and independently associated (negatively and positively, respectively) with handedness in binary logistic regression. Conclusions: The lack of biological plausibility of the aforementioned variables' associations with handedness, and the contradiction in their directions of association, suggest that left-handedness among IDUs is not associated with significantly worse health outcomes. [ABSTRACT FROM AUTHOR]

Aims: There are currently 39,000 people on methadone or buprenorphine treatment in Australia, representing approximately one third of the opioid-dependent population. An educational DVD, entitled Access All Areas, was developed to inform, attract and engage opioid-dependent drug users into treatment, with a view to increasing users' understanding of the benefits and risks of treatment and factors impacting the way treatment is delivered. Methods: A pilot evaluation of the draft DVD was conducted with 99 opioid users recruited from two public opioid treatment clinics and four Needle Syringe Programs (NSP). Participants viewed a 1-hour segment of the DVD and completed a pre- and post-test knowledge questionnaire, and an evaluation questionnaire. Findings: After viewing the DVD, the majority of participants had a 'better understanding of the benefits of treatment' (95%), and were 'more likely to ask about hepatitis C treatment' (69%). Among participants not on opioid treatment, 37% were 'more interested in the idea of treatment' after viewing the DVD. The mean number of correct responses to knowledge questions increased marginally after viewing the DVD (14/28 vs. 15/28; p <.05). However, there were considerable increases in the proportion of participants who responded correctly to questions regarding pregnancy and opioids, the dental effects of methadone, and hepatitis. Conclusions: This study provides preliminary evidence of the benefits of this educational resource to people with opioid dependence. Future research is planned evaluating the DVD in a controlled trial exploring treatment engagement, retention, and other outcomes. [ABSTRACT FROM AUTHOR]

Aims: Although mental-health problems are common among drug-treatment consumers, little is known about how mental health is discussed by service providers or understood by clients within treatment settings. We analysed how co-occurring drug and mental-health problems are discussed in Australian drug-treatment settings, particularly clinical terminology such as 'comorbidity' or 'dual diagnosis'. Method: 77 drug-treatment clients with common psychological problems (anxiety or depression) and 18 service providers were interviewed about barriers and incentives to treatment for co-occurring drug and mental-health problems. Findings: Consumers had low levels of understanding of clinical terminology for co-occurring drug and mental-health problems, except for those who had accessed literature or participated in programs developed by drug-user organizations. Service providers recognized low levels of consumer mental-health literacy, and advocated a client-centred approach that avoided the use of clinical terminology. Conclusions: Providers should encourage consumers to discuss mental-health problems, and should not avoid using clinical terminology as this may undermine the development of mental-health literacy among consumers. Treatment services may benefit from working with drug-user organizations to develop resources aimed at improving awareness and understanding of mental-health problems among drug-treatment consumers. [ABSTRACT FROM AUTHOR]

As negative employee attitudes towards alcohol and other drug (AOD) policies may have serious consequences for organizations, the present study examined demographic and attitudinal dimensions leading to employees' perceptions of AOD policy effectiveness. Survey responses were obtained from 147 employees in an Australian agricultural organization. Three dimensions of attitudes towards AOD policies were examined: knowledge of policy features, attitudes towards testing, and preventative measures such as job design and organizational involvement in community health. Demographic differences were identified, with males and blue-collar employees reporting significantly more negative attitudes towards the AOD policy. Attitude dimensions were stronger predictors of perceptions of policy effectiveness than demographics, and the strongest predictor was preventative measures. This suggests that organizations should do more than design adequate and fair AOD policies, and take a more holistic approach to AOD impairment by engaging in workplace design to reduce AOD use and promote a consistent health message to employees and the community. [ABSTRACT FROM AUTHOR]

Unlike health policy in the United Kingdom, Australian health policy does not provide a strong endorsement for the involvement of service users in the design, delivery and evaluation of drug treatment services. There has been no research into service-users’ views on the contentious issue of methadone takeaway doses. This study explores the value of takeaway doses from service-users’ perspectives and highlights the contributions that service-user involvement can make to further drug treatment planning, delivery and evaluation. Twenty-five methadone clients were interviewed about the value of methadone takeaway doses. Benefits cited by participants included convenience, less travel and lower costs, protection of confidentiality and less restriction on employment as well as less tangible issues related to feelings of ‘normality’ and flexibility in daily life patterns. Feeling trusted as a methadone client was also an important result of accessing takeaway doses. The inclusion of service-user perspectives is important for ensuring that services are not wrongly targeted and that evaluations of those services do not underestimate or misrepresent their value to clients. This is particularly important in policy around illicit drug use where public and political opinion is often a key driver in decision making. [ABSTRACT FROM AUTHOR]

Aims: To ascertain service providers’ views on barriers and incentives to illicit drug users accessing or remaining in treatment. Methods: Interviews with service providers in Australia were conducted. Results: Two main themes were explored. Service providers suggested that the perception of a person seeking treatment was strongly associated with the image of that person as deficient, defective or lacking, and that this could impede treatment. Service providers also suggested that differing treatment philosophies and their related treatment goals were at the core of many barriers to treatment. We argue that it is important to find a balance between a model of treatment which works and is responsive to clients’ needs while also avoiding the potential for feeding stigma of those who seek treatment for drug dependence. Conclusion: Our results suggest that knowledge and understanding of treatment philosophies are important for people seeking treatment so that clients can find services that match their needs and treatment goals. [ABSTRACT FROM AUTHOR]

Aims: To assess (1) the alcohol and other drug (AOD) consumption patterns of adolescent new entrants to the Australian workforce and (2) the association between these consumption patterns and workplace factors. Methods: A cross-sectional survey of 300 first-year apprentices (aged 15–22 years) employed in South Australian workplaces was conducted. Findings: More than 40% of apprentices surveyed reported cannabis and alcohol consumption patterns that placed them at risk of potential harm. In addition, 19% reported drinking alcohol and 6.7% reported using cannabis during work-related hours. Workplace alcohol availability and the existence of workplace AOD policies were significantly associated with apprentices’ consumption patterns. Apprentices employed in workplaces where alcohol was available used alcohol more often than those reporting no alcohol availability at work. Apprentices reporting an alcohol policy at their workplace reported less alcohol use compared to apprentices reporting no policy. Apprentices reporting a drug policy at their workplace reported lower levels of cannabis and alcohol use compared to those reporting no policy. Conclusions: Workplace factors, in particular workplace AOD policies, were significantly associated with adolescent AOD use both at and away from the workplace. These findings indicate that the workplace has potential as a setting for prevention strategies design to minimize AOD-related harms. [ABSTRACT FROM AUTHOR]

The aim of the study was to investigate the antecedents of community satisfaction towards an Australian drug clinic, with the aim of developing a general model of community stakeholder satisfaction that may apply to other clinics. A structured survey was administered via the telephone and face to face with 490 community stakeholders including residents, businesses and other health and community service providers. Multilingual interviewers were used because a large percentage of participants were from a non-English-speaking background. Community stakeholder satisfaction was found to correlate positively with variables such as stakeholder's perception of the importance of services, understanding of community needs, contribution to community, usefulness of communication, and staff skill. The antecedents related to quality of service, rather than to knowledge of the clinic, showed consistently stronger correlations with overall satisfaction. Stakeholders were least aware of the clinic's services that were rated the most important and given the highest satisfaction scores. It is concluded that regular surveying of community attitudes helps a clinic to modify its services to meet the needs of its community more accurately. Surveying can also provide early warning of growing problems that may, if left unresolved, impede future survival or growth of the clinic. [ABSTRACT FROM AUTHOR]

In Australia, even though there are liquor laws that make it amongst other things, illegal to sell alcohol to persons under 18 years of age and to intoxicated persons, the research shows that there is not a high level of compliance with these laws. This study investigated police reports of enforcement of liquor laws in rural and urban Australia by surveying 270 rural and 336 urban operational police officers. The results showed that police directed most enforcement at individual drinkers in breach of the law rather than the venue that supplied the alcohol. Only 18% of rural and 14% of urban officers claimed to have enforced a breach by a vendor or licensee, whereas 62% of rural officers compared with 52% of urban officers had enforced a breach by an individual in the past 12 months. The enforcement behaviour of both rural and urban officers was significantly influenced by their self-reported knowledge of the liquor laws. In both locations the officers who were the most likely to enforce vendor or licensee breaches were those who claimed they had a very good knowledge of the liquor laws. Our results were consistent with previous research and indicated the need for policy development and training and the enlistment of community support if there is to be a breakthrough in the area of liquor law enforcement at the point of sale. [ABSTRACT FROM AUTHOR]

Aims: Schools have emerged as a key site for prevention and early intervention strategies for antisocial behaviour. This paper examines teacher perspectives of the scope within their day-to-day practice for the implementation of monitoring and management of student risk status for substance misuse. Methods: Teacher perspectives of early intervention for young secondary school students aged 12-14 are examined. Case studies are presented of five non-metropolitan Australian schools located in a low socioeconomic area. Findings: The study identifies a diverse range of early intervention practice in school settings; reports that teachers are pragmatic in their identification of students at risk, and use an under-theorised construct of engagement to manage risk. A number of tensions centring on the perceived purpose of school emerge when early intervention policy is operationalised in the classroom. Conclusion: The student wellbeing policy currently in use in Victorian schools needs to be refined. These revisions should provide schools with a clear and understandable early intervention framework that allows local translation. Any further policy development should be based on teacher understandings and capacity for early intervention. (Contains 3 tables.)

The article comments on the 2012 British Government's Alcohol Strategy. Topics discussed include the strategy's commitment to introduce a minimum price for alcohol, the possibility that public health will become an objective for the Licensing Act and the other initiatives recognized by the Strategy including bans on multi-buy promotions, the addition of alcohol to the National Health Services (NHS) Health Checks scheme and the recognition of the value of Identification and Brief Advice.