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2. Erratum regarding previously published papers
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- 2021
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3. Call for papers themed collection: “Gendered perspectives on young adults’ alcohol intoxication”
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- 2019
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4. Call for papers special issue: The risk environment in rural areas
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- 2019
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5. Response to the Hammoud et al paper on ‘the new MTV generation’
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Gafos, Mitzy, primary, Chas, Julie, additional, and Pialoux, Gilles, additional
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- 2018
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6. Call for papers: Problematizations in drug use policy, practice and research
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- 2018
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7. Call for Papers Themed Collection Parents and substance use; management of risky parenthood
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- 2017
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8. Call for Paper: Themed Collection: Sexualised drug use: LGBT communities and beyond
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- 2017
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9. Call for Papers Themed Collection Parents and substance use; management of risky parenthood
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- 2017
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10. Call for Paper: Themed Collection: Sexualised drug use: LGBT communities and beyond
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- 2017
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11. Call for Papers
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- 2014
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12. Call for Papers
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- 2014
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13. COVID-19 economic impact payments and opioid overdose deaths
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Jon E, Sprague, Arthur B, Yeh, Qizhen, Lan, Jamie, Vieson, and Maggie, McCorkle
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Analgesics, Opioid ,Opiate Overdose ,Stimulus check ,Health Policy ,Overdose ,Drug policy ,COVID-19 ,Humans ,Medicine (miscellaneous) ,Interrupted Time Series Analysis ,Drug Overdose ,Pandemics ,Research Paper - Abstract
Background Given the global economic recessions mediated by the COVID-19 pandemic and that many countries have implemented direct income support programs, we investigated the timing of the COVID-19 economic impact payments and opioid overdose deaths. Methods A longitudinal, observational study design that included data from the Ohio Department of Health was utilized. Statistical change point analyses were conducted to identify significant changes in weekly number of opioid overdose deaths from January 1 of 2018 to August 1 of 2020. Additional analyses including difference-in-difference, time series tests, interrupted time series regression analysis and Granger causality test were performed. Results A single change point was identified and occurred at week 16, 2020. For 2020, the median opioid overdose deaths numbers for weeks 1–16 and weeks 17–32 were 68.5 and 101, respectively. The opioid overdose deaths numbers from weeks 17–32 of 2020 were significantly higher than those in weeks 1–16 of 2020 and those in 2018 and 2019 (before and after week 16). The interrupted time series regression analysis indicated more than 203 deaths weekly for weeks 17–32 of 2020 compared to all other weeks. The result of the Granger causality test found that the identified change point (week 16 of 2020) directly influenced the increase in opioid overdose deaths in weeks 17–32 of 2020. Conclusion The identified change point may refer to the timing of many factors, not only the economic payments and further research is warranted to investigate the potential relationship between the COVID-19 economic impact payments and overdose deaths.
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- 2022
14. Changes in retrospectively recalled alcohol use pre, during and post alcohol sales prohibition during COVID pandemic in Botswana
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J. Maphisa Maphisa and Kefentse Mosarwane
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Adult ,Male ,Botswana ,Alcohol Drinking ,Health Policy ,COVID-19 ,Medicine (miscellaneous) ,Cross-Sectional Studies ,Drug control ,Humans ,Alcohol prohibition ,Pandemics ,health care economics and organizations ,Retrospective Studies ,Research Paper - Abstract
Background The COVID-19 pandemic has seen the implementation of unprecedented legislation and policy, including drug control measures which in some countries, like Botswana, included a temporary full alcohol sales ban. However, the association of such absolute prohibition of alcohol sales on population drinking, including hazardous drinking, during the COVID-19 period has not yet been determined. This study investigated changes in retrospectively recalled alcohol use and hazardous drinking pre (prior 5th August 2020), during (5th August to 3rd September 2020) and post (after 4th September) the second alcohol sales ban in Botswana. Predictors of hazardous drinking across the three time points were also investigated. Methods An online cross-sectional study involving a convenience sample of 1318 adults with a past 12 months drinking history in Botswana was conducted in October 2020 following a month long alcohol sales prohibition. Participants completed a modified Alcohol Use Disorder Identification Test-Consumption (AUDIT-C) alongside demographic questions. Participants were expected to retrospectively recall their alcohol use pre, during and post the second alcohol sales ban. Results The prevalence of alcohol use among participants with a past 12 months drinking history was 91.7% (95%CI= 90.1–93.1) before the second ban, 62.3% (95%CI= 59.7–64.9) during the second ban, and 90.4% (95%CI= 88.7–91.8) after the ban.. Hazardous drinking temporarily decreased by 30% during the second alcohol sales ban, and rose to the pre-ban levels of about 60% after the ban. Significant predictors of hazardous drinking at any of the three time points (pre, during and post the second ban) were being male (AOR ranging from 1.50 to 2.13 for all time points), earning between P3000-P6000 (AOR= 1.69 prior sales ban), being a student (AOR=0.56 during the sales ban), and being employed (AOR= 1.45 post the sales ban). Conclusion The alcohol sales ban was associated with short-lived changes in alcohol consumption and hazardous drinking thereby likely contributed in providing the anticipated and much needed temporary relief to the health system sought by COVID-19 pandemic measures.
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- 2022
15. Treatment of Hepatitis C virus among people who inject drugs at a syringe service program during the COVID-19 response: The potential role of telehealth, medications for opioid use disorder and minimal demands on patients
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Anishaa Sivakumar, Lynn Madden, Elizabeth DiDomizio, Anthony Eller, Merceditas Villanueva, and Frederick L. Altice
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Male ,SARS-CoV-2 ,Differentiated care models ,Syringes ,Health Policy ,People who inject drugs (PWID) ,COVID-19 ,Medicine (miscellaneous) ,Hepacivirus ,Hepatitis C, Chronic ,Opioid-Related Disorders ,Syringe services programs ,Antiviral Agents ,Hepatitis C ,Telemedicine ,Drug Users ,Pharmaceutical Preparations ,HCV treatment ,Implementation science ,Humans ,Substance Abuse, Intravenous ,Pandemics ,Research Paper ,Medications for opioid use disorder (MOUD) - Abstract
Background Healthcare delivery was disrupted during the COVID-19 pandemic, requiring minimized in-person contact between patients and clinicians. During the pandemic, people with opioid use disorder (OUD) were not only at elevated risk for COVID-19, but had markedly reduced access to treatment for OUD, Hepatitis C virus (HCV) and HIV due to recommended decreased in-person visits. Methods From March 15-June 15, 2020 at the syringe services program (SSP) in New Haven, Connecticut, USA, a differentiated care model evolved with reduced clinical demands on people who inject drugs (PWID) to ensure screening and treatment for HCV, HIV and OUD, with a focus on HCV treatment. This model involved a single, bundled screening, evaluation, testing (SET) and monitoring strategy for all three conditions, minimal in-person visits, followed by tele-health communication between patients, outreach workers and clinicians. In-person visits occurred only during induction onto methadone and phlebotomy at baseline and phlebotomy 12 weeks post-treatment for HCV to measure sustained virological response (SVR). Patients received supportive texts/calls from outreach workers and clinicians. Results Overall, 66 actively injecting PWID, all with OUD, underwent bundled laboratory screening; 35 had chronic HCV infection. Participants were 40 years (mean), mostly white (N = 18) men (N = 28) and 12 were unstably housed. Two were lost to-follow-up and 2 were incarcerated, leaving 31 who started pan-genotypic direct-acting antivirals (DAAs). The mean time from referral to initial phlebotomy and initiation of DAAs was 6.9 and 9.9 days, respectively. Fourteen additional patients were newly started on buprenorphine and 6 started on methadone; three and four, respectively, were on treatment at baseline. Overall, 29 (93.5%) PWID who initiated DAAs achieved SVR; among unstably housed persons the SVR was 83.3%. Conclusions In response to COVID-19, an innovative differentiated care model for PWID at an SSP evolved that included successful co-treatment for HCV, HIV and OUD using a client-centered approach that reduces treatment demands on patients yet supports ongoing access to evidence-based treatments.
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- 2022
16. Trends in cannabis use among U.S. adults amid the COVID-19 pandemic
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Kira E. Riehm, Renee M. Johnson, Elizabeth A. Stuart, Savannah G. Brenneke, Luther G. Kalb, Kayla N. Tormohlen, Ian Schmid, Johannes Thrul, Courtney D. Nordeck, and Emily J. Smail
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Adult ,Coronavirus disease 2019 (COVID-19) ,Population ,Medicine (miscellaneous) ,Context (language use) ,Pandemic ,Humans ,Medicine ,education ,Pandemics ,Cannabis ,education.field_of_study ,biology ,SARS-CoV-2 ,business.industry ,Health Policy ,COVID-19 ,Cannabis use ,biology.organism_classification ,Mental health ,United States ,Marijuana ,Self Report ,Substance use ,business ,Research Paper ,Demography - Abstract
Background The COVID-19 pandemic has had an impact on mental health and alcohol use in the US, however there is little research on its impacts on cannabis use. Considering the role of cannabis as a coping strategy or self-medicating behavior, there is a need to understand how individuals who use cannabis have adapted their use amid the pandemic. Therefore, this study examined changes in self-reported cannabis use among US adults in the context of COVID-19 pandemic by (1) describing trends of use during the first 8 months of the pandemic among adults who used cannabis in this period; and (2) characterizing trends of use within sociodemographic subgroups and by state cannabis policy status. Methods The sample consisted of 1,761 US adults who used cannabis at least once during the 8-month study period from the nationally representative Understanding America Study. Linear mixed-effect models were used to model changes in the number of days of past-week cannabis use across 16 waves from March 10, 2020, to November 11, 2020. Results Compared to early March, the number of days cannabis was used per week was significantly higher at the start of April (β=0.11, 95% CI=0.03, 0.18) and May (β=0.21,95% CI=0.05, 0.36). In subsequent months (June - November), the number of days of cannabis use attenuated to levels comparable to March. Trends of cannabis use across the study period generally did not differ across sociodemographic characteristics and state cannabis policy status. Conclusion Though increases in use were marginal among many groups, the evolving pandemic and the growing concern for the mental health of segments of the U.S. population warrant close monitoring of coping behaviors, including substance use.
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- 2022
17. Reprint of: The regulation project: Tools for engaging the public in the legal regulation of drugs
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Emily Amirkhani, Dan Werb, Donald MacPherson, and Scott E. Bernstein
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Canada ,media_common.quotation_subject ,030508 substance abuse ,Medicine (miscellaneous) ,Stakeholder engagement ,ComputingMilieux_LEGALASPECTSOFCOMPUTING ,Context (language use) ,Education ,03 medical and health sciences ,0302 clinical medicine ,Order (exchange) ,Knowledge translation ,Drug policy ,030212 general & internal medicine ,media_common ,Government ,business.industry ,Health Policy ,Legal regulation ,Stakeholder ,Public relations ,Focus group ,Regulatory systems ,Negotiation ,0305 other medical science ,business ,Research Paper - Abstract
Lack of legal regulation and oversight of scheduled drugs in Canada has led to an unsafe drug supply responsible for the deaths of tens of thousands. In addition to contributing to the worst unregulated drug poisoning crisis in Canada's history, the policy framework prohibiting non-medical access to certain drugs has exacerbated numerous public health and safety concerns. An alternative approach to prohibition is for government to retake control of the currently illegal drug market through legal regulatory mechanisms. This paper presents the work of an ongoing international collaboration of organizations advocating legal regulation and some of the knowledge translation tools used to educate and engage the public on legal regulation within Canada. In order to encourage thinking and decision-making among stakeholders in a productive way, models of legal regulation for various substances were created as discussion tools to emerge values and considerations supporting different approaches. The models focus on five questions: 1) who has access to drugs; 2) how access is obtained; 3) where drugs can be accessed; 4) how much people can obtain; and 5) where drugs can be consumed. The models were presented to stakeholders in the context of an international meeting on legal regulation, and then adapted to a more “user-friendly” form: a collaborative negotiation-based Regulation Game, which was presented at a workshop in Montreal, Canada. Engaging different stakeholder groups on policy choices of legal regulation revealed initial barriers that we feel more confident can be overcome through creative and innovative tools such as the Regulation Game. Use of the game as a foundation for more traditional focus groups could be effective in reducing barriers to fulsome policy discussions on legal regulation.
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- 2021
18. How can communities influence alcohol licensing at a local level? Licensing officers’ perspectives of the barriers and facilitators to sustaining engagement in a volunteer-led alcohol harm reduction approach
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Frank de Vocht, Penny A. Cook, Suzanne Audrey, Elizabeth J. Burns, Cathy Ure, Mira Hidajat, Margaret Coffey, Kate Ardern, Sue Hare, and Suzy C. Hargreaves
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Volunteers ,medicine.medical_specialty ,CICA, Communities in Charge of Alcohol ,Medicine (miscellaneous) ,Context (language use) ,HN ,LA(s), local authorities ,HT ,Politics ,RA(s), responsible authorities ,Harm Reduction ,RA0421 ,Statutory law ,JS ,medicine ,Humans ,GM, Greater Manchester ,Harm reduction ,Community engagement ,business.industry ,Health Policy ,Public health ,AHC(s), alcohol health champions ,Public relations ,Harm ,England ,Licensing ,Local government ,ABCD, asset-based community development ,Public Health ,Alcohol ,Qualitative ,business ,Licensure ,Research Paper - Abstract
Despite the World Health Organization’s assertion that communities need to become involved in\ud reducing alcohol harm, evidence of community engagement in alcohol licensing decision-making in\ud England remains limited. The evaluation of the Communities in Charge of Alcohol (CICA)\ud programme offers policymakers, Licensing Authorities and public health practitioners, evidence\ud regarding a specific volunteer-led, place-based approach designed to enable community engagement\ud in licensing with the aim of reducing localised alcohol harm. The study explored factors affecting the\ud sustainable involvement of volunteers in alcohol licensing decision-making from six Licensing\ud Officers' perspectives, through semi-structured interviews. Routinely collected crime, disorder, and\ud hospital admissions data were reviewed for further context as proxies for alcohol-related harm.\ud Licensing Officers perceived sustainable engagement to be impacted by: (i) the extent of alignment\ud with statutory requirements and local political support; (ii) the ability of Licensing Officers to\ud operationalise CICA and support local assets, and; (iii) the opportunity for, and ability of, volunteers\ud to raise licensing issues. The perspectives of Licensing Officers indicate complexities inherent in\ud seeking to empower residents to engage in licensing decision-making at a community level. These\ud relate to statutory and political factors, funding, social norms regarding engagement in licensing\ud decision-making, and the need for networks between critical actors including Responsible Authorities\ud and communities. The evidence indicates that after increasing community capacity to influence\ud alcohol availability decision-making at local level, communities continue to struggle to influence\ud statutory processes to affect alcohol availability where they live and work. More understanding of\ud how to enable effective community engagement is required.
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- 2021
19. Stability in a large drug treatment system: Examining the role of program size and performance on service discontinuation
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Daniel L. Howard, Thomas D'Aunno, Abdullah Alibrahim, Erick G. Guerrero, and Shinyi Wu
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medicine.medical_specialty ,Population ,030508 substance abuse ,Medicine (miscellaneous) ,03 medical and health sciences ,Drug treatment ,0302 clinical medicine ,Negatively associated ,medicine ,Humans ,030212 general & internal medicine ,education ,Service (business) ,education.field_of_study ,business.industry ,Health Policy ,Public health ,United States ,Wait time ,Discontinuation ,Hospitalization ,Pharmaceutical Preparations ,Female ,0305 other medical science ,business ,Research Paper ,Demography ,Methadone ,medicine.drug - Abstract
Background Little is known about the stability of public drug treatment in the United States to deliver services in an era of expansion of public insurance. Guided by organizational theories, we examined the role of program size, and performance (i.e., rates of treatment initiation and engagement) on discontinuing services in one of the largest treatment systems in the United States. Methods This study relied on multi-year (2006–2014) administrative data of 249,029 treatment admission episodes from 482 treatment programs in Los Angeles County, CA. We relied on survival regression analysis to identify associations between program size, treatment initiation (wait time) and engagement (retention and completion rates) and discontinuing services in any given year. We examined program differences between discontinued versus sustained services in pre- and post-expansion periods. Results Sixty-two percent of programs discontinued services at some point between 2006 and 2014. Program size and rates of treatment retention were negatively associated with risk of discontinuing services. Proportion of female clients was also negatively associated with risk of discontinuing services. Compared to residential programs, methadone programs were associated with reduced likelihood of discontinuing services. Two interactions were significant; program size and retention rates, as well as program size and completion rates were negatively associated with risk of discontinuing services. Conclusions Program size (large), type (methadone), performance (retention) and client population (women) were associated with stability in this drug treatment system. Because more than 70% of programs in this system are small, it is critical to support their capacity to sustain services to reduce existing disparities in access to care. We discuss the implications of these findings for system evaluation and for responding to public health crises.
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- 2020
20. Positive effects of community attachment on internalised stigma and wellbeing among people who inject drugs
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Brener, Loren, Broady, Timothy, Cama, Elena, Hopwood, Max, Byrne, Jude, and Treloar, Carla
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- 2021
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21. Reprint of: Why Vietnam continues to impose the death penalty for drug offences: A narrative commentary
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Luong, Hai Thanh
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- 2021
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22. Increased risk of HIV and other drug-related harms associated with injecting in public places: national bio-behavioural survey of people who inject drugs
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Catriona Milosevic, Norah Palmateer, Kirsten M.A. Trayner, Rory Gunson, Saket Priyadarshi, Emily J Tweed, Samantha J. Shepherd, Sharon J. Hutchinson, Andrew McAuley, and David J. Goldberg
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Adult ,Male ,Drug ,media_common.quotation_subject ,Human immunodeficiency virus (HIV) ,030508 substance abuse ,Medicine (miscellaneous) ,HIV Infections ,Logistic regression ,medicine.disease_cause ,Drug Users ,Drug-related harms ,03 medical and health sciences ,Risk-Taking ,0302 clinical medicine ,Risk Factors ,Surveys and Questionnaires ,Environmental health ,Prevalence ,Humans ,Medicine ,030212 general & internal medicine ,Substance Abuse, Intravenous ,media_common ,Population Density ,Harm reduction ,Risk behaviour ,Public injecting ,business.industry ,Public place ,Health Policy ,HIV ,Outbreak ,Cross-Sectional Studies ,Increased risk ,Scotland ,Female ,0305 other medical science ,business ,People who inject drugs ,Research Paper - Abstract
Background:\ud Whilst injecting drugs in public places is considered a proxy for high risk behaviour among people who inject drugs (PWID), studies quantifying its relationship with multiple drug-related harms are lacking and none have examined this in the context of an ongoing HIV outbreak (located in Glasgow, Scotland). We aimed to: 1) estimate the prevalence of public injecting in Scotland and associated risk factors; and 2) estimate the association between public injecting and HIV, current HCV, overdose, and skin and soft tissue infections (SSTI).\ud \ud Methods:\ud Cross-sectional, bio-behavioural survey (including dried blood spot testing to determine HIV and HCV infection) of 1469 current PWID (injected in last 6 months) recruited by independent interviewers from 139 harm reduction services across Scotland during 2017–18. Primary outcomes were: injecting in a public place (yes/no); HIV infection; current HCV infection; self-reported overdose in the last year (yes/no) and SSTI the last year (yes/no). Multi-variable logistic regression was used to determine factors associated with public injecting and to estimate the association between public injecting and drug-related harms (HIV, current HCV, overdose and SSTI).\ud \ud Results:\ud Prevalence of public injecting was 16% overall in Scotland and 47% in Glasgow city centre. Factors associated with increased odds of public injecting were: recruitment in Glasgow city centre (aOR=5.45, 95% CI 3.48–8.54, p
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- 2020
23. Why Vietnam continues to impose the death penalty for drug offences: A narrative commentary
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Luong, Hai Thanh
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- 2021
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24. Rethinking ‘flexibilities’ in the international drug control system—Potential, precedents and models for reforms
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Collins, John
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- 2018
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25. Effects of strength of relationship ties in recovery homes: A conundrum
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Jason, Leonard A., Light, John M., Bobak, Ted, and Bell, Justin
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- 2024
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26. Reducing alcohol harms whilst minimising impact on hospitality businesses: 'Sweetspot' policy options.
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Fitzgerald, Niamh, O'Donnell, Rachel, Uny, Isabelle, Martin, Jack G., Cook, Megan, Graham, Kathryn, Stockwell, Tim, Hughes, Karen, Wilkinson, Claire, McGill, Elizabeth, Miller, Peter G., Reynolds, Jo, Quigg, Zara, and Angus, Colin
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VIOLENCE prevention , *ALCOHOLIC beverages , *RESTAURANTS , *LOBBYING , *HEALTH policy , *DESCRIPTIVE statistics , *BUSINESS , *HARM reduction , *ALCOHOL drinking , *COVID-19 pandemic - Abstract
• Alcohol policies that protect public health do not necessarily harm bars. • 'Sweetspot' policies are those which can improve public health without affecting hospitality businesses. • There is good evidence that increasing the price of shop-bought alcohol is a sweetspot policy. • Restricting remote/online alcohol sales is also a likely sweetspot policy. • Measures to shape or manage the night-time economy are less well supported by evidence. During COVID-19, hospitality businesses (e.g. bars, restaurants) were closed/restricted whilst off-sales of alcohol increased, with health consequences. Post-covid, governments face lobbying to support such businesses, but many health services remain under pressure. We appraised 'sweetspot' policy options: those with potential to benefit public services and health, whilst avoiding or minimising negative impact on the hospitality sector. We conducted rapid non-systematic evidence reviews using index papers, citation searches and team knowledge to summarise the literature relating to four possible 'sweetspot' policy areas: pricing interventions (9 systematic reviews (SR); 14 papers/reports); regulation of online sales (1 SR; 1 paper); place-shaping (2 SRs; 18 papers/reports); and violence reduction initiatives (9 SRs; 24 papers/reports); and led two expert workshops (n = 11). Interventions that raise the price of cheaper shop-bought alcohol appear promising as 'sweetspot' policies; any impact on hospitality is likely small and potentially positive. Restrictions on online sales such as speed or timing of delivery may reduce harm and diversion of consumption from on-trade to home settings. Place-shaping is not well-supported by evidence and experts were sceptical. Reduced late-night trading hours likely reduce violence; evidence of impact on hospitality is scant. Other violence reduction initiatives may modestly reduce harms whilst supporting hospitality, but require resources to deliver multiple measures simultaneously in partnership. Available evidence and expert views point to regulation of pricing and online sales as having greatest potential as 'sweetspot' alcohol policies, reducing alcohol harm whilst minimising negative impact on hospitality businesses. [ABSTRACT FROM AUTHOR]
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- 2024
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27. Towards a social harm approach in drug policy.
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Dertadian, George Christopher and Askew, Rebecca
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DRUG control , *POLICY sciences , *GOVERNMENT policy , *SCHOLARLY method , *SOCIAL justice , *CRIMINOLOGY , *HARM reduction , *PUNISHMENT , *CRIMINAL justice system , *ONTOLOGIES (Information retrieval) - Abstract
In this paper, we explore how the social harm approach can be adapted within drug policy scholarship. Since the mid-2000s, a group of critical criminologists have moved beyond the concept of crime and criminology, towards the study of social harm. This turn proceeds decades of research that highlights the inequities within the criminal legal system, the formation of laws that protect the privileged and punish the disadvantaged, and the systemic challenge of the effectiveness of retribution and punishment at addressing harm in the community. The purpose of this paper is to first identify parallels between the social harm approach and critical drug scholarship, and second to advocate for the adoption of a social harm lens in drug policy scholarship. In the paper, we draw out the similarities between social harm and drug policy literatures, as well as outline what the study of social harm can bring to an analysis of drug policy. This includes a discussion on the ontology of drug crime, the myth of drug crime and the ineffective use of the crime control system in response to drug use. The paper then discusses how these conversations in critical criminology and critical drugs scholarship can be brought together to inform future drug policy research. This reflection details the link between social harm and the impingement of human flourishing, explores the role of decolonizing drug policy, advocates for the centralization of lived experience within the research process and outlines how this might align with harm reduction approaches. We conclude by arguing that the social harm approach challenges the idea that neutrality is the goal in drug policy and explicitly seeks to expand new avenues in activist research and social justice approaches to policymaking. [ABSTRACT FROM AUTHOR]
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- 2024
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28. How is alcohol consumption and heavy episodic drinking spread across different types of drinking occasion in Great Britain: An event-level latent class analysis.
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Holmes, John, Sasso, Alessandro, Hernández Alava, Mónica, Borges Neves, Rita, Stevely, Abigail K, Warde, Alan, and Meier, Petra S
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CROSS-sectional method , *ALCOHOLIC beverages , *STRUCTURAL equation modeling , *DISEASE prevalence , *DESCRIPTIVE statistics , *HOME environment , *ALCOHOL drinking , *ALCOHOLISM - Abstract
• Latent class analyses identify 15 types of drinking in Great Britain in 2019. • Alcohol consumption varies substantially across types of occasion. • Occasions that span the off-trade and on-trade involve particularly heavy drinking. • Heavy drinking is common across most occasion types, but so is moderate drinking. • Most heavy drinking takes place in off-trade only drinking occasions. This paper aimed to (i) update a previous typology of British alcohol drinking occasions using a more recent and expanded dataset and revised modelling procedure, and (ii) estimate the average consumption level, prevalence of heavy drinking, and distribution of all alcohol consumption and heavy drinking within and across occasion types. The paper uses a cross-sectional latent class analysis of event-level diary data that includes characteristics of 43,089 drinking occasions in 2019 reported by 17,821 adult drinkers in Great Britain. The latent class indicators are characteristics of off-trade only (e.g. home), on-trade only (e.g. bar) and mixed trade (e.g. home and bar) drinking occasions. These describe companions, locations, purpose, motivation, accompanying activities, timings, consumption volume in units (1 UK unit = 8g ethanol) and beverages consumed. The analysis identified four off-trade only, eight on-trade only and three mixed-trade occasion types (i.e. latent classes). Mean consumption per occasion varied between 4.4 units in Family meals to 17.7 units in Big nights out with pre-loading. It exceeded ten units in all mixed-trade occasion types and in Off-trade get togethers, Big nights out and Male friends at the pub. Three off-trade types accounted for 50.8% of all alcohol consumed and 51.8% of heavy drinking occasions: Quiet drink at home alone, Evening at home with partner and Off-trade get togethers. For thirteen out of fifteen occasion types, more than 25% of occasions involved heavy drinking. Conversely, 41.7% of Big nights out and 16.4% of Big nights out with preloading were not heavy drinking occasions. Alcohol consumption varies substantially across and within fifteen types of drinking occasion in Great Britain. Heavy drinking is common in most occasion types. However, moderate drinking is also common in occasion types often characterised as heavy drinking practices. Mixed-trade drinking occasions are particularly likely to involve heavy drinking. [ABSTRACT FROM AUTHOR]
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- 2024
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29. The role of gifts in building influence with politicians: Thematic analysis of interviews with current and former parliamentarians.
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Rodriguez, Ara Marie Leal, Adams, Peter J., Sayes, Edwin, and Kypri, Kypros
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INTERVIEWING , *QUESTIONNAIRES , *SOCIAL attitudes , *THEMATIC analysis , *RESEARCH methodology , *INTERPERSONAL relations , *GIFT giving , *PARLIAMENTARY practice - Abstract
Gifts are a powerful way to acknowledge and strengthen interpersonal relationships. As with any relational space, gifting plays various roles in forming and maintaining relationships in political contexts, but its contribution to relationship-building has attracted little attention. This paper examines how politicians in Aotearoa New Zealand both engage with gifting and how they navigate the perceptions of others. Four current members of parliament (MPs) and six retired MPs participated in semi-structured interviews with questions on common practices and common understandings about political gifting. Their responses indicate their use of four different processes: formal processes are the guidelines provided by the government on gifting, but when these are insufficient, contextual processes regarding perceptions of the media, constituents or colleagues are used, or, alternatively, MPs rely on personal values or view gifting in terms of transactional processes with both parties receiving benefits. The paper explores perceptions and complexities of a sequence of gifts during events (event gifting). The authors recommend an improved awareness and understanding of the contribution of gifting practices to political relationship building. [ABSTRACT FROM AUTHOR]
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- 2024
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30. A social cost perspective in the wake of the Portuguese strategy for the fight against drugs
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Gonçalves, Ricardo, Lourenço, Ana, and Silva, Sofia Nogueira da
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- 2015
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31. “Maintaining HIV and HCV prevention and care for people who inject drugs despite COVID‐19 in Hai Phong, Vietnam”
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Giang, Hoang Thi, Duc, Nguyen Quang, Molès, Jean-Pierre, Vinh, Vu Hai, Nagot, Nicolas, Thanh, Nham Thi Tuyet, Huong, Duong Thi, Oanh, Khuat Thi Hai, Khue, Pham Minh, Mai, Le Sao, Trang, Nguyen Thu, Ngoc, Pham Thi, Quillet, Catherine, Feelemyer, Jonathan, Vallo, Roselyne, Michel, Laurent, Jarlais, Don Des, Laureillard, Didier, and Rapoud, Delphine
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- 2022
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32. The estimated costs and benefits of a hypothetical supervised consumption site in Providence, Rhode Island
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Chambers, Laura C., Hallowell, Benjamin D., Zang, Xiao, Rind, David M., Guzauskas, Greg F., Hansen, Ryan N., Fuchs, Nathaniel, Scagos, Rachel P., and Marshall, Brandon D.L.
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- 2022
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33. Antisocial behavior in football matches: Do changes in alcohol sales policy increase violent acts?
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da Silva Dantas, Marke Geisy, Sampaio, Luciano Menezes Bezerra, and Gasparetto, Thadeu
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SOCCER fans , *DELINQUENT behavior , *RISK of violence , *ALCOHOLIC beverages , *RISK assessment , *GOVERNMENT policy , *DESCRIPTIVE statistics , *SPORTS events , *ANTISOCIAL personality disorders , *LOGISTIC regression analysis , *POLICY sciences - Abstract
Background: The violent behavior of football fans is constantly associated with their drinking habits. Aiming to reduce its impact, policy makers often ban the sales and consumption of alcohol beverages during matches. Nonetheless, there are few papers that empirically analyzed such relationship, and our paper aims to shed light on this question. Methods: Out dataset comprises 4,560 matches from the first and second tiers of the Brazilian League, where 245 exhibited at least one antisocial behavior from fans. Ordered logistic regressions are used as method. Results: Our empirical findings evidence that the sales of alcoholic drinks do increase the likelihood of severe antisocial behavior. We also observed a higher likelihood of violent cases when the home club loses its match as well as during crowded matches. Conclusions: We conclude that the change in the alcohol police in Brazil did show a significant association with the likelihood of antisocial behavior among football fans. However, since the magnitude of such effect is small, further research is needed to examine the potential benefits of this policy change. [ABSTRACT FROM AUTHOR]
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- 2024
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34. "It's a big added stress on top of being so ill": The challenges facing people prescribed cannabis in the UK.
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Beckett Wilson, Helen and Metcalf McGrath, Lindsey
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HEALTH services accessibility , *CAREGIVERS , *RESEARCH methodology , *INTERVIEWING , *SOCIAL stigma , *PATIENTS' attitudes , *QUALITATIVE research , *MEDICAL marijuana , *DRUGS , *THEMATIC analysis , *POLICY sciences , *THERAPEUTICS - Abstract
• UK law changed in 2018 to permit cannabis prescribing. Cannabis remains otherwise criminalised. Participants experienced benefits from cannabis across a broad range of conditions. • Most people who need a cannabis prescription in the UK still cannot access one. • Poor implementation of cannabis prescribing policy creates heath inequalities. • Intractable prohibition policy context continues to create social harms. This paper reports on the first qualitative study to interview people prescribed cannabis in the UK. Cannabis is a class B controlled substance under the 1971 Misuse of Drugs (MoD) Act, but a 2018 change to UK regulations provided for the prescription of cannabis for medical purposes. Relatively few people have been able to access a prescription, despite this policy change. This paper examines their experiences. Qualitative, semi-structured interviews were conducted with 24 people with a prescription for cannabis, or their carers. Data was analysed using a reflextive thematic analysis approach. The findings are discussed using a zemiology (social harms) perspective which provides a language for critical reflection on the current cannabis policy context. All participants reported that cannabis had significantly improved their mental and/or physical health, across a broad range of conditions. Many had been able to reduce their use of conventional medicines and reported that cannabis had relatively few side effects. Despite the potentially life-enhancing benefits of cannabis medicine, patients in the UK face multiple barriers to access. These include a lack of funding streams, bureaucratic supply problems, and a lack of training for doctors and police. Even for the few people able to obtain a prescription, the ongoing criminalisation of cannabis in the UK contributed to their experiences of stigmatisation. This often made it difficult and anxiety-inducing to take their medicine in public spaces. The UK government's lack of implementation of medical cannabis legalisation, combined with their ongoing prohibition position, is producing multiple harms to people who need cannabis medicine. The policy context is perpetuating stigmatising attitudes to cannabis which, as we demonstrate, contribute to social harms. We make recommendations on equality of patient access, and highlight the importance of education and policy change as means of combatting stigma. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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35. Synthetic cannabinoid use in an adult male prison in the UK.
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Craft, Sam, Austin, Alice, Tooth, Tom, Glover, Catherine, Garrett, Tina, Blagbrough, Ian S, Sunderland, Peter, Pudney, Christopher R, and Freeman, Tom P
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SUBSTANCE abuse , *PRISONERS , *MOTIVATION (Psychology) , *MEN , *SYNTHETIC drugs , *COMPARATIVE studies , *DRUG laws , *QUESTIONNAIRES , *DESCRIPTIVE statistics , *CANNABINOIDS , *SOCIODEMOGRAPHIC factors , *BRIEF Symptom Inventory , *PSYCHOLOGICAL distress - Abstract
Synthetic cannabinoids (i.e. Spice) are a major public health problem in UK prisons, however, research in this area is limited. Here we aimed to draw comparisons between people with and without experience of using synthetic cannabinoids in prison, to characterise the features of, and motivations for use within this setting and evaluate support for different treatment interventions. Questionnaires were administered to 122 people in a category-B prison for adult males in England between July 2022 and March 2023. Participants were asked questions related to their sociodemographic and custodial characteristics, use of synthetic cannabinoids (and other drugs) inside and outside of prison and psychological distress was measured via the Brief Symptom Inventory (BSI-18). Those that had ever used synthetic cannabinoids in prison completed additional questions related to features of use, motivations for use and support for various interventions. In total 46.7 % (n = 57) of participants reported use of synthetic cannabinoids in prison and this group experienced significantly greater levels of psychological distress compared to those reporting no use (mean (± standard deviation) BSI-18 scores = 23.7 (±16.7) vs 12.8 (±13.6), p < 0.001). Participants mostly reported using paper-based preparations (77.4 %) and use via e-cigarettes (75.9 %). The most strongly endorsed motivations for use included to alleviate boredom (91.1 % strongly agree/agree), to make the sentence pass faster (89.3 % strongly agree/agree) and to cope with stress (80.4 % strongly agree/agree). The interventions that received most support were strategies to better manage time and medication to manage withdrawal. The use of synthetic cannabinoids in UK prisons typically involves the use of paper-based preparations via e-cigarettes, and use is associated with greater levels of psychological distress. Motivations for use were mostly pragmatic (e.g. to alleviate boredom or cope with stress) and interventions should prioritise increasing the time individuals spend out of cells and in meaningful activity. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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36. The movement and translation of drug policy ideas: The case of 'new recovery'.
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Thomas, Natalie, Bull, Melissa, Dioso-Villa, Rachel, and Smith, Kate
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PHARMACEUTICAL policy , *NONGOVERNMENTAL organizations , *BUSINESSPEOPLE , *ALCOHOL drinking , *PHARMACEUTICAL industry - Abstract
Introduction: 'New recovery' can be conceptualised as both a social movement and a broader policy agenda to restructure treatment service systems towards 'recovery-oriented systems of care'. Emerging initially out of the United States, new recovery has gained currency as a policy agenda in other jurisdictions - perhaps most distinctly in the United Kingdom. In 2012, the ideas behind 'new recovery' were debated in the Australian alcohol and other drug field as the Victorian government sought to incorporate recovery principles into policy and service design. This paper uses the policy transfer and policy translation literature to understand how international policy ideas about 'new recovery' were negotiated in the Australian context, focusing specifically on the role of non-government actors in the process.Methods: This paper draws on an analysis of policy documents, organisational documents and interviews with representatives from the Australian non-government alcohol and other drug sector to consider how new recovery was translated into Victorian drug policy.Results: The interactions between organisations and actors - including bureaucrats, governmental agencies and policy entrepreneurs - facilitated the circulation and translation of policy ideas in the Victorian context. Despite this, the analysis suggests that policy transfer was largely a symbolic exercise: overall, some of the key features of new recovery policy from the United States and the United Kingdom, such as encouraging peer-led recovery and mutual aid, were not incorporated in the Victorian policy. NGOs resisted what they considered to be some of the more problematic elements of 'new recovery', and informed the local translation of the policy.Discussion: The results have implications for understandings of the relationship between social movements, non-government organisations and the state, as well as the dynamics of knowledge transfer in drug policy. [ABSTRACT FROM AUTHOR]- Published
- 2019
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37. Should we smoke it for you as well? An ethnographic analysis of a drug cryptomarket environment.
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Kowalski, Michala, Hooker, Claire, and Barratt, Monica J.
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CRYPTOMARKETS , *ETHNOGRAPHIC analysis , *SELF-reliance , *LIMINALITY , *SEMI-structured interviews - Abstract
Why aren't cryptomarkets more widely used? Researchers from a wide array of fields have attempted to answer this question by studying the size of drug cryptomarkets, the substances trafficked, and their structure. In this paper we address the potential acceptance of drug cryptomarkets by studying their perceived ease of use. This paper draws on observational data collected over 350 h of unstructured observation during an ethnographic study conducted in April–September 2016 of the two most prominent drug cryptomarkets at the time, in addition to seven face-to-face semi-structured qualitative interviews. Use of cryptomarkets relies on specialised knowledge. The administrators of the cryptomarkets do not play a publicly visible role in facilitating or easing cryptomarket use while simultaneously expecting cryptomarket users to exhibit self-reliance. We argue that the current levels of complexity and obfuscation constructed in the cryptomarket environment act as a barrier to the widespread acceptance of this technology. Through studying cryptomarkets' potential for widespread use we have shed light on current barriers to their growth requirement of specialised knowledge in order to use cryptomarkets and no public efforts to bridge the knowledge gap on behalf of cryptomarket administrators. As cryptomarkets continue to develop the ease of use of these platforms are bound to change, and with them the likelihood that cryptomarket usage may increase. [ABSTRACT FROM AUTHOR]
- Published
- 2019
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38. The opioid crisis and the infrastructure of social capital.
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Sered, Susan Starr
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OPIOID abuse , *SOCIAL capital , *CULTURAL capital , *PUBLIC health - Abstract
This paper reflects upon ethnographic work carried out in a suburban Massachusetts town that has experienced particularly high rates of opioid mis/use. In open-ended conversations, residents attributed the local opioid crisis to institutional betrayals of various sorts. Building upon the idea that social capital tends to be health-enhancing, this paper traces the decline in the infrastructure of social capital and the associated decline in cultural capital or scripts for making sense out of life's challenges. [ABSTRACT FROM AUTHOR]
- Published
- 2019
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39. "I don't want to introduce it into new places in my life": The marketing and consumption of no and low alcohol drinks.
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Nicholls, Emily
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DEBATE , *SOCIAL change , *TEMPERANCE , *ALCOHOL drinking , *DRINKING behavior , *HEALTH promotion - Abstract
Recent years have seen an expanding 'no and low alcohol' (NoLo) drinks market in the United Kingdom and other high-income countries. With the UK government pledging to increase the availability of NoLos and encourage their consumption, further research is required to underpin policy and explore the potential for NoLos to ease – or exacerbate – alcohol-related harm. This paper draws on original primary research on NoLo marketing and consumption in the UK; analysis of two NoLo marketing campaigns and semi-structured interviews with both drinkers and non-drinkers who consume NoLos. Addition marketing was identified in the promotion of NoLo products, encouraging consumers to incorporate NoLo consumption into new spatial and temporal contexts on top of their typical weekly drinking patterns. However, there was resistance towards these practices from consumers, who stressed they were more likely to drink NoLos in place of alcohol and incorporate them into their existing drinking routines. This paper expands a currently very limited evidence base and contributes directly to ongoing debates around 'addition' versus 'substitution' (i.e. whether NoLo products are being used on top of or in place of alcohol). Findings highlight both some of the challenges and opportunities of the expanding market, pointing towards the problematic presence of 'addition marketing' but also highlighting the ways consumers might challenge this and use NoLos flexibly to reduce consumption. As a result, NoLo promotion could function as one tool amongst many to help at least some consumers drink in moderation, alongside a broader package of measures such as education and wider social change. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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40. Is non-medical use normal? Normalisation, medicalisation and pharmaceutical consumption.
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Dertadian, George Christopher
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DRUGS of abuse laws , *SUBSTANCE abuse , *PLEASURE , *RACE , *SOCIOECONOMIC factors , *DRUG utilization , *SOCIAL skills - Abstract
The theory of the normalisation of youth drug use in advanced capitalist societies has had an enduring legacy in contemporary drug scholarship. While the literature on the normalisation of 'illicit' drugs is well developed, less has been written about application of the theory to emerging discourse of pharmaceutical 'abuse', and how this might necessitate different thinking around what can be considered normal consumption. Pharmaceuticals are not directly associated with criminality, and their use does not traditionally attract stigma. In fact, social science scholarship has illustrated how many substances deemed illicit are normalised in the context of an ever-growing set of medical treatments. This paper explores the assumptions about legality, sociality and pleasure which sit behind the drug normalisation thesis, by reflecting on the relevance of drug normalisation in relation to pharmaceuticals, as well as examining scholarship on the medicalisation of society and qualitative research on non-medical use to illustrate the parallel processes of normalisation that apply to pharmaceuticals. The paper argues that questions of normalisation in relation to pharmaceutical use require a deeper engagement with the normative expectations we attach to pleasure, consumption and medicine, and the way this is structured by proximity to medical authority, whiteness and middle-classness. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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41. Political constructions of people who use drugs in the Philippines: A qualitative content analysis.
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Lasco, Gideon
- Abstract
• Various terms were used to refer to people who use drugs during Duterte's drug war. • These terms pervade policy documents, bills, laws, memoranda and other official texts. • Examples include 'drug user', 'drug dependent', 'drug personality', and 'drug abuser'. • All these terms contributed to the problematization of people who use drugs. This paper examines the political constructions of people who use drugs in the Philippines throughout the presidency of Rodrigo Duterte (2016–2022), during which the government engaged in a 'war on drugs' and promoted a punitive drug regime. Building on and drawing inspiration from the global drug policy scholarship that has looked at the ways in which drugs are framed and problematised in various domains, this study used qualitative content analysis to review 96 documents from national government agencies - including strategic action plans, directives, memorandums, guidelines, annual reports, and legislative measures. Foremost, the study finds that various terms were interchangeably used to refer to 'drug users' - dependent, offender, personality, abuser - and all of them contributed to the problematisation of people who use drugs as a societal "menace". As "drug dependents", they were likewise portrayed as necessitating treatment or rehabilitation. Moreover, presented as victims or passive subjects, their agency and subjectivity are not acknowledged in the documents, even as counter-discourses, mainly from opposition lawmakers, challenge these portrayals and call for people-centered, harm reduction approaches. Overall, these overlapping framings cast people who use drugs simultaneously as victims, criminals, deviants, and sick individuals to the detriment of their security, health, and well-being - and to the retrogression of drug policy in the country. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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42. Gendered pleasures, risks and policies: Using a logic of candidacy to explore paradoxical roles of alcohol as a good/poor health behaviour for Australian women early during the pandemic.
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Foley, Kristen, Ward, Paul R., and Lunnay, Belinda
- Abstract
• Investigates relational enactments of gendered alcohol consumption during the pandemic, contrasted with special attention on women as a 'priority population' for alcohol-related harm reduction. • Adopts a gendered approach to understanding the alcohol-harm paradox, the breast cancer paradox, and the risk-pleasure paradox in women's health policies. • Synthesises evidence to construct a burden of proof that problematising women's consumption at an individual level alone has potential to worsen inequities in gendered alcohol-related harms and broader health outcomes. • Showcases how gender-responsive alcohol policy needs to be cross-sectoral and address upstream factors to protect women from alcohol harm. Drinking alcohol facilitates pleasure for women while also elevating disease risk. Symbolic expectations of what alcohol 'does in' life per lay insight (relax, identity-work, connect) sit in tension with scientific realities about what alcohol 'does to' women's bodies (elevate chronic disease risks such as breast cancer). Policy must work amidst – and despite – these paradoxes to reduce harm(s) to women by attending to the gendered and emergent configurations of both realities. This paper applies a logic of candidacy to explore women's alcohol consumption and pleasure through candidacies of wellness in addition to risk through candidacies of disease (e.g. breast cancer). Using qualitative data collected via 56 interviews with Australian women (n = 48) during early pandemic countermeasures, we explore how risk perceptions attached to alcohol (like breast cancer) co-exist with use-values of alcohol in daily life and elucidate alcohol's paradoxical role in women's heuristics of good/poor health behaviours. Women were aged 25–64 years, experienced varying life circumstances (per a multidimensional measure of social class including economic, social and cultural capital) and living conditions (i.e. partnered/single, un/employed, children/no children). We collated coding structures from data within both projects; used deductive inferences to understand alcohol's paradoxical role in candidacies of wellness and disease; abductively explored women's prioritisation of co-existing candidacies during the pandemic; and retroductively theorised prioritisations per evolving pandemic-inflected constructions of alcohol-related gendered risk/s and pleasure/s. Our analysis illuminates the ways alcohol was configured as a pleasure and form of wellness in relation to stress, productivity and respectability. It also demonstrates how gender was relationally enacted amidst the priorities, discourses and materialities enfolding women's lives during the pandemic. We consider the impact of policy regulation of aggressive alcohol marketing and banal availability of alcohol in pandemic environments and outline gender-responsive, multi-level policy options to reduce alcohol harms to women. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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43. Chemsex as lines of flight? Critical Deleuzean perspectives on chemical intimacies.
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Tan, Qian Hui and Tan, Rayner Kay Jin
- Abstract
• In a bid to resist a medical-moralist paradigm dominating public health ideologies, we make a case for understanding chemsex among men in Singapore vis-à-vis Deleuzean lines of flight. • Through a queer deleuzean framing, we illustrate how chemically inflected sexual encounters can offer deterritorialising flights of fantasy and freedom from a heteronormative social structure that stigmatises gay sex, among other normative regimes. • We explored how lines of flight generated by chemsex are dynamic (i.e. they can turn into lines of non-flight) and have to be unpacked contextually (i.e. in relation to unfolding senses of self and the social environment). We have also demonstrated that such deterritorialising flights of freedom can catalyse unplanned outcomes, including the propensity to reterritorialise. • Our analysis has not shied away from incorporating heartfelt anecdotes that perpetuate medico-moral, public health perspectives even as we are committed to a critical-political discussion on chemical-sexual intimacies. • Future research in this arena could potentially investigate the complicated, conflicted and protracted intimate relationships that users may have with their drug(s) of choice, as well as the varied lines of (non-)flight that these chemicals can endow over a longitudinal study. Public health scholars informed by a dominant biomedical paradigm have in their 'rush to risk' emphasised the problematic aspects of chemsex. Meanwhile, critical chemsex scholars have attemped to destigmatise such sexual-chemical practices and foreground how they can be transformative. Taking these two perspectives as points of departure, we make a case for understanding chemsex vis-à-vis Deleuzean lines of flight. Semi-structured in-depth interviews were conducted with 33 purposively sampled sexual minority men seeking therapy for chemsex dependency in Singapore. Interview topics included participants' experiences and histories of chemsex, substance use, and their ongoing recovery. Interviews were audio-recorded, transcribed and then analysed according to key themes. We illustrate how chemically inflected sexual encounters can offer deterritorialising flights of fantasy and freedom from a heteronormative social structure that pathologises gay sex. At the same time, we argue that these flight lines are not static, neither do they extend indefinitely in space-time. Rather, we show how flights of freedom can evolve into lines of fright (or non-flight) when chemsex practitioners are met with critical thresholds that reveal the less-than-desirable aspects of being intoxicated. Consequently, they may eventually consider the reterritorialisation of their lives (i.e. abstinence and recovery) as a more constructive option. Regardless of their decisions to ride on chemically-induced flight lines or to take a step back from such deterritorialising pathways, they have troubled stereotypical perspectives of drug users as passive automatons. This paper enriches the chemsex scholarship by presenting a Deleuzean conceptualisation of chemical-sexual intimacies without romantacising and/or overstating the 'escape'/'freedom' that chemsex can facilitate. Future research in this arena could explore the complicated intimate relationships that users may have with their drug(s) of choice, and their varied lines of (non-)flight over a longitudinal study. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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44. Development of an evidence-based hepatitis C education program to enhance public health literacy in the Australian prison sector: The Hepatitis in Prisons Education program (HepPEd).
- Author
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Sheehan, Yumi, Lafferty, Lise, Tedla, Nicodemus, Byrne, Marianne, Dawson, Olivia, Stewart, Sami, Leber, Bianca, Habraken, Nikitah, and Lloyd, Andrew R
- Subjects
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HEPATITIS C diagnosis , *EVALUATION of human services programs , *HEPATITIS C treatment , *HEALTH literacy , *JOB involvement , *CORRECTIONAL institutions , *INTERPROFESSIONAL relations , *INTERVIEWING , *AFFINITY groups , *INFORMATION resources , *PRISONERS , *MOTIVATION (Psychology) , *RESEARCH methodology , *HEPATITIS C , *PUBLIC health , *NEEDS assessment , *MEDICAL screening , *COMMITTEES , *TIME , *SOCIAL stigma - Abstract
Australia's prisons have a high chronic hepatitis C (HCV) prevalence (8 %). Antiviral therapies and prison-based hepatitis services are available, but only a minority of those eligible are being treated. Improving the HCV public health literacy of the prison sector via targeted education may overcome key barriers to scale-up treatment. This paper describes the: i) HCV public health literacy of the prison setting; ii) barriers and solutions for HCV education and service engagement; iii) HCV education program co-design and development processes; and iv) HepPEd resources. A national needs assessment was conducted to analyse the HCV public health literacy of the target audience groups in the prisons (healthcare providers; custodial officers; people in prison) to inform development of a prison-specific HCV education program (HepPEd). Structured interviews were conducted with key informants (n = 40). Three National Steering Committees, one for each target group, were convened to co-design and develop HepPEd. Only healthcare providers involved with hepatitis care were considered to have 'good' to 'very good' HCV health literacy (including knowledge, attitudes, and capabilities), with all other groups considered less favourably. Key barriers identified included being time poor (healthcare providers), poor motivation (custodial officers) and stigma (people in prison). Peer education delivery was considered a key facilitator for custodial officers and people in prison. A suite of multi-modal resources addressing the perceived gaps in HCV health literacy was developed, with a broad theme of 'Let's talk about hep C'. Delivery of HepPEd was designed to overcome key barriers and utilise facilitators for each group. Significant gaps in HCV health literacy were perceived amongst the target audience groups. The comprehensive co-design and development processes utilised in HepPEd suggest the program will be well-placed to improve the HCV public health literacy of the prison sector and thereby enhance HCV testing and treatment rates amongst people in prison. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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45. Designing drunkenness: How pubs, bars and nightclubs increase alcohol sales.
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Tutenges, Sébastien and Bøhling, Frederik
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ALCOHOLISM , *NIGHTCLUBS , *ALCOHOLIC beverage sales & prices , *CAPITALISM , *HAPPY hours - Abstract
Using ethnographic data, this paper investigates the techniques used inside pubs, bars and nightclubs to solicit and sustain alcohol consumption among patrons. Focus is on venues with the majority of patrons belonging to the age group of approximately 15-35 years. The paper identifies a number of techniques, both overt and covert, including: alcohol advertising; special offers (e.g. 'Happy Hours' and 'all you can drink' specials); bartenders' use of strategic intimacy, flirtation, and encouragements to buy more; speed drinking devices (e.g. shot glasses, 'beer bongs' and large pitchers); and architectural features that hamper moderate drinking while accelerating the purchase and intake of alcohol. These techniques were used most extensively in low-priced venues with the youngest patrons (e.g. themed chain pubs) and less so in more expensive venues with more adult patrons (e.g. craft beer bars). The paper argues that youth-oriented drinking venues may be conceived as staged atmospheres of consumption where individuals are seduced and compelled into purchasing alcohol. A team of 12 researchers collected the data through interviews and observations in pubs, bars and nightclubs in four cities across Denmark. [ABSTRACT FROM AUTHOR]
- Published
- 2019
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46. Attitudes towards people living with HIV and people who inject drugs: A mixed method study of stigmas within harm reduction programs in Kazakhstan.
- Author
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Stringer, Kristi Lynn, Mukherjee, Trena, McCrimmon, Tara, Terlikbayeva, Assel, Primbetovac, Sholpan, Darisheva, Meruyert, Hunt, Timothy, Gilbert, Louisa, and El-Bassel, Nabila
- Subjects
- *
HIV-positive persons , *INJECTIONS , *MEDICAL care use , *HARM reduction , *SOCIAL norms - Abstract
Background: High levels of stigma towards people who inject drugs (PWID) and people living with HIV (PLWH) exist in Kazakhstan, yet little is known about the role of stigma in harm reduction service settings. In this paper, we use a mixed method design to explore and describe the actionable drivers and facilitators of stigma among harm reduction service providers. Additionally, we describe the manifestations of stigma among PWID who are living with HIV (PWID/LWH), and the impact that stigma has on harm reduction and healthcare service utilization.Methods: Eight focus groups with 57 PWID/LWH were convened between March 2016 and July 2016 to describe manifestations of stigma from the perspective of syringe exchange program (SEP) clients. Additionally, we surveyed 80 nurses, social workers, outreach workers, and providers of HIV care at SEPs between January 2017 and July 2017 to assess stigmatizing attitudes among staff within the SEP environment. Joint displays were used to integrate quantitative and qualitative data.Results: The actionable drivers of stigma identified in this study include negative opinions and moral judgements towards PWID/LWH. Facilitators identified included stigmatization as a social norm within the service provision environment, a lack of awareness of anti-discrimination policies, and lack of enforcement of anti-discrimination policies. Qualitative findings highlight manifestations of stigma in which PWID/LWH experienced denial of services, perceived negative attitudes, and avoidance from service provision staff. PWID/LWH also described segregation in healthcare settings, the use of unnecessary precautions by providers, and unauthorized disclosure of HIV status.Conclusions: This paper highlights the urgent need to address stigma in the harm reduction and HIV service settings in Kazakhstan. These findings have implications for informing an actionable model for stigma reduction for providers who deliver services to PWID/LWH in Kazakhstan. Drivers, facilitators, and manifestations of stigma are multifaceted and addressing them will require a multilevel approach. [ABSTRACT FROM AUTHOR]- Published
- 2019
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- View/download PDF
47. Priorities and recommended actions for how researchers, practitioners, policy makers, and the affected community can work together to improve access to hepatitis C care for people who use drugs.
- Author
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Day, Emma, Broder, Tina, Bruneau, Julie, Cruse, Sally, Dickie, Melisa, Fish, Suzanne, Grillon, Celine, Luhmann, Niklas, Mason, Kate, McLean, Elizabeth, Trooskin, Stacey, Treloar, Carla, and Grebely, Jason
- Subjects
- *
HEPATITIS C , *OPIOIDS , *SEXUAL health , *HARM reduction , *HEALTH equity - Abstract
It is estimated that 6.1 million people with recent injecting drug use (PWID) are living with hepatitis C virus (HCV). Although HCV-related morbidity and mortality among PWID continues to increase, the advent of direct acting antiviral (DAA) HCV regimens with cure rates >95% provides an opportunity to reverse the rising burden of disease. Additionally, given evidence that opioid substitution therapy and high-coverage needle and syringe programs can reduce HCV incidence by up to 80%, there is an opportunity to reduce HCV transmission with increased coverage of harm reduction services. However, there are significant patient, provider, health system, structural, and societal barriers that impede access to HCV prevention and care for PWID. The International Network on Hepatitis in Substance Users (INHSU), in collaboration with the Australasian Society for HIV, Viral Hepatitis, Sexual Health Medicine (ASHM), Harm Reduction International, the Canadian Network on Hepatitis C, Canadian Research Initiative in Substance Misuse, the National Viral Hepatitis Roundtable, Médecins du Monde and CATIE, held a roundtable discussion prior to the Harm Reduction Conference in Montreal, Canada on 13th May 2017 to discuss how to improve HCV prevention and care for PWID. Over 100 international researchers, practitioners, policy makers, advocates, and affected community members came together to discuss shared priorities for action, develop actionable next steps and to create partnerships to enable application of priorities. This paper highlights the key priority areas identified by participants including: enhancing global coverage of harm reduction services; addressing punitive drug policies; ensuring access to affordable HCV diagnostics and treatment; improving the evidence-base for HCV prevention, testing, linkage to care and treatment; implementing integrated HCV programs; advancing peer-based models of HCV care; and tackling social determinants of health inequalities for PWID. This paper also highlights the recommended actions for each priority identified by the participants from this roundtable. [ABSTRACT FROM AUTHOR]
- Published
- 2019
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48. The implementation of overdose prevention sites as a novel and nimble response during an illegal drug overdose public health emergency.
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Wallace, Bruce, Pagan, Flora, and Pauly, Bernadette (Bernie)
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DRUG overdose , *PUBLIC health , *HARM reduction , *DRUG utilization , *LEGISLATION - Abstract
Background: Drug-related overdoses were declared a public health emergency in British Columbia, Canada in April, 2016 facilitating the scale-up of responses including rapid sanctioning and implementation of overdose prevention sites (OPSs). OPSs are a health service providing supervised injection and immediate overdose response. In BC, OPSs were operational within weeks of sanctioning. In the first year of operation over 20 OPSs were established with approximately 550,000 visits and no overdose deaths at any site. In this paper, we examine the implementation of OPSs as a novel and nimble response to prevent overdose deaths as a result of injection drug use.Methods: A multiple case study design was used with the Consolidated Framework for Implementation (CFIR) informing the analysis. Three sites in a single city were included with each site constituting a case. In this paper, we focus on qualitative interviews with 15 staff and their perceptions of the implementation of the OPSs as well as provincial and local documents.Results: The legislative process to implement OPSs was unprecedented as it sanctioned supervised injection services as an extraordinary measure under a declared public health emergency. Innovative and inclusionary practices were possible within state-sanctioned OPSs, as the sites were government-directed yet community-developed, with PWUD centred in service design, implementation and delivery. OPSs lack permanency and may be limited to the duration of the public health emergency.Conclusion: The rapid implementation of OPSs provides an international example of an alternative to lengthy and often onerous sanctioning processes for supervised consumption services (SCSs). Overdose prevention sites provide an example of a novel service design and nimble implementation process that combines the benefits of state-sanctioned injection services with community-driven implementation. Such evidence questions the continued acceptability of governments' restrictive sanctioning processes, which have limited expansion of SCSs internationally and the implementation of services that are not necessarily aligned with the needs of PWUD. [ABSTRACT FROM AUTHOR]- Published
- 2019
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49. Aboriginal alcohol policy and practice in Australia: A case study of unintended consequences.
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d'Abbs, Peter, Burlayn, and Jamijin
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POLICY sciences , *ALCOHOL , *INDIGENOUS Australians , *SOCIOECONOMICS - Abstract
This paper examines attempts by members of a remote Aboriginal community in the Northern Territory (NT), Australia, to control alcohol use, and the impact of policy decisions taken by national, territory and local governments on those attempts between 2007 and 2017. The Australian Government's main policy instrument for reducing alcohol-related harms from 2010 was the Alcohol Management Plan (AMP), officially defined as a plan, negotiated at a local community level with a high level of community input, for the effective management of alcohol use by the local community. The paper shows that the policy as implemented had the unintended consequence of undermining rather than enhancing the capacity of the community to act collectively in managing alcohol, largely as a result of the interactions of four sets of factors: (1) the policies as formulated; (2) actions taken to implement the policies, (3) the responses of those affected by the policies, and (4) the socio-ecological context in which these events occurred. The paper seeks to identify the processes through which these consequences were generated, and the implications for future policy-making, policy implementation and community-level initiatives for managing alcohol in Aboriginal communities. [ABSTRACT FROM AUTHOR]
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- 2019
- Full Text
- View/download PDF
50. Why are young people drinking less than earlier? Identifying and specifying social mechanisms with a pragmatist approach.
- Author
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Törrönen, Jukka, Roumeliotis, Filip, Samuelsson, Eva, Kraus, Ludwig, and Room, Robin
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PRAGMATISM , *ALCOHOL drinking , *SOCIAL media , *LIFESTYLES , *INTERVENTION (Social services) - Abstract
Recent surveys have found a strong decrease in alcohol consumption among young people and this trend has been identified in European countries, Australia and North America. Previous research suggests that the decline in alcohol consumption may be explained by changes in parenting style, increased use of social media, changes in gender identities or a health and fitness trend. We use qualitative interviews with drinking and non-drinking young people from Sweden (N = 49) to explore in what way and in what kinds of contexts these explanations may hold true and how they alone or together may explain declining alcohol consumption among young people. By using the pragmatist approach, we pay attention to what kinds of concerns, habits, practices, situations and meanings our interviewees relate to adolescents' low alcohol consumption or decline in drinking. By analyzing these matters, we aim to specify the social mechanisms that have reduced adolescents' drinking. Our paper discovers social mechanisms similar to previous studies but also a few that have previously been overlooked. We propose that the cultural position of drinking may have changed among young people so that drinking has lost its unquestioned symbolic power as a rite of passage into adulthood. There is less peer pressure to drink and more room for competing activities. This opening of a homogeneous drinking culture to the acceptance of differences may function as a social mechanism that increases the success of other social mechanisms to reduce adolescents' drinking. Furthermore, the results of the paper suggest a hypothesis of the early maturation of young people as more individualized, responsible, reflective, and adult-like actors than in earlier generations. Overall, the paper provides hypotheses for future quantitative studies to examine the prevalence and distribution of the identified social mechanisms, as well as recommends directions for developing effective interventions to support young people's healthy lifestyle choices. [ABSTRACT FROM AUTHOR]
- Published
- 2019
- Full Text
- View/download PDF
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