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8. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010

Author

Lim, Stephen S, Vos, Theo, Flaxman, Abraham D, Danaei, Goodarz, Shibuya, Kenji, Adair-Rohani, Heather, AlMazroa, Mohammad A, Amann, Markus, Anderson, H Ross, Andrews, Kathryn G, Aryee, Martin, Atkinson, Charles, Bacchus, Loraine J, Bahalim, Adil N, Balakrishnan, Kalpana, Balmes, John, Barker-Collo, Suzanne, Baxter, Amanda, Bell, Michelle L, Blore, Jed D, Blyth, Fiona, Bonner, Carissa, Borges, Guilherme, Bourne, Rupert, Boussinesq, Michel, Brauer, Michael, Brooks, Peter, Bruce, Nigel G, Brunekreef, Bert, Bryan-Hancock, Claire, Bucello, Chiara, Buchbinder, Rachelle, Bull, Fiona, Burnett, Richard T, Byers, Tim E, Calabria, Bianca, Carapetis, Jonathan, Carnahan, Emily, Chafe, Zoe, Charlson, Fiona, Chen, Honglei, Chen, Jian Shen, Cheng, Andrew Tai-Ann, Child, Jennifer Christine, Cohen, Aaron, Colson, K Ellicott, Cowie, Benjamin C, Darby, Sarah, Darling, Susan, Davis, Adrian, Degenhardt, Louisa, Dentener, Frank, Des Jarlais, Don C, Devries, Karen, Dherani, Mukesh, Ding, Eric L, Dorsey, E Ray, Driscoll, Tim, Edmond, Karen, Ali, Suad Eltahir, Engell, Rebecca E, Erwin, Patricia J, Fahimi, Saman, Falder, Gail, Farzadfar, Farshad, Ferrari, Alize, Finucane, Mariel M, Flaxman, Seth, Fowkes, Francis Gerry R, Freedman, Greg, Freeman, Michael K, Gakidou, Emmanuela, Ghosh, Santu, Giovannucci, Edward, Gmel, Gerhard, Graham, Kathryn, Grainger, Rebecca, Grant, Bridget, Gunnell, David, Gutierrez, Hialy R, Hall, Wayne, Hoek, Hans W, Hogan, Anthony, Hosgood, H Dean, III, Hoy, Damian, Hu, Howard, Hubbell, Bryan J, Hutchings, Sally J, Ibeanusi, Sydney E, Jacklyn, Gemma L, Jasrasaria, Rashmi, Jonas, Jost B, Kan, Haidong, Kanis, John A, Kassebaum, Nicholas, Kawakami, Norito, Khang, Young-Ho, Khatibzadeh, Shahab, Khoo, Jon-Paul, Kok, Cindy, Laden, Francine, Lalloo, Ratilal, Lan, Qing, Lathlean, Tim, Leasher, Janet L, Leigh, James, Li, Yang, Lin, John Kent, Lipshultz, Steven E, London, Stephanie, Lozano, Rafael, Lu, Yuan, Mak, Joelle, Malekzadeh, Reza, Mallinger, Leslie, Marcenes, Wagner, March, Lyn, Marks, Robin, Martin, Randall, McGale, Paul, McGrath, John, Mehta, Sumi, Memish, Ziad A, Mensah, George A, Merriman, Tony R, Micha, Renata, Michaud, Catherine, Mishra, Vinod, Hanafiah, Khayriyyah Mohd, Mokdad, Ali A, Morawska, Lidia, Mozaffarian, Dariush, Murphy, Tasha, Naghavi, Mohsen, Neal, Bruce, Nelson, Paul K, Nolla, Joan Miquel, Norman, Rosana, Olives, Casey, Omer, Saad B, Orchard, Jessica, Osborne, Richard, Ostro, Bart, Page, Andrew, Pandey, Kiran D, Parry, Charles DH, Passmore, Erin, Patra, Jayadeep, Pearce, Neil, Pelizzari, Pamela M, Petzold, Max, Phillips, Michael R, Pope, Dan, Pope, C Arden, III, Powles, John, Rao, Mayuree, Razavi, Homie, Rehfuess, Eva A, Rehm, Jürgen T, Ritz, Beate, Rivara, Frederick P, Roberts, Thomas, Robinson, Carolyn, Rodriguez-Portales, Jose A, Romieu, Isabelle, Room, Robin, Rosenfeld, Lisa C, Roy, Ananya, Rushton, Lesley, Salomon, Joshua A, Sampson, Uchechukwu, Sanchez-Riera, Lidia, Sanman, Ella, Sapkota, Amir, Seedat, Soraya, Shi, Peilin, Shield, Kevin, Shivakoti, Rupak, Singh, Gitanjali M, Sleet, David A, Smith, Emma, Smith, Kirk R, Stapelberg, Nicolas JC, Steenland, Kyle, Stöckl, Heidi, Stovner, Lars Jacob, Straif, Kurt, Straney, Lahn, Thurston, George D, Tran, Jimmy H, Van Dingenen, Rita, van Donkelaar, Aaron, Veerman, J Lennert, Vijayakumar, Lakshmi, Weintraub, Robert, Weissman, Myrna M, White, Richard A, Whiteford, Harvey, Wiersma, Steven T, Wilkinson, James D, Williams, Hywel C, Williams, Warwick, Wilson, Nicholas, Woolf, Anthony D, Yip, Paul, Zielinski, Jan M, Lopez, Alan D, Murray, Christopher JL, and Ezzati, Majid

Published
2012
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18. Toronto drug treatment court: participant intake characteristics as predictors of 'successful' program completion

Author

Newton-Taylor, Brenda, Patra, Jayadeep, and Gliksman, Louis

Subjects
Drug addicts -- Care and treatment, Drug addicts -- Comparative analysis, Drug abuse -- Care and treatment, Drug abuse -- Management, Company business management, Law, Psychology and mental health, Sociology and social work
Abstract

Through descriptive and multivariate analyses, program outcomes for three groups of Toronto Drug Treatment Court participants (TDTC) were compared focusing on their substance use. legal, and socioeconomic differences at entry into the program, and their compliance behaviors during the first month of the program. Multivariate analyses demonstrated that graduate and expelled non-engaged participants were significantly different from the moment they started the program. At the time of application to the program expelled non-engaged participants used crack/cocaine on more days in the prior 90-day period, were in custody at their first TDTC appearance, had more criminal convictions over their lifetime, reported more recent substance use, and committed more breaches of their bail conditions than the other two participant groups. However, differences between graduate and expelled-engaged participants were not as clear, indicating important program outcome similarities between the two groups and how drug treatment court success should be conceptualized and measured.

Published
2009

19. Predictors of methadone maintenance treatment utilization in a multisite cohort of illicit opioid users (OPICAN)

Author

Fischer, Benedikt, Cruz, Michelle Firestone, Patra, Jayadeep, and Rehm, Jurgen

Subjects
Methadone maintenance -- Research, Health
Abstract

Although methadone maintenance treatment (MMT) has been a primary treatment response to illicit opioid use in Canada for decades, analytical treatment data are scarce. Using data from the multisite OPICAN cohort of illicit opioid and other drug users repeatedly assessed between 2002 (baseline) and 2005 (last follow-up [FU]), we (1) longitudinally examined characteristics associated with MMT uptake between baseline and FU and (2) cross-sectionally compared drug use patterns between cohort participants in MMT (n = 133) and those not in MMT (n = 400) at the last FU through bivariate and multivariate analyses (stepwise logistic regression). Significant baseline predictors of MMT uptake emerging in the logistic regression model included injection drug, heroin, as well as alcohol use, housing status, and Quebec City as a site. Furthermore, lower prevalence levels of opioid (e.g., morphine and OxyContin) and nonopioid (e.g., cocaine and crack) drug use as well as lower frequency of heroin use days were observed among MMT users. This study highlights potential factors relevant for improved MMT uptake and illustrates possible reductions of drug use related to MMT. Keywords: Methadone maintenance treatment (MMT); Canada; Opioid use; Alcohol; Treatment uptake; Housing; Epidemiology

Published
2008

22. The costs of alcohol, illegal drugs, and tobacco in Canada, 2002 *

Author

Rehm, Jurgen, Gnam, William, Popova, Svetlana, Baliunas, Dolly, Brochu, Serge, Fischer, Benedikt, Patra, Jayadeep, Sarnocinska-Hart, Anna, and Taylor, Benjamin

Subjects
Substance abuse -- Prevention -- Health aspects -- Economic aspects -- Social aspects, Health, Psychology and mental health, Prevention, Economic aspects, Social aspects, Health aspects
Abstract

Objective: The aim of this study was to estimate costs attributable to substance use and misuse in Canada in 2002. Method: Based on information about prevalence of exposure and risk relations for more than 80 disease categories, deaths, years of life lost, and hospitalizations attributable to substance use and misuse were estimated. In addition, substance-attributable fractions for criminal justice expenditures were derived. Indirect costs were estimated using a modified human capital approach. Results: Costs of substance use and misuse totaled almost Can. $40 billion in 2002. The total cost per capita for substance use and misuse was about Can. $1,267: Can. $463 for alcohol, Can. $262 for illegal drugs, and Can. $541 for tobacco. Legal substances accounted for the vast majority of these costs (tobacco: almost 43% of total costs; alcohol: 37%). Indirect costs or productivity losses were the largest cost category (61%), followed by health care (22%) and law enforcement costs (14%). More than 40,000 people died in Canada in 2002 because of substance use and misuse: 37,209 deaths were attributable to tobacco, 4,258 were attributable to alcohol, and 1,695 were attributable to illegal drugs. A total of about 3.8 million hospital days were attributable to substance use and misuse, again mainly to tobacco. Conclusions: Substance use and misuse imposes a considerable economic toll on Canadian society and requires more preventive efforts. (J. Stud. Alcohol Drugs 68: 886-895, 2007), THE BURDEN AND COST OF SUBSTANCE USE and misuse in established market economies is enormous (Anderson and Baumberg, 2006; Andlin-Sobocki and Rehm, 2005; Collins and Lapsley, 2002; Ezzati et al., [...]

Published
2007

23. Alcohol-attributable morbidity and resulting health care costs in Canada in 2002: recommendations for policy and prevention *

Author

Taylor, Benjamin, Rehm, Jurgen, Patra, Jayadeep, Popova, Svetlana, and Baliunas, Dolly

Subjects
Medical care, Cost of -- Observations -- Economic aspects -- Health aspects -- Research -- Political aspects -- 2002 AD, Drinking of alcoholic beverages -- Influence -- Political aspects -- Economic aspects -- Health aspects -- Research -- 2002 AD, Morbidity -- Risk factors -- Research -- 2002 AD, Alcohol-related disorders -- Research -- Risk factors -- 2002 AD, Health, Psychology and mental health, Influence, Observations, Economic aspects, Political aspects, Research, Risk factors, Health aspects
Abstract

Objective: Alcohol is one of the most important risk factors for burden of disease, particularly in high-income countries such as Canada. The purpose of this article was to estimate the number of hospitalizations, hospital days, and the resulting costs attributable to alcohol for Canada in 2002. Method: Exposure distribution was taken from the Canadian Addiction Survey and corrected for per capita consumption from production and sales. For chronic disease, risk relations were taken from the published literature and combined with exposure to calculate age- and gender-specific alcohol-attributable fractions. For injury, alcohol-attributable fractions were taken directly from available statistics. Data on the most responsible diagnosis, length of stay for hospitalizations, and costs were obtained from the national Canadian databases. Results: For Canada in 2002, there were 195,970 alcohol-related diagnoses among acute care hospitalizations, 2,058 alcohol-attributable psychiatric hospitalizations, and 183,589 alcohol-attributable admissions to specialized treatment centers. These accounted for 1,246,945 hospital days in acute care facilities, 54,114 hospital days in psychiatric hospitals, and 3,018,688 hospital days in specialized treatment centers (inpatient and outpatient). The main causes of alcohol-attributable morbidity were neuropsychiatric conditions, cardiovascular disease, and unintentional injuries. In total, Can. $2.29 billion were spent on alcohol-related health care. Conclusions: Alcohol poses a heavy burden of disease as well as a financial strain on Canadian society. However, there are evidence-based effective and cost-effective policy and legislative interventions as well as measures to better enforce these laws., ALCOHOL ACCOUNTS FOR high levels of mortality, morbidity, and social problems. More than 60 causes of death have been attributed to alcohol consumption (Corrao et al., 1999; Rehm et al., [...]

Published
2007

31. Are alcohol prices and taxes an evidence-based approach to reducing alcohol-related harm and promoting public health and safety? A literature review.

Author

Patra, Jayadeep, Giesbrecht, Norman, Rehm, Jurgen, Bekmuradov, Dennis, and Popova, Svetlana

Subjects
Drinking of alcoholic beverages -- Prevention, Excise tax -- Influence, Public health -- Research, Alcoholic beverages -- Prices and rates, Company pricing policy
Abstract

Background Alcohol is a major risk factor for disease and disability. Using 2004 data the World Health Organization analyzed the impact of 26 risk factors on the global burden of [...], This literature review examines alcohol prices and taxes as potential prevention strategies--examining the links with high-risk drinking and drinking patterns and alcohol-related harm. A literature search of the studies on alcohol price and taxation was conducted using multiple electronic bibliographic databases. Examined outcomes were a) drinking patterns and high risk drinking; and b) harm from alcohol. Fifty-four relevant studies were evaluated, and the majority found that a change in price or taxes on alcohol had an impact on one or more of the two main outcome variables. Significant variations exist across studies in terms of designs, settings, effects across groups, and types of harm. In order to reduce alcohol-related trauma, chronic disease, and other consequences of high-risk drinking, an increase in pricing/taxation is a central component of an overall alcohol strategy. KEY WORDS: Alcohol, price, tax, drinking patterns, morbidity, mortality.

Published
2012

32. Alcohol-related laws and avoidable burden and its costs due to motor vehicle collisions in Canada.

Author

Popova, Svetlana, Patra, Jayadeep, Sarnocinska-Hart, Anna, Gnam, William, Mann, Robert E., and Rehm, Jurgen

Subjects
Alcoholism -- Research, Drinking and traffic accidents -- Research, Traffic accidents -- Research, Drunk driving -- Research
Abstract

Despite the important decreases in the past two decades in the levels of impaired driving and alcohol-attributable motor vehicle collisions (MVCs) in Canada, drunk driving remains a serious problem, especially [...], The purpose of this study was to estimate the avoidable alcohol-attributable burden and costs of health care, criminality,, and the indirect costs of lost productivity due to disability or premature death attributable to motor vehicle collisions (MVCs) in Canada. A polio, effectiveness approach was used and the impact of three effective alcohol policy interventions aimed to reduce alcohol-impaired driving was modeled. The results demonstrated that implementation of drunk-driving countermeasures will further reduce the alcohol-attributable burden and costs due to MVCs in Canada. Implications for policy formation and targeted prevention efforts are discussed. KEY WORDS: Avoidable cost, injuries, mortality, morbidity, alcohol policy, enforcement.

Published
2011

39. Factors associated with treatment compliance and its effects on retention among participants in a court-mandated treatment program.

Author

Patra, Jayadeep, Gliksman, Louis, Fischer, Benedikt, Newton-Taylor, Brenda, Belenko, Steven, Ferrari, Michel, Kersta, Stephanie, and Rehm, Jurgen

Subjects
Patient compliance -- Research, Drug abuse -- Care and treatment, Recidivism -- Prevention, Drug courts -- Research
Abstract

In North America, a significant proportion of criminal offenders are drug-involved. This is evidenced by findings from the Arrestee Drug Abuse Monitoring program in the United States, in which over [...], Drug treatment court (DTC) programs have been implemented and promoted in American as well as Canadian judicial systems as an effective tool for reducing criminal recidivism rates. An evaluation of the program in Toronto revealed that the drug court participants' substance abuse and criminal behaviors are reduced while they are under the drug courts 'jurisdiction, and to some extent recidivism is reduced after participants leave the program. However, while we know from the literature that there are positive effects of the program, the characteristics of drug-dependent offenders who benefit the most from the DTC are less clear. The main purpose of this study was to understand where the prediction from literature, that compliance determines success in treatment, fails. Thus, study participants were divided into two groups: 1) those who might normally be expected to not comply yet who do in the long run (unexpected retention, UR); and 2) those who might normally be expected to comply, but who do not (unexpected expulsions, UE). Discriminant function analysis showed that participants considered UR were subject to conditions of social disadvantage yet quite motivated; whereas UE participants had no housing concern, no indication of family problems, but had additional criminal justice involvement at an early stage of the program. Implications for strengthening DTCs as well as suggestions f or future research in the drug treatment and drug court fields are discussed. KEY WORDS: Toronto drug treatment court, treatment retention, compliance, noncompliance, implications.

Published
2010

42. Deaths associated with high-volume drinking of alcohol among adults in Canada in 2002: a need for primary care intervention?

Author

Patra, Jayadeep, Taylor, Benjamin, and Rehm, Jurgen

Subjects
Drinking of alcoholic beverages -- Research, Mortality -- Research, Primary nursing -- Research
Abstract

Alcohol is causally related to many different causes of death, including different cancers, cardiovascular diseases, mental health conditions, digestive diseases and injury categories (English et al. 1995; Gutjahr et al. [...], This study estimates risks of mortality associated with high-volume drinking for Canada in 2002 by age and sex. Distribution of exposure was taken from a major Canadian survey and corrected for per capita consumption from production and sales. High-volume drinking was defined as a daily consumption of ≥40 grams of pure alcohol (at least 3 Canadian drinks) for men and ≥ 20 grams of pure alcohol (at least 1.5 Canadian drinks) for women. Risk relations were taken from the published literature and combined with exposure to calculate age-and sex-specific alcohol-attributable fractions for high-volume drinking. Information on mortality was obtained from Statistics Canada and combined with alcohol-attributable fractions to estimate the overall mortality due to alcohol. About 4,950 net deaths (3,236 in those below 70 years of age) were due to high-volume drinking of alcohol in Canada in 2002. This constituted 2.2% (5.0% among those below 70 years of age) of all deaths. The net deaths were composed of 5,717 deaths caused and 767 deaths prevented. There was an age gradient, with the net deaths highest in 45-59 years age group. About 70.6% (5,717/8, 103) of the overall deaths caused by alcohol were the result of high-volume drinking. Overall, the net impact of high-volume drinking of alcohol consumption on mortality in Canada is high. Policies should strive to reduce the burden of high-volume alcohol consumption. In addition to alcohol control measures, individual level interventions should be implemented in primary care to significantly reduce such burden. KEY WORDS: Alcohol, high-volume drinking, mortality, primary care, policy

Published
2009

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