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INTRODUCTION: Alcohol abstinence remains common among adults globally, although low and middle-income countries are experiencing declines in abstention. The effect of alcohol policies on lifetime abstinence is poorly understood. The International Alcohol Control (IAC) policy index was developed to benchmark and monitor the uptake of effective alcohol policies and has shown strong associations with alcohol per capita consumption and drinking patterns. Uniquely, the index incorporates both policy 'stringency' and 'impact', reflecting policy implementation and enforcement, across effective policies. Here we assessed the association of the IAC policy index with lifetime abstinence in a diverse sample of jurisdictions.METHODS: We conducted a cross-sectional analysis of the relationship between the IAC policy index score, and its components, and lifetime abstinence among adults (15+ years) in 13 high and middle-income jurisdictions. We examined the correlations for each component of the index and stringency and impact separately.RESULTS: Overall, the total IAC policy index scores were positively correlated with lifetime abstinence (r = 0.76), as were both the stringency (r = 0.62) and impact (r = 0.82) scores. Marketing restrictions showed higher correlations with lifetime abstinence than other policy domains (r = 0.80), including restrictions on physical availability, pricing policies and drink-driving prevention.DISCUSSION AND CONCLUSION: Our findings suggest that restricting alcohol marketing could be an important policy for the protection of alcohol abstention. The IAC policy index may be a useful tool to benchmark the performance of alcohol policy in supporting alcohol abstention in high and middle-income countries.

Introduction: New Zealand’s Alcohol Licencing Trusts (ALTs) are community-owned entities that sell alcohol in their districts and return profits back to the local community.Aim: To investigate supp...

To investigate medicinal cannabis users' intentions to transition to the new prescription Medicinal Cannabis Scheme (MCS) in New Zealand.An online survey of 3,634 past-year medicinal cannabis users completed prior to implementation of the MCS in New Zealand in April 2020. Logistic regression models were fitted to identify predictors of intended future engagement with the MCS.Seventy-eight percent of respondents were aware of the new MCS and 66% intended to use it. Higher income (OR=1.57), younger age (OR=1.02) and smoking cannabis (v. vaping (OR=2.0) or oral ingestion in edible form (OR=2.22)) predicted intention to engage with the MCS. Conversely, Māori (OR=0.63) and those who grew their own cannabis (OR=0.52) were less likely to intend to engage with the new prescription MCS.The lower intended engagement with the MCS by Māori, lower income groups and those who home-grow cannabis may reflect their perceptions of the MCS as restrictive and expensive.

To explore patterns of medicinal cannabis use prior to implementation of the new Medicinal Cannabis Scheme (MCS) in New Zealand.An anonymous online convenience survey of 3,634 last-year medicinal users of cannabis promoted via Facebook™ from May to August 2019.Fifty percent of the sample were female, 18% were Māori and the median age was 38 years. The medical conditions for which cannabis was most often used were pain (81%), sleep (66%) and mental health conditions (64%). Respondents perceived cannabis to be an effective therapy and reported reducing use of other pharmaceutical medicines. Fifty-two percent reported side effects from cannabis use, including increased appetite (29%), drowsiness (12%), eye irritation (11%), dependency (10%), memory impairment (10%) and lack of energy (9%). Smoking was the dominant route of administration. Nearly half (47%) had discussed their use of cannabis with a medical professional in the previous year, while 14% had requested a prescription and 5% accessed a prescribed cannabis-based product (mostly oral CBD).Respondents self-medicated with cannabis to treat a wide range of health complaints. Only half discussed medicinal cannabis use with their medical professional, and a minority requested a prescription and used a prescribed cannabis-based product.

Background Small towns in New Zealand have reported high availability of methamphetamine, and conversely a shortage of cannabis. Stakeholders have suggested drug dealers are purposely promoting methamphetamine rather than cannabis. Aims (1) To compare the availability of methamphetamine and cannabis in different size communities; (2) Identify determinants of the high availability of methamphetamine, including low availability of cannabis. Method An online drug survey was promoted via a broadly targeted Facebook™ campaign. Participants were asked if they lived in a “city”, “small town” or “rural area”, their drug use patterns, and local drug market characteristics, including current availability. A total of 6311 people completed the survey. Logistic regression models were constructed to identify independent predictors of reporting high availability of methamphetamine, cannabis, ecstasy and LSD respectively, with low availability of cannabis included as a predictor in the non-cannabis markets. Results Methamphetamine was reported to be more available than cannabis in all regions. Methamphetamine was more available in towns/rural areas than in cities. Significant predictors of high availability of methamphetamine were living in a town/rural area (OR = 1.38), purchasing from a gang member (OR = 1.88), daily methamphetamine use (OR = 2.41), Maori ethnicity (OR = 1.36) and reporting low availability of cannabis (OR = 1.89). Low availability of cannabis was not a predictor of high availability of ecstasy or LSD. Living in a town/rural area was not a predictor of high availability of cannabis, LSD or ecstasy. Purchasing from a gang member was a predictor of high availability of cannabis (OR = 1.80) and LSD (OR = 4.61). Conclusions Further research is required to identify what causal relationships, if any, there are between the statistical associations of high methamphetamine availability, living in a small town, purchasing from a gang, and low cannabis availability. It may be the case that small towns offer an environment where a gang can control the local drugs market.

Introduction New Zealand has a number of unusual geographical features that may influence the price of illegal drugs including international isolation, numerous rural communities, and two separate islands (North and South Islands). Aims (1) Collect data on the prices of different drug types from all regions of New Zealand; (2) Identify independent predictors of the reported prices. Method An online drug survey was promoted via a targeted Facebook™ campaign. A total of 6331 respondents completed the survey. Normal regression models were constructed to identify predictors of the reported price of an ounce of cannabis, gram of methamphetamine, pill of ecstasy and tab of LSD using demographics, drug use frequency, drug market indicators, region, community size, type of seller, and location of purchase as predictor variables. Results Higher availability was a predicator of lower prices for cannabis (-3% per higher availability category), methamphetamine (-4%) and ecstasy (-5%). Those living in the North Island (-26%) and buying from gangs (-5%) paid lower prices for methamphetamine. Those living in rural communities reported higher prices for methamphetamine (+5%) but lower prices for cannabis (-3%). Daily cannabis users (+4%) and those on social welfare (+2%) paid higher prices for cannabis. Conclusion Lower prices for methamphetamine in the North Island may reflect the concentration of methamphetamine manufacture there. The fact that gangs offer lower prices for methamphetamine suggests they do not have monopoly control of this market. Gangs may be able to offer lower prices for methamphetamine due to scale of production/trafficking and lower risk of victimisation. Higher prices for methamphetamine in rural areas may reflect less competitive markets. Lower prices for cannabis in rural communities may be due to proximity to growing locations. Daily cannabis users and those on social welfare may be less able to delay their cannabis purchases to low price harvest months.

To explore health problems and the accessing of health services by frequent legal high users under an interim regulated legal market in central Auckland.Frequent legal high users (monthly+) were recruited from outside eight randomly-selected, licensed, legal high stores in central Auckland from 23 April-7 May, 2014. Eligible participants were emailed a unique invitation to complete an on-line survey; 105 completed the survey.Twenty-seven percent had suffered mental illness during their lifetimes. Eighty percent used synthetic cannabinoids (SC), and 20% 'party pills'. Forty-seven percent of SC users used daily or more often. Other drugs used included alcohol (80%), cannabis (59%), 'ecstasy' (18%) and methamphetamine (15%). Fifty-eight percent of SC users were classified as SC dependent. The most common problems reported from SC use were: insomnia (29%); 'vomiting/nausea' (25%); 'short temper/agitation' (21%); 'anxiety' (21%); 'strange thoughts' (16%); and 'heart palpitations' (14%). The health services most commonly accessed by SC users were: a 'doctor/GP' (9%); 'counsellor' (9%); 'DrugHelp/MethHelp' websites (7%); 'AlcoholDrug Helpline' (4%); 'ambulance' (3%); 'AE' (3%); and hospitalisation (3%).Frequent use of interim licensed SC products was associated with health problems, including dependency. Further research is required to determine the health risks of these products.