Showing papers by "Wayne Hall published in 2000"
TL;DR: It is proposed that the link between early cannabis use and educational attainment arises because of the social context within which cannabis is used and is associated with the adoption of an anti-conventional lifestyle characterized by affiliations with delinquent and substance using peers, and the precocious adoption of adult roles including early school leaving, leaving the parental home and early parenthood.
Abstract: This paper reviews research examining the link between cannabis use and educational attainment among youth. Cross-sectional studies have revealed significant associations between cannabis use and a range of measures of educational performance including lower grade point average, less satisfaction with school, negative attitudes to school, increased rates of school absenteeism and poor school performance. However, results of cross-sectional studies cannot be used to determine whether cannabis use causes poor educational performance, poor educational performance is a cause of cannabis use or whether both outcomes are a reflection of common risk factors. Nonetheless, a number of prospective longitudinal studies have indicated that early cannabis use may significantly increase risks of subsequent poor school performance and, in particular, early school leaving. This association has remained after control for a wide range of prospectively assessed covariates. Possible mechanisms underlying an association between early cannabis use and educational attainment include the possibility that cannabis use induces an 'amotivational syndrome' or that cannabis use causes cognitive impairment. However, there appears to be relatively little empirical support for these hypotheses. It is proposed that the link between early cannabis use and educational attainment arises because of the social context within which cannabis is used. In particular, early cannabis use appears to be associated with the adoption of an anti-conventional lifestyle characterized by affiliations with delinquent and substance using peers, and the precocious adoption of adult roles including early school leaving, leaving the parental home and early parenthood.
595 citations
TL;DR: Australia has its own national estimates of psychiatric morbidity, and the morbidity is associated with considerable disablement, but most of it is untreated.
Abstract: Objectives: The objectives of this study were to estimate the 1-month and 1-year prevalence of mental disorders in the Australian adult population; to determine the amount of disablement associated...
402 citations
TL;DR: Men were at higher risk than women of developing alcohol- and drug-use disorders and the prevalence of both disorders decreased with increasing age, and there were high rates of comorbidity betweencohol- and other drug- use disorders and mental disorders and low rates of treatment seeking.
Abstract: Objective: This study reports the prevalence and correlates of ICD-10 alcohol- and drug-use disorders in the National Survey of Mental Health and Wellbeing (NSMHWB) and discusses their implications...
232 citations
TL;DR: It is still unclear whether this means that cannabis use precipitates schizophrenia, whether cannabis use is a form of ‘self-medication’, or whether the association is due to the use of other drugs, such as amphetamines, which heavy cannabis users are more likely to use.
Abstract: Objective: This paper evaluates evidence for two hypotheses about the relationship between cannabis use and psychosis: (i) that heavy cannabis use causes a ‘cannabis psychosis’, i.e. a psychotic disorder that would not have occurred in the absence of cannabis use and which can be recognised by its pattern of symptoms and their relationship to cannabis use; and (ii) that cannabis use may precipitate schizophrenia, or exacerbate its symptoms.Method: Literature relevant to drug use and schizophrenia is reviewed.Results: There is limited clinical evidence for the first hypothesis. If ‘cannabis psychoses’ exist, they seem to be rare, because they require very high doses of tetrahydrocannabinol, the prolonged use of highly potent forms of cannabis, or a preexisting (but as yet unspecified) vulnerability, or both. There is more support for the second hypothesis in that a large prospective study has shown a linear relationship between the frequency with which cannabis had been used by age 18 and the risk over the...
192 citations
TL;DR: To estimate the prevalence of dependent or daily heroin users in Australia, and to compare the prevalence in Australia with that in other developed countries, a database of heroin users from around the world is analyzed.
Abstract: Objective: To estimate the prevalence of dependent or daily heroin users in Australia, and to compare the prevalence in Australia with that in other developed countries.
165 citations
TL;DR: Examination of birth cohort trends in the prevalence of use and the age of initiatbn of use of alcohol, tobacco, cannabis, amphetamines, LSD, and heroin finds trends are similar to previous studies.
142 citations
TL;DR: The perceived safety of MDMA is at odds with animal evidence of MDMA neurotoxicity, an increasing prevalence of hazardous patterns of use among recreational MDMA users, and emerging evidence of neurotoxicity among heavier MDMA users.
104 citations
94 citations
TL;DR: Evidence is examined on three claims that the THC content of Australian cannabis plants has increased up to 30 times and an increase in THC content is the most likely explanation of any increase in cannabis‐related problems.
82 citations
TL;DR: A plausible hypothesis is that the greater availability and ease of access to methadone maintenance in the UK contributes to both the lower rate of opioid overdose mortality and the greater apparent contribution that Methadone makes to opioid overdose deaths in that country.
76 citations
TL;DR: In this article, the authors found that the quantity of use and severity of dependence at baseline were the primary predictors of those same variables at follow-up, indicating that cannabis use and dependence are fairly stable among long-term users.
TL;DR: The value of the debate on cannabis is seriously diminished by heated contributions that obstruct rational consideration of important public health and policy issues.
Abstract: The policy debate on cannabis has moved back into prominence in Britain and elsewhere after reports of increases in use during the early 1990s1 and renewed claims about the therapeutic value of marijuana. 2 3 Rational debate has often been obstructed because the media present a forced choice between two sets of views. One of these constructed views is that cannabis is harmless when used recreationally, is therapeutically useful, and hence should be legalised. The other is that recreational use is harmful to health and that cannabis should continue to be prohibited for recreational or therapeutic purposes.4
This oversimplification of the cannabis debate has prevented a more considered examination of eight conceptually separate issues (box). We believe that a competent consideration of these issues would contribute to a more informed debate about the appropriate public policies that could be adopted towards cannabis use for recreational or therapeutic purposes.
#### Summary points
Cannabis use is increasing steadily in many countries and is most prevalent among young people
The value of the debate on cannabis is seriously diminished by heated contributions that obstruct rational consideration of important public health and policy issues
The different domains of the debate should be considered in isolation at first to allow a more objective analysis of the evidence
Substantial public investment in research into the different areas is a prerequisite of rational consideration of public policies
More than 60 different cannabinoids and over 400 active components have been identified in samples of cannabis.2 However, our interest and concerns about associated harms could be much more focused. Should we be especially concerned about the use of new cannabis preparations with higher concentrations of tetrahydrocannabinol? Does using cannabis that has a higher tetrahydrocannabinol content result in a higher intake of tetrahydrocannabinol or do smokers consciously or subconsciously titrate …
TL;DR: The rate of youth suicide in Australia has increased since 1964, particularly among males, and has been paralleled by an increased rate of Youth suicides internationally and by an increase in other psychosocial problems including psychiatric illness, criminal offending and substance use disorders.
Abstract: Objective: This paper examines trends in the rate of suicide among young Australians aged 15–24 years from 1964 to 1997 and presents an age-period-cohort analysis of these trends.Method: Study design consisted of an age-period-cohort analysis of suicide mortality in Australian youth aged between 15 and 24 for the years 1964–1997 inclusive. Data sources were Australian Bureau of Statistics data on: numbers of deaths due to suicide by gender and age at death; and population at risk in each of eight birth cohorts (1940–1944, 1945–1949, 1950–1954, 1955–1959, 1960–1964, 1965–1969, 1970–1974, and 1975–1979). Main outcome measures were population rates of deaths among males and females in each birth cohort attributed to suicide in each year 1964–1997.Results: The rate of suicide deaths among Australian males aged 15–24 years increased from 8.7 per 100 000 in 1964 to 30.9 per 100 000 in 1997, with the rate among females changing little over the period, from 5.2 per 100 000 in 1964 to 7.1 per 100 000 in 1997. Whil...
TL;DR: The intervention was designed to reduce the stockpiling of medicines used for chronic medical conditions under the PBS safety net to increase the minimum re‐supply period for prescriptions on the Pharmaceutical Benefits Scheme in November 1994.
TL;DR: In this article, the authors examined the impact of the CEN scheme on the prevalence of lifetime and weekly cannabis use in South Australia and other Australian states and territories, including Tasmania, New South Wales, Queensland and Western Australia.
Abstract: This study sought to examine the impact of the Cannabis Expiation Notice (CEN) scheme on the prevalence of lifetime and weekly cannabis use in South Australia. Data from five National Drug Strategy Household Surveys between 1985 and 1995 were examined to test for differences in trends in self-reported: (1) lifetime cannabis use; and(2) current weekly cannabis use, after controlling for age and gender, between South Australia and the other states and territories. Between 1985 and 1995, rates of lifetime cannabis use increased in SA from 26% to 36%. There were also significant increases in Victoria (from 26%to 32%), Tasmania (from 21%to 33%) and New South Wales (from 26% to 33%). The increase in South Australia was significantly greater than the average increase throughout the rest of Australia, but the other Australian states differed in their rates of change. Victoria and Tasmania had similar rates of increase to South Australia; New South Wales, Queensland and Western Australia showed lower rates of incr...
01 Jan 2000
TL;DR: This report has been prepared in order to provide a comprehensive overview of the epidemiology and circumstances of heroin overdose, and of interventions that may potentially reduce mortality from overdose.
Abstract: Over the past decade fatal opioid overdose has emerged as a major public health issue in Australia. This report has been prepared in order to provide a comprehensive overview both of the epidemiology and circumstances of heroin overdose, and of interventions that may potentially reduce mortality from overdose.
01 Jan 2000
TL;DR: The 2000 Illicit Drug Reporting System (IDRS) represents the fifth year of existence for the IDRS and data are collected and published on the price, purity and availability of heroin, amphetamine, cocaine, cannabis and (since 2000) ecstasy.
Abstract: The 2000 Illicit Drug Reporting System (IDRS) represents the fifth year of existence for the IDRS. The main purpose of the IDRS is to provide annual strategic early warning of emerging drug trends in the major illicit drug classes. Specifically, annual data are collected and published on the price, purity and availability of heroin, amphetamine, cocaine, cannabis and (since 2000) ecstasy, through three convergent methodologies:
TL;DR: The view is that “drug-related deaths can, will and must in the near future be radically reduced in number” and that the effort that society expends on preventing premature deaths should apply no less to drug misusers than it does to other classes of people.
01 Jan 2000
TL;DR: Progress on a 10-year follow-up of a randomized controlled trial of early intervention for hazardous alcohol use demonstrates that long-term follow- up is feasible, given sufficient planning and persistence.
Abstract: Early intervention for hazardous alcohol use has been shown repeatedly to be effective in reducing alcohol consumption, limiting alcohol-related problems and improving biochemical parameters. However, in most studies the follow-up period has been 2 years or less. The current paper presents progress on a 10-year follow-up of a randomized controlled trial of early intervention. Methods used for tracing subjects and ensuring minimal refusals are detailed. The intensity of effort required to locate subjects is documented and recommendations for ensuring good follow-up rates are made. At completion of follow-up, 72.5% of the sample reviewed here and 78.2% of the total cohort had been traced. Our experiences demonstrate that long-term follow-up is feasible, given sufficient planning and persistence.
Journal Article•
TL;DR: In an ideal world social policies toward cannabis would be informed by epidemiological evidence on the prevalence of cannabis use and the personal harms that it caused and by evaluations of the costs and benefits of alternative social policies designed to minimize these harms.
Abstract: In an ideal world social policies toward cannabis would be informed by epidemiological evidence on the prevalence of cannabis use and the personal harms that it caused and by evaluations of the costs and benefits of alternative social policies designed to minimize these harms. Policy should not be
Journal Article•
01 Jan 2000
TL;DR: Because overdoses attended by ambulance officers are a more common occurrence than fatal overdoses, they provide an important source of information about heroin use and the location of ambulance attendances provides information about areas in which the use of heroin may be more common.
TL;DR: Ultra-rapid opioid detoxification has at best a very minor role in the treatment of a handful of opioid dependent patients who are unable to complete withdraw in any other way, and ROD may have more of a role as one option for opioid withdrawal in well motivated patients who want to be rapidly inducted onto NM therapy or whowant to enter other types of abstinence-oriented treatment.
Abstract: Ultra-rapid opioid detoxification (UROD) involves the acceleration of opioid withdrawal by administering the opioid receptor antagonist naltrexone under general anaesthesia. There is evidence from uncontrolled and a few controlled studies that UROD accelerates opioid withdrawal and that it achieves high rates of completion of acute opioid withdrawal. However, there is clear evidence that the use of a general anaesthetic is not required to accelerate withdrawal or to achieve high rates of completion of acute opioid withdrawal. These goals can be achieved by using naltrexone or naloxone to accelerate withdrawal under light sedation, a procedure known as rapid opioid detoxification under sedation (ROD). There is also evidence that use of an opioid antagonist is not required to achieve a high rate of completion of acute opioid withdrawal. The mixed agonist-antagonist buprenorphine has achieved comparable rates of completion in similarly selected patients with fewer withdrawal symptoms. There is no evidence from controlled trials that either UROD or ROD increases the rate of abstinence from opioids 6 or 12 months after withdrawal. UROD and ROD may increase the number of patients who are inducted onto naltrexone maintenance (NM) therapy but extensive experience with NM therapy suggests that it only has a limited role in selected patients. Given the lack of evidence of substantially increased rates of abstinence, and the need for anaesthetists and high dependency beds, UROD has at best a very minor role in the treatment of a handful of opioid dependent patients who are unable to complete withdraw in any other way. ROD may have more of a role as one option for opioid withdrawal in well motivated patients who want to be rapidly inducted onto NM therapy or who want to enter other types of abstinence-oriented treatment.
01 Jan 2000
01 Jan 2000
TL;DR: In this article, the authors examined data on ambulance calls in New South Wales over a two-year period, July 1997 to June 1999, and examined the information that ambulance attendances provided on temporal and geographic trends in heroin use.
Abstract: There has been a substantial increase in both the number and the rate of opiate overdose deaths in Australia over the past three decades. In 1964, there were 6 deaths due to opiates among those aged 15-44 years, compared to 600 in 1997. The pattern was similar when rates of death were examined, with an increase from 1.3 per 100 000 persons in 1964 to 71.5 in 1997 (Hall, Degenhardt, & Lynskey, 1999). Approximately half of these deaths occurred in NSW (Lynskey & Hall, 1998). Research suggests that 1-3% of heroin users will die from a heroin-related overdose each year (Darke & Zador, 1996). Non-fatal opiate overdoses are even more common among heroin users. Non-fatal overdoses may be defined as instances where loss of consciousness and depression of respiration occurs but is not fatal, due either to medical intervention or the good health of the person. Approximately two thirds (68%) of a sample of 300 long-term Sydney heroin users reported a non-fatal overdose at some point in their lives. Just under half of these (43%) reported an overdose within the past year, and 80% had witnessed the overdose of another person (Darke, Ross, & Hall, 1996a). Around half (56%) of one sample reported that an ambulance had been called for the most recent overdose they had witnessed (Darke, Ross, & Hall, 1996b). Because overdoses attended by ambulance officers are a more common occurrence than fatal overdoses, they provide an important source of information about heroin use. First, data on the number of ambulance calls to suspected drug overdoses provides an indication of trends in rates of heroin use in the community. Second, the location of ambulance attendances provides information about areas in which the use of heroin may be more common. The current report examined data on ambulance calls in New South Wales over a two-year period, July 1997 to June 1999. There are several elements of interest in the current report. First, we examined the number of these events that occurred over the period. Second, we explored of the quality of the data on these calls. Third, we examined the information that ambulance attendances provided on temporal and geographic trends in heroin use. Finally, we compared geographic data on ambulance attendances with data on fatal heroin overdose deaths in NSW.
01 Jan 2000
01 Jan 2000
TL;DR: An expert workshop in January 1999 drew together a series of expert papers revising the international and national literature in respect to methadone tolerance in relation to safe initiation into methamphetamineadone treatment and pharmacokinetics and pharmacodynamics in clinical practice.
Abstract: An expert workshop in January 1999 drew together a series of expert papers revising the international and national literature in respect to methadone tolerance in relation to safe initiation into methadone treatment and pharmacokinetics and pharmacodynamics in clinical practice. The evidence presented formed the basis for several policy, clinical and research recommendations for induction onto methadone maintenance.