Showing papers in "Drugs-education Prevention and Policy in 2017"
TL;DR: In this article, the use of anabolic androgenic steroids (AAS) in fitness and strength training environments have revealed great variance in users' approach to AAS use and more specifically the...
Abstract: Recent research into the use of anabolic androgenic steroids (AAS) in fitness and strength training environments have revealed great variance in users’ approach to AAS use and more specifically the...
82 citations
TL;DR: Key changes in the authors' knowledge during the 20 years, in particular, in relation to HIV prevalence, changes in the market and patterns of use make anabolic steroid use a public health concern.
Abstract: Aims: The aim of the paper was to identify changes in the extent and patterns of anabolic steroid use in the United Kingdom to better understand the public health implications within the context of the current health-related evidence base. Methods: Using the two time points of 1995 (prior to legislation changes in the United Kingdom) and 2015, a review of the evidence related to health harms was conducted, in conjunction with needle and syringe programme (NSP) data in Cheshire & Merseyside (UK) relating to anabolic steroid users. Findings: Dramatic increases in the numbers of anabolic steroid users accessing NSPs, 553 in 1995 to 2446 in 2015, now accounting for 54.9% of clients. With the inclusion of pharmacy NSPs, this rose to 5336 individual anabolic steroid users. Conclusions: Key changes in our knowledge during the 20 years, in particular in relation to HIV prevalence, changes in the market and patterns of use make anabolic steroid use a public health concern. In the context of increasing numbers of injectors, there is a need for comprehensive interventions.
68 citations
TL;DR: This article conducted an integrative review of the literature to examine which elements of parent-child connectedness and substance-use specific communication are effective across adolescent alcohol, tobacco and drug use.
Abstract: Previous reviews have highlighted parent–child connectedness and communication as important protective factors against adolescent substance use. However, these reviews focus on single substances such as alcohol. An integrative review of the literature was conducted to examine which elements of parent–child connectedness and substance-use specific communication are effective across adolescent alcohol, tobacco and drug use. Forty-two English language, peer reviewed articles were reviewed. Open communication occurs within the context of high connectedness between parents and their children. Conversations about health risks are associated with lower levels of substance use while more frequent conversations, those about parents’ own use, permissive messages and consequences of use are associated with higher levels of use. There are disparities regarding conversations about use of each substance: alcohol and tobacco are easier topics of conversation while drug use is rarely discussed. Parental alcohol a...
62 citations
TL;DR: The systematic review yields mixed results for the effectiveness of the Keepin’ it REAL intervention, and the authors recommend independent, randomised trials for the KiR D.A.R.E.S.R., as well as the development of a standardised measure and evaluation system for in-school substance use prevention programmes.
Abstract: The study investigates the effectiveness and appropriateness of the Drug Abuse Resistance Education (D.A.R.E.) Keepin’ it REAL (KiR) curriculum – America’s most prevalent in-school prevention progr...
59 citations
TL;DR: It is hypothesised that AFMs experience greater coping difficulty and higher levels of strain under conditions of: greater accumulated burden; a family position of structural subordination and dependence; and lack of good quality social support.
Abstract: This paper takes an international perspective on the harm to close family members caused by addiction. It draws on data collected by the Addiction and the Family International Network (AFINet), England, and their colleagues in other countries. It includes qualitative data based on semi-structured interviews in Mexico, England, Australia (an Indigenous sample), Nigeria, and India; quantitative data based on the use of a standard set of questionnaires specifically designed or chosen for use with family members affected by addiction problems collected in Mexico, England, Italy, Brazil and the USA. The results are interpreted to suggest that, although there is a common core to the harm experienced by all affected family members (AFMs), the family harm is variable, dependent in important ways on relationship, social and cultural factors. Specifically, it is hypothesised that AFMs experience greater coping difficulty and higher levels of strain under conditions of: greater accumulated burden; a family p...
34 citations
TL;DR: There are ways in which Bereavement following an overdose differs from bereavement following other deaths associated with alcohol or drugs, and this group’s experience of witnessing and/or responding to previous overdoses indicates the value in prevention programmes targeting relatives/friends.
Abstract: Aims: Overdoses contribute disproportionately to drug-related deaths (DRDs) in the UK, yet little is known about the experiences and needs of those who are bereaved by such deaths, and how their experiences and needs might differ from other bereavements associated with substance use. Methods: An interview study with 32 adults in England and Scotland (part of a larger study). Findings: Five themes describe the core experiences of this group of bereaved people: drug use, the death, official processes, stigma, and overdose awareness and prevention. Together, these findings offer new insights in to the key features of this type of bereavement; for example, living with substance use including previous overdoses, difficult circumstances surrounding the death, having to negotiate the complex procedures involved in processing the death, the stigma such deaths attract, and feelings of guilt, self-blame and an unworthiness to grieve. Conclusions: There are ways in which bereavement following an overdose dif...
33 citations
TL;DR: In this article, the connection between parents' substance abuse and their 0-6 years old children's somatic and psychological health was investigated in a retrospective population-based cohort study.
Abstract: Aims: This study looks at the connection between parents’ substance abuse and their 0–6 years old children’s somatic and psychological health. Methods: A retrospective population-based cohort study...
28 citations
TL;DR: The data revealed that male and female gang members regularly experience disrespectful police behaviour in terms of physical and verbal abuse, which contribute to negative attitudes, fear and distrust of police, while respectful interactions are meaningful and can contribute to positive attitudes towards officers.
Abstract: Recent media accounts have highlighted issues of use and abuse of police force and policing practices targeted at ethnic minorities within inner city areas. To date, little research has focused specifically on the experiences and perceptions of youth gang members in dealing with police. Using data from 253 in-depth interviews with ethnic minority San Francisco-based youth gang members, we examine perceptions of respectful and disrespectful police behavior. Premised on a procedural justice model (Tyler, 2006), we explore how frequently disrespectful police behavior is reported and how these negative experiences shape gang members' attitudes towards the police more generally. We refine our investigation by comparing adverse encounters to examples in which gang members are treated respectfully. Using a data-driven inductive and qualitative theory testing deductive approach, our data revealed that male and female gang members regularly experience disrespectful police behavior in terms of physical and verbal abuse. Our findings indicate that these exchanges contribute to negative attitudes, fear, and distrust of police, while respectful interactions are meaningful and can contribute to positive attitudes towards officers.
27 citations
TL;DR: This study supports providing information on cycle lengths and break periods as part of standard PIEDs-related harm reduction guidelines and safe injecting and dosage education through peer networks or steroid clinics may be useful strategies.
Abstract: Background: A range of indicators point to an international increase in the prevalence of performance and image-enhancing drugs (PIEDs) use, predominantly among young men. Attention to PIEDs-related benefits, adverse health effects, information and health service access are needed. Methods: A cross-sectional survey of 605 men who inject PIEDs was conducted at nine primary needle and syringe programme locations across five local health districts in Sydney. Results: Among anabolic–androgenic steroids (AAS) users (n = 564), anger, rage or irritability (27%, 95%CI: 23.4–30.6) and sexual or genital problems (26.4%, 95%CI: 22.9–30.0) were the most commonly reported adverse health effects. Taking regular, longer breaks between AAS cycles were associated with reduced reports of some adverse effects. Approaching two-thirds of participants had told a doctor about using PIEDs (63.1%, 95%CI: 59.1–67.1). However, as length of time since first injecting PIEDs increased, participants’ perceptions of doctors as ...
27 citations
TL;DR: An overview of the background, historical and contextual factors impacting current approaches to workforce development is provided, followed by a description of changes in the theoretical understandings of effective workforce development which prompted the paradigm shift.
Abstract: Over the past two decades, there has been a major paradigm shift in the conceptualisation of workforce development for the alcohol and other drugs (AOD) sector. Foremost, in this regard, is the shift towards a systems approach. Unlike more traditional approaches, which predominantly address the immediate education and training needs of individual workers, a systems approach is broad and comprehensive and targets individual, organisational and structural factors. It also incorporates issues such as innovation dissemination and systems redesign. This paradigm shift and its implications for workers, services and sectors are outlined. Then, an overview of the background, historical and contextual factors impacting current approaches to workforce development is provided. This is followed by a description of changes in the theoretical understandings of effective workforce development which prompted the paradigm shift. A range of factors impacting at the global and individual worker level are then descri...
25 citations
TL;DR: It is found that measures of policy diffusion and political culture are important drivers of adoption, however, the relative effects of positive pressure from neighbouring states and negative pressure from the ideological distance between adopting and non-adopting states is such that complete diffusion is unlikely.
Abstract: In the past 20 years, the drive to legalise medical marijuana (cannabis) has gained national attention with the public and policy makers. Beginning in 1996 states started implementing MMLs (medical marijuana laws), and by the end of 2015, 23 states and the District of Columbia had adopted laws legalizing marijuana use for medical purposes. We find that measures of policy diffusion and political culture are important drivers of adoption. However, the relative effects of positive pressure from neighbouring states and negative pressure from the ideological distance between adopting and non-adopting states is such that complete diffusion is unlikely.
TL;DR: In this article, a Foucauldian theoretical perspective is used to trace how families have been problematised in the treatment and rehabilitation domains of Irish drug policy and consider the political implications.
Abstract: The affected adult family member has increasingly received attention in drug research, policy and practice fields; however, this development has received limited critical and theoretical examination with respect to the presuppositions underpinning its rationale. Using a Foucauldian theoretical perspective, this article traces how families have been problematised in the treatment and rehabilitation domains of Irish drug policy and considers the political implications. A post-structuralist method, Bacchi’s (2009) “What’s the Problem Represented to Be?” approach, is applied to the analysis of eight drug policy documents published in Ireland between 1971 and 2009. Families are constructed as contributing to both the problem and solution of adolescent drug use. They are imagined as a key resource in treatment of adult drug use but as needing support in this role; and, as such they are constructed as service users in their own right. Families are governed through responsibilisation. The behavioural poli...
TL;DR: In this paper, the authors argue that the bulk of epidemiological research suffers from crucial methodological and conceptual flaws that necessitate a reconsideration of their usefulness in policy and treatment practice.
Abstract: In this paper, we elaborate on the premises of studying problem substance use and treatment disparities among migrants and ethnic minorities Due to the growing medicalisation of research on problem substance use and disparities in this group, policy makers, health researchers and practitioners often feel compelled to rely on epidemiological studies when grounding and understanding the link between ethnicity, problem substance use and treatment disparities We argue that the bulk of epidemiological research suffers from crucial methodological and conceptual flaws that necessitate a reconsideration of their usefulness in policy and treatment practice First, epidemiological research is based on static concepts of ethnicity and race as primordial analytical categories Second, and as a consequence of the first argument, such research rarely distinguishes sufficiently between ethnic and non-ethnic determinants and mechanisms influencing problem substance use and treatment disparities And third, thes
TL;DR: The map and description of university study programmes in the addictions field in Europe, according to degrees, professional backgrounds, titles, methods of delivery, duration, entrance requirements, fees, clinical practice requirements and courses offered provide a basis for discussion and cooperation among programmes and universities.
Abstract: Aims: We mapped and described university study programmes in the addictions field (USPA) in Europe, according to degrees, professional backgrounds, titles, methods of delivery, duration, entrance requirements, fees, clinical practice requirements and courses offered. Methods: The study consisted of two parts: 1) a general mapping of USPA – utilising online databases of scientific literature, and subsequently the Google search engine and 2) a content analysis of the identified study programmes’ websites according to a set of a priori research questions. Findings: A total of 34 USPA were located at 25 universities in eight different European countries. 43.6% (n = 18) were master’s, 15.4% (n = 6) bachelor’s and 12.8% (n = 4) Ph.D. study programmes. Only the Czech Republic offers education across all three levels. The background of many USPA is built on medical (n = 5), social (n = 5) and psychological (n = 4) foundations. Ten programmes are offered both full-time and part-time, and 62% charge tuition...
TL;DR: In this paper, the authors examined how Belgian CSCs have attempted to frame public debate through the media, and examined the ways in which the Belgian social clubs have been framed by that same domestic print media.
Abstract: Aims: Cannabis Social Clubs (CSCs) are non-profit organizations that supply cannabis among their adult members The goal of this paper is twofold: (1) to understand how Belgian CSCs have attempted to frame public debate through the media, and (2) to examine the ways in which the Belgian CSCs have been framed by that same domestic print media Methods: We draw on semi-structured interviews with 15 CSC directors and a qualitative content analysis of Belgian print media (2006–2016), including 164 media articles This dataset is complemented by a review of various Belgian CSCs’ internal documents Findings: Most Belgian CSCs engaged with the domestic media While the framing of the CSC model often focussed on legal issues, the news articles offered also some detail on CSCs’ functioning, in line with their self-defined practices We noted a subtle shift in the framing over time Conclusions: CSCs’ efforts in engaging with the media seem to have been somewhat successful, as they were able to contribute
TL;DR: In this article, the authors investigated how elite athletes perceive the deterrent effect of the testing strategy in their sport and explored whether and how specific factors such as the frequency of testing influence athletes' perceptions of testing as a deterrent.
Abstract: Aims: A central paradigm of global anti-doping policy is detection-based deterrence, i.e. the risk of testing and exclusion from sport are effective doping deterrents. This paper investigates how elite athletes perceive the deterrent effect of the testing strategy in their sport and explores whether and how specific factors such as the frequency of testing influence athletes’ perceptions of testing as a deterrent. Methods: 645 Danish elite athletes completed a web-based questionnaire about their perceptions of testing efforts in their sport. Findings: 75% of the athletes considered the likelihood that a test would prove positive to be a deterrent. By contrast, only 40% found the risk of being selected for testing to be a deterrent. Athletes tested frequently and athletes from doping-risk sports were more likely to perceive testing as a deterrent. In total, 24% regarded neither the likelihood of testing nor detection as deterrents. 8% did not consider the likelihood of testing and detection nor the...
TL;DR: A film was created to explore decision-making and cannabis use among young people in Canada and the diffusion of this drug education innovation underscores the importance of youth engagement in prevention programmes.
Abstract: Aims: In most countries, cannabis use rates are highest among young people. Efforts invested in cannabis prevention programmes have had limited success. In part, this may be attributed to a dearth ...
TL;DR: In this article, the authors discuss the role of the other parent from a child perspective, based on interviews with 23 children who had one parent who misused substances while the other, according to public knowledge, did not.
Abstract: This paper concerns children’s and young people’s accounts about the situation when one parent is misusing substances but the other parent is not. Earlier research on the other parent is scarce and fragmented. The aim of the paper is to discuss the role of the other parent from a child perspective. The results are based on qualitative analysis of interviews with 23 children who had one parent who misused substances while the other parent, according to public knowledge, did not. The main finding is that the other parent is a source of support, help and protection to some children, but difficulties may reduce the other parent’s ability to protect the children. Moreover, the challenges differ in the situations before and after the parents’ separation. The conclusion underlines the importance of taking a family perspective, working with the whole family and seeking solutions that take into account all persons of importance to the children’s welfare. It cannot be taken for granted that the other parent...
TL;DR: In this paper, the authors reviewed the available literature on the learning outcomes, qualitative descriptions and costs of online learning for substance misuse worker training and concluded that good quality online training should meet the needs of substance misuse workers whilst acknowledging that these needs will differ according to worker and context.
Abstract: Effective dissemination from researchers to clinicians can improve outcomes for people using substance misuse services by providing the knowledge and skills necessary to deliver best practice. The internet has the potential to facilitate quick, accurate and affordable learning on a large scale. However, the quality of online resources for substance misuse worker training is rarely evaluated. Aim: To review the available literature on the learning outcomes, qualitative descriptions and costs of online learning. Methods: The literature on online learning, staff training and substance misuse were reviewed following PRISMA guidelines. Findings: Sixteen articles were identified with large variation in study quality and design. Descriptions of online interventions were insufficient for replication or comparison. Good quality online training should meet the needs of substance misuse workers whilst acknowledging that these needs will differ according to worker and context. Conclusions: Published research ...
TL;DR: This study assesses the impact of youth drug treatment on substance use, offending and wellbeing in a sample of young people recruited from specialist youth alcohol and drug treatment.
Abstract: Aims: The current study assesses the impact of youth drug treatment on substance use, offending and wellbeing in a sample of young people recruited from specialist youth alcohol and drug treatment....
TL;DR: In this article, a theoretical analysis of the place of substance use within social work education and workforce development in England is presented, using ecological systems theory as its theoretical framework, and the relationship between social work and practice, and wider systemic and situational constraints which have helped or hindered social work's engagement with substance use issues.
Abstract: This paper offers a theoretical analysis of the place of substance use within social work education and workforce development in England. Using ecological systems theory as its theoretical framework, it explores the relationship between social work education and practice, and wider systemic and situational constraints which have helped or hindered social work’s engagement with substance use issues. Furthermore, it suggests that the current direct government intervention in social work education and practice, in addition to the cuts in budgets and its privatisation agenda, has been unhelpful in supporting change and professional development in relation to substance use. It will draw on the limited international data that show similar challenges for social work in relation to substance use beyond England and the UK. It will conclude with an argument for strengthening the social work voice in relation to substance use education and practice in spite of the systemic pressures.
TL;DR: It is suggested that people who regularly attend A&E for alcohol-related reasons collectively experience multiple and complex needs, but individually have diverse patterns of drinking and other problems.
Abstract: Aims: To provide new insights into the socio-demographic characteristics of people who frequently attend Accident and Emergency (AE 12 females; aged 20–68 years) recruited from six A&E departments across London, United Kingdom. Participants had all attended A&E ≥10 times within the last year or ≥5 times in the last three months for an alcohol-related condition. Detailed data relating to participants’ socio-demographic characteristics were systematically coded and analysed. Findings: Participants reported many years of heavy drinking, and high levels of mental and physical ill health, unemployment, dependence on state benefits, housing problems and social isolation. Frequency of A&E attendances varied greatly by participant, patterns of drinking and other substance use were diverse, and the nature and exten...
TL;DR: It is argued that the current approach is not effective and, in some ways, may undermine the goal of health promotion at the amateur level, and proposed alternative, health-centred strategies that focus on athlete empowerment and choice through critical awareness of a variety of substances, associated risks and rewards.
Abstract: Anti-doping regulations are intended, at least in part, to promote the health of athletes. While most anti-doping efforts target elite and professional competitors, there have been recent moves by sport governing bodies to expand anti-doping testing to include amateur athletes. Drawing on previous critiques of anti-doping policies and illustrating cases, this article outlines five of the challenges to health promotion of applying the current detect and ban model to the amateur level of sport. I argue that the current approach is not effective and, in some ways, may undermine the goal of health promotion at the amateur level. In order to address these challenges, I propose alternative, health-centred strategies that focus on athlete empowerment and choice through critical awareness of a variety of substances, associated risks and rewards, and the role of expertise in decision-making.
TL;DR: The problems encountered during data collection for the IAC study in South Africa are described and recommendations for addressing identified challenges are put forward.
Abstract: Aims: There is limited literature on the challenges encountered during household surveys on alcohol consumption in low- and middle-income countries. This paper aims to describe the problems encount...
TL;DR: Taking into consideration people's beliefs and psychological traits could increase the effectiveness of health behaviour change strategies to curb alcohol consumption.
Abstract: Aims: The first aim was to explore whether university students possess the information, motivation and behavioural skills required to adhere to government guidelines for alcohol consumption expressed in “units” of alcohol. The second aim was to identify correlates of greater motivation to adhere to guidelines and greater capacity to monitor alcohol unit intake. Methods: An online questionnaire was completed by 614 university students aged 18–30 living in South-East England. Key outcome variables were motivation to adhere to unit-based guidelines and a novel measure of accuracy of estimating recent alcohol unit intake. Findings: Respondents had poor knowledge of unit-based guidelines and their motivation to adhere to them was low. Only half of the sample had the skills to accurately estimate the alcohol unit content of their recent alcohol consumption. Greater capacity to accurately estimate recent alcohol unit intake and greater motivation to adhere to unit-based guidelines were related to psychol...
Abstract: In early club studies, nightlife domains are often depicted as scenes where class and ethno-racial boundaries are dissolved into post-modern cultural formations. This article adds to a growing body of research challenging this characterisation, by exploring how the policing of nightlife accessibility contributes to the (re)production of ethnic divisions and inequalities in nocturnal consumer spaces. Based on ethnographic research in Denmark, the article explores the key governmental rationalities informing bouncers’ exclusion of visible ethnic minority men. The article argues that bouncers’ ethnic governance is a multi-dimensional process which can be analysed using different analytical approaches. While the first part uses the concept of “vernacular risk perception” to highlight how bouncers’ ethnic governance is driven by loss-reductive logics, combined with prejudiced thinking, the second part uses an interactional perspective to illustrate how bouncers’ ethnic governance is also the product of...
TL;DR: This paper explored the association between maternal communication style and adolescents' motivation to change alcohol use, as well as the intervening role of autonomy and relatedness needs frustration and coping responses (i.e. oppositional defiance and submission) in this association.
Abstract: Aim: The study aimed to explore the association between maternal communication style [controlling vs. autonomy-supportive (AS)] and adolescents’ motivation to change alcohol use, as well as the intervening role of autonomy and relatedness needs frustration and coping responses (i.e. oppositional defiance and submission) in this association. Methods: A vignette-based study was conducted with 134 adolescents (Mage = 17.46 years) randomly assigned to a controlling or an AS condition, describing a maternal reaction to an alcohol use episode. Then, adolescents reported upon their experienced need frustration, their coping responses and their motivation to change alcohol use. Findings: Results indicated that adolescents in the controlling condition felt more frustrated in their needs for autonomy and relatedness that adolescents confronted with the AS reaction. When adolescents experienced frustration regarding their autonomy need, they coped by submitting to the maternal request, which in turn predicte...
TL;DR: The study indicates that, as preventive policies can influence parental practices in a positive way in the majority of families, special attention needs to be paid to families with heavy parental alcohol use.
Abstract: Aims: In this study we look at (1) changes in parenting practices related to adolescents’ alcohol use in Finland from 2006 to 2012 and (2) whether parents’ own drinking behaviour is related to the ...
TL;DR: Favourite NPS was associated with a good buzz/feeling, euphoria, enhancing sociability and relaxation, and ease of availability, cheapness and legality of NPS were cited, and achieving a predictable, safe high was important.
Abstract: Introduction: Novel psychoactive substances (NPS) are rapidly proliferating in the United Kingdom and elsewhere. We lack detailed information on rationales for their use. Methods: Qualitative data ...
TL;DR: This article explored the social meaning of age in relation to drug use and found that age remains an important explanatory factor for people's drug use, yet few studies explore the social meanings of age This article.
Abstract: Aims: Age remains an important explanatory factor for people’s drug use, yet few studies explore the social meaning of age in relation to drug use How adults practise and present their drug use as