Daly C, Griffin E, Corcoran P, et al. (2020) International Journal of Drug Policy, 76: 102609.

https://www.drugsandalcohol.ie/31526/

This study aimed to examine the incidence of intentional drug overdose (IDO), to identify the predictors of fatal IDO and to establish which drugs are linked with greater risk of a fatal outcome.

Male gender, increasing age and multiple drug use were associated with fatal IDO outcome. Tricyclic antidepressants and opioids were associated with a significantly increased risk of death following intentional overdose. Clinicians need to consider the case fatality risk of drugs when determining treatment for patients at risk of or those who have previously harmed themselves.

Sheridan A, Quintyne KI and Kavanagh P (2020) Irish Medical Journal, 113(1): 8.

https://www.drugsandalcohol.ie/31554/

In Ireland, 20% of adults smoke. Many current and ex-smokers live with ill-health and disability as a result of smoking, and this study aimed to quantify the extent of smoking-related hospitalisations in Irish publicly funded hospitals.

Smoking continues to cause a considerable impact on hospital services in Ireland.

Brennan R and Van Hout MC (2020) Heroin Addiction and Related Clinical Problems, Early online.

https://www.drugsandalcohol.ie/31533/

This study aims to add to the evidence based on diverted pregabalin use in the opioid agonist treatment (OAT) cohort in Ireland.

We report here on the first study in Ireland investigating the experiences of individuals who access opioid agonist treatment and reported current or recent pregabalin use. Increased pharmaco-vigilance amongst medical practitioners is warranted when prescribing Lyrica to individuals with vulnerabilities such as a history of problematic drug use. Trauma informed interventions in addition to pragmatic harm reduction information for polydrug users to prevent cross tolerance, dependence and overdose deaths should be part of the healthcare and policy response.

Smyth BP and McCarney G (2020) Irish Medical Journal, 113(1): 2.

https://www.drugsandalcohol.ie/31553/

[Editorial] In the 1990s, Ireland had the youngest population of heroin dependent patients in Europe. At that time problems were largely confined to Dublin, and within Dublin use was concentrated in specific areas of very significant deprivation. At the peak of the heroin epidemic in 1996, there were over 180 adolescents (under 18) presenting for addiction treatment in Dublin annually with a heroin use disorder. Given that addiction services had been developed with adults in mind, the National Drug Treatment Centre established the Young Persons Program (YPP) in 2000, in recognition of the very different needs of these young patients. The authors, both child and adolescent psychiatrists, arrived into the service a few years later.

Lynn E, Cousins G, Lyons S and Bennett KE (2019) Drug and Alcohol Dependence, 206: 107741.

https://www.drugsandalcohol.ie/31323/

In this study we examined factors associated with pregabalin-positive poisoning deaths (PPPD) between 2013 and 2016 in Ireland.

Enhanced training to prescribers and treatment providers on the potential risks associated with pregabalin, particularly among people who use drugs, is required.

Frankis J, Flowers P, McDaid L and Bourne A (2018) Sexual Health, 15(2): 144–150.

https://www.drugsandalcohol.ie/31315/

This paper establishes the prevalence of chemsex drug use among men who have sex with men (MSM), the extent to which these drugs are used in a sexual context, as well as their associated behaviours and circumstances of use.

Only a small proportion of MSM in Scotland, Wales, Northern Ireland and the Republic of Ireland reported chemsex, and, for the first time, it is demonstrated that not all chemsex drug use was sexualised. Nevertheless, MSM who engage in chemsex (MWEC) reported substantial sexual risk inequalities. These novel findings highlight several opportunities for intervention, particularly around the multiple vulnerabilities of MWEC, opportunities for early identification of those most vulnerable to chemsex-related harm and the potential to develop a specialised responsive patient pathway.

Hegerl U, Maxwell M, Harris F, Koburger N, Mergl R, Székely A, et al. (2019) PLoS One, 14(11): e0224602.

https://www.drugsandalcohol.ie/31340/

This paper reports on the primary outcome of the intervention (the number of completed and attempted suicides combined as 'suicidal acts') and on results concerning process evaluation analysis. Interventions were implemented in four European cities in Germany, Hungary, Portugal and Ireland, with matched control sites.

Hypothesised mechanisms of action for successful implementation were observed and drivers for 'added-value' were identified: local partnership working and 'in-kind' contributions; an approach which valued existing partnership strengths; and synergies operating across intervention levels. It can be assumed that significant events during the implementation phase had a certain impact on the observed outcomes. However, this impact was, of course, not proven.

Gilpin DF, McGown KA, Gallagher K, et al. (2019) Respiratory Research, 20: 267.

https://www.drugsandalcohol.ie/31477/

This study compared the effect of e-cig vapour (ECV) and cigarette smoke (CSE) on the virulence and inflammatory potential of key lung pathogens (Haemophilus influenzae, Streptococcus pneumoniae, Staphylococcus aureus and Pseudomonas aeruginosa).

The findings suggest that ECV and CSE can induce changes in phenotype and virulence of key lung pathogens, which may increase bacterial persistence and inflammatory potential.

Houghton F and McInerney D (2019) Irish Journal of Medical Science, Early online.

https://www.drugsandalcohol.ie/31423/

Ireland’s relationship with alcohol is decidedly problematic. Per capita alcohol consumption and binge drinking rates in Ireland are both worryingly high. Such excess results in significant costs in terms of morbidity, mortality, finances and valuable and finite health and hospital resources. Results from both the ESPAD [European Schools Project on Alcohol and Other Drugs] survey and the HBSC [Health Behaviour in School-Aged Children] survey therefore clearly indicate that youth initiation into alcohol use is a significant issue. Further validation of this issue may be seen in results from the National Alcohol Diary Study which indicated that almost two-thirds (63.9%) of males and half (51.4%) of females in Ireland started drinking alcohol before the age of 18 years. These findings are extremely important as evidence examining the impact of alcohol on the developing brain has identified the ‘disrupting effects of adolescent binge drinking on the developmental trajectories of both brain and personality'.

Bates C (2019) Irish Probation Journal, 16: 184–197.

https://www.drugsandalcohol.ie/31389/

This article considers the context and policy development in Ireland around the introduction of safer injecting facilities (SIFs), in addition to exploring the debates about their operation. The findings from a small-scale research study, conducted by the author as part of a master’s programme in criminology and criminal justice in University College Dublin in 2018, are outlined. The focus of this research was to gauge the views of members of An Garda Síochána (n = 5) based in the Dublin metropolitan area on the potential for SIFs to operate effectively and efficiently.

Gardaí were identified as appropriate participants as they are often the first point of contact with street drug users and have an awareness of how the introduction of SIFs may impact on policing strategy and operations.

O’Dwyer K (2019) Irish Probation Journal, 16: 153–167.

https://www.drugsandalcohol.ie/31390/

This article discusses the role of mentoring in reducing youth crime, drawing on a 2016 evaluation of Le Chéile mentoring services in the Republic of Ireland. There are many studies of mentoring of ‘at risk’ children and young people, which show a range of benefits when good practice is followed. There are fewer studies of mentoring of young offenders, and results are less clear-cut – variously described as ‘promising’, ‘mixed’, ‘indirect’, ‘modest’, ‘tantalising’ or lacking clear evidence.

The article examines the reasons for the equivocation about mentoring outcomes in other jurisdictions and explores possible reasons for Le Chéile’s positive results. It discusses a number of themes, including the importance of volunteer mentors, the building of relationships of trust, the balance between listening and challenging, and the importance of commitment and perseverance.

Crosbie E (2019) Health Policy, 123(10): 932–935.

https://www.drugsandalcohol.ie/31537/

Tobacco Free Ireland set out 60 recommendations and measures to reach the 2025 target, including introducing SP [standardized packaging]. Tobacco companies and trademark and intellectual property organizations opposed the SP proposal claiming it would: (1) not work to reduce smoking levels, (2) increase illicit tobacco trade, (3) create unnecessary problems for retailers, and (4) violate domestic and international laws governing trademarks. However leading health groups in Ireland presented evidence on how SP would communicate the harms of tobacco to smokers and discourage young people from beginning to smoke. These efforts combined with strong political will helped Ireland to become the second country in the world to enact standardized packaging for all tobacco products.

Comiskey C (2020) Harm Reduction Journal, 17(1): 3.

https://www.drugsandalcohol.ie/31534/

Policy development by partnership is difficult, however, 'Reducing Harm, Supporting Recovery: A health led response to drug and alcohol use in Ireland 2017-2025' hailed a new era. This policy was based on an agreed philosophy and core values across a 21-member partnership and has stated a common commitment to a health-led response.

A key recommendation from the process was to ensure that all voices had an equal opportunity to be heard and to ensure that priority actions identified from the wider sources of evidence were not lost during the extended process. The breadth of the partnership aided this. While we have succeeded in developing a sound strategy, success will depend on continuing support from the partnership and appropriate resourcing from the ministries.

Rosalim JP (2020) Journal of Correctional Health Care, 26(1): 27–35.

https://www.drugsandalcohol.ie/31593/

This study examined from an Irish perspective the contentious policy debate about providing clean needles to injecting drug users within prison systems; specifically, it examined the views of six senior managers who were prison health staff and security management.

Research participants were generally opposed to the introduction of prison-based needle and syringe exchange programs (PNSP) in Ireland. They argued that (1) PNSP were unnecessary since injecting drug use within Irish prisons has declined significantly, (2) PNSP, by making needles freely available to prisoners, would make prisons riskier since these needles might be used as weapons against prison staff or other prisoners, and (3) PNSP might be seen as condoning illicit drug use and sending the 'wrong message'. It is concluded that, for the moment at least, there is little likelihood of PNSP becoming a reality in the Irish Prison Service.

Crowley D, Murtagh R, Cullen W, Lambert JS, McHugh T and Van Hout MC (2019) BMC Infectious Diseases, 19(1): 702.

https://www.drugsandalcohol.ie/31395/

The aim of this review was to map key findings and identify gaps in the literature (published and unpublished) on HCV [hepatitis C virus] infection in Irish PWUD [people who use drugs] and prisoners.

Ireland like other European countries has high levels of undiagnosed and untreated HCV infection. Collecting, synthesising and identifying gaps in the available literature is timely and will inform national HCV screening, treatment and prevention strategies.

Lynch T, Ryan C, Hughes CM, et al. (2020) Addiction, Early online.

https://www.drugsandalcohol.ie/31589/

The aim of the study is to assess the effectiveness of brief interventions in primary care aimed at reducing or discontinuing long-term benzodiazepine/Z-drug (BZRA) use.

Brief interventions delivered in primary care are more effective than usual care in reducing and discontinuing long-term benzodiazepine/Z-drug use.

Drugnet Ireland is the quarterly newsletter of Ireland’s focal
point for the EMCDDA and is produced in collaboration with the HRB National Drugs Library. Drugnet Ireland is published by
the Health Research Board.

Managing editor:    Brian Galvin
Copy-editing:          O’Hanlon Media

© Health Research Board, 2020
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