O’Dwyer C, Mongan D, Millar S, Rackard M, Galvin B, Long J, et al. (2019) BMC Public Health, 19(1): 1323.

https://www.drugsandalcohol.ie/31239/

In this study we explored the prevention paradox in the Irish population by comparing alcohol-dependent drinkers (high-risk) to low-risk drinkers and non-dependent drinkers who engage in heavy episodic drinking (HED).

Our results indicate that the majority of alcohol consumption and related harms in the Irish population are accounted for by low- and moderate-risk drinkers, and specifically by those who engage in heavy episodic drinking. A population-based approach to reducing alcohol-related harm is most appropriate in the Irish context. Immediate implementation of the measures in the Public Health (Alcohol) Act (2018) is necessary to reduce alcohol-related harm in Ireland.

Doyle A, Lyons S and Lynn E (2019) Fire Safety Journal, 110: 102892.

https://www.drugsandalcohol.ie/31208/

For the first time in the Republic of Ireland, analysis using coronial data describes all fire-related fatalities occurring during the years 2014–2016.

Alcohol features prominently with alcohol present on toxicology for 54 (51%) fatalities. A Blood Alcohol Concentration (BAC) of at least 160 mg of alcohol per 100 mL of blood (mg/100 ml) was present in 35 fatalities (33% of all fatalities) and, of those, the majority were male and in the 35–59 years age group. The high BAC levels in a significant number of fire fatalities draws attention to the negative impact of alcohol on fire-related mortality.

O’Callaghan ME, Regan L, Wilson M, Byrne E, Hollywood B, O’Kelly F, et al. (2019) Irish Journal of Medical Science, Early online.

https://www.drugsandalcohol.ie/31236/

This project aims to evaluate the accuracy and acceptability of oral fluid testing for patients on methadone maintenance and also gather patient views on their treatment.

This study presents evidence that oral fluid testing is acceptable to most patients. While oral fluid testing was inferior to urine testing for benzodiazepines, it may have an adjunctive role to play in methadone maintenance provision. Patients reported more negative than positive aspects of methadone maintenance.

Crowley D, Lambert JS, Betts-Symonds G, Cullen W, Keevans M, Kelly E, et al. (2019) Eurosurveillance, 24(14): 1800369.

https://www.drugsandalcohol.ie/31182/

We aimed to estimate the seroprevalence of untreated chronic HCV infection and to identify associated risk factors in an Irish male prison.

The level of untreated chronic HCV infection in Irish prisons is high, with IDU [injecting drug use] the main associated risk.

Sadlier C, O’Connell S, Kelleher M and Bergin C (2019) International Journal of STD & AIDS, 30(5): 472–478.

https://www.drugsandalcohol.ie/31260/

The aim of this study was to measure temporal trends in incidence and risk factors for IPD (defined as culture of Streptococcus pneumoniae from blood, cerebrospinal fluid or both) in a cohort of HIV-positive patients attending an ambulatory HIV care centre in Dublin, Ireland over a 10-year period 2006–2015. Incidence of IPD was determined as events per 100,000 person-years' follow-up. Poisson regression was used to assess linear trend in incidence over time.

HIV-positive individuals remain at greater risk of IPD compared to the general population. Pneumococcal vaccine should be seen as a priority to ensure optimal protection for HIV-positive patients.

Smyth BP, O’Farrell A and Daly A (2019) Irish Medical Journal, 112(9): 1000.

https://www.drugsandalcohol.ie/31216/

We sought to describe the changing pattern of cannabis use and cannabis related health harms.

A concerted public health response is required to address escalating cannabis related health harms which have coincided with the arrival of more potent cannabis.

Murtagh R, Swan D, O’Connor E, McCombe G, Lambert JS, Avramovic G, et al. (2018) Interact J Med Res, 7(2): e10313.

https://www.drugsandalcohol.ie/30874/

We aimed to examine whether patients receiving opioid substitution therapy in primary care practices in Ireland were receiving guideline-adherent care regarding HCV [hepatitis C virus] screening. Ireland has developed a model of care for delivering opioid substitution treatment in the primary care setting. We conducted this study given the shift of providing care for PWID [people who inject drugs] from secondary to primary care settings, in light of current guidelines aimed at scaling up interventions to reduce chronic HCV infection and associated mortality. With general practice and primary care playing an increased role in HCV care, this study highlights the importance of prioritizing the development and evaluation of real-world clinical solutions that support patients from diagnosis to treatment completion.

Crowley D, Van Hout MC, Murphy C, Kelly E, Lambert JS and Cullen W (2018) Health & Justice, 6(1): 23.

https://www.drugsandalcohol.ie/30873/

We aim to identify the barriers and enablers to HCV screening and treatment in Irish prisons and inform the implementation of a HCV screening program within the Irish Prison Services (IPS).

Upscaling HCV management in prisons requires an in-depth understanding of all barriers and facilitators to HCV screening and treatment. Engaging prison officers in the planning and delivery of health care initiatives is a key strategy to optimising the public health opportunity that prisons provide.

Iqtidar M, Sharma K, Mullaney R, Kelly E, Keevans M, Cullinane M, et al. (2018) BJPsych Open, 4(5): 401–403.

https://www.drugsandalcohol.ie/30871/

Deaths in Irish prisons between 2009 and 2014 were retrospectively analysed using coroner's findings, including post-mortem toxicology.

There were 69 deaths in custody, 38 of which met inclusion criteria. All deaths by overdose (16) were positive for illicit drugs; 53% of deaths (8 of 15) due to hanging were also positive for illicit drugs, and 29% of deaths (2 of 7) from other causes were toxicology positive. In conclusion, 26 unnatural deaths (68%) were associated with use of illicit drugs, which are a major contributory factor to deaths of prisoners.

O’Reilly H, Hagerty A, O’Donnell S, Farrell A, Hartnett D, Murphy E, et al. (2019) Alcohol and Alcoholism, 54(5): 551–558.

https://www.drugsandalcohol.ie/30884/

The aim of this randomized controlled trial was to examine the impact of daily supportive text messages over a 6-month treatment period on mood and alcohol consumption in individuals with a dual diagnosis of alcohol use disorder (AUD) and depression following completion of an inpatient treatment programme.

Supportive text messages provide an early initial benefit in decreasing symptoms of depression and stress, with a further positive impact on alcohol consumption following a longer treatment period. Benefits did not persist six months after the intervention ended.

Columb D, Griffiths MD and O’Gara C (2019) Irish Journal of Psychological Medicine, Early online.

https://www.drugsandalcohol.ie/30885/

This article briefly examines online gaming and describes the characteristics of gaming disorder. Some features of online gaming that have addictive potential and similarities to other addictive behaviours such as gambling disorder are discussed. Finally, the article examines treatment options available for gaming disorder and treatment going forward from an Irish perspective.

Percy A, Agus A, Cole J, Doherty P, Foxcroft D, Harvey S, et al. (2019) Prevention Science, 20(6): 844–851.

https://www.drugsandalcohol.ie/30889/

The aim of this study was to examine the extent of recanting (inconsistencies in reporting of lifetime alcohol use) and its impact on the assessment of primary outcomes within a large-scale alcohol prevention trial.

While differential rates of recanting have the potential to undermine the analysis of prevention trial outcomes, recanting is easy to identify and control for within trial primary outcome analyses. Adjusting for recanting should be considered as an additional sensitivity test within prevention trials.

Sunday S and Kabir Z (2019) International Journal of Environmental Research and Public Health, 16(15): 2759.

https://www.drugsandalcohol.ie/30908/

This study aimed to assess the impact of carers' smoking status on childhood obesity in a cohort of children enrolled in the Growing up in Ireland (GUI) study. Participants from the GUI infant cohort were categorized into four groups based on their exposure status: Neither caregiver smoked (60.4%), only primary caregiver smoked (13.4%), both caregivers smoked (10.9%).

Exposure to primary carers' smoking (98% are biological mothers) was found to be significantly associated with childhood overweight/obesity at age three (Odds Ratio: 1.30, 95% CI: 1.17-1.46) and at age five (OR: 1.31, 95% CI: 1.16-1.49). Exposure to both carers' smoking status was significantly associated with increased odds of childhood overweight/obesity across both waves. These findings emphasize the health burden of childhood obesity that may be attributable to maternal smoking postnatally and through early childhood in Ireland.

McNamara S, Stokes S and Nolan J (2019) Irish Medical Journal, 112(7): 970.

https://www.drugsandalcohol.ie/30910/

200 urine samples from patients attending the HSE National Drug Treatment Centre (NDTC) who are monitored on a regular basis for drug and alcohol use and which tested positive for benzodiazepine class drugs by immunoassay screening were subjected to confirmatory analysis to determine what Benzodiazepine drugs were present and to see if etizolam or other new benzodiazepines are being used in the addiction population currently.

Benzodiazepine prescription and use is common in the addiction population. Of significance we found evidence of consumption of an illicit new psychoactive benzodiazepine, Etizolam.

Petty-Saphon N and Kavanagh P (2020) Irish Journal of Medical Science, 189(1): 3–10.

https://www.drugsandalcohol.ie/30938/

A secondary analysis of Healthy Ireland 2015 was undertaken to identify determinants of smoking cessation attempts and the use of smoking cessation aids in the general adult population in Ireland.

This study highlights the need to strengthen smoking cessation in Ireland to increase the number of smokers that successfully quit and achieve a Tobacco Free Ireland. The development and implementation of National Clinical Guidelines for the Diagnosis and Treatment of Tobacco Addiction will play a key role in this.

Költő A, Cosma A, Young H, Moreau N, Pavlova D, Tesler R, et al. (2019) International Journal of Environmental Research and Public Health, 16(17): 3063.

https://www.drugsandalcohol.ie/30964/

Sexual minority youth are at higher risk of substance use than heterosexual youth. However, most evidence in this area is from North America, and it is unclear whether the findings can be generalized to other cultures and countries. In this investigation, we used data from the 2014 Health Behaviour in School-aged Children (HBSC) study to compare substance use in same- and both-gender attracted 15-year-old adolescents from eight European countries (n = 14,545) to that of their peers who reported opposite-gender attraction or have not been romantically attracted to anyone.

The results suggest that sexual minority stigma (and love on its own) may contribute to higher substance use among adolescents in European countries.

Deacy JJP and Houghton F (2019) Irish Medical Journal, 112(7): 975.

https://www.drugsandalcohol.ie/30911/

Opioid addiction in many countries has risen considerably in recent years, leading to the increasing use of terms such as the Opioid Crisis and the Opioid Epidemic. Substantial international attention has focused on this issue following significant increases in opioid related overdoses resulting in death. This phenomenon has been particularly marked in countries such as the USA and the UK. It is estimated that in 2015 Europe experienced 8,441 deaths from opioid overdose. The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) notes that Ireland has also experienced a significant rise in opioid and methadone related deaths in recent years. Evidence suggests that on average heroin users will overdose three times in their lifetime, and that one in two heroin addicts will die from an overdose.

Bunting B and Bharat C (2019) Addiction Research & Theory, 27(4): 347–353.

https://www.drugsandalcohol.ie/31109/

This study presents prevalence estimates and ages of onset for alcohol use, regular use, use disorders and remission from use disorders in Northern Ireland, and the time for transitioning between these stages.

The consumption of alcohol is high within Northern Ireland with some 83% of the population consuming alcohol, and with over 90% of this group taking alcohol on a regular basis. The abuse of alcohol was particularly marked amongst students and males, with dependence showing a higher prevalence amongst those with the lowest level of educational attainment, and where the commencement of alcohol consumption was at an early age. Transitions between stages of lifetime alcohol use, regular use, and use disorders were associated with the early commencement of alcohol use, education, cohort use and being male.

Wells JSG, Bergin M, Van Hout MC, McGuinness P, De Pleissis J, Rich E, et al. (2018) Journal of Pharmacy & Pharmaceutical Sciences, 21: 286–295.

https://www.drugsandalcohol.ie/31117/

The aim of this novel study was to report on the results of a survey of customers purchasing OTC codeine containing medicinal products at pharmacies in Ireland, South Africa and England; exploring use, sources of knowledge and perception of risks.

Codeine containing products are widely purchased and used in all three jurisdictions. Whilst the majority of customers appear to have some awareness and knowledge of risks, it does not materially impact on their purchasing behaviour with a substantial minority purchasing/using such products on a weekly basis. This regularity of purchase, whilst indicative of the popularity of such products, may also be a potential indicator of misuse. Future research is needed in relation to cultural and gendered differences and targeted information giving and harm reduction initiatives for safe usage of these medicinal products.

Comiskey C, Galligan K, Flanagan J, Deegan J, Farnann J and Hall A (2019) Journal of Addictions Nursing, 30(3): 169–176.

https://www.drugsandalcohol.ie/31044/

The aims of this study were to establish from clients their nursing needs and to use these findings alongside an objective measurement of clients' health to inform the development of a nurse-led treatment model.

Clients articulated the role of the nurse in their physical care; however, unexpectedly, clients identified nurses as an essential source of psychological support and expressed the wish for the role to be expanded in terms of managing methadone treatment and accessing additional services and resources. Results contributed to the formation of the nurse-led, client mental-health-focused, Healthy Addiction Treatment Recovery Model for addiction nursing services. In terms of national policies, findings provided new evidence articulated by service users on their desire for the expansion of nurse prescribing in addiction services and an expansion of the role to more adequately address client needs.

Clancy C, Kelly P and Loth C (2019) Journal of Addictions Nursing, 30(3): 139–148.

https://www.drugsandalcohol.ie/31046/

In this article, we discuss the state of the art of addiction nursing in Europe. This state is viewed throughout the United Kingdom, Ireland, and the Netherlands and has a direct link to the future. Despite differences, the three countries share nursing values. The start of International Nurses Society in Addictions Nursing Ireland and the Netherlands is only the beginning of a new connection and cooperation Europe-wide.

James PD, Comiskey C and Smyth BP (2019) Journal of Addictions Nursing, 30(3): 211–218.

https://www.drugsandalcohol.ie/31042/

The aim of this study was to understand more about the experience of young, treatment-seeking, cannabis users.

Young cannabis users in treatment can clearly identify many negative aspects of their cannabis use but are particularly ambivalent toward cannabis. Reluctance to aim for abstinence is common.

Arensman E, Larkin C, McCarthy J, Leitao S, Corcoran P, Williamson E, et al. (2019) BMC Psychiatry, 19(1): 275.

https://www.drugsandalcohol.ie/31050/

The Suicide Support and Information System Case Control study (SSIS-ACE) aimed to compare psychosocial, psychiatric and work-related risk factors across three groups of subjects: suicide decedents, patients presenting to hospital with a high-risk self-harm episode, and general practice controls.

The study allows for the investigation of consistency across different data sources and contributes to the methodological advancement of psychological autopsy research. The study will also inform clinical and public health practice. The comparison between suicide cases and controls will allow investigation of risk and protective factors for suicide more generally, while the comparison with high-risk self-harm patients will help to identify the factors associated specifically with a fatal outcome to a self-harm episode. A further enhancement is the particular focus on specific work-related risk factors for suicide.

Leão T, Perelman J, Clancy L, Hoffmann L, Kinnunen JM, Mélard N, et al. (2019) European Journal of Public Health, Early online.

https://www.drugsandalcohol.ie/31098/

In this study, we aimed at estimating the costs of school smoking bans, school prevention programmes and non-school bans (smoking bans in non-educational public settings, bans on sales to minors and bans on point-of-sale advertising), implemented in Finland, Ireland, the Netherlands, Belgium, Germany, Italy and Portugal, for 2016.

Costs of the tobacco control policies evaluated here depend mainly on the number of person-hours allocated to their implementation, and on the scale of intervention. Non-school bans presented the lowest costs, and the implementation of all policies cost up to €36 pp for 1 year.

Comiskey C, Bretteville-Jensen AL, Bergeron H, Bühringer G, Dargan P, Davoli M, et al. (2020) Addiction, 115(2): 199–200.

https://www.drugsandalcohol.ie/30863/

[Editorial] With the breadth of new psychoactive substances and international policy changes, an analysis of specific responses in all areas of drug supply and demand is beyond the resources of a single country. The Scientific Committee of the EMCDDA calls for a strengthening of global monitoring and evidence synthesis and a renewed vigour in collaborative efforts to expand training, research and the quality and comparability of data across Europe and beyond.

Swan D, Cullen W, Macías J, Oprea C, Story A, Surey J, et al. (2018) Expert Review of Gastroenterology & Hepatology, 12(3): 303–314.

https://www.drugsandalcohol.ie/30877/

This paper describes the Hepcare Europe project, a collaboration between five institutions across four member states (Ireland, UK, Spain, Romania), to develop, implement and evaluate interventions to improve the identification, evaluation and treatment of HCV among PWID [people who inject drugs].

Hepcare has the potential to make an important impact on patient care for marginalised populations who might otherwise go undiagnosed and untreated. Lessons learned from the study can be incorporated into national and European guidelines and strategies for HCV.

Flynn D, Joyce M, Spillane A, Wrigley C, Corcoran P, Hayes A, et al. (2019) Addiction Science & Clinical Practice, 14(1): 28.

https://www.drugsandalcohol.ie/30939/

It has been hypothesised that the skills training, which is a facet of the full DBT [dialectical behaviour therapy] programme, might be effective for people with severe emotional dysregulation and other co-occurring conditions, but who do not meet the criteria for BPD [borderline personality disorder]. However, there is limited research on standalone DBT skills training for people with substance misuse and emotional dysregulation.

This DBT skills training programme, adapted from standard DBT, showed positive results for participants and appears effective in treating people with co-occurring disorders. Qualitative results of this mixed methods study corroborate the quantitative results indicating that the experiences of participants have been positive. The study indicates that a DBT skills programme may provide a useful therapeutic approach to managing co-occurring symptoms.