Lynn T, Lynn E, Keenan E and Lyons S (2018)
J Stud Alcohol Drugs, 79(2): 286–292.
https://www.drugsandalcohol.ie/28728/

The purpose of this study was to provide trend analysis on all deaths among drug users who injected at or around the time of their death in Ireland between 1998 and 2014.

This study is the first to describe the trends in all deaths among drug users who injected at or around the time of their death in Ireland between 1998 and 2014. The analysis provides empirical evidence that can be used by policy makers to support the ongoing improvement of drug treatment services, harm reduction initiatives, and overdose prevention strategies for people who inject drugs.

McDonagh D, Connolly N and Devaney C (2018)
Child Care in Practice, Early online.
https://www.drugsandalcohol.ie/28867/

This paper focuses on the help-seeking behaviour of those affected by substance use within their families, exploring the ways in which informal, semi-formal and formal supports are drawn on. The prohibitive factors and barriers influencing decision making by families in need is also discussed. Through a qualitative research approach this study collates the perspectives of a cohort of family members in Ireland, with a view to informing and enhancing the design and delivery of support services. While participants positively endorsed most forms of formal support, services were sought and accessed in an ad-hoc fashion, with a range of psychological, geographical and emotional barriers presenting.

The availability of services and the stigma associated with having family members affected by substance-use disorders are also highlighted. The paper provides opportunities and recommendations for potential ways of overcoming such barriers in order to access family support at an earlier stage.

Cadogan CA, Ryan C, Cahir C, Bradley CP and Bennett K (2018) Br J Clin Pharmacol, 84(6): 1354–63.
https://www.drugsandalcohol.ie/28750/

The aim of this study was to examine prescribing trends for benzodiazepines and Z-drugs to General Medical Services (GMS) patients in Ireland.

Benzodiazepine prescribing to the GMS population in Ireland significantly decreased from 2005 to 2015, and was coupled with significant increases in Z-drug prescribing. The study shows that benzodiazepine and Z-drug prescribing is common in this population, with a third receiving long-term prescriptions. Targeted interventions are needed to reduce potentially inappropriate long-term prescribing and use of these medications in Ireland.

Maduemem KE, Adedokun C and Umana E (2018)
Ir Med J, 111(4).
https://www.drugsandalcohol.ie/28870/

Suicide is the third most common cause of death among adolescents globally, and poisoning is the leading method of attempted suicide. Survival after self-poisoning or drug overdose (OD) is common, providing an opportunity for secondary prevention. The aim of this study was to highlight pattern of presentations and preceding factors of OD in an adolescent population. We retrospectively evaluated the data of 85 adolescents presenting to a large regional hospital with OD over a 3-year period. The female-to-male ratio was 4.3:1. The median age of adolescents was 15.83 (range: 11.32–16.98) years. History of deliberate self-harm (DSH) was documented in 44.7%. Twenty-eight (33%) patients had been under the care of the CAMHS prior to index admission. Acetaminophen was the commonest drug used. Depression was the most common cause of mental illness in the study group. Substance abuse and conduct disorder were significantly commoner in males (p<0.05). Self-poisoning including OD in adolescence is a strong predictor of suicide; understanding the probable triggers can be significant in establishing appropriate prevention strategies.

Griffin E, Murphy C, Perry IJ, Lynch B,
Arensman E and Corcoran P (2018)
Ir J Med Sci, Early online.
https://www.drugsandalcohol.ie/28777/

We assessed the impact of the reconfiguration of acute services within a hospital group in terms of the number and clinical management of self-harm presentations.

There is evidence to suggest that acute hospital reconfiguration of hospital services impacts on patterns of patient flow. Findings have implications for those implementing reconfiguration of acute services.

Hughes E, Hopkins L and Parker R (2018)
PLoS ONE, 13(2): e0192393.
https://www.drugsandalcohol.ie/28817/

We aimed to describe changes in survival in alcoholic hepatitis (AH) over time by examining published data.

There has been no improvement in mortality from AH.
This is not explained by changes in severity of disease.
This emphasises the urgent need for effective treatments
for this alcoholic hepatitis.

Windle J (2017) Criminol Crim Justice, Early online.
https://www.drugsandalcohol.ie/28797/

This article analyses 10 years (2004–2014) of An Garda Síochána controlled drug data to investigate the impact of economic recession and globalization on the Irish illicit drug market. The limited international literature on recessions and drug markets suggests that economic downturns can increase both drug consumption and dealing. Gardaí data may, however, suggest that the 2008 Great Recession reduced drug use and dealing, yet increased the cultivation and manufacture of drugs: trends which largely conflict with the international literature. Two testable hypotheses are drawn from the data: (1) net consumption and trade of illicit drugs were reduced by emigration triggered by the Great Recession; (2) the Great Recession forced an adaptation in the market which sped up the process towards import substitution of cannabis cultivation. The article concludes by investigating how recent changes highlight the globalized nature of Irish drug markets before proposing avenues for further research.

Darcy C (2018) Irish Journal of Sociology, 26(1): 5–24.
https://www.drugsandalcohol.ie/28662/

This paper highlights a significant gender disparity within Ireland’s illicit drug landscape, which is predominantly composed of men. Irish men’s historical gender invisibility contributed to their predominance as drug users being overlooked. Thus, this paper focuses a masculinities lens on Irish men’s recreational use of illicit drugs, making their drug taking visible as a gendered activity.

The study reveals masculinities are an interpretative lens employed by men when trying to understand their own or other men’s drug taking. It is argued that men’s drug taking and masculinities intersect. In homosocial contexts, men’s recreational use of illicit drugs can contribute to them demonstrating masculinities to other drug-taking men; however, outside of these contexts, the same behaviours can be viewed by non-drug takers as emasculating.

Daly C, Griffin E, Ashcroft DM, Webb RT,
Perry IJ and Arensman E (2018)
Eur J Public Health, 28(4): 681–686.
https://www.drugsandalcohol.ie/28709/

We aimed to determine the profile of patients engaging in overdose, to identify drugs frequently used and to quantify the contributions of multiple drug use and alcohol involvement.

People who engage in IDO frequently take prescription only or sales restricted drugs, often involving alcohol and/or multiple drug use. These findings highlight the importance of addressing drug and alcohol misuse, potential inappropriate prescribing and the enforcement of legislation restricting specific drug sales.

Brennan R, Wells J and Van Hout MC (2018)
Int J Drug Policy, 55: 47–50.
https://www.drugsandalcohol.ie/28680/

New evidence with regard to a previously undocumented practice — self-phlebotomy, known as 'bloodletting' — in contemporary injecting performance and image enhancing drug (PIED) culture is the subject of this paper. While self phlebotomy has been evidenced in psychiatric patients previously, it was performed here in people who inject AAS [anabolic-androgenic steroids] as a self-directed healthcare procedure.

This study is intended to provide the first snapshot of online communal activity around practice of self-phlebotomy or bloodletting amongst people who inject AAS. Further research in this area is warranted, and will be of benefit to healthcare workers, treatment providers and policy makers particularly as this relates to evidence informed and targeted harm reduction policies and effective public health interventions.

Daly C, Griffin E, Ashcroft DM, Webb RT,
Perry IJ and Arensman E (2017)
Clin Drug Invest, 38(4): 373–380.
https://www.drugsandalcohol.ie/28436/

This paper examines the trends in the prevalence of gabapentinoids taken in intentional drug overdoses (IDO),
the profile of individuals taking them, and associated overdose characteristics.

This study identified the increasing use of gabapentinoids in IDO, describing the profile and overdose characteristics of presentations. It is important for clinicians to exercise vigilance while prescribing gabapentinoids, including being aware of other medications that their patients may have access to. Our findings support the need for routine monitoring for signs of misuse among those prescribed gabapentinoids.

Manning RM and Greenwood RM (2018)
Am J Community Psychol, 61(1–2): 88–103.
https://www.drugsandalcohol.ie/28449/

In the present mixed-methods study, the relationship of service providers’ work-related values to their service users’ recovery experiences in the microsystem of homelessness were examined. Findings confirm that providers’ values are an important influence on service users’ recovery. Results are discussed in terms of their implications for recovery-oriented theory and practice.

Van Hout MC, Benschop A, Bujalski M, Dabrowska K, Demetrovics Z, Felvinczi K, et al. (2017)
Int J Ment Health Addict, 6(2): 480–95.
https://www.drugsandalcohol.ie/28500/

The study describes health and social consequences of recent NPS use as reported in a survey of marginalised, nightlife and online NPS users in the Netherlands, Hungary, Portugal, Ireland, Germany and Poland (n=3023).

Marginalised users reported substantially more acute side effects, more mid- and long-term mental and physical problems, and more social problems. Development of country-specific NPS awareness raising initiatives, health and social service needs assessments, and targeted responses are warranted.

Papanastasiou N, Hill S and Amos A (2018)
Nicotine Tob Res, Early online.
https://www.drugsandalcohol.ie/28488/

We reviewed existing qualitative evidence on young
people and smoking in Europe in order to assess whether, in what ways and why young people comply with, adapt to, resist or circumvent tobacco control policies in their respective countries.

There is very little qualitative evidence exploring the
impacts of tobacco control on youth smoking in Europe.
To develop more effective smoking prevention policies that take account of local political, social and cultural contexts, more qualitative research from a wider range of European countries is needed in order to understand how tobacco control impacts on young people’s social worlds and smoking behaviours.

Barrett P, Griffin E, Corcoran P, O’Mahony M
and Arensman E (2018)
J Affect Disord, 229: 523–31.
https://www.drugsandalcohol.ie/28457/

The study aim was to estimate the incidence of self-harm among the homeless population and to assess factors associated with self-harm.

The study only reflects self-harm presenting to hospital, and assumes no change in homelessness status after index presentation. Residual confounding may affect the results.

There is a disproportionate burden of self-harm among the homeless. Targeted preventive actions are warranted.

O’Rourke C, Linden MA, Lohan M and Bates-Gaston J (2016) Brain Inj, 30(7): 839–54.
https://www.drugsandalcohol.ie/28446/

The aim of this review is to systematically explore the literature surrounding the rates of traumatic brain injury (TBI) and their co-occurrences in a prison population.

The high degree of variation in TBI rates may be attributed to the inconsistent way in which TBI was measured, with only seven studies using valid and reliable screening tools. Additionally, gaps in the literature surrounding personality outcomes in prisoners with TBI, female prisoners with TBI and qualitative outcomes were found.

Moylett S and Hughes BM (2017) Addict Behav Rep, 6: 56–64.
https://www.drugsandalcohol.ie/28433/

The study presented one of the first examinations of the associations among personality, alcohol-related protective behavioural strategies (PBS), alcohol consumption, sexual intercourse and sex-related alcohol negative consequences in Irish, female college students (n=522).

The findings of this study posited that the use of PBS
has a key role to play in the levels of sexual intercourse
and alcohol consumption, age and openness, and the associated negative sexual consequences in Irish, female college students.

O’Regan A, Cullen W, Hickey L, Meagher D and Hannigan A (2018) BMC Fam Pract, 19(1): 30.
https://www.drugsandalcohol.ie/28595/

The aims of this study were to investigate the prevalence of documentation of problem alcohol use in patient records in Irish general practice, and to describe the documentation of its diagnosis and treatment.

This is the first large scale study of patient records in general practice in Ireland looking at documentation of screening and treatment of problem alcohol use. It highlights the current lack of documentation of alcohol problems and the need to re-inforce positive attitudes among GPs in relation to preventive work.

Ivers JH, Larkan F and Barry J (2018)
J Psychoactive Drugs, 50(3): 231–39.
https://www.drugsandalcohol.ie/28586/

The aim of the study was to gain an in-depth understanding of opioid-dependent patients’ lived experiences post-detoxification.

Recovery was seen as a process that was not always linear, and lapse and relapse were viewed as part of this process. Patients had great insight into ’risk factors for relapse’, information and knowledge gained over several years and many treatment episodes. Furthermore, the findings illustrate the role insight plays in any learning and growth experience and the emphasis that is placed upon it within the treatment journey; insight is a fundamental underpinning to any real growth and development. The current article argues that insight merits a more explicit role in the model of recovery capital.

Campbell A, O’Neill N and Higgins K (2017)
Int J Drug Policy, 40: 93–101.
https://www.drugsandalcohol.ie/28564/

Due to the recent emergence of NPS and rapidly changing nature of the market, evidence about the way in which the emerging drugs are managed in health and social care settings is limited.

Study respondents reported that addressing NPS related issues with service users was a key aspect of their daily role and function. Levels of injecting behaviours were also viewed as relatively high by study participants. Almost all workers used harm reduction as their primary approach when working with service users and the majority of respondents called for additional practical training in relation to addressing drug interactions and intervening with NPS related issues.

Brandon AM and O’Connell M (2017)
Br J Criminol, azx080, Early online.
https://www.drugsandalcohol.ie/28629/

This exploratory study examines whether disparities exist between the sentencing of Irish and non-Irish defendants, using data from the Irish Prison Service.

Non-Irish nationals were statistically significantly under-represented in the offence categories, ‘attempted robbery’, ‘vehicle theft’, ‘criminal damage’, ‘robbery’, ‘parking fine offences’, ‘assault causing harm’, ‘intoxication in a public place’, ‘threatening behaviour in a public place’, ‘unlawful possession of drugs’ and ‘no television licence’. They were statistically significantly over-represented in the offence categories, ‘driving under the influence’, ‘no vehicle insurance’, ‘theft’ and ‘possession of drugs for sale/supply (to the value of <€13,000)’.

Groshkova T, Cunningham A, Royuela L, Singleton N,
Saggers T and Sedefov R (2018)
Int J Drug Policy, 56: 187–196.
https://www.drugsandalcohol.ie/28619/

This paper reviews some conceptual issues and measurement challenges relevant to the interpretation of price data. It also highlights the issues with between-country comparisons of drug prices and introduces the concept of affordability of drugs, going beyond purity-adjustment to account for varying national economies.

It is argued that purity-adjusted price alone provides an incomplete comparison of retail price across countries. The proposed new method takes account of the differing economic conditions within European countries, thus providing a more sophisticated tool for cross-national comparisons of retail drug markets in Europe. Future work will need to examine other potential uses of the drug affordability tool.

Ahern S, Burke LA, McElroy B, Corcoran P, McMahon EM, Keeley H, et al. (2018) Eur Child Adolesc Psychiatry, Early online.
https://www.drugsandalcohol.ie/28585/

We aimed to conduct a full cost-effectiveness analysis (CEA) of the large pan-European school-based RCT, Saving and Empowering Young Lives in Europe (SEYLE).

This CEA supports YAM [Youth Aware of Mental Health] as the most cost-effective of the SEYLE interventions in preventing both a suicide attempt and severe suicidal ideation.

Rochford C, Edgeworth D, Hashim M and Harmon D (2018)
Ir J Med Sci, Early online.
https://www.drugsandalcohol.ie/28551/

The aim of this study was to evaluate the attitudes of Irish patients with chronic pain towards medicinal cannabis.

The study highlights the attitudes of chronic pain patients in Ireland towards medicinal cannabis. It shows their desire to have medical cannabis legalised for chronic pain and that they view it as a reasonable pain management option.

Arensman E, Griffin E, Daly C, Corcoran P,
Cassidy E and Perry IJ (2018)
PLoS ONE, 13(3): e0193587.
https://www.drugsandalcohol.ie/28690/

The specific objectives of this study were to examine variation in the care of self-harm patients in hospital settings and to identify the factors that predict recommended next care following self-harm.

The extensive hospital variation in recommended next care indicates that management of self-harm patients may be determined more by where they present than by the needs of the patient. The study outcomes underline the need to standardise the clinical management of self-harm patients in general hospital settings.

O’Halloran L, Nymberg C, Jollans L,
Garavan H and Whelan R (2017)
Addiction, 112(4): 719–26.
https://www.drugsandalcohol.ie/28642/

We outline how neuroimaging data can identify the neural predictors of adolescent alcohol-use initiation and misuse by using prospective longitudinal studies to follow initially alcohol-naive individuals over time and by neuroimaging adolescents with inherited risk factors for alcohol misuse.

Neuroimaging predictors of alcohol use have shown modest utility to date. Future research should use out-of-sample performance as a quantitative measure of a predictor's utility. Neuroimaging data should be combined across multiple modalities, including structural information such as volumetrics and cortical thickness, in conjunction with white-matter tractography. A number of relevant neurocognitive systems should be assayed; particularly, inhibitory control, reward processing and executive functioning. Combining a rich magnetic resonance imaging data set could permit the generation of neuroimaging risk scores, which could potentially yield targeted interventions.

Morton S, O’Brien K and O’Reilly L (2018)
Community Dev J, Early online.
https://www.drugsandalcohol.ie/28721/

This paper considers the role of boxing training and mentoring in the context of the change processes for participants engaging in a twenty-week community based integrated fitness and education substance use rehabilitation programme.

The positive attributes associated with the ‘boxer’ identity has the potential to provide an alternative to ‘the addict’ identity within socially disadvantaged communities. It is argued that the boxing gym, particularly when nested within a range of educational and emotional supports, can become an empowering setting within a community. The coaching approach has the potential to challenge gendered norms in relation to sport and fitness, while also supporting participants to utilize their physical bodies with intent and focus. The inclusion of programme mentors is an important consideration for substance use rehabilitation programmes, especially within communities characterized by exclusion and isolation.

Feliu A, Filippidis FT, Joossens L, Fong GT, Vardavas CI,
Baena A, et al. (2018)
Tob Control, Early online.
https://www.drugsandalcohol.ie/28618/

The aim of this paper was to assess the midterm association of tobacco control policies on smoking prevalence and quit ratios among 27 European Union (EU) Member States (EU27).

EU27 should continue implementing comprehensive tobacco control policies as they are key for reducing the prevalence of smoking and an increase in tobacco cessation rates in their population.