Recent publications

Mongan D, Millar SR, O’Dwyer C, Long J and Galvin B (2020) BMJ Open, 10(7): e034520.
https://www.drugsandalcohol.ie/32429/

The aim of this study was to determine awareness of drinking pattern in an Irish population using a representative random sample and to identify characteristics associated with self-awareness of hazardous or harmful drinking.

The results of this study suggest that patterns of alcohol use in Ireland are problematic. Older respondents and those with lower educational attainment are less likely to be aware of their hazardous or harmful drinking pattern. There is also a population of younger, more-educated drinkers who engage in potentially risk-taking behaviours and these subjects are aware of their harmful drinking pattern. Initiatives to reduce overall alcohol consumption and raise awareness around drinking patterns are required.

Crowley D and Delargy I (2020) Harm Reduction Journal, 17: 49.
https://www.drugsandalcohol.ie/32420/

In response to Covid-19, healthcare is increasingly being delivered by telephone and video consultation, and this report describes the development of a national model of remote care to eliminate waiting lists and increase access to OAT [opioid agonist treatment] in Ireland.

The development of a remote model of healthcare delivery allows for the reduction in transmission risks associated with Covid-19, increases access to OAT, reduces waiting times and minimises barriers to services. An evaluation of this model is ongoing and will be reported once completed. Fast adaptation of OAT delivery is critical to ensure access to and continuity of service delivery and minimise risk to our staff, patients and community. Innovative models of remote healthcare delivery adapted during the Covid-19 crisis may inform and have important benefits to our health system into the future.

O’Connor AM, Cousins G, Durand L, Barry J and Boland F (2020) PLoS ONE, 15(5): e0232086.
https://www.drugsandalcohol.ie/32009/

This systematic review aims to identify both protective factors supporting retention in OST [opioid substitution treatment], and risk factors for treatment dropout.

Younger age, substance use, particularly cocaine and heroin use, lower doses of methadone, criminal activity/incarceration, and negative attitudes to MMT [methadone maintenance treatment] appear to be associated with reduced retention in OST. A consensus definition of retention is required to allow for comparability across future studies.

Cully G, Leahy D, Shiely F and Arensman E (2020) Archives of Suicide Research, Early online.
https://www.drugsandalcohol.ie/32267/

This study addressed the experiences of engaging with healthcare services following a self-harm presentation to hospital of high lethality or high suicidal intent by documenting patients' experiences.

Our findings show that satisfaction with services, help-seeking and treatment adherence may be improved by ensuring the consistent provision of timely, comprehensive and supportive aftercare following a HRSH [high-risk self-harm] presentation. Absence of these aspects of care may contribute to ongoing distress and further suicidal behavior.

Vaughan E, Power M and Sixsmith J (2020) AIDS Care, 32(9): 1162–1167.
https://www.drugsandalcohol.ie/32237/

This study examined the stigma experiences in healthcare settings of people living with HIV (PLHIV) in Ireland.

The findings indicate experiences of enacted, anticipated and internalised stigma were common. A further finding of spatial stigma was also uncovered. Analysis showed these experiences impacted participants' engagement with care and affected health-seeking behaviours and treatment adherence. The results suggest stigma experienced in healthcare settings may impact negatively on health outcomes.

Crowley D and Cullen W (2020) Heroin Addiction and Related Clinical Problems, Early online.
https://www.drugsandalcohol.ie/32214/

This study aims to describe and discuss the associated evidence for the measures implemented to reduce the risks associated with COVID-19 to Irish OAT [opioid agonist treatment] services.

Irish OAT services have implemented the following measures: reduced supervision requirements, increased the use of virtual patient care, streamlined assessment and induction processes to remove barriers to OAT access, provided home delivery of medications, increased access to naloxone and overdose programmes, targeted health and social interventions for the homeless and reduced our prison population. For now, non-essential services including drug and blood-borne virus screening and hepatitis C treatment have been postponed. Planning and review of Irish OAT services is ongoing so that further adaptations can be implemented as challenges emerge.

Clarke M, Devlin J, Conroy E, Kelly E and Sturup-Toft S (2020) Journal of Public Health, 42(3): 519–524.
https://www.drugsandalcohol.ie/32262/

This paper describes the approach to contact tracing taken by the Irish Prison Service (IPS).

A partnership approach with development of prison-led CTTs [contact tracing teams] can provide an effective mechanism for contact tracing of COVID-19 cases within the prison setting.

Hayden JC and Parkin R (2020) Irish Journal of Psychological Medicine, 37(3): 198–203.
https://www.drugsandalcohol.ie/32165/

This article reviews the pandemic-related challenges and responses by pharmacists, as well as forming recommendation for areas of professional support and role expansion, particularly in the case of mental health.

D’Sa S, Foley D, Hannon J, Strashun S, Murphy A-M and O’Gorman C (2020) Irish Journal of Medical Science, Early online.
https://www.drugsandalcohol.ie/32150/

Our aim was to evaluate current knowledge on the psychological impact of homelessness in children. Using the PRISMA model, we performed a review of the currently available literature on the psychological impact of homelessness on children.

Our study highlights violence, aggression and poor academic learning outcomes to be just some of the key findings in our review of homelessness in childhood, worldwide. Unfortunately, there has been minimum research to date on paediatric homelessness within the context of the Irish population. We anticipate this review to be the first chapter in a multipart series investigation to evaluate the psychological morbidity of paediatric homelessness within the Irish society.

Griffin E, Kavalivdou K, Bonner B, O’Hagan D and Corcoran P (2020) EClinicalMedicine, 23: 100378.
https://www.drugsandalcohol.ie/32147/

The aim of this study was to establish the risk of repeat presentation to hospital following suicidal ideation and to identify factors which were associated with further ideation or subsequent self-harm.

During the period April 2014 to March 2019, a total of 14,695 presentations to hospital due to suicidal ideation were made in Northern Ireland. The cumulative incidence of repeat presentation to hospital was 40.5% within five years, with an 18.3% risk of subsequent self-harm. Previous ideation had the strongest association with repeat presentation. There was evidence of recidivism considering further ideation, with an increased risk according to number of previous presentations. In contrast, risk of subsequent self-harm was highest after the first or second presentation. Male gender and alcohol were associated with further ideation, while females and young people were more likely to re-present with self-harm.

Leão T, Perelman J, Clancy L, Mlinarić M, Kinnunen JM, Nuyts PAW, et al. (2020) Nicotine & Tobacco Research, 22(7): 1202–1209.
https://www.drugsandalcohol.ie/32240/

We assessed the cost-effectiveness of five tobacco control policies (nonschool bans, including bans on sales to minors, bans on smoking in public places, bans on advertising at points-of-sale, school smoke-free bans, and school education programs), implemented in 2016 in Finland, Ireland, the Netherlands, Belgium, Germany, Italy, and Portugal.

All five policies were highly cost-effective in all countries according to the World Health Organization thresholds for public health interventions. Cost-effectiveness was preserved even when using the highest costs and most conservative effectiveness estimates.

O’Sullivan B, Scully P, Curtin RJ and Plant BJ (2020) QJM: An International Journal of Medicine, Early online.
https://www.drugsandalcohol.ie/32239/

We aimed to ascertain the prevalence of tobacco consumption in a sporting population. We also endeavoured to quantify the use of e-cigarettes and assess exposure to passive smoking.

The prevalence of smoking in our study population was higher than other literature reports. Further studies are essential to evaluate the potential negative effects this may be having on sporting performance, career progression and indeed injury occurrence/rehabilitation. It is imperative to address the matter of smoking in athletes, not only for public health concerns but also considering they are important role models in our society.

Vallance K, Vincent A, Schoueri-Mychasiw N, Stockwell T, Hammond D, Greenfield TK, et al. (2020) Journal of Studies on Alcohol and Drugs, 81(2): 273–283.
https://www.drugsandalcohol.ie/32152/

The purpose of this study was to examine the framing of news coverage of alcohol warning label (AWL) initiatives that included a cancer message on alcohol containers in two different countries. Policy contexts and industry perspectives were also evaluated.

News coverage of AWLs with a cancer message was more supportive in Canada than Ireland, where alcohol industry perspectives were consistently foregrounded. Industry arguments opposing the cancer label bore similarities across contexts, often distorting or denying the evidence. Increasing awareness of industry messaging strategies may generate more critical coverage of industry lobbying activities and increase public support for alcohol policies.

Columb D, Hussain R and O’Gara C (2020) Irish Journal of Psychological Medicine, 37(3): 164–168.
https://www.drugsandalcohol.ie/32062/

The COVID-19 pandemic has undoubtably had a major impact on the provision of physical healthcare in Ireland and worldwide. The mental health impact of this pandemic cannot be underestimated, particularly relating to patients suffering with addiction. Heightened public stress and anxiety levels, increasing isolation and the physical consequences of addiction play a large role in the proliferation and ongoing relapse of substance misuse and behavioural addiction. Service provision is an ongoing challenge due to the increasing need for services given the increased mental health burden of COVID-19 but also the restrictions in place in clinical areas to achieve social distancing. The necessary adaptations to service provision provide opportunities for the analysis of current processes used in our addiction unit and the introduction of new processes to our service. The current crisis tests the sustainability of the service to provide the high standard of care required for these patients.

Mitchell JM, Jeffri FJ, Maher GM, Khashan AS and McCarthy FP (2020) Journal of Affective Disorders, 269: 94–100.
https://www.drugsandalcohol.ie/32011/

The aim of the study was to investigate the relationship between prenatal maternal alcohol consumption and the risk of attention deficit hyperactivity disorder (ADHD), the strengths and difficulties questionnaire (SDQ) score and abnormal hyperactivity score in seven-year-old children.

Light, moderate or heavy antenatal alcohol consumption was not associated with an increased susceptibility to ADHD or behavioural outcomes in this study. However, due to the limited number of cases we cannot rule out an increased risk of ADHD in relation to heavy alcohol consumption.

Keogh B, Brady AM, Downes C, Doyle L, Higgins A and McCann T (2020) Issues in Mental Health Nursing, 41(9): 799–806.
https://www.drugsandalcohol.ie/32010/

A Traveller Mental Health Liaison Nurse (TMHLN) was introduced in one health care region in Ireland to provide support for Travellers and increase their access to mental health services. The aim of this paper is to present the findings from an evaluation which explored Travellers' access to and reasons for accessing the TMHLN, the interventions provided and their experiences of and perceptions of the role of the TMHLN.

The findings highlight how the interpersonal skills associated with mental health nursing set against recovery orientated and culturally congruent practices are suitable approaches when working with Travellers.

Founta O, Adamzik K, Tobin A-M, Kirby B and Hevey D (2019) Journal of Clinical Psychology in Medical Settings, 26(2): 200–219.
https://www.drugsandalcohol.ie/31944/

This study investigates (a) the prevalence of psychological distress, alexithymia and alcohol misuse in psoriasis patients; and (b) the relationship between psoriasis severity, alexithymia, alcohol and psychological distress in patients with psoriasis.

Alexithymia was associated with anxiety, depression and worry; subjective psoriasis severity was associated with worry. Alcohol misuse was related to anxiety and worry, but not to depression. Appropriate identification and treatment of alcohol difficulties and psychological distress of patients with psoriasis is needed.

Columb D, Wong MC, O’Mahony V, Harrington C, Griffiths MD and O’Gara C (2020) Irish Journal of Psychological Medicine, Early online.
https://www.drugsandalcohol.ie/32390/

The aim of the present study was to analyze gambling advertisements shown during live sporting events broadcast in Ireland and to assess these advertisements for responsible gambling (RG) practices.

Gambling advertisements are commonly shown during live televised sporting broadcasts in Ireland, especially during live football matches and typically before the adult television watershed. Gambling legislation is required to minimize harm to vulnerable groups including children

Leahy D, Larkin C, Leahy D, et al. (2020) Social Psychiatry and Psychiatric Epidemiology, 55: 1525–1533.
https://www.drugsandalcohol.ie/32384/

There is limited research on the associations between factors relating to mental and physical health in people who died by suicide.

Different factors associated with suicide were identified among people with mental and physical illness and those with and without a diagnosis, and need to be taken into account in suicide prevention. The identified factors highlight the importance of integrated care for dual-diagnosis presentations, restricting access to means, and early recognition and intervention for people with high-risk self-harm.

Hayden JC, Kelly L and McNicholas F (2020) Acta Paediatrica, 109(11): 2237–2242.
https://www.drugsandalcohol.ie/32236/

Deliberate self-poisoning or overdose is a common presentation to the paediatric emergency departments (ED) due to a lack of emergency access to child and adolescent mental health services. We overview medical and psychiatric assessment of overdoses in youth with the most commonly implicated drug, paracetamol, as a case study.

Given the importance of timely assessment and treatment, paediatric emergency staff need to be familiar with the protocol for care. Attention needs to be focused on both the medical and psychological risk, and staff need to consider the reasons behind the overdose, and following a biopsychosocial assessment, ensure that the young person and family are adequately signposted for future mental health care if needed.

Costa C, Ismail M, Stevenson D, Gibson B, Webb R and Bailey M (2020) Journal of Analytical Toxicology, 44(3): 218–225.
https://www.drugsandalcohol.ie/31930/

Fingerprints have been proposed as a promising new matrix for drug testing. In previous work it has been shown that a fingerprint can be used to distinguish between drug users and nonusers. Herein, we look at the possibility of using a fingerprint to distinguish between dermal contact and administration of heroin.

This research highlights the importance of washing hands prior to donating a fingerprint sample to distinguish recent contact with heroin from heroin use.

Melia R, Francis K, Hickey E, et al. (2020) JMIR mHealth and uHealth, 8(1): e12516.
https://www.drugsandalcohol.ie/32322/

This review aimed to examine the effectiveness of currently available mobile health (mHealth) technology tools in reducing suicide-specific outcomes.

The small number of studies reported in this review tentatively indicate that such tools may have a positive impact on suicide-specific outcomes. Future mHealth intervention evaluations would benefit from addressing the following 3 main methodological limitations: (1) heterogeneity of outcomes: a lack of standardized measurement of suicide outcomes across studies; (2) ecological validity: the tendency to exclude potential participants because of the elevated suicide risk may reduce generalizability within clinical settings; and (3) app regulation and definition: the lack of a standardized classification system for mHealth intervention type points to the need for better definition of the scope of such technologies to promote safe practice.

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

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