Journal articles
The following abstracts are cited from recently published articles relating to the drugs and alcohol situation in Ireland.
Policy proposals for reducing alcohol-related harm: comparing and contrasting recent British and Irish policy documents
Butler S (2012)
Drugs: education, prevention and policy, 2012,10 July. Early online.
www.drugsandalcohol.ie/18060
The UK policy document The Government’s Alcohol Strategy (hereafter the GAS) was published in March 2012, just weeks after Ireland’s Department of Health published the Steering Group Report on a National Substance Misuse Strategy (hereafter the SGR). Despite its ambiguous title, the SGR is solely concerned with alcohol, specifically with how alcohol might be integrated into Ireland’s longstanding National Drugs Strategy, which prior to this had dealt only with illicit drugs. In a short commentary piece such as this it would be tedious, if not impossible, to present a point-by-point comparison of the two documents, but it might be of interest to readers in both jurisdictions to draw some broad comparisons between them. This will be attempted here by looking at the GAS and the SGR from three separate, if somewhat overlapping, perspectives: (1) their primary ideological content; (2) their policy status – either as proposals to government or government approved strategies and (3) the likelihood that all or most of the recommended strategies will be implemented.
Supportive text messaging for depression and comorbid alcohol use disorder: single-blind randomised trial
Agyapong VI, Ahern S, McLoughlin DM and Farren CK
Journal of Affective Disorders, 2012, 29 March. Early online.
www.drugsandalcohol.ie/17916
Mobile phone text message technology has the potential to improve outcomes for patients with depression and co-morbid Alcohol Use Disorder (AUD).This randomised rater-blinded trial aimed to explore the effects of supportive text messages on mood and abstinence outcomes for patients with depression and co-morbid AUD.
Fifty-four participants were randomised to receive twice daily supportive text messages (n = 26) or a fortnightly thank you text message (n = 28) for three months. Primary outcome measures were Beck's Depression Inventory (BDI-II) scores and Cumulative Abstinence Duration (CAD) in days at three months.
There was a statistically significant difference in three-month BDI-II scores between the intervention and control groups. There was a trend for a greater CAD in the text message group than the control group. Limitations of the study include the small sample size, the potential for loss of rater blinding and the lack of long term follow-up to determine the longer term effects of the intervention. The authors conclude that supportive text messages have the potential to improve outcomes for patients with comorbid depression and alcohol dependency syndrome.
Health impacts of increasing alcohol prices in the European Union: a dynamic projection
Lhachimi SK, Cole KJ, Nusselder WJ et al.
Preventative Medicine, 2012,17 June. Early online.
www.drugsandalcohol.ie/17915
Objective. Western Europe has high levels of alcohol consumption, with corresponding adverse health effects. Currently, a major revision of the EU excise tax regime is under discussion. We quantify the health impact of alcohol price increases across the EU.
Data and method. We use alcohol consumption data for member states, covering 80% of the EU-27 population, and corresponding country-specific disease data (incidence, prevalence, and case-fatality rate of alcohol related diseases) taken from the 2010 published Dynamic Modelling for Health Impact Assessment(DYNAMO-HIA) database to dynamically project the changes in population health that might arise from changes in alcohol price.
Results. Increasing alcohol prices towards those of Finland (the highest in the EU) would postpone approximately 54,000 male and approximately 26,100 female deaths over 10 years. Moreover, the prevalence of a number of chronic diseases would be reduced: in men by approximately 97,800 individuals with diabetes, 65,800 with stroke and 62,200 with selected cancers, and in women by about 19,100, 23,500, and 27,100, respectively.
Conclusion. Curbing excessive drinking throughout the EU completely would lead to substantial gains in
population health. Harmonisation of prices to the Finnish level would, for selected diseases, achieve more
than 40% of those gains.
Socio-demographic, environmental, lifestyle and psychosocial factors predict self rated health in Irish Travellers, a minority nomadic population
Kelleher C, Whelan J, Daly L and Fitzpatrick P
Health & Place, 2012, 18(2): 330–338
www.drugsandalcohol.ie/17924
Irish Travellers are an indigenous nomadic minority group with poor life expectancy. As part of a census survey of Travellers (80%participation rate),a health status interview was conducted (n=2065,43.5% male).In the final regression model, positive predictors of self-rated health (SRH were having a flush toilet (OR2.2, p=0.021), considering where one lives to be healthy (OR1.9, p=0.017),travelling twice yearly (OR2.3 p=0.026), taking a brisk walk weekly (OR 2.4, p=0.000) and non-smoking (OR 1.7, p=0.03). Conversely, SRH was negatively associated with age (p=0.000), activity-limiting ill health (OR 0.4, p=0.001), or chronic health condition (OR0.4, p=0.002).
Effectiveness of a culturally adapted Strengthening Families Program 12–16 years for high-risk Irish families
Kumpfer K, Xie J and O’Driscoll R
Child and Youth Care Forum, 2012, 41(2): 173–195
www.drugsandalcohol.ie/17347
Cochrane Reviews have found the Strengthening Families Program (SFP) to be the most effective substance abuse prevention intervention. Standardized cultural adaptation processes resulted in successful outcomes in several countries. To promote wide-scale implementation and positive outcomes in Ireland, a unique model of inter-agency collaboration was developed plus guidelines for cultural adaptation with fidelity.
250 high-risk youth and families were recruited to complete SFP and its parent questionnaire. All 21 measured outcomes had statistically significant positive results. Larger effect sizes were found for the Irish families than the USA families (d = 0.57 vs. 0.48 for youth outcomes, d = 0.73 vs. 0.65 for parenting and d = 0.76 vs. 0.70 for family outcomes). Overt and covert aggression, criminality and depression decreased more in Irish youth, but the USA youth improved more in social skills.
This study suggests that SFP 12–16 is quite effective in reducing behavioural health problems in Irish adolescents, improving family relationships and reducing substance abuse. Additionally, the Irish interagency collaboration model is a viable solution to recruitment, retention and staffing in rural communities where finding five skilled professionals to implement SFP can be difficult.
