Journal articles
The following abstracts are cited from recently published journal articles relating to the drugs situation in Ireland.
Library value and impact: taking the step from knowing it to showing it
Dunne M, Nelson M, Dillon L and Galvin B
Library and Information Research, 2013, 37(116).
www.drugsandalcohol.ie/21577
The National Documentation Centre on Drug Use (NDC) is a unique Irish information resource that embraces elements of several library types: national, public, special, academic, digital, and health. This paper presents the results of an evaluation study carried out by NDC staff in two parts, a value survey and impact interviews. Both quantitative and qualitative methods were used to examine aspects of the value and impact of the NDC’s resources and services. Many elements of our approach worked well and contributed to the achievement of our aims and objectives. We outline our approach and suggest some modifications that we might make if we were to repeat the study.
Based on the views and experiences of respondents, we can say that the NDC’s services and resources are valued by our users and have had positive impacts on their work. These impacts have been wide-ranging and have brought about affective, knowledge-based, behavioural, and competence-based change in practice. The study provides the NDC with a significant body of evidence on which to base plans for the development of resources and services over the next few years.
‘Lead us not into temptation’: adolescence and alcohol policy in Europe
Hope A
Alcohol and Alcoholism, 2014, 49(2): 126–127.
www.drugsandalcohol.ie/21446
Although the World Health Organization and the European Community recognize harm to children and young people due to alcohol – whether their own or someone else’s drinking, effective policies to reduce harm are not widely followed. The alcohol beverage industry’s drive to use social networking systems blurs the line between user-generated and industry marketing materials, such that young people are more frequently and at a younger age, potentially exposed to the promotion of alcoholic drinks. This contravenes recommendations arising out of the emerging scientific literature that delaying the onset of drinking and reducing the prevalence of heavy session drinking are likely to promote a healthier next generation.
Alcohol and youth mental health – the evidence base
Fitzgerald A and Dooley B
Psychiatry Professional, 2013, 2(1): 6–8.
www.drugsandalcohol.ie/21265
The My World Survey–Second Level (MWS–SL) assessed alcohol-related behaviours in 6,085 adolescents. Findings demonstrated a significant shift in the frequency, binge drinking and volume of alcohol consumed across the school year. Alcohol use in the Senior Cycle was a particular concern, with 35% outside the low risk category for alcohol behaviour. The MWS-SL found a strong relationship between alcohol use and mental health distress. Risky alcohol behaviour was associated with family conflict and other negative behaviours.
Adolescent males in secondary school in Ireland: alcohol use and depressed mood
Kerr RA
Irish Journal of Applied Social Studies, 2013, 13(1): Article 3.
www.drugsandalcohol.ie/21266
Per capita alcohol consumption by Irish teenagers has doubled over the past three decades. There has also been a doubling of the suicide rate among young men. This study aimed to measure the correlation between alcohol consumption and negative mood (using the Beck Depression Inventory) in a sample (n = 169) of final-year secondary school male students. A questionnaire was devised to ascertain frequency, type and quantity of alcohol consumed, attitudes towards drinking in general, and to assess overall mood disturbance. These two sets of results were analysed and correlation coefficients calculated. It was found that both alcohol consumption and mood disturbance varied widely throughout the sample and that total alcohol consumption correlated weakly but significantly with overall mood disturbance. However, there was a stronger, more significant correlation between frequency of feeling drunk and mood disturbance, indicating a much greater effect on the teenagers’ mood from binge drinking than from consistently drinking the same quantity of alcohol.
A review of drug-facilitated sexual assault evidence: an Irish perspective
McBrierty D, Wilkinson A and Tormey WP
Journal of Forensic and Legal Medicine, 2013, 20(4): 189–197.
www.drugsandalcohol.ie/21237
Drug-facilitated sexual assault (DFSA) is prevalent in Western society. There is a significant degree of confusion regarding the definition and prevalence of DFSA. It is a subject with medical, scientific and legal aspects. These facets are explored in this review through a detailed examination of published data. The legal issues are defined in the context of the Irish judicial system. Several key case-law studies are presented to aid in understanding unresolved difficulties that persist in this complex field of forensics. The aim of this paper is to aid individuals from disparate disciplines to increase their evidence base in the complex and evolving issue of DFSA.
Non-medical use of psychotropic prescription drugs among adolescents in substance use treatment
Apantaku-Olajide T and Smyth BP
Journal of Psychoactive Drugs, 2013, 45(4): 340–346.
www.drugsandalcohol.ie/21192
Little is known about the extent of non-medical use of prescription drugs among European adolescents with substance use disorders. This cross-sectional study examined non-medical use of seven categories of psychotropic prescription drugs (opioid analgesics, ADHD stimulant, sleeping, sedative/anxiolytic, antipsychotic, antidepressant, and anabolic steroid medications) in a clinical sample of Irish adolescents with substance use disorders. Of the 85 adolescents (aged 13-18 years) invited to participate, 65 adolescents (M = 16.3 years, SD = 1.3) took part (response: 74%). Among respondents, 68% reported lifetime non-medical use of any of the prescription drugs; sedative/anxiolytic (62%) and sleeping medications (43%) were more commonly abused. The most frequently reported motives for abuse were "seeking high or buzz" (79%), "having good time" (63%), and "relief from boredom" (56%). Sharing among friends and street-level drug markets were the most readily available sources. Innovative solutions of control measures and intervention are required to address the abuse of prescription drugs.
Impact of new UK paracetamol overdose guidelines on patients presenting to the emergency department
Nfila G, Lee S and Binchy J
Irish Medical Journal, 2014, 107(2): 47.
www.drugsandalcohol.ie/21455
Paracetamol is involved in a large proportion of overdoses that present to the Emergency Department (ED), either as lone or mixed overdoses. Non-treatment of toxic levels can lead to fulminant liver failure. This study is to determine the impact the new UK treatment guidelines1 will have on patients presenting with paracetamol overdose. A retrospective review was performed on all patients who had paracetamol levels done in the ED between September 2011 and August 2012.
A total of 523 patients were identified, 95(18%) of whom had detectable paracetamol levels. 74 patients from the 95 were evaluated. 18(24%) patients were treated with N-acetylcysteine as per the then paracetamol overdose guidelines. Using the new guidelines would have resulted in 3 more patients being admitted. Our study shows that most patients who present following paracetamol overdose do not require treatment with N-acetylcysteine and suggests that the introduction of the new UK treatment guidelines is likely to result in only a small increase in the number of patients requiring treatment.
Emergence of opiate-induced neonatal abstinence syndrome
Healy D, English F, Daniels A and Ryan CA
Irish Medical Journal, 2014, 107(2): 46.
www.drugsandalcohol.ie/21454
Neonatal abstinence syndrome (NAS) is the clinical picture of infants withdrawing from in-utero substance exposure. The incidence of NAS rose in Dublin maternity hospitals in the 1970s and 1980s in parallel with increasing opiate abuse in that city. The purpose of this study was to determine if a similar pattern was emerging in Cork University Maternity Hospital. Data from the Erinville Hospital (2000-2007) and CUMH (2008-2011) were compared. Sixteen cases of NAS were identified, two at Erinville Hosptial and 14 at CUMH. Five of the 16 mothers were using heroin, while ten were on methadone maintenance. All were multi-drug abusers. Newborns requiring pharmacotherapy for NAS (5/16) had prolonged hospitalisations compared to those requiring supportive care. NAS in Cork is increasing. Primary, secondary and tertiary preventative measures are warranted to prevent further escalation.
Open drug scenes and drug-related public nuisance: a visual rapid assessment research study in Dublin, Ireland
Van Hout MC and Bingham T
Journal of Ethnicity in Substance Abuse, 2013, 12(2): 154-178.
www.drugsandalcohol.ie/21345
The research was undertaken at a time of increasing public concerns for drug- and alcohol-related public nuisance in the city center of Dublin, Ireland. Rapid Assessment Research was conducted involving qualitative interviewing with drug service users; business, transport, community, voluntary, and statutory stakeholders (n = 61); and an environmental mapping exercise.
The interplay between homelessness, loitering, an influx of drug users via city metro systems, transient open drug scenes, street drinking, drug injecting, intimidation, knife crime, and prescribed medication abuse was evident. Potential strategies to address drug and alcohol related public nuisance are advised to include the relocation of treatment services, targeted harm reduction initiatives, urban regeneration, improved community rehabilitation pathways, and heightened policing intensity.
Health-related quality of life of HIV-infected intravenous drug users
Surah S, Adams R, Townsend L, Reynolds I et al.
International Journal of STD & AIDS, 2013, 24(11): 867–874.
www.drugsandalcohol.ie/21444
To investigate health-related quality of life in HIV-infected intravenous drug users registered but not engaged in HIV outpatient care we conducted a cross-sectional study to examine health-related quality of life of HIV-infected intravenous drug users registered for care at an inner city HIV unit. EQ-5D, SF-36, SF-6D, mood disorder, clinical and substance misuse data were collected. Mean scores and preference derived utility scores were calculated.
Statistical relationships between health-related quality of life and other variables were explored using univariate and multivariate analysis. Fifty-five patients were recruited, 64% were males. The mean anxiety value was 11.44 (anxious) and mean depression score was 9.3 (borderline depressed). The mean EQ-5D utility was 0.45 (95% CI 0.35, 0.55) and mean SF-6D utility was 0.52 (95% CI 0.48, 0.55). There was no statistical relationship between HIV indices, substance misuse and EQ-5D and SF-6D utility. Anxiety and depression were significantly correlated with EQ-5D and SF-6D utility values on univariate and multivariate analysis. Health-related quality of life was reduced in this HIV-infected intravenous drug user population. Whilst hepatitis C co-infection and substance misuse did not affect health-related quality of life, anxiety and depression had a significant impact on it.
Towards a Framework for implementing evidence based alcohol interventions
Armstrong R and Barry J
Irish Medical Journal, 2014, 107(2).
www.drugsandalcohol.ie/21433
This study tested the feasibility of screening and brief intervention (SBI) within four emergency departments. A total of 944 patients were screened for hazardous and harmful alcohol use. The results showed that there was good co-operation from the public, with 888 (94%) people agreeing to be screened. The screening tool detected that 460 (49%) of those needed no intervention, 345 (36%) needed brief advice and 83 (9%) required referral to specialist services. This showed the value of the screening but also helped to reassure staff that people were happy to take part.
