Journal Articles
The following abstracts are cited from recently published journal articles relating to the drugs situation in Ireland.
Gamma-hydroxybutyrate (GHB): a scoping review of pharmacology, toxicology, motives for use, and user groups
Brennan R and van Hout MC, Journal of Psychoactive Drug, 2014, 46(3): 243–251
http://www.drugsandalcohol.ie/22862/
Gamma hydroxybutyrate (GHB) is a central nervous system depressant with euphoric and relaxant effects. Documentation of GHB prevalence and the underreporting of abuse remains problematic, given the availability of GHB and its precursors γ-butyrolactone (GBL) and 1,4-butanediol (1,4-BD) and the ease of synthesis from kits available on the Internet. The continued abuse of and dependence on GHB, and associated fatalities, present an on-going public health problem. As the drug GHB remains an under-researched topic, a scoping review was chosen as a technique to map the available literature into a descriptive summarised account. PRISMA was used to assist in data retrieval, with subsequent data charting into three key themes (pharmacology and toxicology, outcomes, and user groups). Administered orally, GHB is dose-dependent and popular for certain uses (therapeutic, body enhancement, sexual assault) and amongst user sub-groups (recreational party-drug users, homosexual men). Despite the low prevalence of use in comparison to other club drugs, rising abuse of the drug is associated with dependence, withdrawal, acute toxicity, and fatal overdose. Clinical diagnosis and treatment is complicated by the co-ingestion of alcohol and other drugs. Limitations of the scoping review and potential for further research and harm reduction initiatives are discussed.
Life-time prevalence and psychosocial correlates of adolescent direct self-injurious behavior: a comparative study of findings in 11 European countries
Brunner R, Kaess M, Parzer P, Fischer G et al. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 2014, 55(4): 337–348
http://www.drugsandalcohol.ie/22792/
This study investigates the prevalence and associated psychosocial factors of occasional and repetitive direct self-injurious behaviour (D-SIB), such as self-cutting, -burning, -biting, -hitting, and skin damage by other methods, in representative adolescent samples from 11 European countries.
Cross-sectional assessment of adolescents was performed within the European-Union-funded project, Saving and Empowering Young Lives in Europe (SEYLE), which was conducted in 11 European countries. The representative sample comprised 12,068 adolescents (F/M: 6,717/5,351; mean age: 14.9 ± 0.89) recruited from randomly selected schools. Frequency of D-SIB was assessed by a modified 6-item questionnaire based on previously used versions of the Deliberate Self-Harm Inventory (DSHI). In addition, a broad range of demographic, social, and psychological factors was assessed.
These results suggest high lifetime prevalence of D-SIB in European adolescents. Prevalence as well as psychosocial correlates seem to be significantly influenced by both gender and country. These results support the need for a multi-dimensional approach to better understand the development of SIB and facilitate culturally adapted prevention/intervention.
A newly identified group of adolescents at ‘invisible’ risk for psychopathology and suicidal behavior: findings from the SEYLE study
Carli V, Hoven CW, Wasserman C, Flaminia C et al. World Psychiatry: Official Journal of the World Psychiatric Association (WPA), 2014, 13(1): 78–86
http://www.drugsandalcohol.ie/22790/
This study explored the prevalence of risk behaviours (excessive alcohol use, illegal drug use, heavy smoking, reduced sleep, overweight, underweight, sedentary behaviour, high use of Internet/TV/videogames for reasons not related to school or work, and truancy), and their association with psychopathology and self-destructive behaviours, in a sample of 12,395 adolescents recruited in randomly selected schools across 11 European countries.
Latent class analysis identified three groups of adolescents: a low-risk group (57.8%) including pupils with low or very low frequency of risk behaviours; a high-risk group (13.2%) including pupils who scored high on all risk behaviours; and a third group (‘invisible’ risk, 29%), including pupils who were positive for high use of Internet/TV/videogames for reasons not related to school or work, sedentary behaviour and reduced sleep. Pupils in the ‘invisible’ risk group, compared with the high-risk group, had a similar prevalence of suicidal thoughts (42.2% vs 44%), anxiety (8% vs 9.2%), sub-threshold depression (33.2% vs 34%) and depression (13.4% vs 14.7%).
The prevalence of suicide attempts was 5.9% in the ‘invisible’ group, 10.1% in the high-risk group and 1.7% in the low-risk group. The prevalence of all risk behaviours increased with age and most of them were significantly more frequent among boys. Girls were significantly more likely to experience internalising (emotional) psychiatric symptoms. The ‘invisible’ group may represent an important new intervention target group for potentially reducing psychopathology and other untoward outcomes in adolescence, including suicidal behaviour.
Risk-behaviour screening for identifying adolescents with mental health problems in Europe
Kaess M, Brunner R, Parzer P, Carli V et al. European Child and Adolescent Psychiatry, 2014, 23(7): 611–620
http://www.drugsandalcohol.ie/22789/
Indicated prevention of mental illness among youth is an important public health concern. The aim of this study was to establish a European school-based professional screening among adolescents, which included variables on both a broad range of risk-behaviours and psychopathology, and to investigate the indicative value of adolescent risk-behaviour and self-reported psychopathology on help-seeking and psychological problems that required subsequent mental healthcare.
A two-stage professional screening approach was developed and performed within the multi-centre study ‘Saving and Empowering Young Lives in Europe’ (SEYLE). The first stage of screening comprised a self-report questionnaire on a representative sample of 3,070 adolescents from 11 European countries. In the second stage, students deemed at-risk for mental health problems were evaluated using a semi-structured clinical interview performed by healthcare professionals. 61 % of participants (n = 1,865) were identified as being at-risk in stage one. In stage two, 384 participants (12.5 % of the original sample) were found to require subsequent mental healthcare during semi-structured, clinical assessment. Among those, 18.5 % of pupils were identified due to screening for psychopathology alone; 29.4 % due to screening for risk-behaviours alone; and 52.1 % by a combination of both. Young age and peer victimisation increased help-seeking, while very low body mass index, depression, suicidal behaviour and substance abuse were the best predictors of referral to mental healthcare.
Screening of risk behaviours significantly increased the number of detected students requiring subsequent mental healthcare. Screening of risk behaviours added significant value in identifying the significant amount of European pupils with mental health problems. Therefore, attention to adolescent risk behaviours in addition to psychopathology is critical in facilitating prevention and early intervention. Identifying factors that increase compliance to clinical interviews are crucial in improving screening procedures.
Modeling the impact of place on individual methadone treatment outcomes in a national longitudinal cohort study
Murphy E and Comiskey CM. Substance Use & Misuse, 2015, 50(1): 99–105
http://www.drugsandalcohol.ie/22782/
From 2003 to 2006, 215 clients were recruited to a cohort study of methadone treatment. Participants had their address and clinic geocoded. Treatment outcomes were measured at intake, at one and three years post treatment using the Maudsley Addiction Profile instrument. Spider diagrams and buffer rings were used to visually map clinics and clients. Regression models were used to measure the effect of place.
Results: Client's accommodation and social and criminal problems in the region had a medium to large effect on heroin use. Analysis of buffer rings revealed that clients located within a 10-km radius of a major clinic demonstrated poorer outcomes in terms of heroin use.
Conclusion/Importance: Findings illustrated the relevance of geography to drug treatment outcomes and the planning of services.
Regulatory approaches to new psychoactive substances (NPS) in the European Union
Hughes B and Griffiths P, Addiction, 2014, 109(10):1591–1593
http://www.drugsandalcohol.ie/22745/
As in New Zealand, three European countries (Ireland, Poland, Romania) have chosen to reverse the established control model, using effect-based definitions; the supply of any unregulated psychoactive substance that meets certain criteria is banned unless specifically permitted.
The association between family affluence and smoking among 15-year-old adolescents in 33 European countries, Israel and Canada: the role of national wealth
Pförtner T, Moor I, Rathmann K, Hublett A et al., Addiction, 2014, Early online
http://www.drugsandalcohol.ie/22734/
This study examines the role of national wealth in the association between family affluence and adolescent weekly smoking, early smoking behaviour and weekly smoking among former experimenters. Data were used from the Health Behaviour in School-aged Children (HBSC) study conducted in 2005/2006 in 35 countries from Europe and North America that comprises 60,490 students aged 15 years. Multi-level logistic regression was conducted using Markov Chain Monte Carlo (MCMC) methods to explore whether associations between family affluence and smoking outcomes were dependent on national wealth.
