The following abstracts are cited from published journal articles recently added to the repository of the HRB National Drugs Library at www.drugsandalcohol.ie

Carew AM and Comiskey C (2018) Drug and Alcohol Dependence, 192: 329–37.

https://www.drugsandalcohol.ie/29783/

Literature identifies older people who use opioids as a neglected population. Little is known about temporal changes, or about treatment demand among this population. The EU Treatment Demand Indicator (TDI) for Ireland (1996–2014) was analyzed for trends in new opioid treatment admissions, ageing and drug using behaviors. A Joinpoint analysis was conducted.

The study utilizes European TDI data and finds that those entering treatment in Ireland is older, are injecting longer and are taking longer to enter treatment. These findings highlight how TDI data can be used to identify hidden groups at risk of chronic harm which may require prioritizing in policy and practice.

Melaugh B and Rodrigues H (2018) Social Work and Social Sciences Review, 19(3): 7–16.

https://www.drugsandalcohol.ie/29784/

The purpose of this article is to share how an Irish drugs advocacy organisation, UISCE conducted a consultation with ‘People Who Use Drugs’ (PWUD) to inform the development of Ireland’s National Drugs Strategy: Reducing Harm Supporting Recovery. People who use drugs are considered a ‘hard to reach’ or ‘hidden’ population’ who, because of their marginal status, are often absent from research and drug policy. Indeed, there is a lack of published data on how to engage with PWUD to inform policy development. The paper aims to extend the literature by highlighting how UISCE, employing a ‘peer-led street outreach’ approach, included 51 PWUD in the consultation to inform the Irish national drug strategy. Central to the paper is a description of the steps taken to conduct the consultation with a review of the challenges and benefits of using a ‘street based recruitment’ strategy to engage with hard to reach people who use drugs.

Najeeb N, Halawani M, McElvaney NG and Doyle F (2018) Irish Medical Journal, 111(9): 821.

https://www.drugsandalcohol.ie/29809/

We aimed to determine the prevalence of smoking and smoking cessation advice received by inpatients in Beaumont Hospital and compared results to previous similar studies.

There remains limited provision of smoking cessation advice to inpatients.

Ismail MF, Doherty K, Bradshaw P, O'Sullivan I and Cassidy EM (2018) Emergency Medicine Journal, 36(1): 18–21.

https://www.drugsandalcohol.ie/29777/

In this study, we aim to describe the feasibility of symptom-triggered therapy (STT) in an emergency department (ED) short-stay clinical decision unit (CDU) setting.

STT is potentially feasible as a rapid and effective approach to managing alcohol withdrawal syndrome in the ED/CDU short-stay inpatient setting where patient LOS is generally less than 24 hours.

GBD 2016 Alcohol Collaborators (2018) Lancet, 392(10152): 1015–35.

https://www.drugsandalcohol.ie/29555/

With our comprehensive approach to health accounting within the Global Burden of Diseases, Injuries, and Risk Factors Study 2016, we generated improved estimates of alcohol use and alcohol-attributable deaths and disability-adjusted life-years (DALYs) for 195 locations from 1990 to 2016, for both sexes and for 5-year age groups between the ages of 15 years and 95 years and older.

Alcohol use is a leading risk factor for global disease burden and causes substantial health loss. We found that the risk of all-cause mortality, and of cancers specifically, rises with increasing levels of consumption, and the level of consumption that minimises health loss is zero. These results suggest that alcohol control policies might need to be revised worldwide, refocusing on efforts to lower overall population-level consumption.

Grebely J, Larney S, Peacock A, Colledge S, Leung J, Hickman M, et al. (2019) Addiction, 114(1): 150–66.

https://www.drugsandalcohol.ie/29394/

This study estimated the prevalence and number of people with recent injecting drug use living with HCV, and the proportion of people with recent injecting drug use among all people living with HCV infection at global, regional, and country-levels.

Although, globally, 39.2% of people with recent injecting drug use are living with hepatitis C virus (HCV) and 8.5% of all HCV infections globally occur among people with recent injecting drug use, there is wide variation among countries and regions.

Bourke J, Murphy A, Flynn D and Kells M (2018) Irish Journal of Psychological Medicine, Early online.

https://www.drugsandalcohol.ie/29512/

The objective of this study is to determine the use of direct health care resources by persons with BPD in Ireland and the corresponding costs.

There is a dearth of data on health care resource use and costs of community mental health services in Ireland. The absence of this data is a considerable constraint to research and decision-making in the area of community mental health services. This paper contributes to the limited literature on resource use and costs in community mental health services in Ireland. The absence of productivity loss data (e.g. absenteeism and presenteeism), non-health care costs (e.g. addiction treatment), and indirect costs (e.g. informal care) from study participants is a limitation of this study.

Breslin E, Hanafin J and Clancy L (2018) BMC Public Health, 18(1): 991. https://www.drugsandalcohol.ie/29424/

Smoking prevalence in Ireland is falling in all age groups, but the prevalence of roll-your-own (RYO) tobacco use is rising among young people. This qualitative study aims to explore and understand the factors associated with young people's use of RYO products.

While the lower cost of RYO products is very important for young smokers, other product characteristics and influences also incentivise and disincentivise use. A more comprehensive understanding of the multi-dimensional appeal of these products will assist policymakers to target strategies to reduce the attractiveness to young smokers of these products.

Darcy C (2018) Economic and Social Review, 49(3): 361–72.

https://www.drugsandalcohol.ie/29721/

This article examines the position of drug education workers who deliver drug education in non-formal education settings to children and young people in Ireland. Employing secondary data and document analysis, the paper analyses three national drug strategies and the annual reports of 21 local and regional Drug and Alcohol Task Forces (DATFs), in order to determine the prominence of drug education workers within the statutory response to illicit drug use in Irish society.

Lyphout C, Yates C, Margolin ZR, Dargan PI, Dines AM, Heyerdahl F, et al. (2019) European Journal of Clinical Pharmacology, 75(1): 77–81.

https://www.drugsandalcohol.ie/29713/

The aim of this paper is to describe presentations to the emergency department in Europe related to the recreational use of benzodiazepines and Z-drugs and compare regional differences in these presentations with legal drug sales of benzodiazepines and Z-drugs within each country.

Swabri J, Uzor C, Laird E and O'Carroll A (2018) Irish Journal of Medical Science, Early online.

https://www.drugsandalcohol.ie/29635/

This paper aims to explore and determine the specific health reasons for attending the mobile health unit and to investigate whether the MHC (mobile health clinic) improves access to primary healthcare for homeless people.

While the findings of this study are limited by the small sample size, they nevertheless indicate that the MHC promotes access to primary care service. Results also highlight the need to expand the healthcare approaches on the MHC to adequately meet the health needs of its target population.

Burke L, Nic Gabhainn S and Kelly C (2018) International Journal of Environmental Research and Public Health, 15(9): 1851.

https://www.drugsandalcohol.ie/29613/

This research explores relationships between contextual socio-demographic, health and lifestyle factors and the timing of first sexual intercourse among 15–17-year-olds in Ireland.

The study found that initiation of risk behaviours such as smoking, alcohol use, drunkenness or cannabis at younger ages was predictive of early sexual initiation among girls and boys.

Keogan S, Li S and Clancy L (2018) Tobacco Control, Early online. https://www.drugsandalcohol.ie/29870/

To determine if Allen Carr's Easyway to Stop Smoking (AC) was superior to Quit.ie in a randomised clinical trial (RCT).

All AC quit rates were superior to Quit.ie, outcomes were comparable with established interventions.

Ahern S, Burke LA, McElroy B, Corcoran P, McMahon EM, Keeley H, et al. (2018) European Child & Adolescent Psychiatry, 27(10): 1295–1304.

https://www.drugsandalcohol.ie/29779/

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). The health outcomes of interest were suicide attempt and severe suicidal ideation with suicide plans.

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

Fitzgerald A, Mac Giollabhui N, Dolphin L, Whelan R and Dooley B (2018) PLoS ONE, 13(8): e0202498.

https://www.drugsandalcohol.ie/29577/

The aim of the present study was to examine the role of the individual, family, school, peer, and social environment on alcohol (lifetime and risky), tobacco (risky only), and cannabis use (lifetime and riskiness).

This study indicates that the relationship between the environment and substance use is more complex than previously thought.

Reynolds CME, Egan B, O'Malley EG, Kennedy RA, Sheehan SR and Turner MJ (2019) European Journal of Public Health, 29(1): 170–72.

https://www.drugsandalcohol.ie/29559/

The aim of this randomized controlled trial was to determine whether a behavioural intervention in pregnancy supported by online information would improve smoking cessation rates. However, due to a number of challenges, recruitment to this trial was reluctantly halted. We aimed to recruit 220 maternal smokers within 2 years and after screening 1995 women, just 22 enrolled over a 8-month period. Only three women accessed the online element of the intervention and, at follow up, no women reported quitting. We report our findings as they may inform the design and powering of future smoking cessation interventions in pregnancy.

Rai LA, O'Halloran L, Jollans L, Vahey N, O'Brolchain C and Whelan R (2019) Addictive Behaviors, 88: 73–76.

https://www.drugsandalcohol.ie/29569/

The ability to update reward and punishment contingencies is a fundamental aspect of effective decision-making, requiring the ability to successfully adapt to the changing demands of one's environment. In the case of nicotine addiction, research has predominantly focused on reward- and punishment-based learning processes among current smokers relative to non-smokers, whereas less is known about these processes in former smokers.

Current smokers and ex-smokers were less likely to learn from rewards, supporting the hypothesis that deficient reward processing is a feature of chronic addiction. In addition, current smokers were more sensitive to punishment than ex-smokers, contradicting some recent findings.

O'Farrell A, Kingsland M, Kenny S, Eldin N, Wiggers J, Wolfenden L and Allwright S (2018) Drug and Alcohol Review, 37(1): 14–22.

https://www.drugsandalcohol.ie/29526/

The study aimed to test the effectiveness of an intervention to reduce alcohol misuse and related harms amongst amateur sports people in Ireland.

Intervention in community sports clubs may be effective in reducing the number of alcohol-related harms. Low levels of intervention participation and inadequate intervention dose are possible reasons for lack of a broader intervention effect.

Shanahan KM and O'Grady MJ (2018) Irish Medical Journal, 111(7): 785.

https://www.drugsandalcohol.ie/29434/

Neonatal abstinence syndrome (NAS) is a constellation of symptoms and signs of withdrawal developing in infants following intrauterine exposure to opioids. In Ireland currently, this is typically methadone substitution for treatment of heroin addiction. In the United States, NAS has been declared an epidemic with a 5-fold increase in incidence between 2000 and 2012 and a current prevalence as high as 2% of live births. In Ireland, data from the Hospital Inpatient Enquiry (HIPE) system indicates that between 2012 and 2016, 501 infants were treated for NAS; half of whom were in the three Dublin maternity hospitals. The most recent survey of practice within neonatal units in Ireland and the UK identified widespread variation in methods for assessment and treatment of NAS, reflecting the lack of quality evidence upon which current treatment regimens are based.

Fennessy P, Murphy L and Crowe S (2018) Irish Medical Journal, 111(8): 807.                                                            

https://www.drugsandalcohol.ie/29642/

We present a case of a five-year-old female admitted postoperatively to the Paediatric Critical Care Unit with a history of refractory seizures for which her parents were administering cannabis oil.