ABSTRACT
OBJECTIVES: Exploration of experience of harms due to another person's drinking within a demographic particularly vulnerable to these consequences. Importance of study: Largest sampling of young Australian risky drinkers, who are underrepresented in general population surveys. The range of harms due to others' drinking reported here is more comprehensive than documented elsewhere. STUDY TYPE: Cross-sectional self-report survey. METHODS: Participants were 14-19 years old and screened as being within the riskiest-drinking 25% for their age cohort. The convenience sample of 3465 was recruited primarily by social media advertising. Face-to-face interviews were conducted in all eight Australian capital cities (n = 596), supplemented by online surveys (n = 2869). Past 12-month experience of 13 harms due to others' drinking was assessed by age, gender and perpetrator. RESULTS: Females were more likely to experience seven harms, mainly characterised by fear and harassment, including being harassed or bothered at a party or some other private setting (41% vs 34% of males, p < 0.001), being given unwanted sexual attention (71% vs 47%, p < 0.001) and being put in fear (33% vs 20%, p < 0.001). Males were more likely to experience three harms, characterised by aggression: being yelled at, criticised or verbally abused (38% vs 33% of females, p = 0.002), being pushed or shoved (42% vs 28%, p < 0.001) and being physically hurt (17% vs 11%, p < 0.001). Teenagers of a legal alcohol-purchase age were more likely to experience harassment in public settings (49% vs 32-34%, p < 0.001) and unwanted sexual attention (66% vs 51-59%, p < 0.001) compared with younger teenagers. Seven of the harms studied were more likely (p < 0.01) to be perpetrated by people the respondents knew, and five (those associated with fear and aggression) were more likely to be perpetrated by strangers. CONCLUSION: Young people who are risky drinkers commonly experience multiple harms from others' drinking. Many of these alcohol harms to others are reported here for the first time, as previous studies of adolescent drinking have focused almost exclusively on the harms young people have experienced from their own drinking. This refocusing on the harms caused by the drinking of others may prompt greater community concern and concomitant calls for better alcohol regulation.
Subject(s)
Age Factors , Alcohol Drinking/epidemiology , Sex Factors , Underage Drinking/statistics & numerical data , Violence/statistics & numerical data , Adolescent , Adult , Australia/epidemiology , Cross-Sectional Studies , Female , Humans , Male , Risk Assessment , Surveys and Questionnaires , Young AdultABSTRACT
Abstract: Introduction: Misuse of pharmaceutical drugs, particularly by young people, is an issue of rising concern. Poly-substance use is common among regular psychostimulant users (RPU), and mental health problems are associated with pharmaceutical misuse, but RPU do not generally acknowledge their use as problematic. Objective: To examine links between mental health and misuse of non-prescription pharmaceuticals in a group of regular users of illicit psychostimulants. Method: Face to face structured interviews were conducted in April 2015 with 763 regular users of illicit psychostimulants as part of the Annual Ecstasy and Related Drugs Reporting System study in Australia. Results: At least half of the RPU in this study reported extra-medical or misuse of pharmaceuticals in the last six months in addition to regular use of illicit psychostimulants. Higher levels of psychological distress were recorded for RPU who also reported recent illicit use of opioids, antidepressants, benzodiazepines, or over-the-counter (OTC) codeine. Recent misuse of benzodiazepines or OTC codeine was associated with self-reported mental health problems and having attended a mental health professional. Those reporting recent misuse of opioids were at increased risk of mental health problems and more likely to record high levels of psychological distress, but less likely to have received prescription medications for their mental health problem. Discussion and conclusion: Regular users of illicit psychostimulants who also misuse pharmaceuticals are at increased risk of mental health problems, even after accounting for their use of illicit psychostimulants. Screening of this group for mental health problems is recommended.
Resumen: Introducción: El uso indebido de psicofármacos, particularmente entre los jóvenes, es un tema de creciente preocupación. El policonsumo de sustancias es común entre los usuarios regulares de psicoestimulantes (URP), y, pese a que hay problemas de salud mental asociados con el uso indebido de medicamentos, los URP generalmente no reconocen su consumo como problemático. Objetivo: Examinar las relaciones entre la salud mental y el uso indebido de psicofármacos no prescritos en un grupo de URP. Método: Se realizaron entrevistas cara a cara con 763 URP como parte del Estudio Anual del Sistema de Reporte de Éxtasis y Drogas Relacionadas en Australia. Resultados: Al menos la mitad de los URP en este estudio informaron el uso extramédico o indebido de psicofármacos en los últimos seis meses, además del uso regular de psicoestimulantes ilícitos. Se hallaron niveles más altos de distrés psicológico para los URP, quienes también informaron de un uso ilícito reciente de codeína, opiáceos, antidepresivos o benzodiazepinas sin prescripción médica. El uso indebido reciente de codeína o benzodiazepinas sin prescripción se asoció a problemas autorreportados de salud mental y a asistencia a consulta con un profesional de salud mental. Aquellos que informaron el uso indebido reciente de opioides mostraron mayor riesgo de problemas de salud mental y mayor probabilidad de registrar altos niveles de distrés psicológico, pero menor probabilidad de haber recibido psicofármacos prescritos para su problema de salud mental. Discusión y conclusión: Los URP que también consumen indebidamente psicofármacos están en mayor riesgo de presentar problemas de salud mental, incluso después de considerar su consumo de psicoestimulantes ilícitos. Se recomienda una evaluación por tamizaje para problemas de salud mental en este grupo.
ABSTRACT
Needle and syringe program (NSP) coverage is commonly used to assess NSP effectiveness. However, existing measures don't capture whether persons who inject drugs (PWIDs) stockpile syringes, an important and novel aspect of NSP coverage. In this study, we determine the extent of stockpiling in a sample of Australian PWIDs and assess whether including stockpiling enhances NSP coverage measures. As part of the Illicit Drug Reporting System study, PWIDs reported syringes procured and given away, total injections in the last month, and syringes currently stockpiled in 2014. We calculated NSP coverage with and without stockpiling to determine proportional change in adequate NSP coverage. We conducted receiver operating characteristic curve analysis to determine whether inclusion of stockpiled syringes in the measure improved sensitivity in discriminating cases and noncases of risky behaviors. Three-quarters of the sample reported syringe stockpiling, and stockpiling was positively associated with nonindigenous background, stable accommodation, no prison history, longer injecting careers, and more frequent injecting. Compared with previous measures, our measure was significantly better at discriminating cases of risky behaviors. Our results could inform NSP policy to loosen restricted-exchange practice, allowing PWIDs greater flexibility in syringe procurement practices, promoting greater NSP coverage, and reducing PWIDs' engagement in risky behaviors.
