Measuring treatment outcomes in gambling disorders: a systematic review.

BACKGROUND AND AIMS: Considerable variation of outcome variables used to measure recovery in the gambling treatment literature has precluded effective cross-study evaluations and hindered the development of best-practice treatment methodologies. The aim of this systematic review was to describe current diffuse concepts of recovery in the gambling field by mapping the range of outcomes and measurement strategies used to evaluate treatments, and to identify more commonly accepted indices of recovery. METHODS: A systematic search of six academic databases for studies evaluating treatments (psychological and pharmacological) for gambling disorders with a minimum 6-month follow-up. Data from eligible studies were tabulated and analysis conducted using a narrative approach. Guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) were adhered to. RESULTS: Thirty-four studies were reviewed systematically (RCTs = 17, comparative designs = 17). Sixty-three different outcome measures were identified: 25 (39.7%) assessed gambling-specific constructs, 36 (57.1%) assessed non-gambling specific constructs, and two instruments were used across both categories (3.2%). Self-report instruments ranged from psychometrically validated to ad-hoc author-designed questionnaires. Units of measurement were inconsistent, particularly in the assessment of gambling behaviour. All studies assessed indices of gambling behaviour and/or symptoms of gambling disorder. Almost all studies (n = 30; 88.2%) included secondary measures relating to psychiatric comorbidities, psychological processes linked to treatment approach, or global functioning and wellbeing. CONCLUSIONS: In research on gambling disorders, the incorporation of broader outcome domains that extend beyond disorder-specific symptoms and behaviours suggests a multi-dimensional conceptualization of recovery. Development of a single comprehensive scale to measure all aspects of gambling recovery could help to facilitate uniform reporting practices across the field.

Co-ingestion of energy drinks with alcohol and other substances among a sample of people who regularly use ecstasy.

INTRODUCTION AND AIMS: Despite the potential harms of mixing unregulated drugs with energy drinks (ED), research to date has primarily been focused on EDs co-ingested with alcohol. Consequently, the aim of the present study was to explore the rate of use, harms and correlates of EDs co-ingested with alcohol and other drugs among a sample of people who regularly use illicit stimulant drugs. DESIGN AND METHODS: In 2010, 693 Australians who regularly used ecstasy completed a 1-h interview about their past six-month ED and drug use. RESULTS: Three-quarters of the sample (77%) had recently consumed EDs with other substances, primarily alcohol (70%) and ecstasy (57%). People who consumed ED with alcohol versus those who had consumed ED with ecstasy and with alcohol (only 8% reported only consuming ED with ecstasy) had similar profiles in regards to demographics, drug use, mental health and drug-related problems. Primary motives for consuming ED with alcohol included increased alertness (59%), the taste (25%), to party for longer (23%) and to combat fatigue (16%). One-half (52%) and one-quarter (27%) of participants who consumed EDs with alcohol and with ecstasy respectively had recently experienced adverse outcomes post-consumption, primarily headaches (24% and 11%) and heart palpitations (21% and 14%). DISCUSSION AND CONCLUSIONS: Co-ingestion of EDs with licit and illicit drugs is common among people who regularly use ecstasy and related drugs. Adverse outcomes of co-ingestion suggest that targeted education regarding negative interactive drug effects is crucial for harm reduction. [Peacock A, Sindicich N, Dunn M, Whittaker E, Sutherland R, Entwistle G, Burns L, Bruno R. Co-Ingestion of Energy Drinks with Alcohol and Other Substances among a Sample of People Who Regularly Use Ecstasy. Drug Alcohol Rev 2016;35:352-358].

Tobacco and e-cigarette use amongst illicit drug users in Australia.

OBJECTIVE: To examine the rates and patterns of tobacco and e-cigarette use amongst two samples of illicit drug users in Australia. METHOD: Data were obtained from the 2015 Illicit Drug Reporting System (IDRS) and the 2015 Ecstasy and Related Drugs Reporting System (EDRS). These studies comprised cross-sectional samples of 888 people who inject drugs (PWID) and 763 regular psychostimulant users (RPU). RESULTS: Tobacco was consumed by the majority of both samples, however, use in the 6 months preceding interview was significantly higher amongst PWID (92.2%) than RPU (82.4% [OR 2.53 95% CI 1.86-3.44]). Inversely, PWID were less likely to have a history of e-cigarette use: 31.5% of PWID reported lifetime use of e-cigarettes (vs. 57.0% of RPU [OR 0.35 95% CI 0.28-0.42]) and 18.1% reported use in the 6 months preceding interview (vs. 33.7% of RPU [OR 0.44 95% CI 0.35-0.55]). PWID were more than three times as likely than RPU to report using e-cigarettes as a smoking cessation tool (OR 3.09 95% CI 2.03-4.71), but were less likely to use e-liquids that contained nicotine (OR 0.52 95% CI 0.32-0.83). Higher levels of poly drug use, daily tobacco use, recent use of synthetic cannabinoids and employment status were found to be significantly associated with e-cigarette use. CONCLUSION: The use of e-cigarettes was relatively common amongst Australian samples of PWID and RPU. Whilst the majority of PWID reported using e-cigarettes as a smoking cessation tool, it appears that RPU are using them for experimental or recreational purposes.