Drug and alcohol review
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Drug and alcohol review · Jan 2011
Australian governments' spending on preventing and responding to drug abuse should target the main sources of drug-related harm and the most cost-effective interventions.
A notable feature of Australian drug policy is the limited public and professional attention given to the financial costs of drug abuse and to the levels and patterns of government expenditures incurred in preventing and responding to this. Since 1991, Collins and Lapsley have published scholarly reports documenting the social costs of drug abuse in Australia and their reports also contain estimates of governments' drug budgets: revenue and expenditures. ⋯ This pattern of resource allocation does not adequately reflect an evidence-informed policy orientation in that it largely fails to focus on the drug types that are the sources of the most harm (tobacco and alcohol rather than illicit drugs), and the sectors for which we have the strongest evidence of the cost-effectiveness of the available interventions (treatment and harm reduction rather than legislation and law enforcement). The 2010-2014 phase of Australia's National Drug Strategy should include incremental changes to the resource allocation mix, and not simply maintain the historical resource allocation formulae.
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Drug and alcohol review · Sep 2010
Combined effects of law enforcement and substitution treatment on heroin mortality.
To explore the combined effects of street-level law enforcement and substitution treatment programs on drug-related mortality, taking into account prevalence of heroin use and changes in injecting behaviour. ⋯ Our analysis revealed that the amount of police resources allocated to law enforcement was determined rationally, however, on biased grounds and with untoward consequences. Substitution treatment of heroin users reduced drug-related mortality in the long run, but different factors masked its impact for several years. Therefore, the introduction-or the expansion-of opioid substitution treatment programs should not be promoted with the argument of an immediate reduction of drug-related deaths in a country.
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Drug and alcohol review · Sep 2010
ReviewCognitive behaviour therapy (CBT) for the treatment of co-occurring depression and substance use: current evidence and directions for future research.
ISSUES AND APPROACH: The high rates of co-occurring depression and substance use, and the negative impact of this on illness course and outcomes have been well established. Despite this, few clinical trials have examined the efficacy of cognitive behaviour therapy (CBT). This paper systematically reviews these clinical trials, with an aim of providing recommendations for how future research can develop a more robust evidence base for the treatment of these common comorbidities. Leading electronic databases, including PubMed (ISI) and PsychINFO (CSA), were searched for peer-reviewed journal articles using CBT for the treatment of co-occurring depression and substance use. Of the 55 articles identified, 12 met inclusion criteria and were included in the review. ⋯ Rather than declaring the 'dodo bird verdict' that CBT and all other psychotherapies are equally efficacious, it would be more beneficial to develop more potent forms of CBT by identifying variables that mediate treatment outcomes.
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Drug and alcohol review · May 2010
Case ReportsIllicit ketamine induced frequency of micturition in a young Malay woman.
The growing use of illicit ketamine among young adults poses a public health concern in Malaysia. In contrast to medical use of ketamine, illicit use has been reported to produce adverse effects on the urinary tract and, in particular the bladder. APPROACH AND KEY FINDINGS: This case report describes a young Malay woman who developed severe bladder symptoms (urinary frequency) after consuming illicit ketamine. A history of illicit ketamine use was initially missed, and she was consequently diagnosed and treated for a urinary tract infection. Her symptoms persisted despite several courses of antibiotics. The patient was subsequently referred to an urologist where cystoscopic examination and biopsy of the bladder found changes consistent with interstitial cystitis. This was despite the absence of haematuria. Renal function was normal. ⋯ Illicit ketamine use may lead to severe urinary tract problems that can be irreversible even after ketamine has ceased. Early diagnosis is critical although difficult when ketamine use is not divulged during the consultation with the physician. Physician consideration of this new clinical entity is important, particularly in cases where the symptoms do not resolve with usual treatment.
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Drug and alcohol review · Mar 2010
What women in France say about alcohol abstinence during pregnancy.
In spite of the implemented policies warning of the dangers of alcohol consumption for pregnant women, many women still continue drinking during pregnancy. This article focuses on the question of the representations of alcohol consumption during pregnancy in France. ⋯ Alcohol consumption during pregnancy already constitutes a real taboo for the heath care professionals in France. It is extremely urgent and imperative that they recommend total abstinence during pregnancy, in order to avoid any irreversible consequences for the unborn babies.