Drug and alcohol review
-
Drug and alcohol review · Nov 2006
Review Comparative StudyComparative cost-effectiveness of policy instruments for reducing the global burden of alcohol, tobacco and illicit drug use.
Alcohol, tobacco and illicit drug use together pose a formidable challenge to international public health. Building on earlier estimates of the demonstrated burden of alcohol, tobacco and illicit drug use at the global level, this review aims to consider the comparative cost-effectiveness of evidence-based interventions for reducing the global burden of disease from these three risk factors. Although the number of published cost-effectiveness studies in the addictions field is now extensive (reviewed briefly here) there are a series of practical problems in using them for sector-wide decision making, including methodological heterogeneity, differences in analytical reference point and the specificity of findings to a particular context. ⋯ The application of generalised CEA to a range of personal and non-personal interventions for reducing the burden of addictive substances is described. While such a development avoids many of the obstacles that have plagued earlier attempts and in so doing opens up new opportunities to address important policy questions, there remain a number of caveats to population-level analysis of this kind, particularly when conducted at the global level. These issues are the subject of the final section of this review.
-
Drug and alcohol review · Nov 2006
ReviewCommunity-based interventions and alcohol, tobacco and other drugs: foci, outcomes and implications.
The social, health and economic burdens from alcohol, tobacco and other drugs have impacts globally, national and locally. Effective interventions are needed at each level in order to reduce the extensive harm and attendant costs. This paper examines four topics: options available to the local community, evidence of effectiveness, links between local experiences and national and regional initiatives and implications for future research and intervention. ⋯ There is also not a consistent relationship between local and national interventions, although some themes are apparent: in tobacco control there may be good synergy across jurisdictional levels, for alcohol there is evidence that as national control measures are eroded local communities are encouraged or required to take up these agendas, and with regard to illicit drugs there may be tension between law enforcement priorities at the national level and harm reduction orientations locally. Future initiatives need to have appropriate evaluations as a standardised part of prevention initiatives, and include the development of national databases of what is going on locally. These initiatives should promote national policies that include setting parameters and guidelines, but nevertheless do not dictate specific steps and strategies how to achieve local goals in reducing risk and harm.
-
We report here on the illicit drug situation in six Pacific nations: Fiji, Papua New Guinea, Samoa, Solomon Islands, Tonga and Vanuatu. The report is based on the 'Situational analysis of illicit drug issues and responses in Asia and the Pacific', commissioned by the Australian National Council on Drugs Asia Pacific Drug Issues Committee. The situational analysis was a comprehensive desk-based review; data sources included published and unpublished literature and information from key informants. ⋯ Drugs such as heroin, methamphetamines and cocaine are not used commonly due to their high cost compared to the average income. Currently, there is no overall regional or country-based illicit drug policy for the Pacific and few treatment programs; limited data exist to aid in understanding illicit drug use and the harms associated with its use in the Pacific. This review highlights the urgent need for strategic alcohol and drug research in the Pacific as a foundation for the development of policy.
-
Drug and alcohol review · May 2006
The role of remote community stores in reducing the harm resulting from tobacco to Aboriginal people.
The objective of this study was to assess the potential for reducing the harm resulting from tobacco use through health promotion programmes run in community stores in remote Aboriginal communities. The Tobacco Project utilised data from 111 stakeholder interviews (72 at baseline and 71 at follow-up after 12 months) assessing presence of sales to minors, tobacco advertising, labelling and pricing. It also involved the assessment of observational data from community stores and comments obtained from 29 tobacco vendors derived from community surveys. ⋯ All stores had unofficial no-smoking policies in accessible parts of the store. Remote community stores complied with existing legislation, aside from allowing access of minors to vending machines. There may still be potential for proactive tobacco education campaigns run through community stores and for a trial assessing the effect of changes in tobacco prices on tobacco consumption.
-
Drug and alcohol review · May 2006
Stopping petrol sniffing in remote Aboriginal Australia: key elements of the Mt Theo Program.
Petrol sniffing is a major form of substance misuse in Aboriginal communities across Australia. This practice has detrimental effects on the health and wellbeing of individual sniffers, their families, communities and wider society. ⋯ This paper looks at the Mt Theo Program, regularly cited as 'the success story' in petrol sniffing interventions. The aim of this paper is to demonstrate key elements that have contributed towards Mt Theo Program's rare achievement: (1) initially, a multi-faceted approach including an outstation and youth programme, (2) community-initiated, operated, owned basis of the organisation, which incorporates (3) strong partnership between Indigenous and non-Indigenous team members and (4) an ability to operate beyond crisis intervention.