Drug and alcohol review
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Drug and alcohol review · Sep 2003
From scrubland to vintage wine: Australia's response to substance-related problems in the last 40 years.
Over the last 40 years Australia's response to substance-related problems compared with most western nations has been outstandingly good. Since the 1960s concerns about problems of substance use have expanded from a focus on alcohol to include tobacco and a wide range of other licit as well as illicit psychoactive substances. During this period there have been major advances in our knowledge and understanding of substance-related problems and effective methods of prevention, intervention and treatment. ⋯ These initiatives have been associated with reductions in alcohol and tobacco use and related problems and evidence of reductions in some problem areas associated with illicit drug use. Despite these gains, there have been areas of failure and missed opportunities. Finally, it is critical to ensure that past achievements and opportunities for continued successful initiatives are not undermined by identifiable impediments and risks that could imperil the philosophy, goals, infrastructure and programmes that form the basis for Australia's success to date.
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The advent of bupropion hydrochloride sustained release (Zyban) has heralded a major change in the options available for smoking cessation pharmacotherapy. Bupropion is a selective re-uptake inhibitor of dopamine and noradrenalin which prevents or reduces cravings and other features of nicotine withdrawal. Bupropion is a useful oral and non-nicotine form of pharmacotherapy for smoking cessation. ⋯ The major safety issue with bupropion is risk of seizures (estimated at approximately 0.1%) and it should not be prescribed to patients with a current seizure disorder or any history of seizures. In clinical trials of bupropion for smoking cessation no seizures were reported. Allergic reactions occur at a rate of approximately 3% and minor adverse effects are common including dry mouth and insomnia.
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Drug and alcohol review · Mar 2003
Family functioning, alcohol expectancies and alcohol-related problems in a remote aboriginal Australian community: a preliminary psychometric validation study.
While a large proportion of Aboriginal Australians do not consume alcohol, those who do frequently show severe alcohol problems, and alcohol problems are associated with family conflict and violence. The aims were to examine the internal coherence and reliability of measures of family and alcohol measures for indigenous Australians in remote communities. This study involved 99 indigenous people from a remote North Queensland community. ⋯ Expectancies of affective change had sound internal reliability for drinkers, and covaried with alcohol problems in the expected direction. The Alcohol Use Disorders Identification Test had two distinct factors relating to consumption and problems, but quantity/frequency measures may have limited reliability due to the common practice among drinkers of sharing alcohol. These measures should facilitate the detection and initial assessment of alcohol and family problems, and may be useful for evaluating change in future interventions that target family and alcohol problems.
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Drug and alcohol review · Dec 2002
Comparative StudyDiversity of substance use in eastern Arnhem Land (Australia): patterns and recent changes.
The objective of this study was to describe patterns of substance use among remote Aboriginal community populations. The setting was the eastern Arnhem Land ('Miwatj') region of the Northern Territory's (NT) 'Top End', with a population of 4217 Aboriginal people over 15 years of age using a cross-sectional description and comparison. Sample 1 (n = 689) from the region used data from health-worker consensus classification of kava, alcohol, tobacco, petrol and cannabis use. ⋯ Tobacco use patterns in women may have been changing. Average per capita consumption of alcohol was low compared with other 'Top End' areas. Such varied and dynamic substance use patterns pose challenges for research and policy.
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Drug and alcohol review · Mar 2002
ReviewPetrol sniffing in Aboriginal communities: a review of interventions.
Petrol sniffing (and other forms of inhalant misuse) occur within some Aboriginal communities across Australia. However, there is little documented information about the nature and combination of interventions that are most effective in addressing it. This article reviews published and unpublished literature relevant to petrol sniffing in Australian Aboriginal communities. ⋯ We argue that interventions should address as many as possible of these factors. Further, while no strategy is likely to succeed without strong support from local community members, governments also have an important role in addressing petrol sniffing. Consistent funding for strategies directly addressing petrol sniffing and co-ordinated government responses to the broader needs of Aboriginal young people and their communities are critical.