Trenbolone is a high-risk anabolic-androgenic steroid (AAS), yet quantitative evidence describing its psychosocial and physical harm profile remains limited. This study compared self-reported concerns among men who used trenbolone in the past 12 months (trenbolone group) with those who used other AAS but not trenbolone (non-trenbolone group). Data were drawn from male respondents to the Global Drug Survey 2024 who reported past-year AAS consumption (N = 1146; Mage = 31.46, SD = 9.93). Participants were categorised as the trenbolone group (n = 237) or non-trenbolone group (n = 909) based on past-12-month injectable trenbolone use. Chi-squared tests examined between-group differences in psychosocial and physical concerns. Multiple-response frequencies and UpSet plots were used to assess number and co-occurrence of reported harms. Chi-square analyses indicated that psychosocial concerns, including mood instability, irritability and depressive symptoms, were significantly more common among the trenbolone group (all p < 0.001), with small-to-moderate effect sizes (ϕ = 0.13 to 0.20). Physical concerns, particularly cardiovascular and hepatic effects, were also significantly more prevalent among the trenbolone group (all p < 0.001; ϕ = 0.18 to 0.20). UpSet plot visualisations showed denser clustering of harms among the trenbolone group compared with the non-trenbolone group. Trenbolone use is associated with a higher prevalence and co-occurrence of psychosocial and physical concerns relative to other AAS use. These harms suggest trenbolone use is reflective of severe risk profiles within the AAS-using communities. Targeted harm-reduction messaging and clinical screening strategies may be warranted for this subgroup.

Executive functioning (EF) consists of basic components (inhibition, working memory [WM] and flexibility) and more complex components that depend on the proper functioning of the basic components. Deficits in EF are common in alcohol use disorder (AUD) and can impact treatment effectiveness and quality of life. This study examined the impact of neuropsychological rehabilitation (NR) on improving these functions. A prospective observational cohort study was conducted in an AUD treatment unit, with three evaluation points: baseline and after 3 and 6 months. The study compared EF recovery in patients undergoing group therapy for AUD (WTG: weekly therapeutic groups; NRG: NR group). The sample consisted of 65 participants who underwent medically assisted detoxification from April 2021 to August 2023. The following instruments were administered: a sociodemographic questionnaire, the Hospital Anxiety and Depression Scale, the Dependency Severity Questionnaire, the Frontal Assessment Battery (FAB), the Wisconsin Card Sorting Test, the Trail Making Test, the Verbal Fluency Test, the Wechsler Adult Intelligence Scale and the Colour and Word Test-Stroop. Statistical procedures included parametric and nonparametric tests and linear mixed-effects models. EF improved in both groups, but the NRG showed a higher increase in The FAB after 3 months, which was reflected in better performance in its key components (WM and flexibility). This improvement was maintained 6 months after the start of treatment. Integrating NR into AUD treatments appears to contribute to greater and faster improvement.

In the UK, consumption of alcohol-free (< 0.05% ABV) and low-alcohol (≤ 1.2% ABV; NoLo) drinks is more prevalent among heavier drinkers and socially advantaged groups. If heavier drinkers are substituting alcoholic drinks with NoLo drinks, this could improve public health. However, socioeconomic differences in consumption could exacerbate alcohol-related health inequalities. Socioeconomic groups vary in their reasons for drinking alcohol, with less advantaged individuals more likely to drink alcohol to cope. This study examined whether alcohol drinking motives can help explain differences in NoLo consumption. A total of 2549 adults residing in Great Britain provided data on at least monthly NoLo consumption, hazardous drinking (AUDIT-C), alcohol drinking motives, social grade, education, age and gender, via the Alcohol Toolkit Study. Path analysis explored mediating effects of drinking motives between sociodemographic characteristics, hazardous drinking and NoLo consumption. Drinking alcohol to conform, education and hazardous drinking were positively associated with NoLo consumption. Drinking alcohol to cope with depression was a serial mediator between social grade and NoLo. Drinking to cope with depression, more frequently reported among lower social grades, weakened the positive relationship between hazardous drinking and NoLo consumption (β = -0.001, 95% CI -0.002, -0.000). Enhancement and social motives also weakened this relationship, partially mediating pathways between age, gender, education and NoLo consumption. While hazardous drinking is positively associated with NoLo consumption, for those drinking to cope with depression, for enhancement or for social reasons, this effect diminishes, potentially limiting the public health potential for those who drink for these reasons, including disadvantaged groups.

Gabapentinoid prescribing and related harms are increasing internationally, yet population-level evidence on non-medical use in Australia is lacking. This study estimated the prevalence and correlates of past-year non-medical gabapentinoid use and examined temporal trends. Data were pooled from the 2016, 2019 and 2022-2023 National Drug Strategy Household Surveys (N = 67,103). Analyses applied person-level survey weights and accounted for the complex design. Weighted descriptive, trend and multinomial logistic regression analyses were conducted, with covariates prespecified using a directed acyclic graph. Past-year non-medical gabapentinoid use among Australians aged ≥ 14 years increased from 0.06% in 2016 to 0.15% in 2022-2023 (Adjusted Wald F = 5.86, p = 0.016; OR = 1.57, 95% CI 1.09, 2.25). Among those reporting any non-medical pain medication use, the proportion involving gabapentinoids rose from 1.7% to 9.3%. Individuals reporting non-medical gabapentinoid use were more likely to report chronic pain (adjusted relative risk ratio [aRRR] = 5.66, 95% CI 3.18, 10.08), high psychological distress (aRRR = 4.26, 95% CI 2.31, 7.84), and socioeconomic disadvantage (aaRRR = 3.45, 95% CI 1.91, 6.27), compared to those reporting no non-medical pain medication use. Most (71%) also reported non-medical opioid use. Although non-medical gabapentinoid use remains uncommon in Australia, its prevalence is increasing. Findings are consistent with non-medical use occurring in the context of unmet pain and mental health needs rather than predominantly recreational use. Enhanced prescriber awareness, harm reduction initiatives, and expanded access to non-pharmacological pain and mental health care are needed.

To appeal to health-conscious consumers, alcohol producers are marketing products with a range of 'better for you' claims. This study aims to: (i) develop a typology of text-based 'better for you' claims used on alcohol products; (ii) assess the prevalence of these claims in the Australian market overall and by alcohol category; and (iii) identify the extent to which products display multiple claims. Between March and November 2024, images of 5982 unique alcohol products were captured in-store from three retailers in Australia. The products were coded for presence and type of 'better for you' claims, with each claim classified into an emergent typology of categories. Descriptive analyses were conducted overall and by alcohol category. Eight major categories of claims were identified: nutrient content, energy content, absence of ingredient, low alcohol, fruit/botanical references, natural, processing and vegan claims. Across the sample, 35% of products displayed at least one claim (range: 1-9 claims), and one in eight displayed multiple claims. Cider (91%) and premix (75%) categories contained the highest proportion of products featuring at least one claim. The use of claims across the Australian alcohol market appears to be quite common, particularly on premix and cider products. Limited regulation of claims allows companies to portray products as 'better for you', potentially misleading consumers and taking advantage of their efforts to be health-conscious. Future work in Australia should prioritise developing policies that restrict the use of claims on alcohol products, particularly those shown to be misleading.

People with opioid use disorder (OUD) are at elevated risk of incarceration. Understanding factors linked to this risk may support more targeted prevention and intervention efforts. This study used cross-sectional survey data to examine associations with time to first incarceration and repeated incarceration among individuals with OUD. Additionally, we wanted to examine the characteristics of people with opioid dependence who had been incarcerated. Data were drawn from 297 adults with OUD in New South Wales, Australia (2023-2024). Participants completed structured interviews covering socio-demographics, substance use, adverse childhood experiences and criminal justice contact. A discrete-time event analysis examined correlates of first adult incarceration from age 18. Overall, 58% of participants reported having been incarcerated. In adjusted models, injecting drug use increased the risk of first-time incarceration in any given year (aOR: 3.55, 1.08-11.66), as did childhood exposure to household substance use (aOR: 1.80, 1.15-2.82), and being male (aOR: 1.83, 1.24-2.69). Greater secondary education reduced incarceration odds (aOR: 0.56, 0.37-0.86). In any given year, younger adults (18-24 years) were at highest risk of incarceration, whereas those aged 35 or older had notably lower odds (aOR: 0.16, 0.09-0.29). Injecting drug use, limited education, and childhood exposure to household substance use were associated with higher incarceration risk. There is a need to consider broader social and developmental factors in supporting individuals with OUD. While systemic change is complex, this study adds to the evidence base that can inform more integrated approaches to reducing incarceration risk.

Trans and gender diverse (trans) people face substantial health and social inequities, yet limited data exist regarding substance use patterns among this population in Australia. Data were sourced from Private Lives 3, a large national survey of LGBTQ+ adults residing in Australia. Trans participants self-reported sociodemographic characteristics, experiences of discrimination, harassment, violence or exclusion, perceived acceptance and affirmation, psychological distress, sexual assault history and substance use behaviours. Multivariable regression analyses identified factors associated with potentially problematic illicit drug use (DAST-10 ≥ 3), potentially hazardous drinking (AUDIT-C ≥ 3), and daily smoking of cigarettes or other tobacco products. Of 1506 trans participants, 23.7% screened positive for potentially problematic illicit drug use, 49.8% for potentially hazardous alcohol use and 8.5% smoked daily. Potentially problematic illicit drug use was associated with unstable housing (aPR = 1.44, p = 0.001), psychological distress (aPR = 1.39, p = 0.022) and sexual assault history (aPR = 1.51, p = 0.001). Potentially hazardous alcohol use was less prevalent among those with affirming partners (aPR = 0.81, p = 0.001) and asexual identity (aPR = 0.65, p = 0.016), but more prevalent among those with a sexual assault history (aPR = 1.17, p = 0.012). Daily smoking was associated with unstable housing (aPR = 1.82, p = 0.002) and sexual assault history (aPR = 2.09, p = 0.002). At-risk substance use among Australian trans adults was most associated with sexual assault and unstable housing, but not gender identity, perceived acceptance, or most experiences of discrimination, harassment, violence, or exclusion. These findings differ from many US studies and may reflect regional sociocultural, legal or healthcare differences, or unmeasured determinants. These findings highlight the need for routine substance-use screening, trauma-informed care, and housing and sexual assault support initiatives for trans Australians.

This study examined whether alcohol use while gambling and engaging in heavy episodic drinking (HED) are associated with gambling harm in Victoria, Australia. It also explored whether combined alcohol use behaviours further increase harm, and whether economically disadvantaged individuals experience greater harm from alcohol use. Data were used from the representative 2023 Victorian Population Gambling and Health Study subsample (N = 3114; 47.9% female; mean age = 46). Regressions were used to test whether HED (six or more drinks per occasion) and drinking while gambling predicted gambling harm and number of harms, measured using the Short Gambling Harm Screen. Alcohol use while gambling was associated with gambling harm (OR = 2.58, 95% CI [1.53, 4.35], p < 0.001) and number of harms (IRR = 2.57, 95% CI [1.65, 4.00], p < 0.001), controlling for HED, gambling expenditure and socio-demographic variables. HED was associated with harm in bivariable models only (OR = 2.20, p < 0.001), not in adjusted models. The interaction between HED and consuming alcohol while gambling was associated with increased gambling harm. Drinking while gambling was associated with increased gambling harm, as were combined alcohol use behaviours. HED was not independently associated with harm. Those with heavier drinking patterns who also consumed alcohol while gambling were at particularly elevated risk. Findings are consistent with restricting alcohol use in gambling venues to reduce gambling-related harm.

Alcohol and other drug use is common in Australia, yet laypeople struggle to detect intoxication in others via observation. We examined cues laypeople use to detect alcohol and cannabis intoxication to explore whether knowledge (in)accuracy may account for intoxication detection difficulties. Participants (N = 467; 77.7% female) completed a survey assessing familiarity with/use of alcohol and cannabis. Participants reported the cues they use to detect whether a person is intoxicated with alcohol and cannabis and rated the difficulty of such detection. Researchers assessed reported cues for accuracy and organised them into descriptive categories. Participant characteristics were examined as predictors of cue accuracy. Alcohol intoxication detection was viewed as easy, while difficulty ratings for cannabis intoxication detection varied. Most reported cues to alcohol and cannabis intoxication were accurate. However, non-responses were common across both substances. Participants provided more cues-including accurate cues-to alcohol intoxication compared to cannabis intoxication. Cannabis consumption on a 'monthly'/'less than monthly' basis was associated with greater cue accuracy, and participants who viewed cannabis intoxication detection as difficult reported less accurate cannabis cues. Accurate assessment of intoxication is essential in many high-risk contexts (e.g., healthcare, criminal justice, road and workplace safety). Our findings suggest that while laypeople can provide some accurate cues to alcohol and cannabis intoxication, substantial knowledge gaps exist-especially for cannabis. Education about an extensive range of cues to intoxication may improve intoxication detection in these contexts.