Alcohol And Other Drug Use Research Articles

Looking through the lens of an educator: the role of schools in the management of alcohol and other drug use among high school learners

ABSTRACT The effects of learners’ alcohol and other drug (AOD) use have far-reaching implications for educators and the teaching environment. The Schools Act 84 of 1996 describes the consequences of misconduct, with its revisions stipulating the conditions and procedures for searching, testing, and drug possession in an attempt to reduce learner substance use. There seem to be inconsistencies in the implementation of guidelines and the current practices at the school level. This research aimed to explore the response by schools to alcohol and other drug use among learners, and the guidelines to identify and address substance use. The study employed a qualitative approach and sampled 14 high schools located in seven municipality clusters in the Cape Town metropole. In-depth semi-structured interviews were conducted with teaching and management personnel. A total of 23 personnel from 11 high schools were interviewed. Thematic analysis was used to identify themes and patterns. Three themes emerged from the data, namely Practices of educators in response to AOD use; Policy-implementation gap; and Lack of agency to effect change. There is a lack of cohesive guidelines for educators to address substance use in schools. Consequently, schools use their own discretion to handle the situation; given their resources and social capital. Educators feel uninformed and ill-equipped to assist learners beyond referral. Further, there is a dearth of knowledge on aftercare and relapse in the contexts of the school/learning environment, both of which are critical components of effectively managing substance use.

Examining Daily Self-Efficacy, Minority Stressors, and Alcohol and Other Drug Use Among Trauma-Exposed Sexual Minority Women and Transgender and Gender-Diverse People.

This study aimed to develop and test a novel model integrating social-learning and self-medication frameworks by examining the association between self-efficacy to resist alcohol and other drug (AOD) use and daily AOD use and unhealthy drinking risk among trauma-exposed sexual minority women (SMW) and transgender and gender-diverse (TGD) people. We examined whether minority stressors moderated these associations. Data were from 57 trauma-exposed SMW and TGD people who participated in a 14-day daily diary study. Multilevel binary logistic models and ordinal logistic models were employed to examine associations between self-efficacy to resist AOD use and daily AOD use and unhealthy drinking risk at within- and between-person levels. We assessed same- and cross-level interactions between daily self-efficacy to resist AOD use and minority stressors in predicting AOD use and unhealthy drinking risk within the same 24-hour period (i.e., standardized as 6 pm to 6 pm; hereafter referred to as "same-day"). Self-efficacy to resist AOD use was associated with lower AOD use and unhealthy drinking risk. Minority stressors were associated with daily AOD use. Among those who experienced higher (vs. lower) average sexual minority stressors over the 2-week daily diary period, higher-than-usual self-efficacy to resist AOD use was less protective in decreasing risk of same-day unhealthy drinking. Interventions aiming to mitigate AOD use and unhealthy drinking risk by bolstering self-efficacy to resist AOD use should consider the impact of recent cumulative exposure to sexual minority stressors in this population. Further, policy efforts are needed to reduce perpetuation of stigma.

Interconnections between unintended pregnancy, alcohol and other drug use, and pregnancy, birth, infant, childhood and socioeconomic outcomes: a scoping review

BackgroundUnintended pregnancy (UIP) and substance use disorder share underlying root causes with similar impacts for women and their offspring in pregnancy, birth and beyond. Furthermore, intoxication with alcohol and other...

Cultural factors in alcohol and other drug use among immigrant youth in Western Australia: A qualitative investigation.

Our aim was to identify the influence of heritage cultural factors and mainstream Australian cultural norms on young culturally and linguistically diverse (CaLD) immigrants' alcohol and other drug (AOD) use attitudes, motives for use, and behaviors. We conducted nine focus groups with 55 youth (aged 16-30; 22 female, 33 male). Participants were from diverse cultural backgrounds including India, Sri Lanka, Ethiopia, Eritrea, Sudan, Hazara-Afghanistan, Burma (Chin and Karen), Malaysia, Singapore, and China. They were first- (80%) and second-generation immigrants to Australia. We constructed three overarching themes: bicultural conflict, freedom versus constraints, and the intersection of gender and culture. Although there were diverse responses, there was widespread recognition of perceived Australian norms around AOD use, particularly drinking alcohol. Our participants reported conformity motives that included fitting in with mainstream Australian culture. Drinking alcohol was also seen as a means for social bonding between immigrant and mainstream youth. Acculturation challenges of reconciling their heritage cultural identity with Australian identity contributed to problematic AOD use. Further research into the prevalence and predictors of AOD-related harm among CaLD youth in Australia is needed to tailor interventions that draw upon immigrant communities' resilience and enhance positive adaptation outcomes. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Representations of alcohol and drug use in the Finnish reform of social and health care service users’ rights

BackgroundA growing body of research has analysed the representations of alcohol and other drugs (AOD) in policy-making, but few studies have focused on the representations reproduced in law-making processes, especially in the context of the regulation of the rights of social and health care service users. This study examined what kind of representations of AOD use are reproduced in the legislative reform of social and health care service users’ rights in Finland. The purpose of the reform is to strengthen social and health care service users’ rights to self-determination and to reduce the use of restrictive measures. MethodsAs its data, the study used a draft of the bill and stakeholder opinions regarding the reform. ‘What's the problem represented to be?’ approach as a methodological framework. ResultsThe study discovered three AOD-related discourses: the Control, Welfare, and Rights and Legality discourses. The Control discourse represented people who use AOD as risky individuals and called for ways to manage risks in treatment situations. The Welfare discourse portrayed people who use AOD as a vulnerable group whose problems should be addressed by the welfare system. The Rights and Legality discourse represented the vague legal definitions of AOD use as the main regulatory problem. The discourses differed in terms of their definitions of self-determination. ConclusionsThe study illustrated how the right to self-determination as a legal concept is contested and can be interpreted in different ways depending on the representations of AOD use. The differing representations highlight the tensions involved in improving the rights of people who use AOD.

Typologies of alcohol and other drug-related risk among lesbian, gay, bisexual, transgender (trans) and queer adults.

Prevalence and patterns of alcohol and other drug (AOD) use among specific lesbian, gay, bisexual, transgender (trans) and queer (LGBTQ+) subpopulations are well established. However, patterns of substance-related risk have been less thoroughly explored. This study aimed to determine typologies AOD risk among LGBTQ+ adults in Australia. Latent class analyses were performed to determine distinct patterns of AOD risk (n = 6835), as measured by the Alcohol Use Disorder Identification Test and Drug Abuse Screening Tool. Demographic characteristics, experience of harassment, assault and/or threats, mental wellbeing and LGBTQ+ connectedness were compared across emergent classes. AOD risk was characterised as 'no risk' (13.3% of sample), 'low risk' (15.1%), 'moderate risk' (alcohol + other drugs; 30.1%), or 'moderate alcohol only risk' (41.5%). The 'moderate risk' class was the most likely class to report recent sexual assault, verbal abuse, harassment and physical threats compared to other classes, while those in the 'moderate alcohol only risk' group were least likely to report these experiences of all classes. However, both the 'moderate risk' and 'moderate alcohol risk only' classes reported greater mental wellbeing and LGBTQ+ connectedness compared to the 'no risk' and 'low risk' classes. Our findings indicate that level of AOD risk is not uniform among some LGBTQ+ adults, nor is the distribution of harms experienced by them. Tailored harm-reduction interventions may be fruitful in attenuating harms based on risk profile; most specifically, LGBTQ+ individuals engaging in moderately risky concurrent AOD use.

Substance use and sexual identity: health disparities in NYC sexual health clinics

ABSTRACT Background The prevalence of alcohol and other drug (AOD) use among lesbian, gay, and bisexual (LGB) adults is well documented; less is known about rates of unhealthy AOD use that could escalate into substance use disorders. Methods In a retrospective sample of 11,278 patients seen in New York City Sexual Health clinics, rates of unhealthy AOD use were compared by sexual identity (i.e., gay/lesbian, bisexual, and heterosexual). Results Patients who identified as LGB reported higher rates of unhealthy AOD use than patients who identified as heterosexual. Patients who identified as bisexual reported the highest rates of AOD use. Conclusion Findings are consistent with existing research on LGB health disparities. Healthcare providers can use non-judgmental approaches to elicit information from clients about sexual orientation, sexual health, and substance use. Implementing SBIRT in school and community settings addresses these behaviors without contributing to stigma.

Sexual minority disparities in psychosocial functioning following substance use recovery among a representative sample of US adults

PurposeSexual minority (SM; e.g., gay, lesbian, bisexual) individuals are disproportionately impacted by alcohol and other drug (AOD) use disorders and psychosocial factors that can exacerbate AOD use disorders and hinder recovery. This study examines SM sub-group differences (monosexual [gay/lesbian] versus bisexual) regarding adaptation to recovery measured by indices of psychosocial functioning. Identifying differential needs of gay/lesbian versus bisexual individuals could improve services to better meet the needs of SM individuals in recovery. MethodsUsing data from the National Recovery Study, a nationally representative cross-sectional sample of US adults who reported resolving an AOD problem (N = 2,002), we compared heterosexual to monosexual and bisexual SM individuals on socio-demographic characteristics, AOD use and treatment, and psychosocial variables. ResultsBisexual individuals were significantly younger than heterosexual individuals (p = .002 and p ≤ 0.001 among men and women, respectively) and reported significantly fewer years since AOD problem resolution compared to heterosexual individuals (p = .004 and p = .003 among men and women, respectively). Most notably, bisexual individuals, but not gay/lesbian individuals, reported significantly lower quality of life (QOL), happiness, self-esteem, and significantly higher distress compared to heterosexual individuals. ConclusionBisexual, but not monosexual, SM individuals in recovery from an AOD use disorder, were younger and reported worse psychosocial functioning than heterosexual individuals. Findings highlight significant differences between monosexual versus bisexual identified individuals with a notable disadvantage experienced by bisexual individuals. More needs to be learned about the challenges faced by bisexual individuals in recovery to better address their needs and support long-term AOD recovery.

“She gives it to her child who doesn’t even talk”: a qualitative exploration of alcohol and drug use among primary school-age children in Uganda

BackgroundThere is little research on alcohol and other drugs (AOD) use by school-age children in low-resource settings like Uganda. Including the voices of children in research can inform prevention and early intervention efforts for those at risk of AOD use. The aim of this study was to understand the perspectives of children aged 6 to 13 years regarding AOD in Uganda.MethodsThis qualitative study was conducted in Mbale district, Uganda from February to March 2020. Eight focus group discussions (FGDs) were conducted with 56 primary school-age children, stratified by age (6–9 and 10–13 years), sex (male and female), and school status (in school and out of school). All FGDs were conducted in either Lumasaaba or Luganda. The FGDs were audio-recorded, transcribed verbatim, and translated into English. Data were coded, and overarching themes were identified using thematic framework analysis.ResultsTwo themes identified were (1) Children’s perceptions and experiences with AODs. The participants understood alcohol by its consistency, colour, odour, and by brand/logo. They described the types and quantities of AOD consumed by school-age children, brewing processes for homemade alcoholic drinks, and short and long-term consequences of the use of alcohol. (2) Contributing factors to childhood drinking included: Stress relief for children who experienced multiple adversities (orphaned, poverty-stricken, and hailing from broken homes), fitting in with friends, influence from families, and media exposure that made alcohol look cool. Children would start drinking at an early age) or were given alcohol by their parents, sometimes before they could start talking. In the community, alcohol and other drugs were cheap and available and children could drink from anywhere, including in the classroom.ConclusionsChildren eligible for primary education in Uganda can easily access and use AOD. Several factors were identified as contributing to alcohol and other drug use among children, including availability and accessibility, advertising, lack of parental awareness and supervision, peer influence, adverse childhood experiences, socioeconomic factors, and cultural norms. There is a need for multi-sectoral action for awareness of childhood AOD use and deliberate consideration of children in the planning, design, and implementation of research, policies, and programs for prevention and early intervention.

Counseling for opioids prescribed at discharge of hospitalized adolescent trauma patients

BackgroundExpert consensus recommends prescription opioid safety counseling be provided when prescribing an opioid. This may be especially important for youth with preexistent alcohol and other drug (AOD) use who are at higher risk of developing opioid use disorder. This study examined the frequency that adolescent trauma patients prescribed opioids at hospital discharge received counseling and if this differed by adolescents’ AOD use.MethodThis study was embedded within a larger prospective stepped-wedge type III hybrid implementation study of AOD screening across a national cohort of pediatric trauma centers. Data were collected during 2018–2021 from admitted adolescent trauma patients (12–17 yo) at seven centers. Patient data were extracted from the electronic health record (EHR) on any prescribed discharged opioids, documentation of counseling delivered on prescribed opioid, who delivered counseling, and patients’ AOD screening results. Additionally, adolescents received an online survey within 30 days of hospital discharge that included asking about hospital discussions on safe use of prescription pain medication.ResultsOf the 247 adolescent trauma patients enrolled, 158 completed the 30-day survey. AOD screening results were documented in the EHR for 139 patients (88%), with 69 (44.1%) screening AOD-positive. Opioids at discharge were prescribed to 86 (54.4%) adolescent patients, with no significant difference between those screened AOD-positive and AOD-negative (42.4% vs. 46.3%, p = 0.89). Counseling was documented in the EHR for 30 (34.9%) of those prescribed an opioid and was not significantly different by sex, age, race, ethnicity or between adolescent patients with documentation of AOD use (29.3%) versus those who did not (33.3%, p = 0.71). According to the adolescent survey, among those prescribed an opioid, 61.2% reported someone had talked with them about safe use of newly prescribed pain medications with again no difference between AOD-positive and AOD-negative screening results (p = 0.34).ConclusionsAlthough adolescent trauma patients recalled discussions on safe use of prescribed pain medication more often than was documented in the EHR, these discussions were not universal and did not differ if adolescents had screened positive or negative for AOD use as documented in the EHR.Trial Registry: clinicaltrials.gov NCT03297060.

Piloting the integration of SMART Recovery into outpatient alcohol and other drug treatment programs

BackgroundResearch suggests peer support groups can amplify and extend treatment effects and enhance long-term recovery from Alcohol and Other Drug (AOD) problems. However, they are rarely integrated into outpatient treatment programs, resulting in a missed opportunity for peer-to-peer learning, and increased connection to others social networks where people want to reduce or cease substance use.MethodIn this mixed-methods study, we examined the uptake, participant experiences and impacts of Self-Management and Recovery Training (SMART) when embedded in three public AOD treatment programs in a pilot program in Australia. Groups were delivered initially in-person but transitioned online during the COVID-19 pandemic.ResultsA total of 75 SMART Recovery groups were run by the pilot sites, with an average attendance of 6.5 people per meeting. Among Participants (N = 31) who completed the survey, 94% reported benefits relating to substance use (i.e., reduction/ successful maintenance of abstinence), 71% reported improvements in their mental health and wellbeing, 74% reported improvements in their physical health, and 81% reported feeling better connected with others. In-depth qualitative interviews were conducted with 10 participants to explore their experiences. Thematic analysis revealed four themes: motivation to attend, active ingredients, views on the integration of SMART into formal AOD, and the advantages and disadvantages of online groups.ConclusionTaken together, these findings suggest embedding SMART Recovery in AOD treatment is a worthwhile endeavour. This was indicated by a good uptake and evidence of multiple and unique benefits to participants over and above their usual care, notably, better management of their AOD use, health, wellbeing, and sense of connection with others.

Alcohol and other drug use patterns and services in an integrated refugee settlement in Northern Zambia: a formative research study

BackgroundEvidence on patterns of alcohol and other drug (AOD) use and how to effectively deliver services to address AOD use in humanitarian settings is limited. This study aimed to qualitatively explore the patterns of AOD use among Congolese refugees in Mantapala Refugee Settlement and members of the surrounding host community and identify potential appropriate intervention and implementation approaches to address AOD use disorders among conflict-affected populations.MethodsFifty free listing interviews, 25 key informant interviews, and four focus group discussions were conducted among refugees, host community members, humanitarian implementing agency staff, and refugee incentive workers. These participants were selected based on their knowledge of AOD use and related problems in the settlement and the surrounding host community in northern Zambia.ResultsCannabis and home-brewed alcohol were the substances that were perceived to be most commonly used and have the greatest impact on the community. Participants reported that self-medication, boredom, and relief of daily stressors associated with lack of housing, safety, and employment were reasons that people used AODs. Participants recommended that programming include components to address the underlying causes of AOD use, such as livelihood activities. Stigma due to the criminalization of and societal ideals and religious beliefs regarding AOD use was identified as a substantial barrier to accessing and seeking treatment.ConclusionsOur study’s findings indicate the need for services to address AOD use in Mantapala Refugee Settlement. Interventions should consider the social and structural determinants of AOD use.

The Alcohol and Polysubstance Behaviors of Mandated College Students Prior to Collegiate Sporting Events: An Assessment of Pregaming

Background: Despite a litany of education and prevention efforts seeking to curtail alcohol and other drug (AOD) use behaviors of United States (U.S.) college students, AOD use remains pervasive among the American college student population. Socio-cultural reinforcement of AOD behaviors, such as pregaming (PG), are often considered normative aspects of the collegiate experience, potentially introducing, and/or exacerbating, AOD use among U.S. college students. Objective: Due to the unique relationship PG has with the U.S. college experience and sports culture, this study explored the relationship between PG prior to a live sporting event and frequency of alcohol use, and the likelihood of persons who pregame also engaging in polysubstance use (>1 substance during drinking/use event). Methods: This study was conducted with college students (n = 816) attending a large public university in the Southeastern Conference (SEC) who violated campus alcohol use policies. Results: Beyond the influence of important demographic covariates, PG (p < .001) was significantly associated with a greater frequency of alcohol use. Moreover, students who participated in PG festivities were nearly 2.5 times more likely to participate in polysubstance use. Discussion: PG prior to live collegiate sporting events has clear public health and policy implications. Future efforts should institute and enforce risk-management policies on college campuses and employ event-specific alcohol and polysubstance use prevention and intervention strategies.

Developing the Weaving Healthy Families Program to Promote Wellness and Prevent Substance Abuse and Violence: Approach, Adaptation, and Implementation.

Family prevention programs that enhance mental health, wellness, and resilience-while simultaneously addressing violence and alcohol and other drug (AOD) abuse-among Indigenous families are scarce. This gap in culturally grounded and community-based programs creates a critical need to develop and evaluate the efficacy of such prevention programs. This article fills this gap, with the purpose of describing the structure and content of the Weaving Healthy Families (WHF) program, a culturally grounded and community-based program aimed at preventing violence and AOD use while promoting mental health, resilience, and wellness in Indigenous families. The focus then turns to how to approach this process of developing and implementing the program in a culturally grounded and community-based way.

Engaging patients who use alcohol and other drugs: A practical approach

The treatment of alcohol and other drugs (AOD)-related issues is an essential skill for all general practitioners (GPs). The ongoing harm and significant burden of disease experienced by people who use AOD, as well as the impact of this on their families and communities, displays the need for engagement and upskilling in this clinical area. Provide GPs with a clear and practical approach to supporting patients who useAOD. Historically, AOD use has been associated with shame, societal judgement and a punitive treatment approach. These factors have been shown to adversely affect treatment outcomes, including a significant delay to, and low engagement with, treatment. An approach focusing on rapport and the therapeutic alliance is best practice and incorporates a strengths-based approach of whole-person, trauma-informed care and motivational interviewing to support behaviour change.

Media reporting on alcohol and other drugs in Australia and the Mindframe guidelines: Baseline data.

The aim of this study was to generate a baseline database of print media reporting on alcohol and other drug (AOD) issues prior to the release of the Mindframe guidelines in March 2019. Specifically, to: (i) describe the content associated with media entries that focus on AOD use in Australian news media; (ii) determine how the media entries compare to several domains associated with recently developed Mindframe guidelines for publicly reporting on AOD; and (iii) identify content factors associated with different scores. Media entries between July 2016 and June 2017 were searched for key AOD-related terms using the Australian and New Zealand Newsstream database. Two coding schemes were developed to rate a stratified sample of 50% of the media entries against the Mindframe guidelines. Associations between content and total comparison scores were determined using linear regression models. Detailed coding of the 2007 articles identified as relevant for the current study indicated that a majority (67%) were focused on one of three substances: alcohol, cannabis or methamphetamine. Most of the entries were either law enforcement (22%) or criminal justice related (19%). Entries that focused on methamphetamine scored significantly lower than entries on alcohol when compared to the Mindframe guidelines, similarly entries focused on crime/justice-related topics scored significantly lower than entries focused on positive outcomes. A disproportionate number of print media entries, particularly those related methamphetamine use, focused on crime or justice-related topics, potentially further contributing to stigma, and emphasising the legal consequences of AOD use.

Learning that cannot come from a book: An evaluation of an undergraduate alcohol and other drugs subject co-produced with experts by experience.

Alcohol and other drugs (AOD) use is a significant public health issue and is associated with high mortality and morbidity rates. Despite this, people who use drugs are often reluctant to seek care due to the lack of trauma-informed treatment and harm reduction treatment options, as well as experiences of stigma and discrimination in health services. Arguably, AOD education that is co-produced with people who use alcohol and drugs can enhance future health professionals' ability to practice in ways that support the needs of this population. This paper reports on a qualitative co-evaluation of a co-produced undergraduate nursing AOD subject. The AOD subject was co-planned, co-designed, co-delivered, and co-evaluated with experts by experience, who have a lived experience of substance dependence and work as advocates and peer workers. Following the delivery of the subject in 2021 and 2022, focus groups were undertaken with 12 nursing students. Focus group data indicate that the co-produced subject supported participants to understand and appreciate how stigma impacts on nursing care and how to recognize and undertake 'good' nursing care that was oriented to the needs of service users. Student participants noted that being co-taught by people who use drugs was particularly powerful for shifting their nursing perspectives on AOD use and nursing care and took learning beyond what could be understood from a book. Findings indicate that co-produced AOD education can shift nursing students' perceptions of AOD use by providing access to tacit knowledge and embodied equitable and collaborative relationships with people who use drugs.

Facets of Gender Expression and Discrimination in Relation to Alcohol and Other Drug Use Severity Among Sexual Minority Women and Gender Diverse Individuals Assigned Female at Birth.

Purpose: Sexual minority women and gender diverse individuals assigned female at birth (SMW+) consistently report more alcohol and other drug (AOD) use severity than heterosexual women, with greater disparities reported among bisexual plus (bi+) SMW (including bisexual, pansexual, queer, and those with attractions to more than one gender regardless of identity). Furthermore, emerging evidence suggests that SMW with masculine gender expression (e.g., SMW with masculine gender appearance) disproportionately experience problematic AOD use compared to those with feminine gender expression. The minority stress model, which has predominantly been investigated in relation to internalized homonegativity and sexuality-based discrimination, may also account for these AOD use disparities. This study examined gender expression, related discrimination, and AOD use severity among SMW+. Methods: In a 2020 sample of SMW+ (n = 236), we investigated AOD use severity in relation to gender expression (appearance, emotional expression, and gender roles) and gender expression-based discrimination after controlling for internalized homonegativity and sexuality-based discrimination through an online survey. Results: Masculine gender roles were associated with AOD use severity, whereas masculine appearance and emotional expression were not. In multivariable models, gender identity was inconsistently associated with alcohol use severity, sexuality-based discrimination was consistently associated with alcohol use severity and inconsistently associated with other drug use severity, and gender expression-based discrimination was associated with neither. Conclusion: This study emphasizes the importance of examining intersecting aspects of minority identity among SMW+, including facets of gender expression, in relation to AOD use severity.

Experiences of trauma and alcohol and other drug use by domestic, family, and sexual violence offenders: A review of 6 months of sentencing remarks from the Supreme Court of the Northern Territory, Australia

The Northern Territory (NT) has the highest rates of domestic, family and sexual violence (DFSV) in Australia. Although we know that alcohol and other drug (AOD) use and trauma both contribute to DFSV in the NT, some specifics remain unknown. This paper aims to (a) describe the extent of AOD involvement in criminally serious DFSV, (b) describe the volume of trauma experienced by convicted criminally serious DFSV offenders, and (c) qualitatively explore the judicial recognition of the intersections between alcohol and trauma. To do this we reviewed Judicial Sentencing Remarks (JSRs) from the Supreme Court of the NT. A content analysis of all DFSV JSRs from July to Dec 2020 was undertaken ( n = 64). A structured coding instrument was developed to extract quantitative and qualitative variables through repeated reviews by multiple authors. Descriptive statistics regarding demographics, number of significant traumatic events experienced, and AOD involvement were generated. The qualitative data from which these statistics were generated was used to explore the interplay between trauma and AOD involvement. The majority of offenders had experienced at least one form of trauma. The social determinants of health underpinned a significant amount of this trauma, with housing, poverty, and unemployment frequently described. The use of alcohol as a maladaptive coping mechanism was explicitly recognised. There was frequent judicial recognition of the intersections between trauma, alcohol, and violence, however addressing trauma as an essential part of rehabilitation processes was rare. Trauma and AOD use were widespread among convicted DFSV offenders, with alcohol involved in the majority of incidents. Further research is required to understand the bio-psycho-social factors involved in the relationship between trauma, alcohol, and DFSV. Systematic piloting and trialling of interventions is necessary to determine what approaches are effective for preventing DFSV and reducing recidivism for people with intersecting experiences of trauma and AOD concerns.

Shifting school health priorities pre-post cannabis legalization in Canada: Ontario secondary school rankings of student substance use as a health-related issue.

This study examined how schools prioritize ten key health concerns among their student populations over time and whether schools' prioritization of alcohol and other drug use (AODU) corresponds to students' substance use behaviours and cannabis legalization as a major policy change. Data were collected from a sample of secondary schools in Ontario, Canada across four years (2015/16-2018/19 [N2015/16 = 65, N2016/17 = 68, N2017/18 = 61 and N2018/19 = 60]) as a part of the COMPASS study. School-level prevalence of cannabis and alcohol use between schools that did and did not prioritize student AODU as a health concern was examined. Ordinal mixed models examined whether student cannabis and alcohol use were associated with school prioritization of AODU. Chi-square tests examined changing health priorities among schools pre-post cannabis legalization. School priority ranking for AODU was mostly stable over time. While AODU was identified as an important health concern, most schools identified mental health as their first priority across the four years of the study. No significant changes to school AODU priorities were observed pre-post cannabis legalization nor was school prioritization of AODU associated with student cannabis and alcohol use behaviours. This study suggests that schools may benefit from guidance in identifying and addressing priority health concerns among their student population.