Young People's Drug Research Articles

Young people's drug use stayed level during pandemic

Alcohol use declined and use of nicotine and misuse of prescriptions increased among 10‐to‐14‐year‐olds during the pandemic, according to a study published last week. Overall, the rate of drug use among these young people remained stable during the pandemic based on repeated surveys of more than 7,800 people ages 10 to 14 conducted between September 2019 and August 2020.

Understanding the needs of local youth to inform drug and alcohol prevention and harm reduction services: A qualitative study.

Reducing drug and alcohol harm is a public health priority and the Australian government has adopted a harm minimisation approach to policy. Understanding the needs of local youth is necessary for the design of relevant prevention and harm reduction services. Using 5 unstructured focus groups and 10 interviews involving 30 participants recruited from different settings, this study explored youth perspectives around alcohol and other drugs and the psychosocial factors that influence their substance use. Three main themes were identified. First, young people perceived that drugs fell into a hierarchy related to the harm they cause and the stigma associated with use. Second, the importance of validating a young person's experience with using drugs (regardless of where they were placed on their substance-use trajectory) as a measure to increase the credibility of drug education programs. Third, the significant influence of peers on young people's drug attitudes and behaviours. Drug and alcohol education strategies must be more explicit regarding harm across all drug types, regardless of legal status or perceived social acceptability. Prevention services would benefit from including lived realities from young people's varied and changing experiences with using substances. Peer involvement in the design of preventive strategies (and involvement in participatory research to identify felt needs) is paramount to ensure teachings are grounded in a young person's social context and lived realities. SO WHAT?: This study provides information to guide the development of appropriate and authentic drug and alcohol prevention and harm reduction services for young people.

Prevention Harmful Consumption of Alcohol and Drugs in Sao Tome and Principe Through Public Health Communication: The Scientific Protocol

Sao Tome and Principe is an African low-and-middle-income country, where extreme poverty causes major health inequalities. No systematic research has been done on the consumption of alcohol and drugs in Sao Tome and Principe, and only overall statistics are available based on the importation of alcoholic drinks and their distribution among the population. There are also no studies on consumption of alcohol and illicit substances in children and youth and no preventive measures being undertaken. Besides that, manual databases present significant limitations, considering the lack of causes associated with mortality rates (0 - 5 years and > 5), and the difficulty to establish a cause/effect relation between diseases, deaths and life expectancy. No relevant data with burden of life was found in the reports of Centro Nacional de Endemias or the non-governmental, organization Instituto Marques de Valle Flor, a facilitator on healthcare clinical specialties selected on a voluntary basis by doctors from Portuguese hospitals. So, we proposed to provide a first overview of family and housing conditions, and above all, the consumption of alcohol and illegal drugs in young people. Thus, a project, the National Survey on Harmful Consumption of Alcohol and Drugs in Schools of Sao Tome and Principe, will be realized in order to better characterize the situation among children and young students and test public health communication strategies and preventive interventions aimed at this target-population. Interventions were designed taking into consideration local sociocultural realities of target audiences. We considered dialect language, single-parent families (matriarchal structure) and polygamy (mostly) in men and a country and governments led by men (patriarchal structure) and, in which the woman's role, as Food and Agriculture Organization of the United Nations reports, remains overlooked. Subsequently, we will collect traditional alcohols samples from the two main islands for analysis (at Laboratório de Estudos Farmacêuticos and Laboratório Nacional de Engenharia Civil - Portugal) and to determine heavy metals in the production process and impact on burden of life. In order to characterise the country's situation in terms of alcohol and illicit substances consumption a literature review was carried out through a search in several international electronic databases, such as those of the World Health Organization, World Health Organization Africa, United Nation, The Lancet and Lancet Global Health, etc. Available data of the following institutions of Sao Tome and Príncipe was also analyzed: National Institute of Statistics, Ministry of Education, Culture and Training and Ministry of Health and Social Affairs. Several interviews with community and church leaders as well as with members of catholic missions were carried out to better understand the local situation. Following this, a nationwide cross-sectional survey of a sample of 2064 students will be carried out. This will include a questionnaire on socio-demographic characteristics, lifestyles, health behaviors/attitudes, alcohol and illicit substances consumption. Finally, based on the overall diagnosis obtained, some edutainment health communication preventive interventions will be tested in the primary schools of three districts (EDUCA_TURTLE) and on the radio journalists (EDUCA_PRESS). These were evaluated by primary school teachers and by radio journalists.

Characterising the number and type of presentations to a tertiary emergency department by young people affected by drugs and alcohol

Objective The aim of this study was to investigate the frequency and type of emergency department (ED) presentations involving drugs and/or alcohol (DA) among young people. Methods A retrospective chart review was conducted of patients aged 14-25 years who presented to the ED at a tertiary hospital between 7 October and 25 November 2013. Data were collected on standardised data sheets, including whether DA was a factor in the patient's presentation. Results In all, 713 ED presentations of patients aged 14-25 years were included in this review (mean age 20 years). Of these, 94 (13%) presentations involved DA (median blood alcohol level 0.12%; range 0.01-0.39%); among patients aged 14-17 years, 13 (8%) presentations involved DA. Patient presentations involving DA were more likely to occur overnight and at weekends, had higher Australasian Triage Scale scores and had longer ED lengths of stay. These patients were also more likely to present with aggression, because of an assault, or with mental health disorders. Conclusion DA are involved in a substantial number of presentations of young people to the ED and are associated with an increased risk of assault and aggression. Public health strategies should target the links between DA use and mental health in young people. What is known about the topic already? It is known that the use of alcohol and drugs in young people is an ongoing public health concern. Research suggests this cohort of the population is more likely to present to an ED with an injury than the comparative age group not intoxicated by drugs or alcohol, and is more likely to be reviewed after hours. Alcohol is the predominant drug that had been used by young people at the time of the present study. What does this paper add? This paper reviews the number and types of presentations to a tertiary ED. In so doing, many more areas were researched (rather than simply link to injury) and, as a result, it was found that young people present to the ED with an increased risk of mental health issues and an increased risk of aggression. The study also found that young people intoxicated with DA most commonly presented for different reasons than the same sober cohort. What are the implications for practitioners? We know that young people intoxicated with DA represent a different public health issue than the sample group, and, as a result, public health initiatives must concentrate on the confounding factors of the presenting complaint, notably education surrounding the risk of mental health disturbance and increased aggression rates. Furthermore, the study should benefit practitioners, showing that more mental health services should be available after hours for this cohort presenting with issues related to DA.

Sudden cardiac death associated to substances of abuse and psychotropic drugs consumed by young people: A population study based on forensic autopsies

BackgroundToxic substances are one of the main risk factors for sudden cardiac death (SCD) in young people. However, there is limited information about this matter based on clinical research. The aim of this study was to analyze the use of substances of abuse (legal and illicit) and prescribed psychotropic drugs in young people who died by SCD. MethodsA population-based study performed in 15–35-year-olds who died by SCD in Biscay (Basque-Country) between 1991 and 2016. Cases were analyzed prospectively by a complete autopsy, toxicological and histopathological studies. A case was considered positive for exposure to cardiotoxic substances if smoking status was diagnosed or if toxicological analysis detected any drug associated with increased risk of SCD. ResultsThere were 204 SCD; 98 (48%) were exposed to a cardiotoxic substance, including smoking status (n = 72) and/or positive toxicology (n = 58). Illicit drugs (n = 29, mainly cannabis and cocaine), ethanol (n = 25), and prescribed psychotropic drugs (n = 11) were detected. Positive cases were more frequent in males than in females (54% vs. 19%). They were also more common in subjects who died by acute (86%) and chronic (71%) ischemic heart disease than in myocardial diseases (33%) and sudden arrhythmic death syndrome (36%). All positive cases of illicit drugs were males. Smoking status was very high in deaths due to acute ischemic heart disease. ConclusionsThe proportion of users of substances of abuse was unexpectedly high, even more prevalent than other cardiovascular risk factors. Toxic substances could play an important role as triggers of SCD in young people.

Street level society

This paper aims to reflect on research findings from different empirical studies of social work with young drug users and socially excluded young people in Copenhagen. In the paper we account for historical changes in social policy and interventions into young people's drug taking in Copenhagen, and we discuss some of the most central dilemmas in today's social work with young drug users. Among other things, we identify pervasive marginalizing dynamics in the social system that result partly from the deep-rooted cultural dichotomy between stigma and taboo that organizes the drug issue, and partly from the decentralizing and specializing efforts characteristic of the Danish welfare state and its institutions. We discuss a general turn towards street level interventions to address the problems of social exclusion, as well as different attempts to create what we term street level heterotopias - sites of alternate ordering - where issues of drug use and other social problems can be dealt with and objectified in more flexible ways and handled as part of ongoing social practices of everyday life.

Evaluación de los programas de prevención en drogas en el marco de la política nacional de la juventud

El consumo de drogas constituye un fenómeno emergente en Salud Pública, su impacto se ve en la calidad de vida de los jóvenes y deteriora la economía del Estado. La promulgación de una nueva ley y la creación del Instituto Nacional de la Juventud abren brecha para el trabajo de incidencia política, impulsando iniciativas de políticas públicas en pro de la juventud, como titulares de derecho en la legislación hondureña. Materiales y métodos: se analizaron desde el enfoque de derecho a la salud y la equidad 15 programas sobre prevención del consumo de drogas lícitas e ilícitas en los jóvenes de 12 a 30 años; y su vinculación con la Política Nacional de Juventud. Se realizó un análisis cuantitativo basado en un estudio documental, desde el inicio del Consejo Nacional de Juventud, la Ley Marco para el Desarrollo Integral, hasta la elaboración y promulgación de la política.El Sistema Nacional de Juventud responsable de la gestión e Intervenciones estratégicas para la equidad social de los jóvenes en la prevención del consumo de drogas, no ha consolidado una estrategia que permita la disminución en el uso y abuso de drogas. La suscripción de acuerdos e implementación de programas se vinculan con los lineamientos estratégicos de la Política Nacional de Juventud, no obstante, no han alcanzado resultados esperados en el disfrute pleno de los derechos de la juventud. Con respecto a la ubicación de los programas, están en su mayoría en el área rural, enfocando sus acciones en procesos integrales de atención psicológica, espiritual, educativa y emprendedurismo. Asimismo, desempeñan funciones de protección social.

Macro Social Flaws and Intervention's Unfinished Business: A Personal Note on Young People's Drug Use in Hong Kong

This paper traces how social, economic, and cultural changes in Hong Kong in the past five decades might have affected the pattern of illicit drug use among young people in Hong Kong. The prevalence of illicit drug use by young people had been very low before the 1990s, and like adult users, young users mostly used heroin. This pattern of drug use started to change in the late 1990s, when there was a sudden upsurge of drug use among young people, and psychoactive drugs such as ketamine quickly replaced heroin as the most popular drugs among them. An attempt is made to explain the new pattern of young people's drug use with respect to the changes of the social, economic and cultural conditions of Hong Kong since the 1960s, making use of Beck's risk society perspective and Parker's concept of normalization of recreational drug use. The identification of macro social flaws points to the need to address societal factors impeding successful interventions, which will involve reducing the blockage of upward mobility for young people, and providing them with the latest scientific knowledge of the physical and mental damages of ketamine and other psychoactive drugs for their better understanding of the risk of drug use.

Multidimensional Family Therapy (MDFT) for Young People in Treatment for Non‐opioid Drug Abuse: A Systematic Review

This is a Campbell Systematic Review of the effect of Multidimensional Family Therapy (MDFT) for treating abuse of cannabis, amphetamine, ecstasy or cocaine (referred to here as non-opioid drugs) among young people aged 11-21 years. The misuse of prescription drugs and the use of ketamine, nitrous oxide and inhalants such as glue and petrol are not considered in this review. Youth drug abuse is a severe problem worldwide and recent reports describe ominous trends of youth drug abuse and a lack of effective treatment. This review is concerned with drug abuse that is severe enough to warrant treatment. It focuses on young people who are receiving MDFT specifically for non-opioid drug abuse. MDFT is a manual-based, family-oriented treatment, designed to eliminate drug abuse and associated problems in young peopleâ?Ts lives. MDFT takes a number of risk and protective factors into account; the approach acknowledges that young peopleâ?Ts drug abuse is linked to dimensions such as home life, friends, school and community (Liddle et al., 2004). MDFT aims to modify multiple domains of functioning by intervening with the young person, family members, and other members of the young personâ?Ts support network (Austin et al., 2005). MDFT is thus based on a number of therapeutic alliances, with the young drug abuser, his or her parents and other family members, and sometimes with school and juvenile justice officials. After a rigorous search of the literature, five randomized controlled studies with samples of 83-450 participants were identified. Three studies were conducted by MDFT program developers, one study was conducted by an independent investigator with the program developer as a co-author, and one study was conducted by independent investigators. Four studies were performed in the US, while the other was performed across five European countries. We used meta-analytic procedures to summarise the available evidence on the effects of MDFT in comparison with other interventions on drug abuse, education, family functioning, risk behavior and retention in treatment. In this review, we interpret a value of the standardised mean difference, SMD=0.20 as a small effect size, in line with the general practice (Cohen, 1988). We note, however, the possibility that such a value might actually represent a larger effect if it is equivalent to a large reduction in the percentage of days a youth uses drugs, but we cannot comment further as we were unable to analyse the absolute effect of MDFT given that no studies comparing MDFT to no other treatment were available. The findings are as follows: - On drug abuse: Based on the available evidence we conclude that MDFT has an effect on drug abuse reduction compared to other treatments, although the difference is small. - On education: There is insufficient evidence to conclude whether MDFT has an effect on education compared to other treatments. - On family functioning: There is no available evidence to conclude whether MDFT has an effect on family functioning compared to other treatments. - On risk behavior and other adverse effects: There is no available evidence to conclude whether MDFT has an effect on risk behavior and other adverse effects compared to other treatments. - On treatment retention: MDFT may result in improved treatment retention in young drug abusers compared to other interventions The evidence found was limited as only five studies were included, and two studies had significant amounts of missing data. The evidence was very limited in terms of the outcomes reported on education, family functioning and risk behavior, and was insufficient for firm conclusions to be drawn on the effectiveness of the treatment with regard to such outcomes. There is evidence that MDFT is slightly more effective in treating young peopleâ?Ts drug abuse than other treatments; however, the difference is small. Furthermore, none of the five included studies could be characterised as a robust RCT with a low risk of bias on all assessed domains. One study provided insufficient information on core issues for the risk of bias to be assessed and therefore we find reason to question the validity of this study. Well-designed, randomized controlled trials within this population are needed. More research is also required to identify factors which modify the effect of MDFT and to identify which particular youth subgroups may be most likely to respond.

Cognitive‐Behavioural Therapies for Young People in Outpatient Treatment for Non‐Opioid Drug Use: A Systematic Review

Youth drug use is a severe problem worldwide. This review focuses on Cognitive-Behavioural Therapy (CBT) as a treatment for young people who misuse non-opioid drugs, such as cannabis, amphetamines, ecstasy and cocaine, which are strongly associated with a range of health and social problems. CBT is an individualized and multicomponent intervention that combines behavioural and cognitive therapy. While behavioural therapy mainly focuses on external settings and observable behaviour, cognitive therapy is concerned with internal cognitive processes. The primary focus of CBT is to reduce usersâ?T positive expectations about drug use, to enhance their self-confidence to resist drugs, and to improve their skills for problem-solving and for coping with daily life stressors. The objective of this review is to assess the effectiveness of CBT for young people (aged 13-21) in outpatient treatment for non-opioid drug use and to explore any factors that may moderate outcomes. The literature search yielded a total of 18,514 references, of which 394 were deemed potentially relevant and retrieved for eligibility determination. Of these, 360 did not fulfil the screening criteria and were excluded. Four records were unobtainable. A total of seven unique studies, reported in 17 papers, were included in the review. Meta-analysis was used to examine the effects of CBT on drug use reduction, social and family functioning, school problems, treatment retention and criminal activity compared to a group of other interventions (Adolescent Community Reinforcement Approach (ACRA), Chestnut Bloomington Outpatient (CBOP) (+Assertive Continuing Care (ACC)), Drugs Harm Psychoeducation curriculum (DHPE), Functional Family Therapy (FFT), Interactional Therapy (IT), Multidimensional Family Therapy (MDFT), and Psychoeducational Therapy (PET)). Our main objective was to evaluate the current evidence on the effect of CBT on abstinence and drug use reduction for young people in outpatient treatment for non-opioid drug use. Seven randomised trials, involving 953 participants, were included in this review. Each of the seven included studies compared CBT to another intervention. We analysed the effects in the short term (from the start of treatment to up to 6 months thereafter), medium term (from 6 months to less than 12 months after the start of treatment), and long term (12 months or more after the start of treatment). We analysed CBT that was delivered with an add-on component such as motivational interviewing (four studies) separately from CBT that was delivered without an add-on component (three studies). Based on meta-analysis of data from the four included studies analysing CBT with an add-on component, there was no evidence of a relative effect of CBT for the reduction of youth drug use frequency compared to other interventions (ACRA, CBOP (+ACC), DHPE, FFT and MDFT). The random effects standardized mean difference was -0.14 (95% CI -0.64, 0.36) for the short term based on four studies, -0.06 (95% CI -0.44, 0.32) for the medium term based on four studies and -0.15 (95% CI -0.36, 0.06) for the long term based on two studies. Based on meta-analysis of data from the four included studies analysing CBT without an add-on component, there was no evidence of a relative effect of CBT for the reduction of youth drug use frequency compared to other interventions (IT, MDFT, and PET ). The random effects standardized mean difference was -0.13 (95% CI -0.68, 0.42) for the short term based on two studies, -0.08 (95% CI -0.48, 0.31) for the medium term based on three studies and 0.02 (95% CI -0.48, 0.52) for the long term based on two studies. Thus, the available data does not support the hypothesis that there is a drug use reduction effect from using CBT with young drug users compared to other interventions (ACRA, CBOP (+ACC), DHPE, FFT, IT, MDFT, and PET ). Statistically significant heterogeneity was present in the short term. In the medium term statistically significant heterogeneity was present between studies analysing CBT with an add-on component. In the analysis of studies without an add-on component there was no statistically significant heterogeneity in the medium term. Due to the low power of detecting heterogeneity with only two studies included in the analysis, this result should be interpreted with caution. There was no heterogeneity between studies in the long term; however, with only two studies included in the analyses the power to detect heterogeneity was low. The primary outcome measured as recovery could only be analysed in the long term. The meta-analysis of CBT with an add-on component was inconclusive as the eight different comparison combinations analysed showed different results. Only one study analysing CBT without an add-on component provided data on recovery status. The reported effect was not statistically significant.

Family Behavior Therapy (FBT) for Young People in Treatment for Non‐opioid Drug Use: A Systematic Review

This publication is a systematic Campbell review of the effect of the family therapy approach Family Behavior Therapy (FBT) for treatment for non-opioid drug use (e.g., cannabis, amphetamine, ecstasy or cocaine) among young people aged 11-21 years.Youth drug use is a severe problem worldwide. Recent reports describe concerning trends in the use of drugs by young people and a lack of available treatment. FBT is a manual-based family therapy approach that seeks to reduce drug use among youth by identifying stimuli and triggers for drug taking, and teaching self-control and other skills to correct the problem behaviors related to drug use. This approach is based on the therapeutic premise that the family carries a profound influence on child and youth development and that interventions need to be flexible and tailored to the unique characteristics of the families. It is also argued that there is a need for interventions to be problem-focused, targeting first those patterns of behavior that most directly influence the youth’s drug use.

Functional Family Therapy (FFT) for Young People in Treatment for Non‐opioid Drug Use: A Systematic Review

This Campbell systematic review assesses the effectiveness of FFT to reduce drug abuse (cannabis, amphetamines, ecstasy, or cocaine) among young people aged 11 to 21 years. The review includes two randomised controlled trials, but summarises findings from only one study reporting on the outcome of drug use.Two studies, reported in three papers, are included. Both were conducted in the USA. Only one provides outcomes related to youth drug use. It compares the effectiveness of FFT with that of alternative treatments.The results from the one study reporting on the effect of FFT on youth drug use shows a short‐term (four month) reduction in the use of cannabis, an effect that disappears in the longer term.There is a dearth of evidence on the effectiveness of FFT for the treatment of non‐opioid drug use in young people.Executive Summary/AbstractBACKGROUNDYouth drug use is a severe problem worldwide. Usage of cannabis, amphetamine ecstasy and cocaine, referred to here as non‐opioid drugs, are strongly associated with a range of health and social problems.Functional Family Therapy (FFT) is a short‐term, manual‐based, behaviorally oriented family therapy program for young people with behavior problems such as drug abuse, juvenile delinquency and violence. Delivered in an outpatient setting, it aims to help young people and their families by improving family interactions and relationship functioning by addressing dysfunctional individual behavior.As with many other forms of family therapy, FFT targets young people and their families as a system. As such, it recognizes the important role of the family system in the development and treatment of young people's drug abuse problems.OBJECTIVESThe main aim of this review is to evaluate the current evidence on the effects of FFT on drug abuse reduction for young people in treatment for non‐opioid drug use.SEARCH METHODSA wide range of electronic bibliographic databases were searched using a relatively narrow search strategy, in July 2013. We performed extensive searches in a broad selection of government and policy databanks, grey literature databases, citations in other reviews and included primary studies, and by hand searches of relevant journals and internet searches using Google. We also corresponded with researchers in the field of FFT. No language or date restrictions were applied to the searches.SELECTION CRITERIATo be eligible for inclusion, studies must have: involved a manual‐based outpatient FFT treatment for young people aged 11‐21 years enrolled for non‐opioid drug use; used experimental, quasi‐experimental or non‐randomized controlled designs; reported at least one eligible outcome variable measuring abstinence, reduction of drug use, family functioning, education or vocational involvement, retention, risk behavior or other adverse effects; not focused exclusively on treating mental disorders; and had FFT as the primary intervention.DATA COLLECTION AND ANALYSISThe literature search yielded a total of 6,719 records, which were screened for eligibility based on title and abstract. From these, 108 potentially relevant records were retrieved and screened in full text, of which 9 records were potentially relevant. Finally, two studies based on three records were included in the review. Metaanalysis was not possible because only one study provided numerical results on the effect of FFT on drug use reduction.RESULTSTwo studies were included and both analyzed relative effects, comparing FFT to other interventions. Only one study provided numerical results on drug use reduction comparing FFT to two other interventions (CBT and a group intervention). The reported results indicate a positive effect favoring FFT on drug use frequency at 4‐month follow up, with no statistically significant difference at 7‐month follow up.AUTHORS' CONCLUSIONSThere is insufficient firm evidence to allow any conclusion to be drawn on the effect of FFT for young people in treatment for non‐opioid drug use. There is a need for more research, and particularly for more methodologically rigorous studies in the field of treatment for young drug users.The aim of this systematic review was to explore what is known about the effectiveness of FFT for the purpose of reducing youth drug use. The evidence found does not provide a basis for drawing conclusions about actual outcomes and impacts. Consequently, no substantive conclusion on the effectiveness can be made, neither supporting nor rejecting of the present FFT treatment approach.

Swedish high-school pupils' attitudes towards drugs in relation to drug usage, impulsiveness and other risk factors.

Background. Illicit drug use influences people’s lives and elicits unwanted behaviour. Current research shows that there is an increase in young people’s drug use in Sweden. The aim was to investigate Swedish high-school pupils’ attitudes, impulsiveness and gender differences linked to drug use. Risk and protective factors relative to drug use were also a focus of interest.Method. High school pupils (n = 146) aged 17–21 years, responded to the Adolescent Health and Development Inventory, Barratt Impulsiveness Scale and Knowledge, and the Attitudes and Beliefs. Direct logistic, multiple regression analyses, and Multivariate Analysis of Variance were used to analyze the data.Results. Positive Attitudes towards drugs were predicted by risk factors (odds ratio = 37.31) and gender (odds ratio = .32). Risk factors (odds ratio = 46.89), positive attitudes towards drugs (odds ratio = 4.63), and impulsiveness (odds ratio = 1.11) predicted drug usage. Risk factors dimensions Family, Friends and Individual Characteristic were positively related to impulsiveness among drug users. Moreover, although boys reported using drugs to a greater extent, girls expressed more positive attitude towards drugs and even reported more impulsiveness than boys.Conclusion. This study reinforces the notion that research ought to focus on gender differences relative to pro-drug attitudes along with testing for differences in the predictors of girls’ and boys’ delinquency and impulsiveness. Positive attitudes towards drugs among adolescents seem to be part of a vicious circle including risk factors, such as friendly drug environments (e.g., friends who use drugs) and unsupportive family environments, individual characteristics, and impulsiveness.

Assembling the dominant accounts of youth drug use in Australian harm reduction drug education

Education programs are a central element of Australian harm reduction drug policy. Considered less judgmental and more effective than the punitive policies of Australia's past, harm reduction drug education is premised on the goal of reducing ‘risks’ and harms associated with illicit drug use rather than an elimination of use per se. In this article I analyse two sets of key texts designed to reduce drug related harm in Australia: harm reduction teaching resources designed for classroom use and social marketing campaigns that are targeted to a more general audience. I identify two significant accounts of young people's drug use present in Australian harm reduction drug education: ‘damaged mental health’ and ‘distress’. I then draw on some of Deleuze and Guattari's key concepts to consider the harm reducing potential these accounts may have for young people's drug using experiences. To demonstrate the potential limitations of current drug education, I refer to an established body of work examining young people's experiences of chroming. From here, I argue that the accounts of ‘damaged mental health’ and ‘distress’ may work to limit the capacity of young drug users to practice safer drug use. In sum, current Australian harm reduction drug education and social marketing may be producing rather than reducing drug related harm.

National-level drug policy and young people's illicit drug use: A multilevel analysis of the European Union

IntroductionRecent research has called upon investigators to exploit cross-national differences to uncover the cultural and structural factors influencing drug use. While the individual-level correlates are well-established, little is known about the association between cross-national variation in drug policies and young people's substance use. This study examines, net of individual-level predictors, the association between national-level drug policy and use of an illicit drug other than cannabis. MethodsThe study uses Eurobarometer repeated cross-sectional surveys in 2002 and 2004 of adolescents aged 15–24 drawn in multistage, random probability samples proportional to population size and density within regions of their country (N=15,191). Participants completed self-reported measures of last month drug use, attitudes toward drugs, school and work participation, and demographics. Gathered from several international bodies, national-level policy measures include drug offense levels, possession decriminalization, and presence and usage of harm reduction strategies. ResultsHierarchical logistic regression models demonstrate that, while controlling for important individual-level predictors, in countries where there is no restriction on possession of drugs for personal use, the odds of drug use in the last month are 79% lower (p<0.05). On the other hand, higher usage of treatment and drug substitution are associated with higher levels of drug use. These results are robust to several alternate specifications. ConclusionsAmong the strongest and most consistent findings, eliminating punishments for possession for personal use is not associated with higher drug use. The results indicate that researchers should take national-level context into account in individual-level studies of drug use.

Brief Strategic Family Therapy (BSFT) for Young People in Treatment for Non‐Opioid Drug Use: A Systematic Review

Brief Strategic Family Therapy (BSFT) for Young People in Treatment for Non‐Opioid Drug Use: A Systematic Review

PROTOCOL: Family Behavior Therapy (FBT) for young people in treatment for non‐opioid drug use

PROTOCOL: Family Behavior Therapy (FBT) for young people in treatment for non‐opioid drug use

PROTOCOL: Multidimensional Family Therapy (MDFT) for young people in treatment for non‐opioid drug use

PROTOCOL: Multidimensional Family Therapy (MDFT) for young people in treatment for non‐opioid drug use

PROTOCOL: Cognitive‐Behavioural Therapies for Young People in Outpatient Treatment for Non‐Opioid Drug Use

PROTOCOL: Cognitive‐Behavioural Therapies for Young People in Outpatient Treatment for Non‐Opioid Drug Use

Is there an association between seeing incidents of alcohol or drug use in films and young Scottish adults' own alcohol or drug use? A cross sectional study.

BackgroundAs the promotion of alcohol and tobacco to young people through direct advertising has become increasingly restricted, there has been greater interest in whether images of certain behaviours in films are associated with uptake of those behaviours in young people. Associations have been reported between exposure to smoking images in films and smoking initiation, and between exposure to film alcohol images and initiation of alcohol consumption, in younger adolescents in the USA and Germany. To date no studies have reported on film images of recreational drug use and young people's own drug use.MethodsCross sectional multivariable logistic regression analysis of data collected at age 19 (2002-4) from a cohort of young people (502 boys, 500 girls) previously surveyed at ages 11 (in 1994-5), 13 and 15 in schools in the West of Scotland. Outcome measures at age 19 were: exceeding the 'sensible drinking' guidelines ('heavy drinkers') and binge drinking (based on alcohol consumption reported in last week), and ever use of cannabis and of 'hard' drugs. The principle predictor variables were an estimate of exposure to images of alcohol, and of drug use, in films, controlling for factors related to the uptake of substance use in young people.ResultsA third of these young adults (33%) were classed as 'heavy drinkers' and half (47%) as 'binge drinkers' on the basis of their previous week's consumption. Over half (56%) reported ever use of cannabis and 13% ever use of one or more of the 'hard' drugs listed. There were linear trends in the percentage of heavy drinkers (p = .018) and binge drinkers (p = 0.012) by film alcohol exposure quartiles, and for ever use of cannabis by film drug exposure (p = .000), and for ever use of 'hard' drugs (p = .033). The odds ratios for heavy drinking (1.56, 95% CI 1.06-2.29 comparing highest with lowest quartile of film alcohol exposure) and binge drinking (1.59, 95% CI 1.10-2.30) were attenuated by adjustment for gender, social class, family background (parental structure, parental care and parental control), attitudes to risk-taking and rule-breaking, and qualifications (OR heavy drinking 1.42, 95% CI 0.95-2.13 and binge drinking 1.49, 95% CI 1.01-2.19), and further so when adjusting for friends' drinking status (when the odds ratios were no longer significant). A similar pattern was seen for ever use of cannabis and 'hard' drugs (unadjusted OR 1.80, 95% CI 1.24-2.62 and 1.57, 95% CI 0.91-2.69 respectively, 'fully' adjusted OR 1.41 (0.90-2.22 and 1.28 (0.66-2.47) respectively).ConclusionsDespite some limitations, which are discussed, these cross-sectional results add to a body of work which suggests that it is important to design good longitudinal studies which can determine whether exposure to images of potentially health-damaging behaviours lead to uptake of these behaviours during adolescence and early adulthood, and to examine factors that might mediate this relationship.