Topics

Substance‐related disorders

Advising pregnant women to avoid alcohol

To the Editor: I thank Cameron and colleagues for their timely report,1 particularly in the context of publicity for a new self-help book by economist Emily Oster, which questions advice about avoiding alcohol during pregnancy.2,3 I note with interest that Cameron et al’s study reports that proportionally more of the women who consumed alcohol beyond the first trimester were older and more highly educated. Oster has ...

Tracy W Soh

13 11208

The sources of pharmaceuticals for problematic users of benzodiazepines and prescription opioids

This study shows that different approaches may be required to reduce unsanctioned use of different pharmaceuticals due to differences in how drugs are sourced. The data also highlight that plans to monitor only Schedule 8 benzodiazepines and prescription opioids may have limited effects on prescription opioid users who use non-prescribed sources and may represent a lost opportunity for reducing unsanctioned benzodiazepine use.

Suzanne Nielsen BPharm, BPharmSc(Hons), PhD · Raimondo Bruno PhD · Louisa Degenhardt BA(Hons), MClinPsych, PhD · Mark A Stoove PhD, BAAppSci(Hons) · Jane A Fischer BA, MSPD · Susan J Carruthers MPH, PhD · Nicholas Lintzeris MB BS, FAChAM, PhD

13 11331

NBOMe — a very different kettle of fish . . .

To the Editor: We are concerned that recent media reports about a 17-year-old Sydney boy who died after allegedly consuming 25B- or 25I-NBOMe might lead to an increase in the incidence of NBOMe toxicity among patients presenting to emergency departments. NBOMe was reported to be available online for as little as $1.50 per tab.1 The subsequent media interest is likely to have increased public awareness of ...

David G E Caldicott · Stephen J Bright · Monica J Barratt

Online screening for alcohol and other drug problems: an acceptable method for accessing help

To the Editor: Alcohol and other drug (AOD)-related harms are considerable,1 yet individuals with AOD disorders are reluctant to seek treatment.2,3 Barriers to help-seeking include issues of stigma and a lack of understanding of what treatment involves. One possible approach to improving access is the use of online tools that provide advice about available help options. While online screening for alcohol has shown value as ...

Ann S Wilson · David W Best · Michael Savic · Dan I Lubman

The extent of alcohol advertising in Australia: an audit of bus stop advertisements

To the Editor: There is significant concern about drinking patterns and alcohol-related harm among young people. A comprehensive approach to preventing harm from alcohol is needed, with population approaches including curbs on alcohol promotion.1 The National Preventative Health Taskforce has recommended phasing out alcohol promotions “from times and placements which have high exposure to young people”.1 Exposure to alcohol advertising influences young people; research consistently shows ...

Hannah L Pierce · Julia M Stafford · Mike Daube

Substance‐related disorders Poem 5 November 2012 Free

Angiocrine factors: reasons for and against the quitting of smoking

“This regeneration process also restores the physiological respiratory function of the lungs, which is mediated by amplification of various epithelial progenitor cells and regeneration of the alveolar sacs” — Dr Bi-Sen Ding, Cornell University Visitation resumes first with the most ardent ornithologists. Loony they pierce, stride right on in, primed by the song of ocular gadgets to a once-blighted habitat that’s chalked up its comeback to a mad cheeping action poker-faced finches go ...

Kent E MacCarter MA(Lit)

Harm minimisation in Australian prisons — health protection still depends on where you serve your time

To the Editor: In June 2007 we highlighted the inconsistent application of community-accepted harm minimisation strategies, when offered to prisoners, among the various Australian jurisdictions.1 We sought information from the eight prisoner health services to assess how harm minimisation strategies were being implemented in each jurisdiction (Box). Progress has been slow, particularly in Queensland and the Northern Territory. The positive progress, however, has been the trial of condom ...

Michael H Levy · Carla Treloar

The need and direction for drug law reform in Australia

Illicit drug use should be viewed primarily as a health and social problem, and be funded accordingly. Half a century of a drug policy relying primarily on drug law enforcement has failed to curb the demand and supply of illicit drugs in Australia. However, adverse consequences of this approach have increased overall, including deaths, disease, crime and corruption. Every year, 400 Australians die from a heroin overdose. ...

Alex D Wodak FRACP, FAChaM, FAFPHM

Wod10959 fm

A battlefield occupational risk not to be ignored

To the Editor: The Australian Defence Force (ADF) ensures outstanding medical care for wounded soldiers by providing skilled field medics, sophisticated evacuation services and excellent in-theatre hospital care. In Afghanistan, in 2011–2012, among 136 troops deployed for 5 months, our ADF medical team dealt with six soldiers who had had significant exposure to blood: two sharps injuries incurred while searching insurgents two sharps injuries to medics providing combat casualty care two ...

Anthony D Holley · Daniel J Weber · Michael C Reade

Myopathy and possible intestinal dysfunction in a patient treated with colchicine and simvastatin

To the Editor: We report a case in which the concurrent administration of colchicine and simvastatin led to significant morbidity with myopathy and intestinal dysfunction. An 84-year-old man presented with an acute flare of gout, and was treated with 1 mg of colchicine daily for 3 days, and then 0.5 mg daily. His pain improved over the next 72 hours. He then noticed progressive generalised muscle ache and weakness in ...

Danielle H J Oh · Shuang Quan Chan · Andrew M Wilson

Trends in alcohol-attributable hospitalisation in the Northern Territory, 1998–99 to 2008–09

Objective: To examine trends in hospitalisation for alcohol-attributable conditions in the Northern Territory Aboriginal and non-Aboriginal populations between the financial years 1998–99 and 2008–09.Design and setting: Retrospective descriptive analysis of inpatient discharge data from NT public hospitals.Main outcome measures: Alcohol-attributable hospitalisation by age, sex, Aboriginality, region of residence and medical conditions, with annual time trends.Results: Annual rates of ...

Shu Qin Li MPH, MB, BNursing · Sabine L M Pircher MPH, BNutrDiet · Steven L Guthridge MB BS, MPH, FAFPHM

Indigenous health Letters 3 September 2012 Free

Listening to what Indigenous people in remote communities say about alcohol restrictions and cannabis use: “Good thing that the alcohol’s gone, but the gunja has kept going”

In Cape York Indigenous communities, alcohol restrictions started in 2002–2003, with local prohibition in some communities since 2008. These restrictions may have halved alcohol-related injuries, a historically important change. However, residents of Cape York Indigenous communities suggest that there has been an accompanying rise in cannabis use over this period. During consultations in 2011 for Minister Macklin’s controversial Stronger Futures in ...

Cape York Cannabis Project Team

The value of a support group for doctors with substance use disorders

To the Editor: The Victorian Doctors Health Program (VDHP) was established in 2001. It is the only full-time doctors’ health program in Australia. Based on similar programs in North America and Europe, the VDHP provides a comprehensive, supportive service to medical students and doctors suffering from mental health and/or substance use issues. The lifetime prevalence of substance use disorders in Australian doctors has been estimated at ...

Cheryl Wile · Kym Jenkins

Is the non-medical use of prescription stimulants a problem in Australia?

To the Editor: There have been claims that the non-medical use of prescription stimulants is widespread and increasing in the United States and other developed countries, particularly among university students.1 In the context of rising education and general living costs, economic uncertainty and high rates of anxiety and depression among young people,2 it is plausible that some students may cope with study demands by using ...

Jayne C Lucke · Wayne D Hall

An intensive smoking intervention for pregnant Aboriginal and Torres Strait Islander women: a randomised controlled trial

Objective: To determine the effectiveness of an intensive quit-smoking intervention on smoking rates at 36 weeks’ gestation among pregnant Aboriginal and Torres Strait Islander women.Design: Randomised controlled trial.Setting and participants: Pregnant Aboriginal and Torres Strait Islander women (n = 263) attending their first antenatal visit at one of three Aboriginal community-controlled health services between June 2005 and December 2009.Intervention: A general ...

Sandra J Eades BMed, PhD · Rob W Sanson-Fisher PhD, ClinMPsych · Mark Wenitong BMed · Katie Panaretto MB BS · Catherine D’Este BMath, PhD · Conor Gilligan BBiomedSc, PhD · Jessica Stewart BA/LLB, MPP

It’s more than the presenting complaint

Work, as well as life, can lead to surprising placesIf someone had suggested in my medical student days that I would end up working where I do, I would have laughed. But, no one knows where experiences, conversations and opportunities might lead. Like many idealistic medical students, I did electives in areas of need. My first was in north-east Arnhem Land. Returning to lectures, I remember ...

Marianne E Jauncey BMed, MPH(Hons), FAFPHM

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