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Biomedical subjects

J Hando

Publications and source records attributed to J Hando.

11 recordsLinked to original sources

Ecstasy use in Australia: patterns of use and associated harm.

This study explored patterns of ecstasy use and associated harm through the administration of a structured interview schedule to 329 ecstasy users, recruited from three Australian cities. A broad range of ecstasy users were interviewed, but on the whole, the sample was young, relatively well educated and most were employed or students. Patterns of use were varied, although extensive polydrug use was the norm. High rates of intravenous drug use were recorded, which may relate to an over-representation of chaotic intravenous polydrug users. Subjects had experienced an average of eight physical and four psychological side-effects, which they attributed to their ecstasy use in the preceding 6 months. Approximately 40% of the sample also reported financial, relationship and occupational problems. Young, female, polydrug users and those who binged on ecstasy for 48 h or more appeared most at risk of experiencing harm that they related to their ecstasy use. One-fifth of the sample had received treatment for an ecstasy-related problem, most often from a GP or natural therapist, and 7% were currently in treatment. One quarter wanted to reduce their use because of financial, relationship and psychological problems. A total of 15% wanted formal treatment for an ecstasy-related problem and 85% requested more information. These results have implications for the development of policies to respond to drug use among this population.

Adolescent↗

Amphetamine-related harms and treatment preferences of regular amphetamine users in Sydney, Australia.

Amphetamines remain a popular illicit drug among young adults in Australia and a number of other countries, particularly by injection. A significant increase in the number of people presenting to drug treatment services with a primary amphetamine problem in Australia and the US has occurred in recent years. A survey of 200 regular amphetamine users was conducted in Sydney to determine the treatment issues and preferences of this population. Substantial harm associated with the use of this drug was found, most notably psychological problems, physical health problems, dependence and financial problems. A perceived need for amphetamine-specific treatment was evident. Popular treatment options requested by users included pharmacotherapies, natural therapies and counselling. While regular amphetamine users can attend existing treatment services, the efficacy of these treatments for amphetamine problems has not been evaluated. There is also a need to develop and evaluate amphetamine-specific interventions in order to attract this population into treatment.

Adolescent↗

Risky drug practices and treatment needs of youth detained in New South Wales Juvenile Justice Centres.

Demographic, drug use and criminal correlates of risky drug practices were examined among 279 detained youth in NSW Juvenile Justice Centres. Binge drinking was common, with 63% reporting the consumption of at least five drinks in a row in the 2 weeks prior to incarceration. It was associated with being older, being from an English-speaking background, regular tobacco consumption and having a current drug problem. A quarter (24%) of the sample had injected an illicit drug, over one-third (37%) of whom also reported sharing needles. Injectors were more likely to be polydrug users, regular amphetamine users and have a past history of drug treatment. While 16% of the sample indicated a need for drug treatment, only 10% were currently receiving some form of treatment, most commonly counselling. Appropriate strategies are needed among this population to address gaps in treatment provision.

Journal Article↗

An Australian profile on the use of cocaine.

Data collected on cocaine in Australia in the mid to late 1980s, when law enforcement and treatment centres were concerned with possible increases in cocaine use, indicated a low prevalence of use. This article reports findings from the Australian component of the 1993-94 World Health Organization study entitled "Initiative on Cocaine", which provides an updated analysis of cocaine use patterns and consequences. The two components of this study were a "country profile" which summarized existing health, law enforcement and survey data on cocaine use from national, regional and city level records, and a key informant study which consisted of interviews with people from Sydney and Melbourne who were familiar with cocaine use through personal, professional and observational experience. Findings show that the prevalence of cocaine use has remained low among the general population in Australia (around 2%), and few people present to treatment services with primary cocaine problems or are arrested. However, the use of cocaine seems to have increased among inner Sydney injecting drug users. There have also been indications of larger police seizures of cocaine, reflecting a possible increase in availability. Recommendations are made to provide relevant interventions and continually monitor patterns of cocaine use, particularly among at-risk groups.

Adolescent↗

Psychological morbidity and route of administration among amphetamine users in Sydney, Australia.

A sample of 301 amphetamine users were interviewed about their experiences of psychological symptoms prior to, and subsequent to, their initiation of amphetamine use. Psychological morbidity was common, with 44% scoring greater than a conservative cut-off of 8 on the General Health Questionnaire. The most commonly reported symptoms subsequent to the onset of amphetamine use were depression (79%), anxiety (76%), paranoia (52%), hallucinations (46%) and violent behaviour (44%). All these symptoms increased in prevalence after the onset of amphetamine use. Route and frequency of amphetamine administration were significant independent predictors of overall psychological morbidity, while route of administration was related to the experience of hallucinations, violent behaviour and paranoia. The avoidance of injection as a route of administration and the use of amphetamines less than weekly are recommended as steps that users can take to reduce the psychological sequelae of amphetamine use.

Adult↗

The Severity of Dependence Scale (SDS): psychometric properties of the SDS in English and Australian samples of heroin, cocaine and amphetamine users.

The Severity of Dependence Scale (SDS) was devised to provide a short, easily administered scale which can be used to measure the degree of dependence experienced by users of different types of drugs. The SDS contains five items, all of which are explicitly concerned with psychological components of dependence. These items are specifically concerned with impaired control over drug taking and with preoccupation and anxieties about drug use. The SDS was given to five samples of drug users in London and Sydney. The samples comprised users of heroin and users of cocaine in London, and users of amphetamines and methadone maintenance patients in Sydney. The SDS satisfies a number of criteria which indicate its suitability as a measure of dependence. All SDS items load significantly with a single factor, and the total SDS score was extremely highly correlated with the single factor score. The SDS score is related to behavioural patterns of drug taking that are, in themselves, indicators of dependence, such as dose, frequency of use, duration of use, daily use and degree of contact with other drug users; it also shows criterion validity in that drug users who have sought treatment at specialist and non-specialist agencies for drug problems have higher SDS scores than non-treatment samples. The psychometric properties of the scale were good in all five samples, despite being applied to primary users of different classes of drug, using different recruitment procedures in different cities in different countries.

Adult↗

Injecting and sexual risk-taking behaviour among regular amphetamine users.

A sample of 301 regular amphetamine users were interviewed regarding injecting and sexual risk-taking behaviours. Two-thirds of subjects were injecting the drug, with males being 1.8 times more likely to do so. Nearly half (41%) of injectors had shared injecting equipment in the preceding month. Females were twice as likely as males to report recent needle sharing. Having a regular sexual partner who injects amphetamines, using benzodiazepines and experiencing higher levels of psychopathology were independently associated with needle sharing. The number of sexual partners in the preceding six months was independently associated with having had paid sex in that period, and higher levels of polydrug use.

Adolescent↗

Route of administration and adverse effects of amphetamine use among young adults in Syndney, Australia.

The relationship between route of administration and the adverse effects of amphetamine use (dependence symptoms, treatment-seeking, adverse psychological symptoms and violence) were examined among 231 Australian amphetamine users, half of whom usually injected amphetamine. Although 87% of users were recruited from non-treatment sources, a third had experienced symptoms of dependence on amphetamine, and a third had experienced an amphetamine-related health problem for which one in four had sought medical attention. There was also a high prevalence of psychological symptoms, such as depression, anxiety, paranoia, hallucinations and violence which were related to frequency of amphetamine use, and use by injection. Amphetamine users need to be better informed about the potential adverse effects of amphetamine use, and about ways in which they can reduce their risks of experiencing these harms by avoiding injecting use, and the regular use of high doses of amphetamines.

Journal Article↗

HIV risk-taking behaviour among amphetamine users in Sydney, Australia.

A survey was undertaken of needle-sharing and sexually risky behaviour among 231 Australian amphetamine users, half of whom usually injected amphetamine. The prevalence of risky needle use and sexual behaviour was similar to that observed in recent Australian surveys of opioid injectors. About a third of those who had ever injected had shared needles, and the variables that best predicted frequency of sharing needles were having an injecting drug user as a partner, having experienced symptoms of dependence on amphetamines, and having sought medical treatment for an amphetamine related problem. Regular condom use with either regular or causal partners was low; only the minority employed in the sex industry regularly used condoms. Sexual risk-taking was not related to needle-sharing or amphetamine use. Although Australian amphetamine and opioid users have reduced their risks of transmitting HIV, there remains a substantial minority of both types of drug injector who continue to place themselves and others at risk by sharing needles and engaging in unsafe sexual behaviour.

Adult↗

Transitions between routes of administration of regular amphetamine users.

A sample of 301 regular amphetamine users was interviewed regarding transitions between routes of administration of amphetamines. Use of amphetamines by injecting was widespread, with two-thirds (67%) of subjects having injected the drug during the preceding 6 months. Needle-sharing was common, with 41% of injectors having shared a needle in the month preceding interview. A transition to regular amphetamine injecting from other routes of administration was reported by 40% of subjects, with males being twice as likely to report such a transition. The median number of such transitions was one. The main reasons given by subjects for the transition to injecting were liking the "rush" from injecting, and seeing it as a more economical and a healthier way to use. A small proportion of subjects (9%) reported a transition away from injecting amphetamines, with a median of one such transition. The most common reason given for abandoning injecting was concern about vascular damage. Interventions to encourage safer use of amphetamines need to address the misconceptions that injecting is more economical and more healthy, and to emphasize the vascular problems associated with injecting.

Adolescent↗