Drug misuse

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Drug misuse

By Martin Woodbridge
HTT drug misuse [Image: Fraz]

This article, written by Martin Woodbridge, centres on increasing practitioners’ knowledge about drug misuse, and on advice to enhance professional judgement, attitudes and communication skills. Robust, New Zealand data are presented to explore the scale of the problem here, the influence of deprivation, and the impact of misuse on family/whānau and our communities. These data and hard-hitting case studies provide a backdrop to the clinical strategy – a set of “clinical tools” and enhanced referral capacity aimed at improving patient wellbeing and population health

This continuing medical education activity has been endorsed by the RNZCGP and has been approved for up to 1 CME credit for continuing professional de, Educate small, BACK panel - grey
References
  1. Nutt D, King L, Phillips L. Drug harms in the UK: A multicriteria decision analysis. Lancet 2010;376(9752):1558–65.
  2. Julien R. A primer of drug action: A concise, nontechnical guide to the actions, uses, and side-effects of psychoactive drugs, 9th ed. New York, NY: AWH Freeman/Owl Book; 2001.
  3. United Nations Office on Drugs and Crime. World Drug Report 2021. Vienna, EU: United Nations Office on Drugs and Crime; 2021.
  4. Wilkins C, et al. Recent trends in illegal drug use in New Zealand, 2006-2013. Findings from the 2006, 2007, 2008, 2009, 2010, 2011, 2012 and 2013 illicit drug monitoring system (IDMS). Auckland, NZ: Social and Health Outcomes Research and Evaluation, School of Public Health, Massey University: 2014.
  5. European Monitoring Centre for Drugs and Drug Addiction. New psychoactive substances in Europe. An update from the EU Early Warning System 2015. Luxembourg, EU: European Monitoring Centre for Drugs and Drug Addiction, Publications Office of the European Union; 2015.
  6. National Drug Intelligence Bureau. Situation assessment: The evolution of ecstasy. Wellington, NZ: National Drug Intelligence Bureau; 2012.
  7. Anthony A. Meet Carl Hart: parent, Columbia professor and heroin user. The Guardian 2021.
  8. Newton T, et al. Theories of addiction: Methamphetamine users' explanations for continuing drug use and relapse. American Journal on Addictions 2009;18(4):294–300.
  9. Aitken C, Winter R. Review of New Zealand’s Needle Exchange Programme for The Ministry of Health, New Zealand. Melbourne, Australia: Burnet Institute; 2008.
  10. Boden J, Fergusson D. Alcohol and depression. Addiction 2011;106(5):906–14.
  11. Chen K, et al. Benzodiazepine use and misuse among patients in a methadone program. BMC Psychiatry 2011;11(90):1–7.
  12. Ministry of Health. Cannabis use 2012/13: New Zealand Health Survey. Wellington, NZ: Ministry of Health; 2015.
  13. Ministry of Health. Alcohol Use 2012/13: New Zealand Health Survey. Wellington, NZ: Ministry of Health; 2015.
  14. Ernest A. The gin epidemic: Much ado about what? Alcohol & Alcoholism 2001;36(5):401–05.
  15. Ministry of Health. National Drug Policy 2015 to 2020. Wellington, NZ: Ministry of Health; 2015.
  16. Fergusson D, Horwood L. Early onset cannabis use and psychosocial adjustment in young adults. Addiction 1997;(92):279–96.
  17. Girling M, et al. Families and heavy drinking: Impacts on childrens wellbeing. In Blue Skies Report. Wellington, NZ: Centre for Social and Health Outcomes Research and Evaluation & Te Ropu Whariki, Massey University; 2006.
  18. Ministry of Health. Tobacco Use 2012/13: New Zealand Health Survey. Wellington, NZ: Ministry of Health; 2014.
  19. Ministry of Health. Amphetamine Use 2012/13: Key findings of the New Zealand Health Survey. Wellington, NZ: Ministry of Health; 2013.
  20. Noller G, Henderson C. Report of the National Needle Exchange Blood-borne Virus Seroprevalence Survey: Report prepared for the Ministry of Health. Christchurch, NZ: NEST; 2014.
  21. Robinson G, et al. Misuse of over-the-counter codeine-containing analgesics: dependence and other adverse effects. N Z Med J 2010;123(1317):59–64.
  22. Sheridan J, Butler R. Prescription drug misuse in New Zealand: Challenges for primary health care professionals. Research in Social and Administrative Pharmacy 2011;7(3):281–93.
  23. Tobias M, Templeton R, Collings S. How much do mental disorders contribute to New Zealand’s tobacco epidemic? Tobacco Control 2008;17:347–50.
  24. Wilkins C, et al. New Zealand Arrestee Drug Use Monitoring (NZ-ADUM) 2010 – 2014. Auckland, NZ: SHORE & Whariki Research Centre, Massey University: 2015.
  25. McFadden M. New Zealand Drug Harm Index: Development of a new Drug Harm Index. Wellington, NZ: Ministry of Health; 2016.
  26. Bedford K, et al. The illicit preparation of morphine and heroin from pharmaceutical products containing codeine: 'homebake' laboratories in New Zealand. Forensic Science International 1987;34(3):197–204.
  27. Boden J, Fergusson D. The short and longterm consequences of adolescent alcohol use. In Young people and alcohol: Impact, policy, prevention and treatment. Saunders J, Rey J (eds). Chichester: Wiley-Blackwell; 2011.
  28. ESR. Drug research on Land Transport Act blood specimens. A report by the Institute of Environmental Science and Research Limited for Ministry of Transport. Wellington, NZ: Ministry of Health; 2012.
  29. Kappatos D. Poly-drug use: The New Zealand experience. Wellington, NZ: ESR; 2008.
  30. Wilkins C, et al. Determinants of high availability of methamphetamine, cannabis, LSD and ecstasy in New Zealand: Are drug dealers promoting methamphetamine rather than cannabis? Int J Drug Policy 2018;61:15–22.
  31. Wilkins C, et al. Determinants of the retail price of illegal drugs in New Zealand. Int J Drug Policy 2020;79:102728.
  32. Ministry of Health. Methodology Report 2019/20: New Zealand Health Survey. Wellington, NZ: Ministry of Health; 2020.
  33. Wilkins C, Sweetsur P. Exploring the structure of the illegal market for cannabis. De Economist 2006;154(4):547–62.
  34. Darke S, Topp L, Ross J. The injection of methadone and benzodiazepines among Sydney injecting drug users 1996 2000: 5-year monitoring of trends from the Illicit Drug Reporting System. Drug and Alcohol Review 2002;21:27–32.
  35. Ministry of Health. Drug use and harm 2012/13: New Zealand Health Survey. Wellington, NZ: Ministry of Health; 2015, unpublished.
  36. Poulsen H, Moar R, Troncoso C. The incidence of alcohol and other drugs in drivers killed in New Zealand road crashes 2004–2009. Forensic Science International 2012;223(1–3):364–70.
  37. Ramaekers J, et al. Dose related risk of motor vehicle crashes after cannabis use. Drug and Alcohol Dependence 2004;73:109–19.
  38. Aitken C, Winter R. Review of New Zealand’s Needle Exchange Programme for The Ministry of Health, New Zealand. Final Report. Melbourne, Australia: Burnet Institute; 2008.
  39. Moore T. Working estimates of the social costs per gram and per user for cannabis, cocaine, opiates and amphetamines. Sydney, Australia: National Drug and Alcohol Research Centre; 2007.
  40. Pattinson K. Opioids and the control of respiration. British Journal of Anaesthesia 2008;100(6):747–58.
  41. Curran C, Byrappa N, McBride A. Stimulant psychosis: systematic review. The British Journal of Psychiatry 2004;185(3):196–204.
  42. Haynes S. Prescription medicine diversion: Situation assessment. Wellington, NZ: National Drug Intelligence Bureau; 2014.
  43. Judson G, et al. Drug injecting in patients in New Zealand methadone maintenance treatment programs: An anonymous survey. Drug & Alcohol Review 2010;29(1):41–46.
  44. Peiris-John R, Kool B, Ameratunga S. Fatalities and hospitalisations due to acute poisoning among New Zealand adults. Internal Medicine Journal 2014;44(3):273–81.
  45. Fergusson D, Boden J. Cannabis use in adolescence. In Improving the transition: Reducing social and psychological morbidity during adolescence. Gluckman P, Hayne H (eds). Wellington, NZ: Office of the Prime Minister’s Science Advisory Committee; 2011.
  46. Moriarty H, et al. Living with addiction: Exploring the issues for families. In Blue Skies Report. Wellington, NZ: Department of Primary Health Care and General Practice, School of Medicine and Health Sciences, University of Otago, Wellington; 2010.
  47. Schäfer G. Family functioning in families with alcohol and other drug addiction. Social Policy Journal of New Zealand 2011:1–17.
  48. Colfax G, et al. Amphetamine-group substances and HIV. Lancet 2010;376(9739):458–74.
  49. Škařupová K. The levels of use of opioids, amphetamines and cocaine and associated levels of harm: Summary of scientific evidence. Thanki D, Vicente J (eds). Luxembourg, EU: European Monitoring Centre for Drugs and Drug Addiction; 2014.
  50. Becroft A, Thompson R. Youth offending: Factors that contribute and how the system responds. In Office of the Children's Commissioner symposium: Child and youth offenders, what works. Wellington, NZ: National Library Auditorium, New Zealand Ministry of Justice; 2006.
  51. Patterson J. 'Alcoholics, drug deals, gang affiliations, domestic violence' - Emergency housing labelled as dangerous. Radio New Zealand 2021.
  52. Ministry of Health. Household Food Insecurity Among Children in New Zealand. Wellington, NZ: Ministry of Health; 2019.
  53. University of Otago. ‘Positive parenting’ can buffer against alcoholism in adulthood. New Zealand Doctor, 28 April 2021.
  54. WHO. Defining sexual health: report of a technical consultation on sexual health. Geneva, EU: WHO; 2006.
  55. Moriarty H, Stubbe M, Bradford S. Opportunities for alcohol and other drug advice in the GP consultation. Wellington, NZ: Ministry of Health; 2009.
  56. Cape G, Hannah A, Sellman D. A longitudinal evaluation of medical student knowledge, skills and attitudes to alcohol and drugs. Addiction 2006;101:841–49.
  57. Weiner M, Wells S, Kerse N. Perspectives of general practitioners towards evaluation and treatment of cardiovascular disease among older people. Journal of Primary Health Care 2009;1(3):198–206.
  58. Pearce W. Let's talk about sex. BPJ 2009;20:17–23.
  59. Gott M, Hinchliff S, Galena E. General practitioner attitudes to discussing sexual health issues with older people. Soc Sci Med 2004;58(11):2093–103.
  60. Colón H, Robles R, Sahai H. The validity of drug use responses in a household survey in Puerto Rico: comparison of survey responses of cocaine and heroin use with hair tests. International Journal of Epidemiology 2001;30(5):1042–49.
  61. Robertson L. 2012/13 Scottish Crime and Justice Survey: Drug Use. Edinburgh, UK: The Scottish Government; 2013.
  62. Pudney S. Survey measures of drug/substance use. SQB Topic Overview 2, 2010.
  63. Hart CL. Drug Use for Grown-Ups: Chasing Liberty in the Land of Fear. New York, NY: Penguin Press; 2021.
  64. Dalrymple T. Romancing Opiates: Pharmacological Lies and the Addiction Bureaucracy. New York, NY: Encounter Books; 2006.
  65. Peterson J. 12 Rules for Life: An Antidote to Chaos. Canada: Random House; 2018.
  66. Ministry of Health. Government response to Report of the Health Committee on Inquiry into improving child health outcomes and preventing child abuse with a focus from preconception until three years of age. Wellington, NZ: Ministry of Health; 2014.
  67. Woodbridge M. Needle Exchange Services: health systems development. Wellington, NZ: Woodbridge Research; 2012.
  68. Woodbridge M, Dowell A, Gray L. ‘He said he had been out doing the traffic’: general practitioner perceptions of sexually transmitted infection and HIV testing strategies for men. Journal of Primary Health Care 2015;7(1):50–56.