Management of Cannabis and Psychostimulant Use among General Practice Patients

While regular and heavy cannabis and psychostimulant use has been associated with significant health and psychological impairments, the extent to which their use is being identified and managed by general practitioners (GPs) remains unclear. The aim of this study was to explore the management of cannabis- and psychostimulant-related problems in Australian general practice. Data from the Bettering the Evaluation and Care of Health (BEACH) study of general practice between April 2000 and March 2007 were analysed. BEACH is an ongoing national study of general practice activity in Australia. It was estimated that during this period GPs in Australia managed illicit drug use about 55,000 times per year and that cannabis and psychostimulants made up 3.2% and 1.6%, respectively, of all encounters at which the illicit drug was specified. The only difference in patient demographics between patients in the two drug groups was that cannabis users were younger than psychostimulant users. Cannabis users were more likely to be managed concurrently for psychotic symptoms but less likely to be treated with antipsychotics. Conversely, patients using psychostimulants were more likely to be prescribed an antipsychotic and/or an anxiolytic for their presenting drug problem. These results suggest that GPs do manage problematic cannabis and psychostimulant use among their patients, and thus should be supported in carrying out appropriate screening, intervention and referral.

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Genetic liability, illicit drug use, life stress and psychotic symptoms: preliminary findings from the Edinburgh study of people at high risk for schizophrenia

Social Psychiatry and Psychiatric Epidemiology ◽

10.1007/s001270170038 ◽

2001 ◽

Vol 36 (7) ◽

pp. 338-342 ◽

Cited By ~ 91

Author(s):

P. Miller ◽

S. M. Lawrie ◽

A. Hodges ◽

R. Clafferty ◽

R. Cosway ◽

...

Keyword(s):

High Risk ◽

Drug Use ◽

Life Stress ◽

Illicit Drug ◽

Illicit Drug Use ◽

Psychotic Symptoms ◽

Genetic Liability

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Identifying a Drug Use Typology of Philadelphia Arrestees: A Cluster Analysis

Journal of Drug Issues ◽

10.1177/002204269802800214 ◽

1998 ◽

Vol 28 (2) ◽

pp. 559-574 ◽

Cited By ~ 11

Author(s):

George S. Yacoubian ◽

Robert J. Kane

Keyword(s):

Drug Use ◽

Drug Users ◽

Illicit Drug ◽

Illicit Drug Use ◽

Policy Implications ◽

Drug Problem ◽

Statistical Tool ◽

Illegal Drug Use ◽

Drug Crime ◽

National Institute Of Justice

The Drug Use Forecasting (DUF) program is a measurement system established by the National Institute of Justice to test booked arrestees for illegal drug use. DUF has consistently shown high levels of illicit drug use among arrestees, including those charged with crimes unrelated to drug use. Measuring the extent and nature of this illicit drug use is essential to, first, determining how severe the drug problem is, and second, developing ideal methods for combating it. Part I of this analysis presents an overview of the drug/crime connection. Part II describes the methodology of the DUF project. Part III, first, describes the utility of clustering as a statistical tool, and second, identifies homogeneous clusters of drug users from a Philadelphia population of 1,329 arrestees. Part IV assesses the policy implications of these classifications.

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Trends and Influences in the History of Australian Drug Legislation

Journal of Drug Issues ◽

10.1177/002204269202200304 ◽

1992 ◽

Vol 22 (3) ◽

pp. 507-520 ◽

Cited By ~ 2

Author(s):

Desmond Manderson

Keyword(s):

Drug Use ◽

Illicit Drug ◽

Illicit Drug Use ◽

International Community ◽

Drug Control ◽

Drug Problem ◽

International Consensus ◽

Drug Legislation ◽

History Of ◽

Independent Assessment

In this article the author briefly traces some features in the emergence in Australia of legislation controlling “dangerous drugs” such as opium, morphine, cocaine and heroin from 1900 to 1950. It is argued that, in common with other similar countries, the first laws prohibiting the non-medical use of drugs were enacted as a symptom of anti-Chinese racism and not out of any concern for the health of users. It is further argued that later laws, which built upon that precedent, developed not through any independent assessment of the drug problem in Australia but rather in response to pressure from the international community. Australia's unthinking acceptance of the growing U.S.-led international consensus relating to “dangerous drugs” influenced legislation, policy and attitudes to illicit drug use. The structure of drug control which emerged incorporated and promoted the fears, values and solutions of other societies without any assessment of their validity or appropriateness.

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Program logic: a framework for health program design and evaluation - the Pap nurse in general practice program

Australian Journal of Primary Health ◽

10.1071/py09072 ◽

2010 ◽

Vol 16 (4) ◽

pp. 319 ◽

Cited By ~ 4

Author(s):

Christine M. Hallinan

Keyword(s):

General Practice ◽

Data Set ◽

Activity Increase ◽

Program Logic ◽

Policy Makers ◽

Health Initiatives ◽

Australian General Practice ◽

Practice Activity ◽

Planning Development ◽

Time Frames

In this paper, program logic will be used to ‘map out’ the planning, development and evaluation of the general practice Pap nurse program in the Australian general practice arena. The incorporation of program logic into the evaluative process supports a greater appreciation of the theoretical assumptions and external influences that underpin general practice Pap nurse activity. The creation of a program logic model is a conscious strategy that results an explicit understanding of the challenges ahead, the resources available and time frames for outcomes. Program logic also enables a recognition that all players in the general practice arena need to be acknowledged by policy makers, bureaucrats and program designers when addressing through policy, issues relating to equity and accessibility of health initiatives. Logic modelling allows decision makers to consider the complexities of causal associations when developing health care proposals and programs. It enables the Pap nurse in general practice program to be represented diagrammatically by linking outcomes (short, medium and long term) with both the program activities and program assumptions. The research methodology used in the evaluation of the Pap nurse in general practice program includes a descriptive study design and the incorporation of program logic, with a retrospective analysis of Australian data from 2001 to 2009. For the purposes of gaining both empirical and contextual data for this paper, a data set analysis and literature review was performed. The application of program logic as an evaluative tool for analysis of the Pap PN incentive program facilitates a greater understanding of complex general practice activity triggers, and also allows this greater understanding to be incorporated into policy to facilitate Pap PN activity, increase general practice cervical smear and ultimately decrease burden of disease.

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US Drug Policy and Perpetual War against the Drug Trade in Mexico

Perspectives on Global Development and Technology ◽

10.1163/15691497-12341552 ◽

2020 ◽

Vol 19 (1-2) ◽

pp. 237-255

Author(s):

Alberto Omar Luna-Monsivais ◽

Marcelo del Castillo-Mussot ◽

Alfredo de la Lama García ◽

Jorge Antonio Montemayor Aldrete

Keyword(s):

Drug Use ◽

Drug Policy ◽

Illicit Drug ◽

War On Drugs ◽

Drug Trade ◽

Drug Problem ◽

New Approach ◽

Historical Process ◽

The Us ◽

Perpetual War

Abstract Globalization of drug consumption has generated a highly lucrative market for illegal traffickers. The US launched a worldwide campaign against illicit drug use, forcing many countries to comply with the ‘War on Drugs.’ We describe this historical process as a perpetual war resulting in violence, criminality, forced displacement, and disappearances in Mexico and other countries. For instance, despite economic, political, and military coercion in Mexico, the “drug problem” shows little sign of going away, unless a new approach regarding drug production and trade is adopted.

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The impact of alcohol and illicit drugs on people with psychosis: The second Australian national survey of psychosis

Australian & New Zealand Journal of Psychiatry ◽

10.1177/0004867412443900 ◽

2012 ◽

Vol 46 (9) ◽

pp. 864-878 ◽

Cited By ~ 39

Author(s):

Elizabeth Moore ◽

Serafino G Mancuso ◽

Tim Slade ◽

Cherrie Galletly ◽

David J Castle

Keyword(s):

Substance Abuse ◽

Drug Use ◽

Alcohol Abuse ◽

Illicit Drug ◽

Illicit Drug Use ◽

Integrated Treatment ◽

National Study ◽

Cannabis Dependence ◽

Cannabis Abuse ◽

The Impact

Objective: To provide the most up-to-date prevalence estimates of alcohol and illicit drug use among individuals with psychosis in Australia, and explore correlates associated with a lifetime diagnosis of both alcohol abuse/dependence and cannabis abuse/dependence. Method: This paper uses data from the Survey of High Impact Psychosis (SHIP), conducted as a follow-up to the first Australian National Low Prevalence (Psychotic) Disorders Study (1997–1998). The SHIP was a national study, carried out across five states, in which a sample of 1825 individuals was recruited through a two-phase sampling framework. Results: Alcohol and illicit drug use was highly prevalent for the entire sample. There were few significant differences in the prevalence or frequency of use across the diagnostic categories examined. Substantial increases in substance abuse/dependence were noted since the 1997–1998 survey (51% diagnosed with alcohol abuse/dependence, 51% with cannabis abuse/dependence and 32% with other illicit drug abuse/dependence, compared to 28%, 23% and 12% respectively, in the 1997–1998 survey by Kavanagh et al., 2004). Factors significantly associated with both lifetime alcohol and cannabis dependence included male gender, younger age, single marital status, lower educational attainment, shorter duration of illness, lifetime presence of hallucinations, higher negative syndrome score and lower body mass index (BMI). A number of other factors were found to be differentially associated with either lifetime alcohol or cannabis dependence. Conclusions: The use of alcohol and illicit substances is common among people with a psychotic illness, with a concerning upward trend in rates of substance abuse/dependence since the 1997–1998 survey. Clinicians should be aware of the potential impact of concurrent substance use and provide integrated treatment for individuals presenting with psychotic illnesses. More research and investment in new intervention programs is required.

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