scholarly journals “Everyone Has the Right to Drink Beer”: A Stakeholder Analysis of Challenges to Youth Alcohol Harm-Reduction Policies in Lebanon

2019 ◽  
Vol 16 (16) ◽  
pp. 2874 ◽  
Author(s):  
Rima T Nakkash ◽  
Lilian A Ghandour ◽  
Nasser Yassin ◽  
Sirine Anouti ◽  
Ali Chalak ◽  
...  
Keyword(s):  
Alcohol Use ◽  
Harm Reduction ◽  
Stakeholder Analysis ◽  
Premature Death ◽  
Evidence Based ◽  
Control Policies ◽  
Alcohol Control ◽  
Non Governmental Organizations ◽  
The Right ◽  
Alcohol Harm Reduction

Background: Alcohol use is a major risk factor in premature death and disability, especially among youth. Evidence-based policies to prevent and control the detrimental effect of alcohol use have been recommended. In countries with weak alcohol control policies—such as Lebanon, stakeholder analysis provides critical information to influence policy interventions. This paper assesses the views of stakeholders regarding a national alcohol harm reduction policy for youth. Methods: We interviewed a total of 22 key stakeholders over a period of 8 months in 2015. Stakeholders were selected purposively, to include representatives of governmental and non-governmental organizations and industry that could answer questions related to core intervention areas: affordability, availability, regulation of marketing, and drinking and driving. We analyzed interview transcripts using thematic analysis. Results: Three themes emerged: Inadequacy of current alcohol control policies; weak governance and disregard for rule of law as a determinant of the status quo; and diverting of responsibility towards ‘other’ stakeholders. In addition, industry representatives argued against evidence-based policies using time-worn strategies identified globally. Conclusions: Our findings indicate that alcohol harm reduction policies are far from becoming a policy priority in Lebanon. There is a clear need to shift the narrative from victim blaming to structural conditions.

scholarly journals “If I knew I could get that every hour instead of alcohol, I would take the cannabis”: need and feasibility of cannabis substitution implementation in Canadian managed alcohol programs

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Bernie Pauly ◽  
Meaghan Brown ◽  
Clifton Chow ◽  
Ashley Wettlaufer ◽  
Brittany Graham ◽  
...  
Keyword(s):  
Alcohol Use ◽  
Harm Reduction ◽  
Partial Substitution ◽  
Organizational Leaders ◽  
Willingness To Participate ◽  
Alcohol Cravings ◽  
Alcohol Harm Reduction ◽  
Alcohol Programs ◽  
Robust Evidence

Abstract Background While there is robust evidence for strategies to reduce harms of illicit drug use, less attention has been paid to alcohol harm reduction for people experiencing severe alcohol use disorder (AUD), homelessness, and street-based illicit drinking. Managed Alcohol Programs (MAPs) provide safer and regulated sources of alcohol and other supports within a harm reduction framework. To reduce the impacts of heavy long-term alcohol use among MAP participants, cannabis substitution has been identified as a potential therapeutic tool. Methods To determine the feasibility of cannabis substitution, we conducted a pre-implementation mixed-methods study utilizing structured surveys and open-ended interviews. Data were collected from MAP organizational leaders (n = 7), program participants (n = 19), staff and managers (n = 17) across 6 MAPs in Canada. We used the Consolidated Framework for Implementation Research (CFIR) to inform and organize our analysis. Results Five themes describing feasibility of CSP implementation in MAPs were identified. The first theme describes the characteristics of potential CSP participants. Among MAP participants, 63% (n = 12) were already substituting cannabis for alcohol, most often on a weekly basis (n = 8, 42.1%), for alcohol cravings (n = 15, 78.9%,) and withdrawal (n = 10, 52.6%). Most MAP participants expressed willingness to participate in a CSP (n = 16, 84.2%). The second theme describes the characteristics of a feasible and preferred CSP model according to participants and staff. Participants preferred staff administration of dry, smoked cannabis, followed by edibles and capsules with replacement of some doses of alcohol through a partial substitution model. Themes three and four highlight organizational and contextual factors related to feasibility of implementing CSPs. MAP participants requested peer, social, and counselling supports. Staff requested education resources and enhanced clinical staffing. Critically, program staff and leaders identified that sustainable funding and inexpensive, legal, and reliable sourcing of cannabis are needed to support CSP implementation. Conclusion Cannabis substitution was considered feasible by all three groups and in some MAPs residents are already using cannabis. Partial substitution of cannabis for doses of alcohol was preferred. All three groups identified a need for additional supports for implementation including peer support, staff education, and counselling. Sourcing and funding cannabis were identified as primary challenges to successful CSP implementation in MAPs.

scholarly journals Associations Between Alcohol Policies and Adolescent Alcohol Use: A Pooled Analysis of GSHS and ESPAD Data

2019 ◽  
Vol 54 (6) ◽  
pp. 639-646 ◽  
Author(s):  
Jonathan K Noel
Keyword(s):  
Alcohol Consumption ◽  
Alcohol Use ◽  
Binge Drinking ◽  
Control Policies ◽  
Adolescent Alcohol Use ◽  
Alcohol Policies ◽  
Adolescent Alcohol ◽  
Pricing Policies ◽  
Alcohol Control ◽  
Drinking Status

Abstract Aims Alcohol-attributable harm remains high worldwide, and alcohol use among adolescents is particularly concerning. The purpose of this study is to determine the effect of national alcohol control policies on adolescent alcohol use in low-, middle- and high-income countries and improve on previous cross-national attempts to estimate the impact of alcohol policy on this population. Methods Data on adolescent (n = 277,110) alcohol consumption from 84 countries were pooled from the Global School-based Health Survey and the European School Survey Project on Alcohol and Other Drugs. Alcohol use measures included lifetime alcohol use, current (past 30 days) alcohol use and current (past 30 days) binge drinking. Information on national alcohol control policies was obtained from the World Health Organization’s Global Information System on Alcohol and Health and scored for effectiveness. Main effects were estimated using two-level, random intercept hierarchical linear models, and the models were adjusted for sex and age of the participants, and pattern of drinking score, gross domestic product based on purchasing power parity and study at the country level. Results Availability (OR [95% CI] = 0.991 [0.983, 0.999]), marketing (OR [95% CI] = 0.994 [0.988, 1.000]) and pricing (OR [95% CI] = 0.955 [0.918, 0.993]) policies were inversely associated with lifetime drinking status. Pricing policies were also inversely associated with current binge drinking status among current drinkers (OR [95% CI] = 0.939 [0.894, 0.986]). There were no associations between the included alcohol policies and current drinking status. Conclusions Strong availability, marketing and pricing policies can significantly and practically impact adolescent alcohol consumption.

scholarly journals COVID-19 Social Restrictions: An Opportunity to Re-visit the Concept of Harm Reduction in the Treatment of Alcohol Dependence. A Position Paper

2021 ◽  
Vol 12 ◽  
Author(s):  
Christos Kouimtsidis ◽  
Bernadette Pauly ◽  
Tessa Parkes ◽  
Tim Stockwell ◽  
Alexander Mario Baldacchino
Keyword(s):  
Substance Use ◽  
Alcohol Use ◽  
Harm Reduction ◽  
Alcohol Use Disorders ◽  
Position Paper ◽  
Substance Use Treatment ◽  
Health And Social Care ◽  
Substance Use Services ◽  
Alcohol Harm Reduction ◽  
The Impact

The COVID-19 pandemic is presenting significant challenges for health and social care systems globally. The implementation of unprecedented public health measures, alongside the augmentation of the treatment capacity for those severely affected by COVID-19, are compromising and limiting the delivery of essential care to people with severe substance use problems and, in some cases, widening extreme social inequities such as poverty and homelessness. This global pandemic is severely challenging current working practices. However, these challenges can provide a unique opportunity for a flexible and innovative learning approach, bringing certain interventions into the spotlight. Harm reduction responses are well-established evidenced approaches in the management of opioid dependence but not so well-known or implemented in relation to alcohol use disorders. In this position paper, we explore the potential for expanding harm reduction approaches during the COVID-19 crisis and beyond as part of substance use treatment services. We will examine alcohol use and related vulnerabilities during COVID-19, the impact of COVID-19 on substance use services, and the potential philosophical shift in orientation to harm reduction and outline a range of alcohol harm reduction approaches. We discuss relevant aspects of the Structured Preparation for Alcohol Detoxification (SPADe) treatment model, and Managed Alcohol Programs (MAPs), as part of a continuum of harm reduction and abstinence orientated treatment for alcohol use disorders. In conclusion, while COVID-19 has dramatically reduced and limited services, the pandemic has propelled the importance of alcohol harm reduction and created new opportunities for implementation of harm reduction philosophy and approaches, including programs that incorporate the provision of alcohol as medicine as part of the substance use treatment continuum.

Paternalism and alcohol policy

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Kari Poikolainen
Keyword(s):  
Alcohol Use ◽  
Blood Alcohol Concentration ◽  
Harmful Effect ◽  
Alcohol Policy ◽  
Third Party ◽  
Motor Vehicles ◽  
Sufficient Evidence ◽  
Control Policies ◽  
Content Type ◽  
Alcohol Control

Purpose The purpose of this paper is to investigate to what degree scientific evidence supports contemporary paternalistic alcohol policy practices targeting fully competent adults. Design/methodology/approach Paternalism may be acceptable if it is effective, fair and protects the safety of the citizen or a third party from the harms caused by the citizen’s autonomic actions. To be justifiable, paternalistic actions should bring about clearly more benefits than harms. Otherwise, autonomy should prevail. The evidence related to alcohol control policies is assessed against these principles. Findings In peaceful civilized societies, alcohol control policies (high prices, restrictions on supply and marketing) have no or only insignificant effectiveness. Some policies are unfair and may bring about more harms than benefits. There is strong evidence showing that brief interventions aiming to reduce alcohol intake are inefficient. Wide-scale screening for such interventions is likely to waste health service resources. There is sufficient evidence to refute the claim that the previously mentioned policies are effective measures to reduce alcohol-related harms. Heavy alcohol use during pregnancy and driving motor vehicles while intoxicated may bring about harm to others than the user. Behavioural interventions to reduce heavy use in pregnancy have been shown to be inefficient. Light alcohol use may have no harmful effect on the developing embryo, whereas heavy use is likely to cause harm. There is moderate evidence for enforcing legal blood alcohol concentration limits to reduce traffic accidents and fatalities. Originality/value This is the first review on the acceptability of paternalism in currently recommended alcohol policies. It shows that in only a few cases, paternalism is effective and compatible with freedom and fairness.

Tailored interventions to support the implementation of the German national guideline on screening, diagnosis and treatment of alcohol-related disorders: a project protocol

2019 ◽  
Vol 65 (6) ◽  
pp. 373-381 ◽  
Author(s):  
Bernd Schulte ◽  
Christina Lindemann ◽  
Angela Buchholz ◽  
Anke Rosahl ◽  
Martin Härter ◽  
...  
Keyword(s):  
Alcohol Use ◽  
Guideline Implementation ◽  
Implementation Strategies ◽  
Organizational Factors ◽  
Diagnosis And Treatment ◽  
Primary Data ◽  
Routine Practice ◽  
Evidence Based ◽  
Advisory Boards ◽  
Prevention And Treatment

Abstract. Background: The German Guideline on Screening, Diagnosis and Treatment of Alcohol Use Disorders aims to increase the uptake of evidence-based interventions for the early identification, diagnosis, prevention and treatment of alcohol-related disorders in relevant healthcare settings. To date, dissemination has not been accompanied by a guideline implementation strategy. The aim of this study is to develop tailored guideline implementation strategies and to field-test these in relevant medical and psycho-social settings in the city of Bremen, Germany. Methods: The study will conduct an impact and needs assessment of healthcare provision for alcohol use orders in Bremen, drawing on a range of secondary and primary data to: evaluate existing healthcare services; model the potential impact of improved care on public health outcomes; and identify potential barriers and facilitators to implementing evidence-based guidelines. Community advisory boards will be established for the selection of single-component or multi-faceted guideline implementation strategies. The tailoring approach considers guideline, provider and organizational factors shaping implementation. In field tests quality outcome indicators of the delivery of evidence-based interventions will be evaluated accompanied by a process evaluation to examine patient, provider and organizational factors. Outlook: This project will support the translation of guideline recommendations for the identification, prevention and treatment of AUD in routine practice and therefore contributes to the reduction of alcohol-related burden in Germany. The project is running since October 2017 and will provide its main outcomes by end of 2020. Project results will be published in scientific journals and presented at national and international conferences.

WITHWomen: User Centered Approach to the Design and Development of a suite of Intimate Partner Violence Screening and Safety Planning Web-Applications (Preprint)

2020 ◽  
Author(s):  
Patricia O'Campo ◽  
Alisa Velonis ◽  
Pearl Buhariwala ◽  
Janisha Kamalanathan ◽  
Maha Awaiz Hassan
Keyword(s):  
Partner Violence ◽  
Web Applications ◽  
Lessons Learned ◽  
Evidence Based ◽  
Safety Planning ◽  
Future Design ◽  
Mhealth Technology ◽  
The Right ◽  
Safe Access ◽  
Health Applications

BACKGROUND The popularity of mHealth technology has resulted in the development of numerous applications for almost every type of self-improvement or disease management. M- and e-health solutions for increasing awareness about and safety around partner violence is no exception. OBJECTIVE These applications allow women to control access to these resources and provide unlimited, and with the right design features, safe access when these resources are needed. Few applications, however, have been designed in close collaboration with intended users to ensure relevance and effectiveness. METHODS We report here on the design of a pair of evidence-based m- and e-health applications to facilitate early identification of unsafe relationship behaviors and tailored safety planning to reduce harm from violence including the methods by which we collaborated with and sought input from population of intended users. RESULTS The demographic characteristics of those who participated in the various surveys and interviews to inform the development of our screening and safety-decision support app are presented in (Table 2). CONCLUSIONS Finally, we share challenges we faced and lessons learned that might inform future design efforts of m- and e-health evidence-based applications.

Perceived Risks and Normative Beliefs as Explanatory Models for College Student Alcohol Involvement: An Assessment of a Campus with Conventional Alcohol Control Policies and Enforcement Practices

NASPA Journal ◽  
2005 ◽  
Vol 42 (2) ◽  
Author(s):  
Todd F. Lewis ◽  
Dennis L Thombs
Keyword(s):  
College Student ◽  
Explanatory Models ◽  
Normative Beliefs ◽  
Control Policies ◽  
Perceptions Of Risk ◽  
Student Drinking ◽  
Alcohol Control ◽  
Effective Interventions ◽  
Alcohol Involvement ◽  
University Communities

The aim of this study was to conduct a multivariate assessment of college student drinking motivations at a campus with conventional alcohol control policies and enforcement practices, including the establishment and dissemination of alcohol policies and the use of warnings to arouse fear of sanctions. Two explanatory models were compared: perceptions of risk and normative beliefs. An anonymous questionnaire was administered to 1,396 students at a large Midwestern university. Data analyses were conducted on the subsample of participants who had reported using alcohol within the past 12 months (n = 1,322). Overall, the results from a canonical correlation analysis indicated that alcohol involvement was best explained by normative beliefs about the drinking practices of one’s closest friends. Perceptions of drinking risk were less important to the explanation of alcohol involvement, and some of these measures unexpectedly had positive associations with indicators of alcohol risk behavior. The findings call into question the conventional deterrence strategies used in many university communities (i.e., belief that students who perceive there to be a low risk of receiving sanctions are those most likely to engage in alcohol related misbehavior). Furthermore, the findings suggest that effective interventions will need to impact students' normative beliefs about the drinking practices of proximal peer groups.

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