Search results

The purpose of this paper is to determine whether the diagnosis of both carers’ mental health problems and substance misuse increase the likelihood of recurrent child maltreatment over and above the individual effects of these factors.

Retrospective secondary data analysis of 29,455 children where child maltreatment was confirmed in the Victorian child protection system between 2001 and 2005. Recorded mental health, alcohol misuse and other drug misuse variables were entered into multivariate logistic regression models predicting repeated child maltreatment. Interactions and a range of other child, carer and socio-economic factors were included in these models.

Carer alcohol misuse, other drug misuse and mental ill health all independently predicted recurrent child maltreatment. The presence of both other drug misuse and mental ill health increased the likelihood that recurrent child abuse was recorded over the likelihood that mental health alone predicted recurrent child maltreatment, and while alcohol misuse had an effect when there was no mental health condition recorded it did not have an additional effect when there was evidence of mental health problems.

Children in families where there is both mental health problems and other drug use problems are at greater risk of repeated maltreatment than where there is evidence of mental health problems or other drug use alone. Where there was evidence of carer mental health problems, alcohol misuse did not add to this likelihood. However, the effect of mental health and other drug use was similar in size to the effect of alcohol misuse alone.

These findings add to understandings of the effects of co-occurring mental health problems and substance misuse on recurrent child maltreatment and differentiate between cases that involve alcohol and other drug misuse.

Alcohol and other drug (AOD) use is common worldwide. There is a wide spectrum of AOD issues that pose a major threat to public health, safety and the wellbeing of communities, families and individuals. There is no doubt that nurses have primary roles in identifying, preventing and addressing AOD use issues in emergency departments and general hospital units, clinics, specialist mental health and drug and alcohol services, sexual health services, youth services and community settings where people seek health care and other assistance. Nurses have credibility and are trusted by communities for their ability to address many health issues, including AOD health problems. Despite the enormous economic burden associated with AOD use across the world, the nursing profession has yet to fully acknowledge and embrace this serious issue for nurses.

With expanded technologic and communication resources there is growing awareness worldwide of the public health problems caused by alcohol, tobacco, and other drug use, misuse, abuse and addiction. Trends vary by culture and region but use of tobacco and alcohol is almost universal and is associated with high rates of mortality and morbidity. While nurses have not universally embraced the prevention and treatment of substance‐related disorders as their province, this is changing as a function of organisations, World Health Organization (WHO) and national initiatives, and the strengthening of nurse education. Actions to promote consensus, identify and review competencies for nurses must consider national and cultural variations, traditions of social change and the need for evidence‐based practice. Collective action by nurses in newly formed and existing organisations, which focus on addictions prevention and treatment, have resulted in initial professional steps. Such progress can be facilitated if achieved in the context of larger international policies and initiatives and in collaboration with members of other professional disciplines.

To outline the paradoxes and contradictions inherent in debates about sport, alcohol, and addiction. It appears that a growing number of sportspeople suffer from addiction to alcohol and other drugs while at the same time alcohol use is widely sanctioned and celebrated in sport. The high-profile falls from grace are a public display of a more insidious, problematic relationship to drugs and alcohol in sport, yet cultural change is often difficult given long standing associations between sport and alcohol.

In the first part of the chapter, the key themes in the drugs, alcohol, and sport debate (notably health and ethics) are discussed. In the second part, some of the relationships between sport and alcohol, such as sponsorship and the cultural sanctioning of particular forms of drinking and masculine identities are examined. In the third, the issues of drug and alcohol addiction and recovery, and the implications for sport and sporting identities are discussed.

The chapter reveals the tensions that underpin the social contexts of drug and alcohol use and misuse in sport. The chapter suggests that a recalibration of popular understandings of masculinity in sport may provide a safe space through which to share battles with alcohol and addiction.

Discussion of the paradoxes and contradictions inherent in the relationships between sport and alcohol have important implications for a discussion and analysis of addiction and alcohol in sport, and for sport and social policy, health promotion, and social care more broadly.

Anecdotal feedback obtained from alcohol and drug and mental health staff across the eastern metropolitan region of Melbourne, Australia suggests that attitudes towards working with people experiencing a dual diagnosis are becoming more positive. The purpose of this paper is to understand if dual diagnosis-specific training delivered to staff within mental health and alcohol and other drug services was a factor positively influencing attitudes.

No formal evaluation assessing the impact of dual diagnosis-specific training on staff attitudes had previously occurred within this region of Australia. Access to staff on two occasions from three distinct sectors provided an opportunity to examine if and, to what degree, attitudes can be influenced by dual diagnosis-specific training. Using a co-designed attitudes survey, information was gathered from mental health and alcohol and drug staff on their attitudes to working with people with co-occurring mental health and substance use problems.

Two surveys were conducted involving 186 staff in 2012 and 110 staff in 2016. The dual diagnosis attitudes survey showed that positive attitudes to working with people experiencing a dual diagnosis were associated with recency of training. While attitudes may be improved by dual diagnosis training, these findings cannot exclude the impact of other dual diagnosis capacity building activities.

This study highlights the benefits of a regional partnership between mental health and alcohol and drug services and people with lived experience of dual diagnosis and the benefit of recent co-designed dual diagnosis training on longitudinally assessed worker attitudes.

To examine a possible link between substance use and risky sexual behaviour, a cross‐sectional study was conducted among 357 inmates across four South African prisons involved in a pre‐release intervention programme for parolees. About 93% of the participants reported using alcohol and 52% used marijuana prior to imprisonment, while 56% reported previous occurrence of sexually transmitted infections (STIs). Logistic regression analyses explored the impact of substance use on intention to reduce risky sexual behaviour. Age and inconsistent use of condoms were positively associated with having an STI prior to incarceration, while reported alcohol and marijuana intake had no effect. Never using condoms before was highly associated with lower intention to engage in preventive behaviours upon release. It can be concluded that inmates demonstrate high levels of substance use and engagement in risky sexual behaviours. Targeted pre‐release substance abuse interventions are essential to reduce the burden of disease amongst offenders.