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The purpose of this paper is to explore current practice, barriers and facilitators to identifying and responding to alcohol problems in memory clinics.

A questionnaire sent to professionals in 55 memory clinics in England, Wales and the Isle of Wight and two focus groups with professionals from three memory clinics in England.

Only 1/35 clinics that responded to the questionnaire was using a standardised alcohol screening tool but all attempted to gain some information about alcohol use. Without screening tools, practitioners found it difficult to determine whether alcohol use was problematic. Barriers to identification/intervention included cognitive impairment, service-user being “on guard” during assessment, presence of family members/carers, time constraints and a perception that brief interventions were not within the remit of memory clinics. Facilitators were obtaining visual clues of problem drinking during home visits and collateral information from family members/carers.

Focus group participants were recruited through convenience sampling and a small number of professionals took part. This means that the findings may be subject to selection bias and limits the generalisability of the findings.

Memory clinics should provide guidance and training for practitioners on how to intervene and respond to alcohol misuse. Further research is required to determine the most effective way to identify alcohol problems in people with cognitive impairment and how to deliver brief alcohol interventions that take account of cognitive deficits.

This is the first study to examine alcohol screening and interventions in memory clinics and identifies a need for guidance, training and further research.

Objective. To report on the patterns of substance use in newly admitted male and female South Australian prisoners using the WHO‐ASSIST screening tool (Alcohol, Smoking and Substance Involvement Screening Test) and observe the feasibility of using the ASSIST and associated Brief Intervention in this population. Data sources. Results of the first 518 prisoners screened using ASSIST in South Australian reception prisons. Results. In the first 10 months of the implementation of the WHO ASSIST, 518 clients were assessed in the 3 metropolitan intake prisons in Adelaide, Australia. This represents 31% of all male and 35% of all female prisoners admitted over this period. Injecting drug use was reported in the previous 3 months by 55% of men and 51% of women. The six most common substances used at high and moderate risk levels, in order of prevalence (from high to low) in males were tobacco, cannabis, amphetamines, opiates, alcohol, and sedatives. In women the order was tobacco, amphetamines, cannabis, opiates and sedatives equal, and alcohol. Fifty percent of men and 33% of women were using four or more substances. Overall rates of substance use related risk amongst men coming into prison are slightly greater than for women. Accessing prisoners for screening within the first few days is difficult with 55% already being released or at court or other external appointments.

There is growing statistical and research evidence to suggest that the prevalence of alcohol misuse is increasing among older adults in the UK. This has been an under‐recognised problem, but is now a source of increasing concern for health and social care providers. Older adults with mental health problems have increased vulnerability to problematic alcohol use, and this is likely to have a significant impact on older people's mental health services (OPMHS).

This paper discusses some of the problems facing OPMHS in relation to increasing alcohol misuse among services users.

There is also evidence that alcohol misuse in older adults is often poorly identified and untreated within health and social care services including OPMHS. Use of an alcohol‐screening tool as part of a health care assessment is an effective way to improve detection. This paper also reviews the use of alcohol screening tools in the detection of alcohol related illness among older adults with mental health problems and proposes a care pathway for the management of alcohol misuse in OPMHS.

Current evidence indicates that the prevalence of alcohol misuse among older adults is increasing and is likely to rise further due to the reasons discussed in this paper.

Alcohol misuse is internationally recognised as a major public health problem. The link between alcohol and crime is strong and offenders have a higher prevalence of alcohol problems when compared with the general population. Alcohol‐related crime is estimated to cost the Scottish economy over £700 m per annum. The purpose of this paper is to measure the nature and prevalence of Alcohol Use Disorders (AUDs) in adult male prisoners on remand in a prison in Scotland.

Using the Alcohol Use Disorders Identification Test (AUDIT) screening tool, all new remand prisoners were screened over a two week period.

Prevalence of alcohol problems within the sample was high: 73 per cent of the sample was identified with an AUD, with 43 per cent with scores indicating possible alcohol dependence.

This is the first study to focus solely on a remand prisoner population and the results show high levels of need. The criminal justice setting is ideally placed to identify and treat alcohol problems in this hard to reach population.

The purpose of this paper is to examine the prevalence of alcohol use disorders (AUDs) amongst young people in the criminal justice system (CJS) in the North East of England and to compare the ability of the Alcohol Use Disorders Identification Test (AUDIT) to the Youth Justice Board ASSET tool in identifying alcohol-related need in Youth Offending Team (YOT) clients.

A validated screening tool (AUDIT) was used to identify alcohol-related health risk or harm. Findings from AUDIT were compared with those of the standard criminogenic risk screening tool used in CJS (ASSET). An anonymous cross-sectional questionnaire was administered during a one-month period in 2008. The questionnaires were completed by 11-17-year-old offenders who were in contact with three YOTs, one Youth Offending Institution and one Secure Training Estate.

In total, 429 questionnaires were completed out of a possible 639 (67 per cent). The majority (81 per cent) of the young offenders were identified as experiencing alcohol-related health risk or harm and 77 per cent scored within a possibly alcohol-dependent range. In total, 77 (30 per cent) of young people completing both assessments were identified as having an AUD by AUDIT but not identified as needing alcohol-related treatment using ASSET.

This research was confined to one geographical area of England, however, the results show that even in this area of high drinking by young people the levels of AUDs amongst young people in the CJS are very high.

There are major social implications to this research. It is imperative for changes to be made to the care pathways in place in the UK for young people coming through the CJS with alcohol-related issues.

This paper adds to the evidence base by using well-validated tools to measure alcohol use amongst young people in the CJS in the UK.

Alcohol misuse leads to a massive drain upon an already stretched NHS budget. High numbers of individuals with alcohol related physical and health needs are being admitted into the secondary health care setting at great financial cost. This paper examines a profile of this population presenting to the secondary care setting over a 12‐month period. It is suggested that the misuse of alcohol does not take place in isolation. It is often accompanied by other problematic behaviours such as domestic violence, inappropriate, neglectful parenting, or child abuse, offending behaviour, and psychological problems. Evidence for the nature and extent of these associated behaviours is reported and discussed. Comparisons are made particularly with data related to tobacco smoking, and the positive aspects of smoking cessation programmes are outlined. Almost all of the population reported on over the 12‐month period were tobacco smokers. The re‐emergence of the incidence of smoking with the reduction of smoking cessation programmes is noted. The challenge for substance misuse services is how best to respond to the needs of this growing population who often present withalcohol misuse together with smoking behaviours. A collaborative model of response is outlined and suggested as the best way forward. This involves substance misuse services working together with professional colleagues within the acute hospital environment and community to ensure sustainable positive clinical outcomes following hospital discharge.

This study aims to review the presentation of substance use disorders in older adults, how addiction intertwines with neurocognitive disorders and how to approach this vulnerable population.

Electronic data searches of PubMed, Medline and the Cochrane Library (years 2000–2021) were performed using the keywords “neurocognitive,” “dementia,” “substance use,” “addiction,” “older adults” and “elderly.” The authors, in consensus, selected pivotal studies and conducted a narrative synthesis of the findings.

Research about substance use disorders in older adults is limited, especially in those with superimposed neurocognitive disorders. Having dual diagnoses can make the identification and treatment of either condition challenging. Management should use a holistic multidisciplinary approach that involves medical professionals and caregivers.

This review highlights some of the intertwining aspects between substance use disorders and neurocognitive disorders in older adults. It provides a comprehensive summary of the available evidence on treatment in this population.

The Glasgow acute addiction liaison nurse service provides a unique service to patients with alcohol and drug issues who are admitted to general hospitals in the Glasgow City area. It offers guidance on withdrawal management, educates patients and staff and provides a facility to refer to appropriate community services. Since its foundation in 2005, patient referrals have increased by more than 3,000. Additionally, it has taken on a greater educational role and is more involved in research and evaluation.

The assessment of cognitive impairment in community services for older people remains under-explored. The paper aims to discuss this issue.

Cognitive impairment was examined in 25 people aged 65 and over with alcohol use disorders, on the caseload of community mental health services over a six-month period. All subjects assessed using Addenbrooke’s Cognitive Assessment (ACE-III).

In total, 76 per cent of the group scored below the cut-off point for likely dementia but only 45 per cent of people scored below the cut-off point for tests of language, compared with 68-84 per cent people in other domains.

This finding has implications for the detection of alcohol-related brain cognitive impairment in clinical settings.

Standardised cognitive testing is common within mental health services for older people, but may also have utility within addiction services.

The early detection of alcohol-related cognitive impairment can improve social outcomes in both drinking behaviour and the social consequences of alcohol-related dementia.

This may be the first published study of cognitive impairment in patients under a mental team for older people with alcohol use disorders and offers some unique findings within this sampling frame.

The purpose of this paper is to explore factors associated with alcohol use disorders (AUDs) among Bhutanese refugees in Nepal, where there has been a mass third-country resettlement operation in place since 2007.

A case-control study was conducted in which the Alcohol Use Disorder Identification Test (AUDIT) was used to confirm AUDs and participants’ eligibility for placement in a case or control group. A translated questionnaire measuring demographic variables and context of drinking was also administered.

In total, 128 questionnaires were completed (32 cases, 96 controls). Compared to participants without AUDs, those with AUDs were more likely to be older (36-50 years) (OR=10.5, 95 per cent CI 2.17-50.81), (50+years) (OR=10.3, 95 per cent CI 2.02-52.71), illiterate (OR=7.3 (2.80-18.42)), use tobacco (smoking or chewing) (OR=4.3 (1.84-10.01)) and be male (OR=3.5 (1.35-8.67)). Reasons for excessive alcohol use included unemployment, unoccupied time and increased family tensions.

The study is the first of which the authors are aware that attempts to examine risk factors associated with AUDs within the context of a mass resettlement operation where camp services are winding down. The findings of this study suggest that greater attention needs to be given toward creating meaningful activities for adult, less educated male migrants awaiting resettlement.