Illicit drug use and experience of harm in the night-time economy

Abstract

The study investigates illicit drug use in the night-time economy and its association with intoxication, harm and violence experienced by licensed venue patrons. Fiveminute structured interviews measuring event-level data were conducted over a 15 month period (March 2010-June 2011) between 9pm-1am. 3,949 patrons interviews were conducted in Newcastle and Geelong, Australian regional cities close to capital cities. Mean age was 24.3 years old (SD=5.8) and 54.4% were male. Six percent of the sample self-reported consuming illicit substances at the time of interview; 7.3% at nightclub venues, 11.8%in the street, 5.5% in pubs and 2.8% in bars. Amphetamines, methamphetamines and ecstasy accounted for two thirds of substance use. Patrons who reported consuming illicit drugs were 1.90 times as likely to be involved in a prior violent incident (OR 1.35-2.70 95%CI, p<0.001). Participants who reported illicit drug use at time of interview were likely to be 0.89 (p<0.001) points higher on self-reported intoxication scale (0-10), and were more likely to have engaged in high risk alcohol consumption Χ 2 (1, n=3,396)=9.63, p<0.01) than those who did not report using drugs. Illicit drug use contributes significantly to the burden of harm and intoxication in nighttime environments, despite being a minority behaviour.

Consumption plans for the rest of the night among Australian nightlife patrons

“…The current findings also have important implications for nightlife safety strategies, given intoxicated patrons intended to consume more alcohol, energy drinks, AmEDs, and illicit drugs, all of which are associated with increased likelihood of experiencing alcohol-related harm or an aggressive incident (Miller et al, 2015;. Our findings reinforce the importance of responsible service of alcohol within the nightlife, as the intention to consume more alcohol in these areas can be addressed with appropriate implementation and enforcement of such policies in licensed venues, which is in line with findings from the community-based interventions in California and Stockholm (Holder et al, 2000;Wallin et al, 2005;Wallin et al, 2003), and with recommendations by Bellis et al (2010).…”

Drug testing, accuracy and harm reduction: a response to Barratt & Ezard

“…Recent work in the United States comparing usual care (in this instance, forced withdrawal from OST) to continued OST demonstrated that entry to community OST within 1 month of prison release was twice as likely among those who remained in OST while in custody [5]. These findings [3,5,7] suggest that examining outcomes of prison OST in isolation from the broader context of treatment as a process that continues prior to, during and after imprisonment is inadequate for understanding treatment effects. We urge researchers in this field to take into account the complementary impacts of OST in prison and post-release.…”

“…We have undertaken this work previously in New South Wales, Australia. In this setting, OST provided in prison reduced deaths in custody [6]; OST in prison immediately prior to release was highly protective against post-release death in the short term, but ongoing OST in the community was needed to maintain this protective effect [3]. Similar findings have been reported in relation to re-incarceration; although OST in prison does not, itself, protect against re-incarceration, remaining in OST when transitioning from custody to the community is associated with a 20% decrease in the risk of re-incarceration [7].…”

“…Nevertheless, we are more confident in these findings than studies which rely simply on self-report, including our own [3]. While there are limitations associated with the drug tests used, we followed the same procedures outlined in the manuals and undertaken by police in roadside drug testing.…”

“…Bird & Hutchinson were among the first to highlight the risk of post-release mortality and the importance of addressing this particular risk [2]. Opioid substitution therapy (OST) while in custody has been proposed as a means to decrease post-release drug-related deaths, through maintenance of opioid tolerance and reduced likelihood of illicit opioid use [3,4] and improved linkage to treatment after release [5]. Bird and colleagues reported recently that the proportion of drug-related deaths across Scotland in the 12 weeks following release from prison that occurred within the first 2 weeks post-release did not change following the introduction of OST in Scottish prisons [4].…”