Characteristics of individuals presenting to treatment for primary alcohol problems versus other drug problems in the Australian patient pathways study

Background: People seeking treatment for substance use disorders often have additional health and social issues. Although individuals presenting with alcohol as the primary drug of concern (PDOC) account for nearly half of all treatment episodes to the Australian alcohol and other drug (AOD) service system, previous treatment cohort studies have focused only on the profile of Australian heroin or methamphetamine users. While studies overseas indicate that clients seeking treatment primarily for their drinking are less likely to experience social and economic marginalisation than those seeking treatment primarily for illicit or pharmaceutical drug use, very little research has directly compared individuals presenting with alcohol as the PDOC to those primarily presenting with other drugs as their PDOC. Methods: Seven hundred and ninety-six participants were recruited at entry to specialist AOD treatment in Victoria and Western Australia, and completed measures of demographic and social factors, substance use, quality of life, service use, and criminal justice involvement. We compared those with alcohol as their PDOC to those with other drugs as their PDOC using Pearson chi-square and Mann–Whitney U tests. Results: Rates of social disadvantage, poor quality of life, high severity of substance dependence, and past-year AOD, mental health, acute health, and social service use were high in all groups. However, participants with alcohol as the PDOC were older; more likely to have an educational qualification; less likely to report criminal justice involvement, housing/homelessness service use, tobacco smoking, or problems with multiple substances; and reported better environmental quality of life; but were more likely to have used ambulance services, than those with other drugs as their PDOC. Conclusions: While those seeking treatment primarily for alcohol problems appear less likely to suffer some forms of social and economic disadvantage or to use multiple substances than those with a primary drug problem, they experience similarly high levels of substance dependence severity and mental health and AOD service use. These findings reinforce the need for AOD services to integrate or coordinate care with programs that address the many complexities clients frequently present with, while also acknowledging differences between those seeking treatment for alcohol versus other drug problems

Substance use outcomes following treatment : findings from the Australian Patient Pathways Study

Background and Aims: Our understanding of patient pathways through specialist Alcohol and Other Drug (AOD) treatment and broader health/welfare systems in Australia remains limited. This study examined how treatment outcomes are influenced by continuity in specialist AOD treatment, engagement with non-AOD community services, and mutual aid, as well as exploring differences between clients who present with a primary alcohol problem compared to those presenting with a primary drug issue. Method: In a prospective, multi-site treatment outcome study, 796 clients from 21 AOD services in Victoria and Western Australia completed a baseline interview between January 2012 and January 2013. 555 (70%) completed follow-up assessment of subsequent service use and AOD use outcomes 12-months later. Results: Just over half of the participants (52.0%) showed reliable reductions in use of, or abstinence from, their primary drug of concern. This was highest among clients who reported meth/amphetamine (66%) as their primary drug of concern and lowest among those who reported alcohol (47%), with 31% achieving abstinence from all drugs of concern. Continuity of specialist AOD care was associated with higher rates of abstinence than fragmented AOD care. Different predictors of treatment success emerged for clients with a primary drug problem as compared to those with a primary alcohol problem; mutual aid attendance (OR=2.5) and community service engagement (OR=2.0) for clients with alcohol as PDOC, and completion of the index treatment (OR=2.8) and continuity in AOD care (OR=1.8) for those with primary drug issues. Conclusion: This is the first multi-site Australian study to include treatment outcomes for alcohol and cannabis users, who represent 70% of treatment seekers in AOD services. The results suggest a substantial proportion of clients respond positively to treatment, but that clients with alcohol as their primary drug problem may require different treatment pathways, compared to those with illicit drug issues, to achieve desirable outcomes

The sources, impact and management of car park runoff pollution: a review

Traffic emissions contribute significantly to the build-up of diffuse pollution loads on urban surfaces with their subsequent mobilisation and direct discharge posing problems for receiving water quality. This review focuses on the impact and mitigation of solids, metals, nutrients and organic pollutants in the runoff deriving from car parks. Variabilities in the discharged pollutant levels and in the potentials for pollutant mitigation complicate an impact assessment of car park runoff. The different available stormwater best management practices and proprietary devices are reported to be capable of reductions of between 20% and almost 100% for both suspended solids and a range of metals. This review contributes to prioritising the treatment options which can achieve the appropriate pollutant reductions whilst conforming to the site requirements of a typical car park. By applying different treatment scenarios to the runoff from a hypothetical car park, it is shown that optimal performance, in terms of ecological benefits for the receiving water, can be achieved using a treatment train incorporating permeable paving and bioretention systems. The review identifies existing research gaps and emphasises the pertinent management practices as well as design issues which are relevant to the mitigation of car park pollution

A philosophical base for urban morphology

Urban Morphology3295-9

Bridging the Gap: Educating family members from migrant communities about seeking help for depression, anxiety and substance misuse in young people

The project fills an important gap in the evidence in terms of barriers and facilitators to help-seeking among young African migrants, their family and communities. The findings of this report can be used by a variety of relevant stakeholders, including recently arrived migrant communities and services, health care providers, and policy makers. Community: - Parents have poor mental health literacy about how to address mental health and alcohol and drug issues in their son or daughter. - Parents were often unsure how to approach the issues without creating conflict with their son or daughter. - High levels of stigma related to mental health and alcohol and drug problems were commonly reported, which was a significant obstacle to seeking professional help. - Differing levels of community connection meant some recently arrived communities lacked the necessary social capital to support young people. Health care providers: - There was limited awareness of available mental health and alcohol and drug specific services, particularly among parents. - Parental concerns around the cultural competency of health professionals meant this form of support may not be viewed as a viable or preferred option. - The financial cost of accessing and receiving professional treatment was identified as a barrier to help-seeking. Policy makers: - Migrant communities welcomed the opportunity to come together and talk about health-related issues affecting young people and the difficulties their parents may have around having a conversation with young people about mental health and alcohol and drug problems. - The health promotion resource has the potential to normalise difficulties encountered by parents when parenting their son or daughter in a new cultural context and to discuss topics that carry significant stigma. - The resource was well received and was considered helpful, relevant and appropriate