Curiosity Killed the M-Cat: an Examination of Illicit Drugs and Media

Using mainstream media communication theories, this article outlines different mechanisms by which media can impact on public perceptions of drugs and crime. The media can set the agenda and define public interest; frame issues through selection and salience; indirectly shape individual and community attitudes towards risk and norms; and feed into political debate and decision making. We demonstrate how the media can fulfill each of these roles by examining the so-called Miaow Miaow (Mephedrone) legal high ‘epidemic’, as reported in the United Kingdom news media from 2009-2010. In doing so we illustrate that by contributing to hysteria, exerting pressure for policy change and increasing curiosity in drug use, the media can have a potentially powerful impact on demand for drugs and public perceptions of illicit drugs and drugs policy.Sydney Institute of Criminology; School of Social Sciences at the University of Western Sydne

Media reporting on illicit drugs in Australia: Trends and impacts on youth attitudes to illicit drug use

News media ought to be recognised as one of the factors that can affect attitudes towards and demand for illicit drugs and there is an opportunity to expand use of news media to shape youth attitudes to drugs. This research funded by the Commonwealth Department of Health and Ageing explored the ways that the Australian print media portrays illicit drug use and how this impacts on youth attitudes. The research method included a retrospective content analysis of 4,397 newspaper articles from 2003 to 2008; a national online survey of 2,296 youth aged 16-24 who reported on the impact of various portrayals on their perception of the risk, acceptability and likelihood of future illicit drug use; and an exploration of media effects on 52 youth attending focus groups. The media content analysis provides a detailed overview of what is making illicit drugs appear in Australian news media, the implied consequences of drug use, moral evaluation of drug use, and the number and type of sources cited in current newspaper reporting. The dominant portrayals in Australian newspaper coverage depicted law enforcement or criminal justice action, and emphasised the legal problems associated with drugs/use. Coverage of harms from illicit drugs was much more rare. The survey indicated that news media reporting can deter interest in illicit drug use. But the most effective reports for deterring interest are currently under-reported in Australian news media. This is because the most effective reports covered health and social harms. These were more effective than the reports on law enforcement arrests or drug busts. The research concludes that, while exploratory, it suggests news media ought to be recognised as one of the factors that can affect attitudes towards and demand for illicit drugs and there is an opportunity to expand use of news media to shape youth attitudes to drugs through more targeted media engagement about health and social harms from drug use. The report and a 4 page summary of the report can be downloaded from the DPMP website: www.dpmp.unsw.edu.au   Citation: Hughes, C., Spicer, B., Lancaster, K, Mathew-Simmons, F., & Dillon, P. (2010). Monograph No. 19: Media reporting on illicit drugs in Australia: Trends and impacts on youth attitudes to illicit drug use. DPMP Monograph Series. Sydney: National Drug and Alcohol Research Centre

What drives the high health care costs of the homeless?

Existing research demonstrates that mean health care costs incurred by those experiencing homelessness are high. However, high mean health care costs mask the fact that a sizeable number of people experiencing homelessness incur low costs and that very high costs are driven by a minority of the homeless population. This paper examines health care costs estimated from two Australian surveys of those experiencing homelessness undertaken by the authors. It demonstrates three important findings. First, higher health care costs are most strongly associated with diagnosed mental health disorders, followed by long-term physical health conditions. Second, having a current drug or alcohol dependency, but no diagnosed mental health disorder or long-term physical health issue, is not associated with higher level health care costs. Finally, higher health care costs are incurred by those with long periods of rough sleeping. The findings of this research provide a significant economic argument for government intervention to break the cycle of homelessness as they reveal significant potential savings to effective interventions for homeless people with diagnosed mental health disorders and long-term rough sleeping

Mental illness and housing outcomes among a sample of homeless men in an Australian urban centre

Objective: The over-representation of mental illness among homeless people across the globe is well documented. However, there is a dearth of Australian literature on the mental health needs of homeless individuals. Furthermore, longitudinal research examining the factors that contribute to better housing outcomes among this population is sparse. The aim of this research is to describe the mental illness profile of a sample of homeless men in an Australian urban centre (in Sydney) and examine the factors associated with better housing outcomes at 12-month follow-up. Methods: A longitudinal survey was administered to 253 homeless men who were involved in the Michael Project: a 3-year initiative which combined existing accommodation support services with assertive case management and access to coordinated additional specialist allied health and support services. A total of 107 participants were followed up 12 months later. The survey examined the demographics of the sample and lifetime mental disorder diagnoses, and also included psychological screeners for current substance use and dependence, psychological distress, psychosis, and posttraumatic stress. Results: Consistent with existing literature, the prevalence of mental illness was significantly greater amongst this sample than the general Australian population. However, mental illness presentation was not associated with housing situation at 12-month follow-up. Instead, type of support service at baseline was the best predictor of housing outcome, wherein participants who received short to medium-term accommodation and support were significantly more likely to be housed in stable, long-term housing at the 12-month follow-up than participants who received outreach or emergency accommodation support. Conclusions: This study provides evidence to support an innovative support model for homeless people in Australia and contributes to the limited Australian research on mental illness in this population

The Cost of Homelessness and the Net Benefit of Homelessness Programs: A National Study: Findings from the Baseline Client survey

This is the first of two Final Reports from the present AHURI Cost of Homelessness study. It outlines the methodological framework for the study, describes the homelessness support environment and reports on the Baseline Client Survey, including a preliminary analysis of the cost-effectiveness of the programs examined and the extent to which it is possible to identify quasi-experimental comparison groups for the target treatment groups

The Cost of Homelessness and the Net Benefit of Homelessness Programs: A National Study: Findings from the Baseline Client survey

This is the first of two Final Reports from the present AHURI Cost of Homelessness study. It outlines the methodological framework for the study, describes the homelessness support environment and reports on the Baseline Client Survey, including a preliminary analysis of the cost-effectiveness of the programs examined and the extent to which it is possible to identify quasi-experimental comparison groups for the target treatment groups

The Michael Project, 2007-2010: New Perspectives and Possibilities for Homeless Men

On Census night 2006, almost 105,000 people were homeless in Australia, an increase of almost five per cent over the preceding five year period. In 2008, the Australian Government set out a national approach to reducing homelessness, with headline targets of halving overall homelessness and offering supported accommodation to all rough sleepers who need it by 2020, along with a range of sub-targets (Commonwealth of Australia, 2008). Mission Australia has been supporting people experiencing homelessness since the middle of the nineteenth century. As a major national not-for-profit agency, Mission Australia has long sought to develop innovative responses to emerging social issues. With the benefit of a philanthropic donation, Mission Australia developed an innovative service pilot project, the Michael Project (2007-2010), to work towards better outcomes with men experiencing homelessness in the Sydney metropolitan region

Pretreatment prediction of response to ursodeoxycholic acid in primary biliary cholangitis: development and validation of the UDCA Response Score

Background: Treatment guidelines recommend a stepwise approach to primary biliary cholangitis: all patients begin treatment with ursodeoxycholic acid (UDCA) monotherapy and those with an inadequate biochemical response after 12 months are subsequently considered for second-line therapies. However, as a result, patients at the highest risk can wait the longest for effective treatment. We determined whether UDCA response can be accurately predicted using pretreatment clinical parameters. Methods: We did logistic regression analysis of pretreatment variables in a discovery cohort of patients in the UK with primary biliary cholangitis to derive the best-fitting model of UDCA response, defined as alkaline phosphatase less than 1·67 times the upper limit of normal (ULN), measured after 12 months of treatment with UDCA. We validated the model in an external cohort of patients with primary biliary cholangitis and treated with UDCA in Italy. Additionally, we assessed correlations between model predictions and key histological features, such as biliary injury and fibrosis, on liver biopsy samples. Findings: 2703 participants diagnosed with primary biliary cholangitis between Jan 1, 1998, and May 31, 2015, were included in the UK-PBC cohort for derivation of the model. The following pretreatment parameters were associated with lower probability of UDCA response: higher alkaline phosphatase concentration (p<0·0001), higher total bilirubin concentration (p=0·0003), lower aminotransferase concentration (p=0·0012), younger age (p<0·0001), longer interval from diagnosis to the start of UDCA treatment (treatment time lag, p<0·0001), and worsening of alkaline phosphatase concentration from diagnosis (p<0·0001). Based on these variables, we derived a predictive score of UDCA response. In the external validation cohort, 460 patients diagnosed with primary biliary cholangitis were treated with UDCA, with follow-up data until May 31, 2016. In this validation cohort, the area under the receiver operating characteristic curve for the score was 0·83 (95% CI 0·79–0·87). In 20 liver biopsy samples from patients with primary biliary cholangitis, the UDCA response score was associated with ductular reaction (r=–0·556, p=0·0130) and intermediate hepatocytes (probability of response was 0·90 if intermediate hepatocytes were absent vs 0·51 if present). Interpretation: We have derived and externally validated a model based on pretreatment variables that accurately predicts UDCA response. Association with histological features provides face validity. This model provides a basis to explore alternative approaches to treatment stratification in patients with primary biliary cholangitis. Funding: UK Medical Research Council and University of Milan-Bicocca