The Age of Onset of Alcohol Use Disorders

Individuals with an alcohol use disorder account for around half of all the alcohol-related harm in developed societies and contribute to around 4% of global disease burden. In the USA, around 18% of men and 10% of women met DSM-5 criteria for alcohol use disorder in the past year. This chapter summarizes what we know about cultural, environmental and genetic factors associated with age of alcohol onset patterns and what remains to be understood. It examines factors associated with alcohol use initiation and the relationship between onset, severity of alcohol use disorders and individual functioning. It assesses patterns of early and late alcohol use as possible clinical markers for more effective treatment and prevention approaches. Evidence on the effectiveness of public policies to delay age of onset is reviewed. The existing evidence is considered in light of methodological challenges in age of onset research, particularly in establishing a possible causal role for early onset of drinking in risk of developing alcohol use disorders

The Age of Onset of Substance Use Disorders

Illicit drug use frequently starts during adolescence and young adulthood. Early initiation of illicit drug use in this period is associated with continued drug use in adulthood, the development of dependence, polydrug use and a number of adverse social, educational and mental health outcomes. Understanding when and why illicit drug use starts has important implications for preventing a major source of personal and financial cost to individuals, families and communities. In this chapter, we review research on the prevalence of drug use in the early years, the impact of early illicit drug use on psychosocial outcomes in young adulthood and widely researched models that explain the early initiation of drug use. We explore the implications of evidence-based models for prevention of the early initiation of illicit drug use

Lee Robins' studies of heroin use among US Vietnam veterans

The work of Robins and her colleagues on heroin addiction among Vietnam veterans sets out in microcosm many of the key factors that play out in the development and maintenance of substance addiction beyond the pharmacology of the drug: price, availability, the process of delivery of the addictive substance, availability of other substances, social norms, education and life circumstances. Robins' studies found high rates of heroin use (34%) and symptoms of heroin dependence (20%) among US soldiers while serving in Vietnam. In the first year after returning to the United States only 1% became re-addicted to heroin, although 10% tried the drug after their return. Like other seminal studies, this work needs to be read in the original, because relying upon secondary interpretations risks being given a selectively edited version of their findings in service of varied policy and theoretical agendas

Money Stories: Financial resilience among Aboriginal and Torres Strait Islander Australians

This report builds on previous work on financial resilience in Australia and represents the beginning of an exploration of the financial resilience of Aboriginal and Torres Strait Islander peoples. Overall, we found significant economic disparity between Indigenous and non-Indigenous Australians. This is not surprising, given the histories of land dispossession, stolen wages and the late entry of Indigenous Australians into free participation in the economy (it is only 50 years since the referendum to include Aboriginal and Torres Strait Islander peoples as members of the Australian population)

Researchers’ perspectives on scientific and ethical issues with transcranial direct current stimulation: An international survey

In the last decade, an increasing number of studies have suggested that transcranial direct current stimulation (tDCS) may enhance brain function in healthy individuals, and ameliorate cognitive and other symptoms in patients suffering from various medical conditions. This, along with its presumed safety, simplicity, and affordability, has generated great enthusiasm amongst researchers, clinicians, patient populations, and the public (including a growing "do-it-yourself" community). However, discussion about the effectiveness and ethics of tDCS thus far has been confined to small groups of tDCS researchers and bioethicists. We conducted an international online survey targeting the opinions of researchers using tDCS who were asked to rate the technique's efficacy in different contexts. We also surveyed opinions about ethical concerns, self-enhancement and public availability. 265 complete responses were received and analyzed statistically and thematically. Our results emphasize the potential uses of tDCS in clinical and research contexts, but also highlight a number of emerging methodological and safety concerns, ethical challenges and the need for improved communication between researchers and bioethicists with regard to regulation of the device. Neither the media reputation of tDCS as a "miracle device" nor concerns expressed in recent neuroethical publications were entirely borne out in expert opinion