Wiley: Drug and Alcohol Review: Table of Contents

Features of Alcohol Harm Reduction Campaigns That Resonate With Older Adults: Insights From an Australian Qualitative Study Using Prompt Videos

Thu, 02 Apr 2026 10:00:08 -0700

ABSTRACT

Introduction

Many countries around the world including Australia, New Zealand, England and the United States of America face increasing alcohol use and alcohol-related harms amongst the ageing population. Despite alcohol being linked to diseases such as cancer and dementia, many conventional alcohol harm reduction campaigns don't resonate with older audiences. This qualitative study aimed to investigate what features of alcohol harm reduction campaigns appeal to a middle-aged and older audience.

Methods

In-depth interviews were conducted with 45 Australian participants aged 54–74 years (mean age 62 years, 62% female, 42% drinking beyond national guidelines). Data analysis followed an inductive thematic approach.

Results

Participants reflected on the construction of their own drinking identities, provided feedback on six pre-existing alcohol harm reduction campaigns, and expressed their preferences for future campaigns. Some participants felt defensive or conflicted about whether alcohol harm reduction campaigns would be appropriate or effective with their demographic. Despite this, participants broadly endorsed campaigns that employed a more positive tone, provided practical advice, and were delivered by a relatable messenger.

Discussion and Conclusion

Findings suggest the use of motivational messaging, as delivered by a non-authoritarian and gender-matched messenger, for future campaigns with this demographic may reduce expressed resistance to health messaging. This large qualitative study generated rich, novel, and nuanced accounts of older adults' perspectives on alcohol harm reduction campaigns.

Executive Functions in Alcohol Use Disorder: The Positive Role of Neuropsychological Rehabilitation—Prospective Cohort Study

Thu, 02 Apr 2026 00:25:18 -0700

ABSTRACT

Introduction

Executive functioning (EF) consists of basic components (inhibition, working memory [WM] and flexibility) and more complex components that depend on the proper functioning of the basic components. Deficits in EF are common in alcohol use disorder (AUD) and can impact treatment effectiveness and quality of life. This study examined the impact of neuropsychological rehabilitation (NR) on improving these functions.

Method

A prospective observational cohort study was conducted in an AUD treatment unit, with three evaluation points: baseline and after 3 and 6 months. The study compared EF recovery in patients undergoing group therapy for AUD (WTG: weekly therapeutic groups; NRG: NR group). The sample consisted of 65 participants who underwent medically assisted detoxification from April 2021 to August 2023. The following instruments were administered: a sociodemographic questionnaire, the Hospital Anxiety and Depression Scale, the Dependency Severity Questionnaire, the Frontal Assessment Battery (FAB), the Wisconsin Card Sorting Test, the Trail Making Test, the Verbal Fluency Test, the Wechsler Adult Intelligence Scale and the Colour and Word Test—Stroop. Statistical procedures included parametric and nonparametric tests and linear mixed-effects models.

Results

EF improved in both groups, but the NRG showed a higher increase in The FAB after 3 months, which was reflected in better performance in its key components (WM and flexibility). This improvement was maintained 6 months after the start of treatment.

Discussion and Conclusions

Integrating NR into AUD treatments appears to contribute to greater and faster improvement.

Approach With Caution: A Pilot Randomised Controlled Trial of Approach Bias Modification for People Undergoing Residential Treatment for Methamphetamine Use Disorder

Wed, 01 Apr 2026 07:25:51 -0700

ABSTRACT

Introduction

Less than one-quarter of people who attend residential rehabilitation for methamphetamine use disorder (MUD) remain abstinent for 1 year. Approach bias modification (ApBM), a cognitive training intervention, reduces relapse rates when delivered during residential rehabilitation for alcohol use disorder. However, there has been little research on ApBM for MUD.

Methods

Twenty-four patients with MUD attending four residential treatment services in Melbourne were randomised, between March 2020 and August 2024, to 6 sessions of either ApBM (n = 10) or sham-control training (n = 14). Safety was monitored during the intervention and acceptability was assessed at the end of training. A blinded researcher assessed methamphetamine use, craving, and dependence severity at follow-ups 1 and 3 months after discharge from residential treatment.

Results

Three ApBM and five control participants experienced adverse psychological reactions to the training task, resulting in two ApBM and 1 control participants withdrawing. However, participants who completed training generally provided positive acceptability ratings (mean Endorsement and Discomfort Scale scores of 69.13 [SD = 10.93] in the ApBM group and 58.83 [SD = 13.41] in controls). Directions of differences in proportions reporting past-month abstinence at 1-month (ApBM: 5/7 [71%]; controls: 5/11 [46%]) and 3-month follow-ups (ApBM: 4/7 [57%]; controls: 3/9 [33%]) and continuous abstinence at 3-month follow-up (ApBM: 3/7 [43%]; controls: 2/11 [18%]) favoured ApBM; however, these differences did not approach significance in this very small sample. Craving and MUD severity outcomes also did not differ significantly between groups.

Discussion and Conclusions

Further research on ApBM's efficacy for MUD may be warranted, but safety concerns suggest caution.

Trial Registration: Australian New Zealand Clinical Trials Registry ACTRN12620000072910. Registered on 30 January 2020 (prospectively registered): https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=378804&isReview=true.

What Are the Characteristics of Households That Purchase Alcohol‐Free and Low‐Alcohol Drinks in Great Britain in 2018 and 2021?

Wed, 01 Apr 2026 03:29:47 -0700

ABSTRACT

Introduction

The increasing popularity of alcohol-free and low-alcohol (NoLo) drinks could reduce alcohol-related harm if those at greatest risk replace their standard alcoholic drinks with these products. This paper aimed to identify: (i) characteristics associated with occasional purchase of NoLo drinks in Great Britain in 2021; and (ii) whether these characteristics changed between 2018 and 2021.

Methods

Logistic regression using data from Worldpanel by Numerator dataset detailing alcoholic and NoLo drink purchases in the off-trade (i.e., shops) by households in Great Britain in 2018 (n = 14,702) and 2021 (n = 15,257). The primary outcome was occasional NoLo purchasing (≥ 4 times in the past year), and secondary outcomes were occasional NoLo beer, cider or wine purchasing.

Results

In 2021, 5.7% of households purchased NoLo ≥ 4 in the past year, compared to 3.0% in 2018. In 2021, these households were more likely to be alcohol purchasers than non-purchasers [low-risk purchasers (≤ 112 g per week): OR = 7.11, p < 0.001; increasing risk (113–280 g per week): OR = 10.72, p < 0.001; higher risk (> 280 g per week): OR = 12.10, p < 0.001] and less likely to be from lower social grades than grade AB (Grade C2: OR = 0.72, p = 0.008; Grade D: OR = 0.58, p < 0.001; Grade E: OR = 0.46, p < 0.001). Results were similar for occasional purchasers of NoLo beer, but there was no significant association with social grade for purchasing NoLo cider or wine. The characteristics associated with occasional NoLo purchasing did not change significantly between 2018 and 2021.

Discussion and Conclusions

Households from higher social grades who purchase more alcohol are more likely to regularly purchase NoLo products.

Higher THC Concentration Medicinal Cannabis Products Efficacy and Safety Considerations: A Rapid Review

Myfanwy Graham, Dereje Assefa, Ngo Cong‐Lem, Suzanne Nielsen — Wed, 01 Apr 2026 00:07:00 -0700

ABSTRACT

Issues

Higher delta-9-tetrahydrocannabinol (THC) concentration medicinal cannabis products are characterised by a higher THC and minimal cannabidiol (CBD) content. This rapid review aims to systematically summarise and evaluate the available evidence regarding the efficacy and safety of higher THC potency medicinal cannabis products relevant to the Australian market in adult populations.

Approach

The rapid literature review protocol was prospectively registered with Open Science Framework: https://doi.org/10.17605/OSF.IO/HNFUT. The comprehensive search (1-January-2014–30-July-2024) included Medline, EMBASE, EMCARE, CINAHL, SCOPUS and the Cochrane Central Register of Controlled Trials databases. Eligible studies (randomised controlled trials and observational studies) were screened by two independent reviewers and then extracted.

Key Findings

We identified 9969 records, resulting in 15 studies (six RCTs and nine observational), with THC concentrations of 16%–22% that met inclusion criteria. Studies examining efficacy for pain (n = 4), ulcerative colitis (n = 1) and chronic obstructive pulmonary disease (n = 1) reported mixed outcomes. Reported adverse events included psychiatric, nervous system and gastrointestinal effects. Validated cannabis use disorder (CUD) screening tools were notably absent from the included studies.

Implications

Few studies have assessed products equivalent to the Australian Category 5 medicinal cannabis product definition, with most having THC concentrations lower than those available for prescription in Australia, including products reported to contain up to 88% THC. High-quality RCTs and longitudinal studies that incorporate validated CUD screening tools are needed.

Conclusion

No evidence was found on safety or efficacy of prescribed Category 5 medicinal cannabis products with THC concentrations above 22% w/w (220 mg/g).

Rethinking Alcohol Harm Reduction

Gabriel Caluzzi — Tue, 31 Mar 2026 03:36:02 -0700

ABSTRACT

Alcohol harm reduction (AHR) includes a pragmatic set of strategies to reduce the acute harms of alcohol consumption without necessarily reducing use, such as managed alcohol plans and intoxication management facilities. While well established in illicit drug research, harm reduction's application to alcohol remains less explicitly examined, both conceptually and in terms of policy articulation. In contrast to population-level consumption-reduction strategies – many of which are effective at preventing harm – AHR often places greater emphasis on acute and immediate harms and may require consumers to take an active role, a feature that has raised concerns about industry mobilising ‘responsible drinking’ narratives. AHR also tends to be subsumed within other alcohol policies and has a less consolidated evidence base. However, drawing on international and Australian evidence, this article outlines practical and ethical reasons for a more explicit focus on AHR, including the substantial burden alcohol places on frontline health systems, its disproportionate impacts on socially disadvantaged populations and its frequent involvement in polydrug use and overdose. AHR can also facilitate cross-sectoral collaboration and lateral policymaking, and contribute to the ethical obligation of policymakers to redress the harms of alcohol commercialisation. Beyond formal policy, AHR already occurs in clinical, educational and nightlife settings. Recognising this, future research and policy efforts should focus on clarifying how harm reduction can be more explicitly integrated within alcohol policy frameworks to complement population-level approaches.

Systematic Review and Meta‐Analysis of the Prevalence of Substance Use Among Adolescents in South Africa

Sun, 29 Mar 2026 21:32:24 -0700

ABSTRACT

Introduction

Substance use among young people is a growing public health concern in South Africa (SA), with implications for short- and long-term mental health, education and development. A lack of use data is among several challenges impeding progress to support young people. To address this gap, this study aimed to synthesise published prevalence data on substance use among adolescents under 19 years of age in SA.

Methods

We conducted a systematic review and meta-analysis following PRISMA guidelines. Searches were run across PubMed, PsycINFO, Web of Science and Scielo. Studies reporting original SA prevalence data in community or school-based samples were included. The Joanna Briggs Institute checklist for prevalence studies was used to assess study quality. Meta-analyses were performed in R, using random effects models and heterogeneity was assessed using I ² statistics and meta-regression.

Results

Thirty publications met inclusion criteria, and these reported 202 prevalence estimates (n = 120,041, mean age 16.1 years). The most commonly reported substances used were alcohol (35.09%, 95% CI 23.83–48.30), tobacco (25.47%, 95% CI 14.56–33.01) and cannabis (10.47%, 95% CI 5.98–17.71) with lifetime prevalence of any substance use of 13.05%, 95% CI 9.65–17.42. Similarly, 12-month data indicated high exposure levels: alcohol 17.45% (95% CI 11.39–25.78), tobacco 11.57% (95% CI 8.92–14.88) and cannabis 6.66% (95% CI 4.82–9.13). However, substantial heterogeneity across studies was detected.

Discussion and Conclusions

High exposure to substances in SA, especially alcohol, tobacco and cannabis, underscores the urgent need for nationally representative surveillance and evidence-based prevention efforts tailored to adolescents, to avoid progression of substance use into substance use disorder.

Issue Information

Sun, 29 Mar 2026 21:29:02 -0700

Drug and Alcohol Review, Volume 45, Issue 4, May 2026.