The Australasian Professional Society on Alcohol and other Drugs

Current Issue

March 2022, Volume 41, Issue 3

The March 2022 issue (41:3) features research alcohol-related research on COVID-19 lessons for alcohol policy; zero-alcohol beverages; non-alcoholic beer in the European Union and UK; a commentary and response on a content analysis of news media coverage around Sydney’s ‘last drinks’ laws; improving measurement of harms from others’ drinking; the convergent and incremental validity of informant-reported drinking motives; electroencephalographic neurofeedback as a tool for reducing harm and risk associated with alcohol use disorder; predictors of length of treatment, discharge reason, and re-admission to Aboriginal alcohol and other drug residential rehabilitation services in New South Wales; Indigenous Australian drinking risk; children with problem drinking parents in Sweden; role of alcohol taxes in moderating alcohol consumption; feasibility and preliminary effectiveness of internet-mediated ‘relapse prevention therapy’ for patients with alcohol use disorder; impact of minimum unit pricing on shifting purchases from higher to lower strength beers in Scotland; and unrecorded alcohol consumption in Thailand.

Other papers focussed on HIV prevalence among non-injecting people who use drugs; prevalence and factors associated with chronic venous insufficiency, leg ulceration and deep-vein thrombosis among people who inject drugs; gender and the first-time provision of injection initiation assistance among people who inject drugs across two distinct North American contexts; development and assessment of a community-based screening tool for mental health disorders among people who inject drugs; and client resistance to hepatitis C treatment initiation in opioid agonist treatment clinics in Sydney.


Virtual Issues

Cannabis legalisation and its impact on access, use and public perceptions

Music Festival Context as a Site for Alcohol/Drug UseMusic Festival Context as a Site for Alcohol/Drug Use






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Comprehensive Reviews

Health harms of non-medical prescription opioid use: A systematic review
Dan Werb, Ayden I. Scheim, Ayorinde Soipe, Samantha Aeby, Indhu Rammohan, Benedikt Fischer, Scott E. Hadland, Brandon D. L. Marshall
18 April 2022 | DOI:

Change in alcohol outcome expectancies from childhood to emerging adulthood: A meta-analysis of longitudinal studies
Martin Pinquart, Katharina Borgolte
2 March 2022 | DOI:

Changes in alcohol use during the COVID-19 pandemic in Europe: A meta-analysis of observational studies
Carolin Kilian, Amy O'Donnell, Nina Potapova, Hugo López-Pelayo, Bernd Schulte, Laia Miquel, Blanca Paniello Castillo, Christiane Sybille Schmidt, Antoni Gual, Jürgen Rehm, Jakob Manthey
20 February 2022 | DOI:

Mapping the research addressing prescription drug monitoring programs: A scoping review
Dimi Hoppe, Leila Karimi, Hanan Khalil
1 February 2022 | DOI:

A qualitative meta-synthesis of pregnant women's experiences of accessing and receiving treatment for opioid use disorder
Freya Tsuda-McCaie, Yasuhiro Kotera
17 January 2022 | DOI:

Why do women consume alcohol during pregnancy or while breastfeeding?
Svetlana Popova, Danijela Dozet, Shahela Akhand Laboni, Krista Brower, Valerie Temple
28 December 2021 | DOI:

Is the relapse concept in studies of substance use disorders a ‘one size fits all’ concept? A systematic review of relapse operationalisations
Fredrik D. Moe, Christian Moltu, James R. McKay, Sverre Nesvåg, Jone Bjornestad
18 November 2021 | DOI:


Why are anti-smoking health-information interventions less effective among low-socioeconomic status groups? A systematic scoping review
Tim van Meurs, Feray R. Çoban, Willem de Koster, Jeroen van der Waal, Joost Oude Groeniger
5 April 2022 | DOI:

Health service utilisation and access for people who inject drugs during COVID-19
Henrietta Efunnuga, Peter Higgs, Shelley Walker, Daniel O'Keefe
9 March 2022 | DOI:

Social recovery in substance use disorder: A metasynthesis of qualitative studies
Mariann Iren Vigdal, Christian Moltu, Jone Bjornestad, Lillian Bruland Selseng
1 February 2022 | DOI:


Original Papers

The Overdose Response with Take Home Naloxone (ORTHN) project: Evaluation of health worker training, attitudes and perceptions
Lauren A. Monds, Maria Bravo, Llewellyn Mills, Annie Malcolm, Rosie Gilliver, William Wood, Mary Ellen Harrod, Phillip Read, Suzanne Nielsen, Paul M. Dietze, Simon Lenton, Anne M. Bleeker, Nicholas Lintzeris
20 April 2022 | DOI:

Nationwide Alcohol-related visits In Singapore's Emergency departments (NAISE): A retrospective population-level study from 2007 to 2016
Zhenghong Liu, Desmond Ren-Hao Mao, Stephanie Fook-Chong, Charles Chia Meng Mak, Xi Xiang Esther Tan, Jun Tian Wu, Kelvin B. Tan, Marcus Eng Hock Ong, Fahad J. Siddiqui
19 April 2022 | DOI:

Hospitalisation with injection-related infections: Validation of diagnostic codes to monitor admission trends at a tertiary care hospital in Melbourne, Australia
Stephanie J. Curtis, Freya J. Langham, Mei Jie Tang, Olga Vujovic, Joseph S. Doyle, Colleen L. Lau, Andrew J. Stewardson
11 April 2022 | DOI:

Young people with prior health service contacts have increased risk of repeated alcohol-related harm hospitalisations
Scott A. Sims, Gavin Pereira, David Preen, Daniel Fatovich, Melissa O'Donnell
6 April 2022 | DOI:

The role of alcohol packaging as a health communications tool: An online cross-sectional survey and experiment with young adult drinkers in the United Kingdom
Daniel Jones, Crawford Moodie, Richard I. Purves, Niamh Fitzgerald, Rachel Crockett
6 April 2022 | DOI:

Estimating alcohol-attributable liver disease mortality: A comparison of methods
Adam Sherk, Marissa B. Esser, Tim Stockwell, Timothy S. Naimi
1 April 2022 | DOI:

What do general practitioners want from specialist alcohol and other drug services? A qualitative study of New South Wales metropolitan general practitioners
Hester Wilson, Michelle Schulz, Craig Rodgers, Nicholas Lintzeris, John J. Hall, Ben Harris-Roxas
30 March 2022 | DOI:

A rural ecosystem of recovery: Lessons from substance users' experiences of accessing services in Western Australia's South West
Beatriz Cuesta-Briand, Michael Taran, Mathew Coleman
22 March 2022 | DOI:

Characteristics of fatal tapentadol-related toxicity in Australia
Shane Darke, Johan Duflou, Amy Peacock, Michael Farrell, Julia Lappin
17 March 2022 | DOI:

Predictors of no, low and frequent emergency department use for any medical reason among patients with cannabis-related disorders attending Quebec (Canada) addiction treatment centres
Marie-Josée Fleury, Guy Grenier, Zhirong Cao, Christophe Huỳnh
10 March 2022 | DOI:

Print and online textual news media coverage of UK low-risk drinking guidelines from 2014 to 2017: A review and thematic analysis
Inge Kersbergen, Penny Buykx, Alan Brennan, Jamie Brown, Susan Michie, John Holmes
10 March 2022 | DOI:

Addiction perceptions among users of smokeless or combustible tobacco attending a tertiary care hospital in India
Vaibhav P. Thawal, Flora Tzelepis, Sima Ahmadi, Kerrin Palazzi, Christine Paul
2 March 2022 | DOI:

Barriers and facilitators to accessing effective clinical supervision and the implementation of a clinical supervision exchange model in the Australian alcohol and other drugs sector
Courtney O'Donnell, Sean Popovich, Nicole Lee, Leanne Hides
1 March 2022 | DOI:

Ambulance attendance for substance and/or alcohol use in a pandemic: Interrupted time series analysis of incidents
Rachael Mason, Amanda Roberts, Robert Spaight, Debbie Shaw, Gregory Adam Whitley, Todd E. Hogue, Aloysius Niroshan Siriwardena, Jim Rogers, Graham R. Law
1 March 2022 | DOI:

High cardiovascular risk in older patients with opioid use disorder: Differences with the general population
Gabriel Vallecillo, Juan Pedro-Botet, Silvia Fernandez, Irene Román, Roberto Elosua, Anna Camps, Marta Torrens, Jaume Marrugat
17 February 2022 | DOI:

Intoxication related to substances use in patients presenting to Ain Shams University Poisoning Treatment Center, Cairo, Egypt (2015–2019)
Sonya M. S. Azab, Hany Tawfik, Bryan D. Hayes
17 February 2022 | DOI:

Prevalence and correlates of cannabis use disorder among Australians using cannabis products to treat a medical condition
Llewellyn Mills, Nicholas Lintzeris, Michael O'Malley, Jonathon C. Arnold, Iain S. McGregor
16 February 2022 | DOI:

Substance of choice, impact of heroin or opium on treatment retention in a multicentre randomised controlled trial in Iran
Michael Jae Song, Jean Nicolas Westenberg, Kiana Kianpoor, Mohammadali Nikoo, Alireza Kazemi, Christian Schuetz, Kerry Jang, Ali Gholami, Shahin Akhondzadeh, Michael Krausz
15 February 2022 | DOI:

Pre-drinking behaviour of people in the night-time economy: Evidence from a street-intercept survey in New Zealand
Michael P. Cameron, Peter G. Miller, Matthew Roskruge
13 February 2022 | DOI:

Injecting drug use opportunities and reasons for choosing not to inject: A population-based study of Australian young adults who use stimulants
Luke Edward Casey, Davoud Pourmarzi, Ellen Leslie Wessel, Robert Kemp, Andrew Smirnov
9 February 2022 | DOI:

Examining the cost and impact of dosing fees among clients in opioid agonist treatment: Results from a cross-sectional survey of Australian treatment clients
Emma Zahra, Rory Chen, Suzanne Nielsen, Anh Dam Tran, Thomas Santo Jr, Louisa Degenhardt, Michael Farrell, Jude Byrne, Robert Ali, Briony Larance
7 February 2022 | DOI:

Stigma towards dependent drinking and its role on caregiving burden: A qualitative study from Goa, India
Sonali Kumar, Jaclyn Schess, Richard Velleman, Abhijit Nadkarni
6 February 2022 | DOI:

Capacity for sustainment of recently established syringe service programs in Appalachian Kentucky: The central role of staff championsCapacity for sustainment of recently established syringe service programs in Appalachian Kentucky: The central role of staff champions
Hannah L. F. Cooper, Skylar Gross, Emma Klein, Monica Fadanelli, April Ballard, Scott Lockard, Evan Batty, April Young, Umed Ibragimov
3 February 2022 | DOI:

Evaluating an Aboriginal community controlled residential alcohol and other drug services: Use of benchmarking to examine within treatment changes in wellbeing
Peter J. Kelly, Joe Coyte, Laura D. Robinson, Frank P. Deane, Sophie Russell, Kathleen Clapham, Elizabeth Dale, Marlene Longbottom, Ryan Solley, Amanda L. Baker
1 February 2022 | DOI:

Correlates of e-cigarette use before and after comprehensive regulatory changes and e-liquid flavour ban among general population
Otto Ruokolainen, Hanna Ollila, Karoliina Karjalainen
1 February 2022 | DOI:

The who and what of women's drinking: Examining risky drinking and associated socio-demographic factors among women aged 40–65 years in Australia
Mia Miller, Yvette Mojica-Perez, Michael Livingston, Emmanuel Kuntsche, Cassandra J. C. Wright, Sandra Kuntsche
26 January 2022 | DOI:

Getting high for likes: Exploring cannabis-related content on TikTokGetting high for likes: Exploring cannabis-related content on TikTok
Brienna N. Rutherford, Tianze Sun, Benjamin Johnson, Steven Co, Tong Liang Lim, Carmen C. W. Lim, Vivian Chiu, Janni Leung, Daniel Stjepanovic, Jason P. Connor, Gary C. K. Chan
24 January 2022 | DOI:

The ‘wounded soul’: What alcoholism means to participants of a women-only Alcoholics Anonymous meeting in São Paulo, Brazil
Edemilson Antunes de Campos, Nadia Z. Narchi
5 January 2022 | DOI:

Changes in and correlates of Australian public attitudes toward illicit drug use
Don Weatherburn, Sergey Alexeev, Michael Livingston
28 December 2021 | DOI:

A longitudinal study among young adults into the predictive effect of perceived efficacy of behavioural strategies and the moderating role of drinking motives on use of protective behavioural strategies
Bella M. González-Ponce, José Carmona-Márquez, Carmen Díaz-Batanero, Belén del Valle Vera, Angelina Pilatti, Fermín Fernández-Calderón
19 December 2021 | DOI:

Alcohol access and purchasing behaviour during COVID-19 pandemic restrictions: An exploration of sociodemographic, health and psychosocial correlates in two Canadian provinces
Kathleen MacNabb, Sarah Blades, Kara Thompson, Daniel J. Dutton, Tong Liu, Mark Asbridge
19 December 2021 | DOI:

Perceived unmet substance use and mental health care needs of acute care patients who use drugs: A cross-sectional analysis using the Behavioral Model for Vulnerable Populations
Brynn Kosteniuk, Ginetta Salvalaggio, T. Cameron Wild, Lillian Gelberg, Elaine Hyshka
2 December 2021 | DOI:

The print media's construction of the ‘drug problem’ in Victorian newspapers: The case of North Richmond Community Health's medically supervised injecting room
Bianca Whiteside, Matthew Dunn
21 October 2021 | DOI:

Opioid agonist treatment and patient outcomes during the COVID-19 pandemic in south east Sydney, Australia
Nicholas Lintzeris, Rachel M. Deacon, Victoria Hayes, Tracy Cowan, Llewellyn Mills, Laila Parvaresh, Lucy Harvey Dodds, Louisa Jansen, Raelene Dojcinovic, Man Cho Leung, Apo Demirkol, Therese Finch, Kristie Mammen
14 September 2021 | DOI:


Drug checking services increase the intention to use drugs in some (small) subgroups of music festival attendees
Paul Calle
9 March 2022 | DOI:

Response to ‘Drug checking services increase the intention to use drugs in some (small) subgroups of music festival attendees’
Sherri Murphy, Stephen J. Bright, Greg Dear
9 March 2022 | DOI:

A comment on participant reimbursement within Australian drug and alcohol research
Daniel T. Winter, Brennan Geiger, Carolyn A. Day
28 February 2022 | DOI:

COVID-19 vaccine acceptability among people in Australia who inject drugs: Update from the 2021 Illicit Drug Reporting System interviews
Olivia Price, Paul M. Dietze, Lisa Maher, Sione Crawford, Amy Peacock
20 February 2022 | DOI:

The feasibility of a drug consumption room in the Australian Capital Territory
Amy Kirwan, Rebecca Winter, Jack Gunn, Filip Djordjevic, Michael Curtis, Chris Gough, Paul M. Dietze
17 January 2022 | DOI:

Drink driving among Aboriginal and Torres Strait Islander Australians: What has been done and where to next?
Michelle S. Fitts, Richard Burchill, Scott Wilson, Gavan R. Palk, Alan R. Clough, Katherine M. Conigrave, Tim Slade, Anthony Shakeshaft, K. S. Kylie Lee
19 December 2021 | DOI:

Declining youth drinking: A matter of faith?
Jonas Raninen, Michael Livingston, John Holmes, Johan Svensson, Peter Larm
1 December 2021 | DOI:


Brief Reports

Who uses digital drugs? An international survey of ‘binaural beat’ consumers
Monica J. Barratt, Alexia Maddox, Naomi Smith, Jenny L. Davis, Lachlan Goold, Adam R. Winstock, Jason A. Ferris
30 March 2022 | DOI:

Interrupted time series analysis of Canadian legal cannabis sales during the COVID-19 pandemic
Michael J. Armstrong, Nathan Cantor, Brendan T. Smith, Rebecca Jesseman, Erin Hobin, Daniel T. Myran
22 March 2022 | DOI:

Overdose deaths and the COVID-19 pandemic in British Columbia, Canada
Heather Palis, Marc-André Bélair, Kevin Hu, Andrew Tu, Jane Buxton, Amanda Slaunwhite
15 December 2021 | DOI:

Do post-quitting experiences predict smoking relapse among former smokers in Australia and the United Kingdom? Findings from the International Tobacco Control Surveys
Bradley Gorniak, Hua-Hie Yong, Ron Borland, K. Michael Cummings, James F. Thrasher, Ann McNeill, Andrew Hyland, Geoffrey T. Fong
9 December 2021 | DOI:


Letter to the Editor

Can urbanisation influence alcohol consumption by Indigenous groups? A brief analysis of Brazilian data
Thiago R. do Carmo, Lucas G. Santos, Alécio V. S. G. e Farias, Mariana P. de Lima Cavalcanti, Gabriel dos Santos Dias, Bruno E. B. R. Nunes, Rafael F. de Oliveira França, Vanessa C. Pereira … See all authors
13 December 2021 | DOI:


Special Section - Qualitative insights on AOD consumption in Australia during COVID-19 

‘Super googs on a Zoom, are you kidding me?’: The pleasures and constraints of digitally-mediated alcohol and other drug consumption
Tristan Duncan, Robyn Dwyer, Michael Savic, Amy Pennay, Sarah MacLean
7 December 2021 | DOI:

‘They're like little police’: Australian parents' perceptions of their children's awareness of drinking during COVID-19
Megan Cook, Sandra Kuntsche, Amy Pennay
9 November 2021 | DOI:

‘When I open it, I have to drink it all’: Push and pull factors shaping domestic alcohol consumption during the COVID-19 pandemic UK Spring 2020 lockdown
Dominic Conroy, Emily Nicholls
27 October 2021 | DOI:

Beyond ‘drinking occasions’: Examining complex changes in drinking practices during COVID-19
Gabriel Caluzzi, Amy Pennay, Anne-Marie Laslett, Sarah Callinan, Robin Room, Robyn Dwyer
3 October 2021 | DOI:


Drug and Alcohol Review - Clinician's Corner

DAR Front Cover

Examining the cost and impact of dosing fees among clients in opioid agonist treatment: Results from a cross-sectional survey of Australian treatment clients





Although the costs of the medications used in opioid agonist treatment (OAT) (methadone and buprenorphine/buprenorphine-naloxone) are funded by the federal Australian government, the costs associated with dosing of these medications are not. As pharmacies and private clinics do not receive government funding for dosing-related costs, a dosing fee is set by these services to cover the cost, and the cost is usually paid directly by the client. In 2019, over 70% of clients receiving OAT in Australia received their dose from a pharmacy. Fees for dosing vary greatly, with previous studies reporting a range between AUD$1.43 and AUD$10.00 per dose.

Other studies have identified dosing fees as a long-standing barrier to engaging and remaining in treatment. As people in OAT are frequently financially vulnerable, our study explored the financial and social impacts of dosing fees. We examined: (a) the percentage of people who paid dosing fees and associated factors; (b) the cost of dosing fees as a percentage of clients’ total income; and (c) whether people had difficulties paying treatment costs and, if so, the consequences.

We conducted a cross-sectional survey of 402 people who use opioids regularly between December 2017 and March 2018 in Australia: 245 were currently engaged in OAT and reported data on dosing fees, of whom 53% (n=129) reported paying dosing fees. Dosing fees were more likely to be paid by clients receiving unsupervised doses. Fees represented <10% of total monthly income for 70% of participants; however, one in four participants paid fees between 10 and <20% of their monthly income, and one in 15 participants paid fees that made up 20% or more of their monthly income.

Among the 360 participants who had ever been in OAT, the most common strategies for paying treatment costs ‘when money was tight’ was to borrow money from family and/or friends (36%), reduce food intake (17%), theft/fraud/dealing (12%), not pay household bills (10%) and reduce drug/alcohol use (9%). Thirty-eight percent reported incurring at least one form of debt as a strategy to make payments. Almost three-quarters (72%) experienced difficulties in paying treatment costs, 36% left treatment earlier than intended and 25% had been excluded from treatment due to payment difficulties.

These impacts of costs are in turn likely to negatively impact clients’ physical health, mental health and social wellbeing. Unplanned treatment cessation in particular (regardless of whether cessation was voluntary or involuntary) may increase the risk of negative outcomes for clients. We know from previous research that stopping treatment suddenly can lead to withdrawal and recommencing opioid use, which may increase overdose risk.

The results of ours and other studies suggest reducing fees may increase the number of people who enter and stay in treatment. As many studies show treatment is cost-effective, the government may save money if they subsidise treatment-related costs, in addition to the positive health and social outcomes that are associated with being in treatment.


Emma Zahra1
Briony Larance1,2,3
Suzanne Nielsen1,4

1 National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
2 School of Psychology, University of Wollongong, Wollongong, Australia
3 Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
4 Monash Addiction Research Centre, Monash University, Melbourne, Australia


Zahra E, Chen R, Nielsen S, Tran AD, Santo T Jr, Degenhardt L, Farrell M, Byrne J, Ali R, Larance B. Examining the cost and impact of dosing fees among clients in opioid agonist treatment: Results from a cross-sectional survey of Australian treatment clients. Drug Alcohol Rev 2022;41:841-50.