The Australasian Professional Society on Alcohol and other Drugs

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COVID‐19 makes a stronger research focus on home drinking more important than ever
Sarah Callinan, Sarah MacLean
13 July 2020 | DOI:


A critical scoping review about the impact of music in the lives of young adults who use drugs
Elise Cournoyer Lemaire, Christine Loignon, Karine Bertrand
17 August 2020 | DOI:

A systematic review of reasons for abstinence from alcohol reported by lifelong abstainers, current abstainers and former problem‐drinkers
Joseph A. Rosansky, Harold Rosenberg
13 July 2020 | DOI:

What is the best indicator of the harmful use of alcohol? A narrative review
Jürgen Rehm, Jean‐François Crépault, Ashley Wettlaufer, Jakob Manthey, Kevin Shield
6 April 2020 | DOI:

Original Papers

Less adolescent alcohol and cannabis use: More deviant user groups?
Hilde Pape, Ingeborg Rossow
18 August 2020 | DOI:

Harmful drinking occurs in private homes in some high‐ and middle‐income alcohol markets: Data from the International Alcohol Control Study
Taisia Huckle, Sarah Callinan, Cuong Pham, Surasak Chaiyasong, Karl Parker, Sally Casswell
17 August 2020 | DOI:

Feasibility and acceptability of take‐home naloxone for people released from prison in New South Wales, Australia
Banafsheh Moradmand‐Badie, Lucy Tran, Noora Oikarainen, Louisa Degenhardt, Suzanne Nielsen, Jillian Roberts, Stephen Ward, Julia Bowman, Sarah Larney
17 August 2020 | DOI:

Sex differences in the multilevel determinants of injection risk behaviours among people who inject drugs in Tijuana, Mexico
Jennifer P. Jain, Steffanie A. Strathdee, Brooke S. West, Patricia Gonzalez‐Zuniga, Gudelia Rangel, Eileen V. Pitpitan
14 August 2020 | DOI:

Subgroups of adults who drink alcohol at low‐risk levels: Diverse drinking patterns and demography
Janette Mugavin, Sarah MacLean, Robin Room, Sarah Callinan
12 August 2020 | DOI:

Characterisation of presentations to a community‐based specialist addiction neuropsychology service: Cognitive profiles, diagnoses and comorbidities
James R. Gooden, Catherine A. Cox, Vanessa Petersen, Ashlee Curtis, Victoria Manning, Dan I. Lubman
12 August 2020 | DOI:

Smoking behaviours and other substance use among Indigenous and non‐Indigenous Australian secondary students, 2017
Christina Heris, Nicola Guerin, David Thomas, Catherine Chamberlain, Sandra Eades, Victoria M. White
11 August 2020 | DOI:

Are the well‐off youth in Sweden more likely to use cannabis?
Isabella Gripe, Anna‐Karin Danielsson, Patrik Karlsson, Siri Thor, Mats Ramstedt
10 August 2020 | DOI:

A comparison of global and egocentric network approaches for assessing peer alcohol use among college students in the United States
Alex M. Russell, Adam E. Barry, Megan S. Patterson
10 August 2020 | DOI:

E‐cigarette use and cigarette smoking initiation among Australian women who have never smoked
Alemu Melka, Catherine Chojenta, Elizabeth Holliday, Deborah Loxton
4 August 2020 | DOI:

Investigation of tobacco and alcohol co‐consumption in Thailand: A joint estimation approach
Nopphol Witvorapong, Polathep Vichitkunakorn
4 August 2020 | DOI:

Onset and trajectory of alcohol and other drug use among Aboriginal men entering a prison treatment program: A qualitative study
Michael F. Doyle, Jill Guthrie, Tony Butler, Anthony Shakeshaft, Katherine Conigrave, Megan Williams
3 August 2020 | DOI:

US national treatment admissions with opioids and benzodiazepines
Cynthia L. Arfken, Darlene D. Owens, Mark K. Greenwald
3 August 2020 | DOI:

Prevalence and sociodemographic factors of risky drinking in Australian older adults
Heng Jiang, Susan Griffiths, Sarah Callinan, Michael Livingston, Hassan Vally
23 July 2020 | DOI:

Decline in adolescent drinking: Some possible explanations
Ingeborg Rossow, Hilde Pape, Leila Torgersen
19 July 2020 | DOI:

Characterising the increasing prevalence of crystal methamphetamine use in Vancouver, Canada, from 2006–2017: A gender‐based analysis
Paxton Bach, Kanna Hayashi, M‐J Milloy, Ekaterina Nosova, Thomas Kerr, Evan Wood, Nadia Fairbairn
14 July 2020 | DOI:

The link between per capita alcohol consumption and alcohol‐related harm in educational groups
Thor Norström, Jonas Landberg
12 July 2020 | DOI:

‘Extreme personal stress’ and ‘a lot of pain’: Exploring the physical, mental and social contexts of extramedical pharmaceutical opioid use in Australian paramedic case descriptions
James Wilson, Tina Lam, Debbie Scott, Rose Crossin, Sharon Matthews, Karen Smith, Dan I. Lubman, Suzanne Nielsen
7 July 2020 | DOI:

Nightlife scene involvement and patterns of prescription drug misuse
Brian C. Kelly, Mike Vuolo
7 July 2020 | DOI:

Self‐managing illicit stimulant use: A qualitative study with patients receiving injectable opioid agonist treatment
Heather Palis, Scott Harrison, Scott MacDonald, David C. Marsh, Martin T. Schechter, Eugenia Oviedo‐Joekes
25 June 2020 | DOI:

Survey methods and characteristics of a sample of Aboriginal and Torres Strait Islander and non‐Indigenous people who have recently used methamphetamine: the NIMAC survey
Rachel Reilly, Handan Wand, Rebecca McKetin, Brendan Quinn, Nadine Ezard, Adrian Dunlop, Kate Conigrave, Carla Treloar, Yvette Roe, Dennis Gray, Jacqueline Stephens, James Ward
on the behalf of the NIMAC Community Researchers and Partner Sites
22 June 2020 | DOI:

Impact of migration from an illicit drug scene on hospital outcomes among people who use illicit drugs in Vancouver, Canada
Tara Beaulieu, Kanna Hayashi, Huiru Dong, Kora DeBeck, Andrew Day, Rachael McKendry, Gaganpreet Kaur, Rolando Barrios, M.‐J. Milloy, Lianping Ti
2 June 2020 | DOI:

Do gender differences in the relationship between living with children and alcohol consumption vary by societal gender inequality?
Kathryn Graham, Sharon Bernards, Katherine J. Karriker‐Jaffe, Sandra Kuntsche, Anne‐Marie Laslett, Gerhard Gmel, Sarah Callinan, Oliver Stanesby, Samantha Wells
1 June 2020 | DOI:

‘He was trapped in his own web’—Dependent drinking as a poverty trap: A qualitative study from Goa, India
Jaclyn Schess, Sonali Kumar, Richard Velleman, Achyuta Adhvaryu, Abhijit Nadkarni
31 May 2020 | DOI:

Use of cannabis and opioids for chronic pain by older adults: Distinguishing clinical and contextual influences
Julie Bobitt, Hyojung Kang, James Alton Croker III, Laura Quintero Silva, Brian Kaskie
29 May 2020 | DOI:

Transitions in smoking and nicotine use from 2016 to 2017 among a UK cohort of adult smokers and ex‐smokers
Erikas Simonavicius, Ann McNeill, Leonie S. Brose
26 May 2020 | DOI:

Effect of alcohol prohibition on liver cirrhosis mortality rates in Canada from 1901 to 1956: A time‐series analysis
Bethany R. Chrystoja, Jürgen Rehm, Jean‐François Crépault, Kevin Shield
25 May 2020 | DOI:

Developmental trajectories of illicit drug use, prescription drug misuse and cannabis practices among young adult cannabis users in Los Angeles
Ekaterina V. Fedorova, Sheree M. Schrager, Lucy F. Robinson, Alexis M. Roth, Carolyn F. Wong, Ellen Iverson, Stephen E. Lankenau
10 May 2020 | DOI:

Experiences of over‐the‐counter codeine misusers and accounts of recovery: A qualitative study in Tasmania, Australia
Melissa Kirschbaum, Tony Barnett, Merylin Cross
4 May 2020 | DOI:

Normalisation of non‐drinking? 15–16‐year‐olds' accounts of refraining from alcohol
Janne Scheffels, Kristin Buvik, Rikke Tokle, Ingeborg Rossow
4 May 2020 | DOI:

Construction workers' alcohol use, knowledge, perceptions of risk and workplace norms
Ann M. Roche, Janine Chapman, Vinita Duraisingam, Brooke Phillips, Jim Finnane, Ken Pidd
29 April 2020 | DOI:

Bidirectional relationships in the development of internalising symptoms and alcohol use in adolescence
Louise Birrell, Tim Slade, Maree Teesson, Katrina Prior, Catherine Chapman, Leanne Hides, Nyanda McBride, Louise Mewton, Steve Allsop, Gavin Andrews, Nicola C. Newton
20 April 2020 | DOI:

Feasibility and reliability of continuously monitoring alcohol use among female adolescents and young adults
Julie M. Croff, Micah L. Hartwell, Ashleigh L. Chiaf, Erica K. Crockett, Isaac J. Washburn
17 March 2020 | DOI:


A call for greater policy and regulatory coherence for an expanding menu of legal psychoactive substances
Benedikt Fischer, Chris Bullen, Wayne Hall
18 May 2020 | DOI:

Opioid‐related overdose deaths among African Americans: Implications for research, practice and policy
Danelle Stevens‐Watkins
12 April 2020 | DOI:

Brief Report

How many more young Australians say that they would use cannabis if it were legal?
Janni Leung, Vivian Chiu, Jack Yiu Chak Chung, Wayne D. Hall, Gary C. K. Chan
29 July 2020 | DOI:

Over the limit? Testing non‐linear associations between alcohol outlets and young adults' alcohol consumption
Sarah Foster, Paula Hooper, Mark Divitini, Matthew Knuiman, Georgina Trapp
22 June 2020 | DOI:

Trends in medical cannabis licensure, Israel, 2013–2018
Sharon R. Sznitman
17 June 2020 | DOI:

Characterising communities impacted by the 2015 Indiana HIV outbreak: A big data analysis of social media messages associated with HIV and substance abuse
Raphael E. Cuomo, Mingxiang Cai, Neal Shah, Jiawei Li, Wen‐Hao Chen, Nick Obradovich, Tim K. Mackey
13 May 2020 | DOI:

Special Issue - Impact of alcohol on mortality in Eastern Europe

Alcohol‐related male mortality in the context of changing alcohol control policy in Lithuania 2000–2017
Daumantas Stumbrys, Tadas Telksnys, Domantas Jasilionis, Vaida Liutkutė Gumarov, Lukas Galkus, Nijolė Goštautaitė Midttun, Mindaugas Štelemėkas
20 March 2020 | DOI:

Spatial patterns of male alcohol‐related mortality in Belarus, Lithuania, Poland and Russia
Pavel Grigoriev, Domantas Jasilionis, Sebastian Klüsener, Sergey Timonin, Evgeny Andreev, France Meslé, Jacques Vallin
27 January 2020 | DOI:

Alcohol control policies and mortality trends in Belarus
Pavel Grigoriev, Anastacia Bobrova
20 January 2020 | DOI:

The changing relation between alcohol and life expectancy in Russia in 1965–2017
Inna Danilova, Vladimir M. Shkolnikov, Evgeny Andreev, David A. Leon
18 January 2020 | DOI:

Alcohol consumption and alcohol policy in Estonia 2000–2017 in the context of Baltic and Nordic countries
Kersti Pärna
4 November 2019 | DOI:

Holding policy makers to account: Monitoring voting patterns on alcohol and tobacco policy in the Lithuanian Parliament
Mindaugas Štelemėkas, Lukas Galkus, Vaida Liutkutė, Gumarov Nijolė, Goštautaitė Midttun, Laura Miščikienė
13 August 2019 | DOI:

Special Issue - Beyond self-reports: ways to obtain more comprehensive insights into substance use events

Alcohol labelling rules in free trade agreements: Advancing the industry's interests at the expense of the public's health
Deborah Gleeson, Paula O'Brien
2 April 2020 | DOI:



Clinician's Corner - June 2020

DAR Front Cover

Clinician's Corner | June 2020      

Clinician’s Corner

Loneliness among people with substance use problems


Loneliness has consistently been linked to poor physical and mental health [1, 2]. The relationship between loneliness and health is thought to be reciprocal in nature. Poor physical and mental health may lead people to feel lonelier (potentially through variables such as their physical functioning or isolation). Conversely, the experience of loneliness may cause people to experience poorer physical and mental health (potentially via altering one’s physiology). Overall, findings related to loneliness and health have been so well documented that the negative physical and mental health effects of loneliness have been compared to risk factors for mortality such as smoking, physical inactivity and obesity [3]. A number of first-world countries have now established national campaigns to tackle loneliness (e.g. Australian Coalition to End Loneliness; Campaign to End Loneliness, UK; Connect2Affect, USA).

While loneliness has been associated with tobacco use [1], increased alcohol use and dependence [4], and illicit drug use [5], there is little understanding of the impact of loneliness on people with substance use disorders (SUD). People with SUD may make and maintain relationships that meet their needs at the time of active substance use but once the person commences the change process, their social needs are likely to have changed (e.g. toward non-using contacts). There is evidence to suggest that greater engagement with networks of people supportive of SUD treatment can sustain longer maintenance of SUD treatment outcomes [6]. As such, when in treatment, and beyond SUD treatment, there may be a need to avoid those situations and relationships that perpetuate ongoing problematic substance use and to connect with people who support one’s abstinence or reduction goals [7]. While the rationale behind such ideas is to best facilitate desirable treatment outcomes, this process is likely to increase the risk of loneliness for people with substance use problems, particularly those that are in the early stages of treatment.

We conducted a narrative systematic review aimed to synthesise existing literature that examined: (i) correlates and predictors of loneliness for people with SUD; (ii) theories underpinning loneliness; (iii) methods employed to measure loneliness; and (iv) loneliness interventions for people with substance use problems. We found 41 articles that were: (i) published in English language; (ii) empirical research; (iii) focused specifically on loneliness (loneliness being a research question of the study or specifically measured as part of the study); and (iv) involved a sample of people with substance use problems (i.e. have a diagnosis of SUD, or accessing treatment specifically for substance use problems).

We found loneliness impacted on the physical and mental health of people with SUD. Higher loneliness was consistently correlated with symptoms of poor physical health (e.g. self-rated health, sleep, pain) and poor mental health (e.g. poor self-esteem, suicidality, wellbeing). Some of the studies included in the review found that greater severity of substance dependence was correlated with greater loneliness, and that substances may be used to avoid distressing feelings such as loneliness. No research has clarified the causal direction or dynamic of this relationship, but it is possible that those who use substances to a greater extent (i.e. higher severity) are also those who are more likely to have difficulty maintaining relationships and/or be stigmatised in society, and ultimately become lonelier as a result of social isolation and stigma.

Only two studies included in this review referenced cognitive theories of loneliness. These theories suggest that one’s expectations about the quality or quantity of their interpersonal relationships influences the way they evaluate those relationships and, in turn, how they feel about them [8]. Therefore, it may be important to consider perceived as well as actual relationships that exist within the individual’s life. Finally, our review also revealed that few measures of loneliness have been validated for use across people with SUD. Loneliness is a notoriously difficult construct to conceptualise and measure, with some measures considering loneliness to be a singular construct and others assessing different types of loneliness, such as social and emotional forms. Additionally, no interventions that specifically aim to address loneliness appear to have been trialled effectively with this population, with just one study having trialled an intervention that was found to yield no effect on loneliness.

The findings from our review suggest that people with SUD experience disproportionate rates of loneliness compared with the general population [9], and that loneliness is linked to poorer health outcomes. Accurate conceptualisation and measurement of loneliness is important in order to be able to intervene. Given the current state of the literature, it is unclear what is most likely to contribute to and maintain loneliness for this population, with a lack of empirical research that has focused on testing prominent loneliness theories (e.g. cognitive theory) across people with SUD. Given the lack of theory-driven research relevant to loneliness in this population, questions remain regarding how best to alleviate loneliness and the associated physical and mental health problems. Cognitive theories may offer some promise, whereby, assessing one’s thoughts about themselves and their relationships may be a starting point to help to conceptualise the experience. However, furthering the theoretical understanding of loneliness and its related constructs is vital in order to help to inform the development of targeted interventions, and ultimately overcome loneliness for this vulnerable population. Our team has recently published a qualitative study that explores loneliness amongst people with SUD ([10]). This study found that participants commonly reported a reciprocal cycle of loneliness and problematic substance use, and that cognitions tended to play a key role in maintaining this cycle. Based on findings from the broader literature and our recent research, our team has also developed and piloted a loneliness intervention, Groups for Belonging [11], for people accessing residential SUD treatment. This study has been published in Drug and Alcohol Review [12]. The findings from this feasibility study point to important future research directions in order to intervene in the deprecating cycle of loneliness and substance use.

Isabella Ingram1, Peter J. Kelly1, Frank P. Deane1, Amanda L. Baker2, Melvin C. W. Goh1, Dayle K. Raftery1, Genevieve A. Dingle3

1Illawarra Health and Medical Research Institute and School of Psychology, University of Wollongong, Wollongong Australia
2School of Medicine and Public Health, University of Newcastle, Newcastle, Australia
3School of Psychology, University of Queensland, Brisbane, Australia



1. Beutel ME, Klein EM, Brahler E, Reiner I, Junger C, Michal M, et al. Loneliness in the general population: prevalence, determinants and relations to mental health. BMC Psychiatry 2017;17:97.
2. Steptoe A, Shankar A, Demakakos P, Wardle J. Social isolation, loneliness, and all-cause mortality in older men and women. Proc Natl Acad Sci U S A 2013;110:5797-801.
3. Holt-Lunstad J, Smith TB, Baker M, Harris T, Stephenson D. Loneliness and social isolation as risk factors for mortality: A meta-analytic review. Perspect Psychol Sci 2015;10:227-37.
4. MacNeill LP, DiTommaso E, Brunelle C. Coping style as a moderator of chronic loneliness and substance use in emerging adults. J Depress Anxiety 2016;5:2167-1044.1000215.
5. Stickley A, Koyanagi A, Koposov R, Schwab-Stone M, Ruchkin V. Loneliness and health risk behaviours among Russian and US adolescents: a cross-sectional study. BMC Public Health 2014;14:366.
6. Frings D, Albery IP. The Social Identity Model of Cessation Maintenance: Formulation and initial evidence. Addict Behav 2015;44:35-42.
7. Best D, Gow J, Taylor A, Knox A, White W. Recovery from heroin or alcohol dependence: A qualitative account of the recovery experience in Glasgow. J Drug Issues. 2011;41:359-77.
8. Cacioppo JT, Hawkley LC. People Thinking About People: The Vicious Cycle of Being a Social Outcast in One's Own Mind. The social outcast: Ostracism, social exclusion, rejection, and bullying. Sydney Symposium of Social Psychology series. New York, NY, US: Psychology Press; 2005. p. 91-108.
9. Ingram I, Kelly PJ, Deane FP, Baker AL, Raftery DK. Loneliness in treatment-seeking substance-dependent populations: Validation of the Social and Emotional Loneliness Scale for Adults-Short Version. J Dual Diagn 2018;14:211-9.
10. Ingram I, Kelly PJ, Deane FP, Baker AL, Dingle GA. Perceptions of loneliness amongst people accessing treatment for substance use disorders. Drug Alcohol Rev 2020;39:484-94.
11. Dingle GA, Ingram I, Haslam C, Kelly PJ. Groups for Belonging - How social connections can help with addiction recovery. Facilitators Manual. University of Queensland and University of Wollongong 2019.
12. Ingram I, Kelly PJ, Haslam C, O'Neil OJ, Deane FP, Baker AL, et al. Reducing loneliness amongst people with substance use disorders: Feasibility of ‘Groups for Belonging’. Drug Alcohol Rev 2020;39:495-504.


A complimentary PDF of the article is available to APSAD members by emailing This email address is being protected from spambots. You need JavaScript enabled to view it..

Ingram I, Kelly PJ, Deane FP, Baker AL, Goh MCW, Raftery DK, Dingle GA. Loneliness among people with substance use problems: A narrative systematic review. Drug Alcohol Rev 2020;39:447-83. doi:10.1111/dar.13064