Caroline Salom

Introduction: Australia's illicit tobacco trade poses major challenges, with evidence of increasing use. We examined: (i) use of illicitly traded tobacco (ITT) and reasons for use among two populations of people who use drugs in Australia; and (ii) factors associated with ITT use, versus exclusive licit tobacco use, in 2024 and 2025. Methods: Cross‐sectional samples of people who regularly (i.e., ≥monthly) used illicit stimulants (Ecstasy and Related Drugs Reporting System (EDRS); n = 1430) or injected drugs (Illicit Drug Reporting System (IDRS); n = 1749) were recruited April–July in 2024 and 2025. Multivariable logistic regression identified factors associated with past 6‐month ITT use. Results: In both samples of people who use drugs, the proportion using ITT among those who had recently used tobacco increased between 2024 and 2025: from 38% to 65% ( p < 0.001) among EDRS participants and from 54% to 73% ( p < 0.001) among IDRS participants. In both years and populations, ITT was most commonly obtained from tobacconists, with price the primary reason for use. Among EDRS participants, males had higher odds of ITT use in both years; older age and recent e‐cigarette and nicotine‐pouch use were associated with ITT use in 2024 only. Among IDRS participants, age was associated with ITT use in both years, while psychological distress was associated with ITT use in 2024 only. Capital city of residence was associated with ITT use across both populations and years; in 2025, lower odds were observed in Perth, Adelaide, Hobart and Canberra versus Sydney. Discussion and Conclusions: Increases in ITT use among these two populations of people who use illicit drugs are concerning. Efforts to restrict availability should prioritise supply‐side controls, alongside treatment and demand‐reduction strategies.

The benefits of social connections for well‐being are often assumed, yet few studies test whether social support predicts mental health over extended periods nor whether these effects are experienced equally across women and men. We address this gap by examining gender differences in the longitudinal associations between perceived social support and psychological distress using 14 annual waves of a nationwide panel study ( N = 75,404; 62.1% women). Multigroup random intercept cross‐lagged panel modelling revealed that within‐person increases in perceived social support predicted subsequent declines in psychological distress over time for both women and men. However, this relationship was bidirectional, and the negative within‐person effects of psychological distress on perceived social support were stronger than the effects of perceived social support on psychological distress among men (but not women). Analyses exploring gender interactions with age, sexual identity and ethnicity revealed that the effects of psychological distress were strongest among older, New Zealand European and heterosexual men. These results suggest that men's psychological distress leads to decreased perceptions of social support from others in their lives, and this effect is more pronounced than the effect of social support over the same timeframe. The implications for health interventions are discussed.

Background and Aims: There is significant concern about potential rising harms from gamma‐hydroxybutyrate (GHB) but an absence of studies internationally synthesising data across indicators to identify changes in harms and broader patterns of use. This paper contributes to addressing this gap by measuring national trends in GHB use, harms and treatment in Australia. Design, setting, and cases: Triangulation of indicators (2013–2024) from Australian triennial population surveys; annual interviews with cross‐sectional non‐representative samples of people who use illicit stimulants or who inject drugs; and administrative data on GHB‐related hospitalisations, GHB‐related deaths, and treatment episodes where GHB was the principal drug of concern. Measurements: Annual trend data were analysed using Joinpoint regression. Survey data were modelled as the annual percent change in the proportion reporting lifetime, past 12‐month, and past 6‐month use, depending on the survey. Administrative data were modelled as the annual percent change in crude rates per 100 000 population. Findings: Lifetime and past 12‐month GHB use in the general population remained below 1.2% and 0.2% respectively, but the latter increased from 0.07% in 2013 to 0.19% in 2022–2023 (annual percent change [APC] 9.3; 95% confidence interval [CI]: 5.2, 13.2). The percentage of people who use illicit stimulants reporting past 6‐month use increased from 5.7% in 2013 to 7.3% in 2017 (APC 11.6; 95%CI: 0.2, 52.9) and from 5.4% in 2019 to 11.5% in 2024 (APC 17.8; 95%CI: 5.9, 41.1). The proportion of people who inject drugs reporting use varied between 7.2% and 17.5% over the short period studied (2020–2024). There were statistically significant increases in GHB‐related hospitalisations from 5.3 in 2012–13 to 19.1 per 100 000 people in 2022–23 (APC 19.0; 95%CI: 11.9, 31.1) and GHB‐related deaths from 0.02 in 2013 to 0.24 per 100 000 people in 2022 (APC 36.5; 95%CI: 27.2, 58.1). Treatment episodes also increased across the period, from 0.07 in 2012–13 to 6.0 episodes per 100 000 people in 2020–21 (APC 97.3; 95%CI: 83.5, 830.9), with no subsequent statistically significant change (8.4 per 100 000 people in 2022–23). Conclusions: Gamma‐hydroxybutyrate use, harms and treatment engagement increased in Australia from 2013 to 2024. These findings highlight a need to implement acceptable, tailored prevention and harm reduction strategies for key populations, and implement stronger monitoring efforts nationally and internationally.

Objectives: The objective of this scoping review was to explore the body of knowledge that exists on the topic of sleep in adults experiencing homelessness. Background: Sleep is essential for health and wellbeing, and has an important role in cognition, decision making and life outcomes. The experience of homelessness increases exposure to risk factors that influence poor sleep health, including social and environmental exposures. People experiencing homelessness may not have the autonomy to mitigate these environmental and social impacts. Methods: For this scoping review, we searched for English language peer‐reviewed articles in PubMed, Web of Science, Scopus, Sociological Abstracts, Social Science Database, Australian Public Affairs Full Text and PsycINFO. Forward and backward searching of included articles was also conducted. The methodology for this scoping review was guided by the scoping review framework in the Joanna Briggs Institute Manual for Evidence Synthesis. Eligibility Criteria: Studies were included if they examined the concept of any dimension of the sleep experience (including sleep‐related daytime impairment) in adults 18 years and over experiencing homelessness in high income countries. Sources of Evidence: This review considered research‐oriented literature, including original research, reviews, meta‐analyses, practice guidelines, qualitative studies, conference abstracts, and government and nongovernment research‐oriented reports. Charting Methods: Data were extracted on publication year, research design, geographical location, participant characteristics, measurement and key findings. Findings were narratively described or presented as frequencies. A thematic analysis was also completed for qualitative research studies. Results: This review extracted data from 101 studies. Of these, 45 were quantitative, 43 were qualitative, 6 were mixed‐methods, and 7 were narrative reviews. The majority of studies included a focus on populations from the United States (56 studies), followed by the United Kingdom (18 studies). Only 34% of the included studies explicitly focussed on sleep as a core objective of the research. In the thematic analysis, the most frequently identified barriers to sleep across studies were safety and security, weather exposure and lack of comfort. Conclusions: This scoping review identified notable gaps in the literature, including a need for validated subjective and objective sleep measures for people experiencing homelessness, and a lack of research on sleep interventions in this population. Review findings can be used to stimulate and guide more targeted research, helping to identify appropriate intervention targets and approaches to improve sleep and related outcomes in this population.

Eating disorders are complex mental health conditions with rising prevalence. Despite this, research and evaluation (R&E) remain under-funded, hindering translation, policy, prevention and advances in care; an equitable and responsive ecosystem of research and knowledge-sharing across the sector is needed to enhance outcomes for people and systems affected by eating disorders. Community members engage with community eating disorder organisations/services to receive guidance and support, often through innovative co-designed programs and resources. Building R&E capacity and capability within community settings is essential in capturing, leveraging and translating local knowledges, such as evaluation outcomes to research, policy, practice settings and the broader community to improve understandings, actions and outcomes. Partnerships between community service providers and academic researchers could be a way of establishing reciprocal knowledge- sharing pathways while simultaneously building internal R&E capacity/capability. The current article presents a longitudinal participatory protocol to plan for, co-design and implement R&E practices within an Australian community-based eating disorder service via an academic partnership. We present a four-stage methodological outline aiming to (a) identify the needs, experiences and feasibility of engaging in R&E in a community eating disorder context; and (b) collaboratively plan for, develop and integrate R&E practices through partnership. We will collect data through focus groups, meetings, interviews, researcher notes and questionnaires across several months. This pragmatic plan can guide future collaborative R&E building efforts within a community mental health context in ways that inform the development and scalability of sustainable, effective and efficient R&E praxis and partnerships across the eating disorder and broader mental health sector.

The persistent difficulty in conceptualizing the relationship between addictive and other mental disorders stands out among the many challenges faced by the field of Psychiatry. The different philosophies and schools of thought about, and the sheer complexity of these highly prevalent clinical conditions make progress inherently difficult, not to mention the profusion of competing and sometimes contradictory terms that unnecessarily exacerbate the challenge. The lack of a standardized term adds confusion, fuels stigma, and contributes to a “wrong door syndrome” that captures the difficulty of not only diagnosing but also treating addictive and other mental disorders in an integrated manner. The World Association on Dual Disorders (WADD) proposes the adoption of the term “Dual Disorder” which, while still arbitrary, would help harmonize various clinical and research efforts by rallying around a single, more accurate, and less stigmatizing designation.

Overdoses and poisonings are among the most common causes of death in young adults. Adolescent problem drinking has been associated with psychiatric morbidity in young adulthood as well as with elevated risk for suicide attempts. There is limited knowledge on adolescent alcohol use as a risk factor for alcohol and/or drug overdoses in later life. Here, data from The Northern Finland Birth Cohort 1986 study with a follow-up from adolescence to early adulthood were used to assess the associations between adolescent alcohol use and subsequent alcohol or drug overdose. Three predictors were used: age of first intoxication, self-reported alcohol tolerance and frequency of alcohol intoxication in adolescence. ICD-10-coded overdose diagnoses were obtained from nationwide registers. Use of illicit drugs or misuse of medication, Youth Self Report total score, family structure and mother’s education in adolescence were used as covariates. In multivariate analyses, early age of first alcohol intoxication [hazard ratios (HR) 4.5, 95% confidence intervals (CI) 2.2–9.2, P < 0.001], high alcohol tolerance (HR 3.1, 95% CI 1.6–6.0, P = 0.001) and frequent alcohol intoxication (HR 1.9, 95% CI 1.0–3.4, P = 0.035) all associated with the risk of overdoses. Early age of first intoxication (HR 5.2, 95% CI 1.9–14.7, P = 0.002) and high alcohol tolerance (HR 4.4, 95% CI 1.7–11.5, P = 0.002) also associated with intentional overdoses. Alcohol use in adolescence associated prospectively with increased risk of overdose in later life. Early age of first intoxication, high alcohol tolerance and frequent alcohol intoxication are all predictors of overdoses.