- Details
- Hits: 486
Importance Children exposed to substance use during pregnancy have increased health needs but whether these are influenced by engagement in out-of-home care is uncertain.
Objective: To evaluate the association between substance use during pregnancy, out-of-home care and hospitalization utilization, and costs from birth up to age 20 years.
Design, Setting, and Participants: This was a retrospective cohort study using individual-linked population birth, hospital, and out-of-home care information of all liveborn infants from New South Wales, Australia, between 2001 and 2020 using longitudinal population-based linkage records from administrative databases. Substance use during pregnancy included newborns with neonatal abstinence syndrome (n = 5946) and intrauterine exposure to drugs of addiction (n = 1260) and other substances (eg, tobacco, alcohol, and illicit drugs or misused prescription drugs; n = 202 098). Children not exposed to substance use during pregnancy were those without known exposure to substance use during pregnancy (n = 1 611 351). Data were analyzed from July 2001 to December 2021.
Main Outcomes: Main outcomes were hospital readmission, length of stay, and cost burden associated with substance use during pregnancy from birth up to age 20 years. Outcomes were investigated using 2-part and Poisson regression models adjusted for sociodemographic characteristics. Mediation analysis was used to evaluate whether the association of substance use during pregnancy with risk of readmission was mediated through engagement with out-of-home care….Excess hospital costs associated with substance use during pregnancy were A$129.0 million in 2019 to 2020. Mediation analyses showed that any out-of-home care contact mediated the association between substance use during pregnancy and risk of inpatient readmission and lower health care cost (decreased by A$25.4 million). For children with neonatal abstinence syndrome, any out-of-home care contact mediated readmission risk by approximately 30%, from adjusted RR, 1.28; 95% CI, 1.19-1.35, to RR, 1.01; 95% CI, 0.98-1.02.
Conclusion and Relevance: Children who were exposed to substance use during pregnancy incurred more hospital costs than children who were not exposed up to 20 years of age, but this was reduced in association with any contact with out-of-home care. This provides insights into possible strategies for reducing health and financial burdens associated with exposure to substance use during pregnancy for children.
- Details
- Hits: 492
The 2024 United Nations World Day Against Illicit Drugs & Trafficking theme is “The evidence is clear: invest in prevention”. The internationally backed Declaration of Oviedo assiduously affirms that prevention must be the priority for our communities. This Asia-Pacific hearing saw commentaries from regional voices on the absolute need for prevention and demand reduction.
and Watch the presentations
- Details
- Hits: 621
China’s Role in Synthetic Opioid Trafficking: Efforts to Reduce the Supply of Precursor Chemicals at the Primary Source.
[Ever since the ‘Opium Wars’, (https://youtu.be/7UScdK82aAo?list=PLTMqlfT-1C1x7ekCSxIhF6HMjHBqMAK6n&t=8) when opium was not only legalised and commercialised on a global scale, but actually became currency; the Chinese people have not forgotten the exploitation they experienced at the hands of the ‘West’. One cannot help but wonder if this is not somehow a process of exacting ‘pay-back’, as well as the long standing strategy of ‘communist’ or otherwise totalitarian regimes endeavour to ‘drug the party west’ into oblivion – i.e. Red Cocaine)
Introduction and Background: The reemergence of illegally manufactured synthetic opioids has complicated the United States’ already difficult illegal drug supply- and demand-reduction efforts. Even as demand persists for heroin and diverted prescription opioids, fentanyl and other synthetic opioids have made their way into the illegal drug supply, confounding traditional efforts to raise prices by reducing the quantity of drugs available to users. It is essential to understand the challenges at hand so that appropriate approaches to solutions can be developed. The United States could be doing more to help reduce supply and should devote resources to efforts expected to produce the greatest return on investment. Of course, it is also necessary to make equal perhaps even greater demand- and harm-reduction efforts, but in this testimony, I will only focus on China’s role on the supply side of the equation.
Conclusion: The Commission on Combating Synthetic Opioid Trafficking final report and technical appendixes contain 78 enabling action items, many of which are directed at Congress and involve China. The action items are binned into five pillars:
- policy coordination and implementation,
- supply reduction,
- demand reduction and public health,
- international cooperation, and
- research and monitoring.
Each pillar contains a series of key actions and associated enabling actions. The Commission focused on actions the United States could take to stem the illegal flow of synthetic opioids or develop ways to mitigate overdose deaths.
For complete presentation click here
- Details
- Hits: 639
With a growing voice for greater permission for illicit substance use in some cultures and entrenched addiction for profit industries like Big Alcohol and Big Cannabis, where should the policy priorities lie?
- Details
- Hits: 665
In observance of World Earth Day, the conversation around environmental impact has taken a sharp turn to address the burgeoning issues surrounding the cultivation and legalization of cannabis. The latest reports draw an inseparable link between this practice and the deterioration of public environmental health.
An authoritative analysis by the UN Office on Drugs and Crime (UNODC) reveals that the carbon footprint of indoor cannabis cultivation is colossal, landing between 16 and 100 times greater than its outdoor counterpart. This difference stems from the energy-intensive nature of artificial cultivation environments. Similarly, laboratory-produced drugs such as cocaine leave a carbon trace 30 times wider than that of cocoa bean production.
The environmental ramifications of these findings are profound. Deforestation and rapacious water usage associated with the illicit cultivation of cannabis significantly contributes to these adverse effects. This hazardous pattern propagates unfavorably, affecting not only human communities but the entirety of the Earth's ecosystems. The UNODC report raises the alarm that other organisms and animals suffer indirectly due to such practices, which ultimately imbalance the delicate food chain.
Our reports inform us that while the cannabis industry burgeons and cannabis stocks soar amid North American and global legalization waves, there's a silent crisis unfolding. Advances in the market are in stark contrast with the escalating ecological footprint, further illuminated by wastewater studies that indicate tracking cannabis use is fraught with challenges.
In an attempt to contextualize the individual's accountability and the cannabis industry's responsibility within the climate change discourse, a recent journal article frames a compelling question. Which came first – the chicken of escalating drug demand driven by addiction and self-medication or the egg of catastrophic environmental damage propelled by drug cultivation and production?
The Dalgarno Institute, acutely focused on the intersection of public health and environmental stewardship, highlights the perils of normalized cannabis usage amidst such dire environmental consequences. It stands firm in its commitment to educating the community and legislatures about the net negative impact of cannabis growth on our planet's wellbeing—both ecological and human. On a day meant to galvanize action towards sustainability and respectful coexistence with nature, we are urged to consider the broader, often concealed, consequences of cannabis legalization.
In keeping with our duty to the community, it is essential for all stakeholders involved, from legislators to consumers, to closely examine the tangible repercussions of their choices. We must commit to the protection of our environment, fortify against public health decline, and resist the allure of unverified, and in many cases, clearly failed ‘Cannabis liberalisation’ solutions to the detriment of planetary health and a growing number of its most vulnerable citizens. As we move forward, the imperative for authentic, serious discourse on the environmental impact of cannabis cultivation is clear. The call to act responsibly and decisively has never been more urgent.
In light of these revelations, the Dalgarno Institute reiterates the urgency of integrating environmental consciousness into our policy-making and communal behaviors. Acknowledging the data presented by the UN Office on Drugs and Crime (UNODC) that highlights the severe environmental implications of indoor cannabis cultivation and synthetic drug manufacturing, our conversation must pivot towards sustainable practices. Similarly, the alarming connections between drug demand, addiction, and environmental degradation necessitate a more profound communal and legislative introspection. It is no longer viable to overlook the ecological footprint associated with the drug industry, especially in the context of cannabis legalisation accelerating pace worldwide.
The challenge lies not only in advocating for policy change but also in fostering a collective responsibility towards environmental stewardship. At the very least we must encourage a transition to outdoor cultivation methods for cultivation of cannabis product for legitimate medicines, that significantly reduce carbon footprints and implement stringent regulations for waste management in drug production. Additionally, supporting research into sustainable licit drug cultivation and production practices can pave the way for innovations that align with our environmental goals.
Our commitment to the environment and public health emphasises the need for informed choices and actions. By recognizing the intricate link between our habits, industries, and the planet's health, we can begin to mitigate the adverse effects highlighted in the UNODC report. Together, as a community invested in the future of our planet, we call for a concerted effort to reevaluate and adjust our practices in favour of a more sustainable and healthy world.
The Dalgarno Institute's engagement with World Earth Day is not merely a call to action but a reminder of our shared responsibility to heal and protect our planet. Through education, policy reform, and community efforts, we can reduce demand and subsequently counter the negative impacts of drug cultivation and production on the environment. It is imperative that we act now, with conviction and collaboration, to ensure a thriving planet for future generations. Team @ Dalgarno Institute