Eilish Gilvarry

National Health Service | NHS · addicitons Northumberland Tyne and Wear Foundation NHS turst

Background Parental substance use is a substantial public health and safeguarding concern. Research examining the impact of parental substance use upon children is well-established, but there is a lack of research examining how parents/caregivers cope with their parenting role within the context of another parent's substance use, or how best to sup...

Background Daily methadone maintenance or buprenorphine treatment is the standard-of-care (SoC) medication for opioid use disorder (OUD). Subcutaneously injected, extended-release buprenorphine (BUP-XR) may be more effective—but there has been no superiority evaluation. Methods This pragmatic, parallel-group, open-label, multi-centre, effectivenes...

Background and Aims Heavy alcohol use and depression commonly co‐occur. However, health and social care services rarely provide coordinated support for these conditions. Using relational autonomy, which recognizes how social and economic contexts and relational support alter people's capacity for agency, this study aimed to (1) explore how people e...

In 2021, during a drug-related death crisis in the UK, the Government published its ten-year drugs strategy. This article, written in collaboration with the Faculty of Public Health and the Association of Directors of Public Health, assesses whether this Strategy is evidence-based and consistent with international calls to promote public health app...

Introduction Opioid use disorder (OUD) is a debilitating and persistent disorder. The standard-of-care treatment is daily maintenance dosing of sublingual buprenorphine (BUP-SL) or oral methadone (MET). Monthly, extended-release, subcutaneous injectable buprenorphine (BUP-XR) has been developed to enhance treatment effectiveness. This study aims to...

Background Sublingual tablet buprenorphine (BUP-SL) and oral liquid methadone (MET) are the daily, standard-of-care (SOC) opioid agonist treatment medications for opioid use disorder (OUD). A sizable proportion of the OUD treatment population is not exposed to sufficient treatment to attain the desired clinical benefit. Two promising therapeutic te...

Amphetamine-type stimulants (ATS) are the second most commonly used class of illicit drugs globally, yet there is limited understanding of which factors contribute to different pathways of ATS use. We sought to compare current, former, and exposed non-ATS users' substance use, mental/physical health, and adverse life experiences. A cross-sectional...

Background and aims: Alcohol use increases throughout adolescence. Emergency Department (ED) attendance is an opportunity for alcohol screening and brief intervention (ASBI), which is effective for adults. This trial evaluated the effectiveness and cost-effectiveness of ASBI compared with screening alone (SA) in high-risk adolescents. Design: Mu...

Introduction Alcohol use by young people is associated with a range of psychological and physical harms. However, similar harms are also reported with disinhibitory conditions such as conduct problems that are said to precede and predispose to alcohol misuse. We explored whether alcohol use or indicators of underlying disinhibition predict psycholo...

This extensively revised new edition provides a practical guide to understanding, assessing and managing physical, psychological and social complications related to drug and alcohol use. It presents a clear review of the aetiology, epidemiology, prevention and treatment of the problematic use of and dependence on alcohol, illicit and prescribed dru...

BACKGROUND: Sublingual buprenorphine (BUP-SL) and liquid methadone (MET) and are the standard-of-care (SOC), daily maintenance medications for the treatment of opioid use disorder (OUD). A sizable proportion of the OUD treatment population does not adhere to treatment and achieve desired clinical benefit. Two promising therapeutic technologies addr...

2021 Background: Alcohol consumption and related harm increase rapidly from the age of 12 years. We evaluated whether alcohol screening and brief intervention is effective and cost-effective in delaying hazardous or harmful drinking amongst low-risk or abstaining adolescents attending Emergency Departments (EDs). Methods: This ten-centre, three-arm...

During independent re-analysis of the cost data for a PhD thesis, a coding error was identified in one of the sensitivity analyses of the cost-utility evaluation of the trial looking at the effect of excluding from the intervention and control costs the cost of missed school days.

Amphetamine Type Stimulants (ATS) are increasingly used drugs globally. There is limited evidence about what shapes ATS use at critical turning points located within drug using pathways. Using turning point theory, as part of a life course approach, the ATTUNE study aimed to understand which social, economic and individual factors shape pathways in...

Background Heavy alcohol consumption is associated with an increased risk of postoperative complications and extended hospital stay. Alcohol consumption therefore represents a modifiable risk factor for surgical outcomes. Brief behavioural interventions have been shown to be effective in reducing alcohol consumption among increased risk and risky d...

Background Alcohol consumption and related harm increase steeply from the ages of 12–20 years. Adolescents in the UK are among the heaviest drinkers in Europe. Excessive drinking in adolescents is associated with increased risk of accidents, injuries, self-harm, unprotected or regretted sex, violence and disorder, poisoning and accidental death. Ho...

Aims To explore adolescents’ experiences of consenting to, and participating in, alcohol intervention trials when attending for emergency care. Methods In-depth semi-structured interviews with 27 adolescents (16 males; aged 14–17 years (Mage = 15.7)) who had taken part in one of two linked brief alcohol intervention trials based in 10 accident and...

Background Adverse effects from young people’s alcohol consumption manifest in a range of physical and psychosocial factors, including neurological issues, cognitive impairment and risk-taking behaviours. The SIPS JR-HIGH pilot trial showed alcohol screening and brief intervention (ASBI) to be acceptable to young people and schools in the north-eas...

Background and aims There is limited evidence on what shapes Amphetamine Type Stimulant (ATS) use trajectories. This systematic narrative review and qualitative synthesis aimed to identify individual, social and environmental influences shaping key phases in the ATS use trajectory: initiation, continuation, increase/relapse, and decrease/abstinence...

Background: Evidence suggests that increased preoperative alcohol consumption increases the risk of postoperative complications; therefore, a reduction or cessation in alcohol intake before surgery may reduce perioperative risk. Preoperative assessment presents an opportunity to intervene to optimise patients for surgery. This multicentre, two-arm...

Aims: There is a clear association between alcohol use and offending behaviour and significant police time is spent on alcohol-related incidents. This study aimed to test the feasibility of a trial of screening and brief intervention in police custody suites to reduce heavy drinking and re-offending behaviour. Short summary: We achieved target recr...

Background: Between 5% and 30% of children in high-income countries live with a substance misusing parent, the majority of which is below dependent levels. However, little is understood about the impact of nondependent parental substance misuse upon children. Methods: We searched the international literature using rigorous systematic methods to...

Objective: To estimate and compare the optimal cut-off score of Alcohol Use Disorders Identification Test (AUDIT) and AUDIT-C in identifying at-risk alcohol consumption, heavy episodic alcohol use, ICD-10 alcohol abuse and alcohol dependence in adolescents attending ED in England. Design: Opportunistic cross-sectional survey. Setting: 10 emerg...

Introduction: The relationship between economic downturns and substance use has been studied in numerous economic crises occurring worldwide, but the precise relationship between the two remains unclear. Aims: The aim of the present study was to undertake a survey on behaviour and perspectives related to the latest European economic crisis among...

Purpose of the study To examine the use of alcohol and other substances among medical and law students at a UK university. Study design Anonymous cross-sectional questionnaire survey of first, second and final year medical and law students at a single UK university. Results 1242 of 1577 (78.8%) eligible students completed the questionnaire. Over...

Background Amphetamine-type stimulants, including amphetamine, methamphetamine, MDMA, and some novel psychoactive substances, are increasingly popular drugs in the UK and globally. Yet there is limited evidence on what shapes use of amphetamine-type stimulants across the life course. We aimed to systematically review and synthesise recent qualitati...

Background There is a known association between psoriasis and heavy alcohol consumption. The association between heavy alcohol consumption and other inflammatory skin diseases remains to be defined. Objectives To examine the prevalence of heavy drinking using the Alcohol Use Disorders Identification Test (AUDIT) in patients with inflammatory skin...

Background Family interventions appear to be effective at treating young people’s substance misuse. However, implementation of family approaches in UK services is low. This study aimed to demonstrate the feasibility of recruiting young people to an intervention based on an adaptation of adult social behaviour and network therapy. It also sought to...

Purpose: Globally, alcohol use is the leading cause of ill health and life years lost in adolescents, although its clinical impact is often overlooked, particularly in England where most research is based in schools. This study aims to examine the prevalence of alcohol consumption and the association between alcohol consumption and age of onset wi...

Introduction Drinking has adverse impacts on health, well-being, education and social outcomes for adolescents. Adolescents in England are among the heaviest drinkers in Europe. Recently, the proportion of adolescents who drink alcohol has fallen, although consumption among those who do drink has actually increased. This trial seeks to investigate...

Background A growing body of research has identified family interventions to be effective in treating young people’s substance use problems. However, despite this evidence, take-up of family-based approaches in the UK has been low. Key factors for this appear to include the resource-intensive nature of most family interventions which challenges imp...

Background: There is evidence of an association between alcohol use and offending behaviour and around a quarter of police time is spent on alcohol-related incidents. Police custody, therefore, provides an important opportunity to intervene. This pilot trial aims to investigate whether a definitive evaluation of screening and brief interventions a...

Purpose: The purpose of this paper is to examine the prevalence of alcohol use disorders (AUDs) amongst young people in the criminal justice system (CJS) in the North East of England and to compare the ability of the Alcohol Use Disorders Identification Test (AUDIT) to the Youth Justice Board ASSET tool in identifying alcohol-related need in Youth...

Background: Alcohol is a major global threat to public health. Although the main burden of chronic alcohol-related disease is in adults, its foundations often lie in adolescence. Alcohol consumption and related harm increase steeply from the age of 12 until 20 years. Several trials focusing upon young people have reported significant positive effe...

Title: A pilot feasibility trial cluster randomised controlled trial of screening and brief alcohol intervention to prevent hazardous drinking in young people aged 14-15 in a high school setting (SIPS JR-HIGH) Authors: Dorothy Newbury-Birch, Stephanie O’Neil, Amy O’Donnell, Simon Coulton, Denise Howel, Elaine McColl, Elaine Stamp, Erin Graybill, Ei...

Aim: To evaluate the effectiveness of different brief intervention strategies at reducing hazardous or harmful drinking in the probation setting. Offender managers were randomized to three interventions, each of which built on the previous one: feedback on screening outcome and a client information leaflet control group, 5 min of structured brief...

Background Alcohol misuse is common in people attending emergency departments (EDs) and there is some evidence of efficacy of alcohol screening and brief interventions (SBI). This study investigated the effectiveness of SBI approaches of different intensities delivered by ED staff in nine typical EDs in England: the SIPS ED trial. Methods and Find...

BackroundPrescribing for substance-dependent youth requires expert knowledge of developmental and contextual issues and use of largely unlicensed medicines. This first national survey aimed to determine the nature of pharmacological treatments delivered in England including the extent of maintenance therapy, supervised consumption and specialties p...

To evaluate the effectiveness of different brief intervention strategies at reducing hazardous or harmful drinking in primary care. The hypothesis was that more intensive intervention would result in a greater reduction in hazardous or harmful drinking. Pragmatic cluster randomised controlled trial. Primary care practices in the north east and sout...

Mean alcohol problems questionnaire (APQ) score by intervention group

Results of interaction tests

PaT plot of procedures

Background Early and heavy drinking by young adolescents is linked to intellectual impairment, increased risk of injury, mental health issues, unprotected or regretted sexual experience, violence, and sometimes accidental death. Our aim was to assess the feasibility of delivering brief alcohol intervention in a school setting with adolescents aged...

RADiANT Brief Advice Tool version 1.0, for use by midwives in the intervention condition.

Background Whilst the overall proportion of young people drinking alcohol in the United Kingdom has decreased in recent years, those who do drink appear to drink a larger amount, and more frequently. Early and heavy drinking by younger adolescents is a significant public health problem linked to intellectual impairment, increased risk of injuries,...

Objectives: This study explored individual and organisational barriers to and facilitators of effective implementation of alcohol screening and brief intervention in 9 Emergency Departments (EDs). This study was part of a large UK research programme on Screening and Intervention Programme for Sensible Drinking (SIPS). Methods: Nine EDs were recruit...

To examine the feasibility and acceptability of alcohol screening and delivery of brief interventions within criminal justice settings. A quantitative survey of those aged 18 or over in English criminal justice settings (three custody suites within police stations, three prisons and three probation offices). The Fast Alcohol Screening Test (FAST) a...

Background Risky drinking in pregnancy by UK women is likely to result in many alcohol-exposed pregnancies. Studies from the USA suggest that brief intervention has promise for alcohol risk reduction in antenatal care. However, further research is needed to establish whether this evidence from the USA is applicable to the UK. This pilot study aims...

A large number of randomised controlled trials in health settings have consistently reported positive effects of brief intervention in terms of reductions in alcohol use. However, although alcohol misuse is common amongst offenders, there is limited evidence of alcohol brief interventions in the criminal justice field. This factorial pragmatic clus...

There have been many randomized controlled trials of screening and brief alcohol intervention in primary care. Most trials have reported positive effects of brief intervention, in terms of reduced alcohol consumption in excessive drinkers. Despite this considerable evidence-base, key questions remain unanswered including: the applicability of the e...

In this paper we report the results of research on the nature and extent of legal and illegal drug use among preteens and those factors associated with illegal drug use at this young age. The paper is based upon a survey of 2318 ten to twelve year olds in Glasgow and Newcastle. Overall around 30% of children reported having been exposed to illegal...

With the increase in drug use and abuse among young people special 'high risk' populations merit particular consideration. Those with substance use disorder commonly have co-morbid psychiatric problems, present with complex needs that require more intensive interventions, specific expertise, training and a variety of appropriate services. Barriers...

Prenatal care reduces the impact of illicit drug use on perinatal outcomes. Women who misuse substances are often excluded from mainstream society and, on becoming pregnant, feel guilty about their drug misuse and the potential effects this could have on their unborn baby. These women are vulnerable in many ways and agencies must ensure that they a...

There is a wealth of evidence regarding the detrimental impact of excessive alcohol consumption on the physical, psychological and social health of the population. There also exists a substantial evidence base for the efficacy of brief interventions aimed at reducing alcohol consumption across a range of healthcare settings. Primary research conduc...

This article outlines the majority of the adverse physical effects that have been described secondary to the consumption of alcohol at levels above recommended sensible limits. These conditions are cited according to the organ system they belong to. Only brief descriptions are provided because of the vastness of this topic. The underlying pathophys...

This chapter describes the common legal and policy context and the pattern of resources that frame and determine how services in England respond to young people in difficulty. It also aims to conceptualize how apparently different organizations can knit together to provide integrated services for young people with complex difficulties. In doing so,...

Regional variations in rates of drug use have been described previously in relation to adolescents. However, reasons for these differences are not clear. Previous publications pointed to higher rates of drug use by Glasgow children compared to children living in Newcastle upon Tyne. This paper explores the hypothesis that a higher rate of drug use...

Alcohol misuse and dependence is a major health and social issue worldwide. This review addresses alcohol dependence, the current approaches to treatment and some methods for trying to prevent relapses.

Buprenorphine safety in overdose has been debated recently, but no mortality data related to this compound from the UK have been published. To gather together all of the buprenorphine mortality figures, a number of different sources have been checked. To inform on buprenorphine safety issues, accessible information related to its availability indic...

Gamma-hydroxybutyrate misuse is a relatively recent phenomenon and one that is far from clearly understood in terms of the likely cost to the user and to the wider community. There have been no systematic studies of the prevalence of dependency on GHB in the UK, nor do we have sufficient information relating to the demographic characteristics or th...

The use of illicit substances has increased in western societies over recent decades, with rates of substance use, including alcohol and tobacco, in the UK currently outstripping those reported in other European countries. There is evidence of earlier age of initiation of substance use including heroin use, as well as polysubstance use (McKeganey e...

Στόχοι: ο στόχος αυτής της μελέτης ήταν αφενός να διερευνήσει τη δομή της οικογένειας και να υπολογίσει τη λειτουργικότητά της αναφορικά με τη χρήση ουσιών από τους εφήβους και αφετέρου να αποδείξει εάν αυτές οι σχέσεις διέφεραν ανάλογα με το φύλο ή ανάλογα με την πόλη απ’ όπου κατάγεται το δείγμα. Σχεδιασμός, χώρος, συμμετέχοντες: η μελέτη αυτή πρ...

The aim of this study was, first, to explore family structure and measures of family functioning in relation to adolescent substance use and secondly, to establish if these relationships differed according to gender or according to the city of origin of the sample. The study surveyed pupils aged 14-15 years in representative samples drawn from five...

We retrospectively reviewed the provision and uptake of hospital services for 253 current and ex-intravenous drug users with hepatitis C virus (HCV). Overall, 237 attended at least one clinic (mean age 32 years, 70% male, 43% on maintenance methadone); 81% had evidence of active viral replication and 137 agreed to a liver biopsy to assess disease s...

This international study investigates factors underlying international variations in rates of youth drug use among representative samples of 15-year-olds in five cities (Bremen, n = 871; Dublin, n = 983; Groningen, n = 487; Newcastle upon Tyne, n = 880; Rome, n = 666). It reveals a higher level of drug use in English-speaking compared to continenta...

The rates of substance use disorders in adolescent persons, the coexistence of other psychiatric disorders, the early initiation of tobacco, drug and alcohol use, and the importance of parental substance use demands early identification, comprehensive assessments, and application of evidence-based prevention and treatment programmes.