Introduction and AimsAcute harm from heavy drinking episodes is an increasing focus of public health policy, but capturing timely data on acute harms in the population is challenging. This study aimed to evaluate the precision of readily available administrative emergency department (ED) data in public health surveillance of acute alcohol harms.Design and MethodsWe selected a random sample of 1000 ED presentations assigned an ED diagnosis code for alcohol harms (the ‘alcohol syndrome’) in the New South Wales, Australia, automatic syndromic surveillance system. The sample was selected from 68 public hospitals during 2014. Nursing triage free‐text fields were independently reviewed to confirm alcohol consumption and classify each presentation into either an ‘acute’ or ‘chronic’ harm. Positive predictive value (PPV) for acute harm was calculated, and predictors of acute harm presentations were estimated using logistic regression.ResultsThe PPV of the alcohol syndrome for acute alcohol harm was 53.5%. Independent predictors of acute harm were ambulance arrival [adjusted odds ratio (aOR) = 3.4, 95% confidence interval (CI) 2.4–4.7], younger age (12–24 vs. 25–39 years: aOR = 3.4, 95% CI 2.2–5.3), not being admitted (aOR 2.2, 95% CI 1.5–3.2) and arriving between 10 pm and 5.59 am (aOR 2.1, 95% CI 1.5–2.8). PPV among 12 to 24‐year‐olds was 82%.Discussion and Conclusions The alcohol syndrome provides moderate precision as an indicator of acute alcohol harms presenting to the ED. Precision for monitoring acute harm in the population is improved by filtering the syndrome by the strongest independent predictors of acute alcohol harm presentations. [Whitlam G, Dinh M, Rodgers C, Muscatello DJ, McGuire R, Ryan T, Thackway S. Diagnosis‐based emergency department alcohol harm surveillance: What can it tell us about acute alcohol harms at the population level? Drug Alcohol Rev 2016;35:693–701]

Introduction Substance use disorders are more prevalent among lesbian, gay, bisexual, transgender and queer (LGBTQ) people than among their heterosexual and cisgender peers. There has been limited alcohol and other drug (AOD) treatment research with LGBTQ people outside of North America. This study aimed to examine the treatment outcomes of clients attending a LGBTQ‐specific AOD counselling service in Australia (ACON's Substance Support Service) and compare their client profile and treatment outcomes with LGBTQ and non‐LGBTQ clients of similar mainstream services. Methods This study was a retrospective analysis of the health records of 284 ACON clients and 1011 clients of five mainstream services in 2016–2018. Clients completed clinical interviews at treatment entry and periodically throughout treatment and completed measures of substance use, severity of dependence, psychological distress and quality of life. Results Most ACON clients were seeking treatment for methamphetamine (58%) and alcohol use (26%). Among ACON clients, there were reductions in past month days of substance use and severity of dependence between treatment entry and counselling sessions 4, 8 and 12 (all P < 0.001). There were statistically significant reductions in psychological distress and improved quality of life among ACON clients. Despite ACON and the mainstream services having similar treatment approaches, their client profiles were markedly different in terms of sociodemographic characteristics, substance use and source of referral, which precluded comparison of treatment outcomes. Discussion and Conclusions ACON's clients showed reduced substance use and improved psychosocial wellbeing during treatment. The findings support the provision of LGBTQ‐specific AOD services.

The New South Wales School Students Health Behaviours Survey (2014) reported a substantial reduction in students aged 12-17 years reporting that they had ever consumed alcohol, from 82.7% in 2005 to 65.1% in 2014. Similar downward trends are reported nationally and internationally. Although overall consumption is declining, national recommendations maintain that it is safest for young people to not drink at all; however, 17% of all young people in Australia consumed alcohol in the past 7 days, with 6% consuming at a significant risk of harm. The factors that influence young people's uptake of alcohol are complex, including biological and broader social factors. This paper identifies some of the diverse influences on young people's alcohol consumption, and policies and programs that support healthy behaviours. IntroductionFor people younger than 18 years, not drinking alcohol is the safest option. 1National guidelines also recommend delaying the first drink of alcohol for young people aged 15-17 years. A promising picture is emerging in line with these recommendations, with clear trends of young Australians delaying their first use of alcohol and refraining from alcohol consumption entirely. National and international alcohol consumption patterns in young peopleThe National Drug Strategy Household Survey 2013 reported a decrease in the proportion of young people (aged 12-17 years) who had ever consumed a full serve of alcohol from 41% in 2010 to 32% in 2013. This coincides with a rise in the average age of alcohol initiation (having consumed at least one full serve of alcohol) for younger people from 14.4 years in 1998 to 15.7 years in 2013.