Publications by authors named "Dan Lewer"

Background: Nearly 3% of adults have attention-deficit and hyperactivity disorder (ADHD), although in the UK, most are undiagnosed. Adults with ADHD on average experience poorer educational and employment outcomes, worse physical and mental health and are more likely to die prematurely. No studies have yet used mortality data to examine the life expectancy deficit experienced by adults with diagnosed ADHD in the UK or worldwide.

View Article and Find Full Text PDF

Background: Opioid substitution therapy (also known as 'opioid agonist therapy' or 'medication treatment of opioid use disorder') is associated with improved health and social outcomes for people who use heroin and other illicit opioids. It is typically managed in the community and is not always continued when people are admitted to hospital. This causes opioid withdrawal, patient-directed discharge, and increased costs.

View Article and Find Full Text PDF

Background: Management of opioid withdrawal in hospital settings is crucial to improve treatment completion and health outcomes among patients who use opioids, such as heroin. Evidence-based clinical guidelines can support responsive provision of opioid substitution therapy (OST). In England there is no standardised application of guidance for substance dependence management across National Health Service (NHS) Hospitals.

View Article and Find Full Text PDF
Article Synopsis
  • Individual injecting practices, like poor hygiene and methods of injecting, can lead to infections, but social factors also heavily influence health outcomes in these scenarios.
  • A review of 107 studies highlighted factors like female gender, homelessness, and substance use that are linked to higher rates of injecting-related infections.
  • Effective prevention and treatment strategies should focus not only on individual behaviors but also on the broader social conditions affecting those who use injectable drugs.
View Article and Find Full Text PDF

Background: Vaping products are effective for helping people to stop smoking and may therefore offer a potential means to reduce high rates of smoking in socioeconomically disadvantaged groups. This study aimed to examine current patterns and perceptions of vaping among people living in social housing in Great Britain compared with those living in other housing types.

Methods: Data were from the Smoking Toolkit Study; a nationally-representative survey conducted in 2023 (n = 23,245).

View Article and Find Full Text PDF

Background: Autistic people are disproportionately likely to experience premature mortality and most mental and physical health conditions. We measured the incidence of diagnosed conditions accounting for the most disability-adjusted life years in the UK population according to the Global Burden of Disease study (anxiety, depression, self-harm, harmful alcohol use, substance use, migraine, neck or back pain, and gynaecological conditions).

Methods: Participants were aged 18 years or above and had an autism diagnosis recorded in the IQVIA Medical Research Database between 01/01/2000 and 16/01/2019.

View Article and Find Full Text PDF

Background: Exposure to air pollution during childhood has been linked with adverse effects on cognitive development and motor function. However, limited research has been done on the associations of air pollution exposure in different microenvironments such as home, school, or while commuting with these outcomes.

Objective: To analyze the association between childhood air pollution exposure in different microenvironments and cognitive and fine motor function from six European birth cohorts.

View Article and Find Full Text PDF

Purpose: To estimate variation in emotional and behavioural problems between primary schools in Bradford, an ethnically diverse and relatively deprived city in the UK.

Methods: We did a cross-sectional analysis of data collected from 2017 to 2021 as part of the 'Born In Bradford' birth cohort study. We used multilevel linear regression in which the dependent variable was the Strengths and Difficulties Questionnaire (SDQ) total score, with a random intercept for schools.

View Article and Find Full Text PDF

Background: Previous research has shown that people who have been diagnosed autistic are more likely to die prematurely than the general population. However, statistics on premature mortality in autistic people have often been misinterpreted. In this study we aimed to estimate the life expectancy and years of life lost experienced by autistic people living in the UK.

View Article and Find Full Text PDF

Background And Aims: People who use illicit opioids have higher mortality and morbidity than the general population. Limited quantitative research has investigated how this population engages with health-care, particularly regarding planned and primary care. We aimed to measure health-care use among patients with a history of illicit opioid use in England across five settings: general practice (GP), hospital outpatient care, emergency departments, emergency hospital admissions and elective hospital admissions.

View Article and Find Full Text PDF

There is increasing international interest in the use of police drug diversion schemes that offer people suspected of minor drug-related offences an educative or therapeutic intervention as an alternative to criminalisation. While there have been randomised trials of some such schemes for their effects on reducing offending, with generally positive results, less is known about the health outcomes, and what works, for whom, in what circumstances and why. This protocol reports on a realist evaluation of police drug diversion in England that has been coproduced by a team of academic, policing, health, and service user partners.

View Article and Find Full Text PDF

Background: Transitional times in opioid use, such as release from prison and discontinuation of opioid agonist treatment (OAT), are associated with health harms due to changing drug consumption practices and limited access to health and social supports. Using a self-controlled (within-person) study design, we aimed to understand if these transitions increase risks of injection drug use-associated bacterial infections.

Methods: We performed a self-controlled case series among a cohort of people with opioid use disorder (who had all previously accessed OAT) in New South Wales, Australia, 2001-2018.

View Article and Find Full Text PDF

Inclusion health groups make up a small proportion of the general population, so despite the extreme social exclusion and poor health outcomes that these groups experience, they are often overlooked in public health investment and policy development. In this paper, we demonstrate that a utilitarian argument can be made for investment in better support for inclusion health groups despite their small size. That is, by preventing social exclusion, there is the potential for large aggregate health benefits to the whole population.

View Article and Find Full Text PDF
Article Synopsis
  • - The study examines how social and structural factors influence the rise of bacterial and fungal infections among injection drug users, emphasizing that these contexts shape both injecting practices and treatment experiences.
  • - A thorough review of qualitative research revealed six descriptive themes, categorized into two main analytical themes: social production of risk (addressing macro-environmental influences like drug supply quality and healthcare practices) and practices of care (highlighting protective strategies employed by users, such as mutual care and self-care).
  • - The findings highlight the complex interplay between societal conditions and individual behaviors, suggesting the need for improved harm reduction policies and healthcare access to better address injection-related infections.
View Article and Find Full Text PDF
Article Synopsis
  • Those who use heroin or other illegal opioids are at a significant risk of fatal overdose shortly after being discharged from the hospital, a phenomenon that has not been thoroughly examined.* -
  • Researchers analyzed 121 coroner reports from the National Programme on Substance Abuse Deaths, focusing on deaths related to opioid use occurring during hospital stays or within 14 days post-discharge.* -
  • The study found that factors contributing to the risk of overdose included hospital policies that discourage openness about drug use, increased use of sedatives during recovery, and underlying health issues that hindered access to treatment after discharge.*
View Article and Find Full Text PDF

Background: Bacterial infections cause substantial pain and disability among people who inject drugs. We described time trends in hospital admissions for injecting-related infections in England.

Methods: We analyzed hospital admissions in England between January 2002 and December 2021.

View Article and Find Full Text PDF
Article Synopsis
  • The study investigates the annual increase in drug poisoning deaths in England and Wales from 1993 to 2018, focusing on seasonal and cyclical patterns.
  • It finds that the death rate peaked in Spring and was notably higher during New Year's celebrations, particularly for non-opioid related deaths.
  • Overall, while the seasonal trends exist, they are minor compared to the overall long-term rise in drug-related fatalities.
View Article and Find Full Text PDF

Objective: To understand the burden of chronic obstructive pulmonary disease among people who use illicit opioids such as heroin, and evaluate inequalities in treatment.

Design: Cohort study.

Setting: Patients registered at primary care practices in England.

View Article and Find Full Text PDF

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 approaches to drugs, which put 'people, health and human rights at the centre'. Elements of the Strategy are welcome, including the promise of significant funding for drug treatment services, the effects of which will depend on how it is utilized by services and local commissioners and whether it is sustained.

View Article and Find Full Text PDF

A PHP Error was encountered

Severity: Warning

Message: fopen(/var/lib/php/sessions/ci_sessionoc3pafjorj27hh5ic7c6vdmv3nnbhs15): Failed to open stream: No space left on device

Filename: drivers/Session_files_driver.php

Line Number: 177

Backtrace:

File: /var/www/html/index.php
Line: 316
Function: require_once

A PHP Error was encountered

Severity: Warning

Message: session_start(): Failed to read session data: user (path: /var/lib/php/sessions)

Filename: Session/Session.php

Line Number: 137

Backtrace:

File: /var/www/html/index.php
Line: 316
Function: require_once