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Hearps AC, Vootukuru N, Ebrahimnezhaddarzi S, Harney BL, Boo I, Nguyen L, Pavlyshyn D, Dietze PM, Drummer HE, Thompson AJ, Jaworowski A, Hellard ME, Sacks-Davis R, Doyle JS. Injecting drug use and hepatitis C virus infection independently increase biomarkers of inflammatory disease risk which are incompletely restored by curative direct-acting antiviral therapy. Front Immunol 2024; 15:1352440. [PMID: 38420130 PMCID: PMC10899672 DOI: 10.3389/fimmu.2024.1352440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 01/25/2024] [Indexed: 03/02/2024] Open
Abstract
Background Hepatitis C virus (HCV) infections are more prevalent in people who inject drugs (PWID) who often experience additional health risks. HCV induces inflammation and immune alterations that contribute to hepatic and non-hepatic morbidities. It remains unclear whether curative direct acting antiviral (DAA) therapy completely reverses immune alterations in PWID. Methods Plasma biomarkers of immune activation associated with chronic disease risk were measured in HCV-seronegative (n=24) and HCV RNA+ (n=32) PWID at baseline and longitudinally after DAA therapy. Adjusted generalised estimating equations were used to assess longitudinal changes in biomarker levels. Comparisons between community controls (n=29) and HCV-seronegative PWID were made using adjusted multiple regression modelling. Results HCV-seronegative PWID exhibited significantly increased levels of inflammatory biomarkers including soluble (s) TNF-RII, IL-6, sCD14 and sCD163 and the diabetes index HbA1c as compared to community controls. CXCL10, sTNF-RII, vascular cell adhesion molecule-1 and lipopolysaccharide binding protein (LBP) were additionally elevated in PWID with viremic HCV infection as compared to HCV- PWID. Whilst curative DAA therapy reversed some biomarkers, others including LBP and sTNF-RII remained elevated 48 weeks after HCV cure. Conclusion Elevated levels of inflammatory and chronic disease biomarkers in PWID suggest an increased risk of chronic morbidities such as diabetes and cardiovascular disease. HCV infection in PWID poses an additional disease burden, amplified by the incomplete reversal of immune dysfunction following DAA therapy. These findings highlight the need for heightened clinical surveillance of PWID for chronic inflammatory diseases, particularly those with a history of HCV infection.
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Affiliation(s)
- Anna C. Hearps
- Disease Elimination Program, Burnet Institute, Melbourne, VIC, Australia
- Department of Infectious Diseases, The Alfred and Monash University, Melbourne, VIC, Australia
| | - Nikil Vootukuru
- Disease Elimination Program, Burnet Institute, Melbourne, VIC, Australia
- Department of Gastroenterology, Eastern Health and Monash University, Melbourne, VIC, Australia
| | | | - Brendan L. Harney
- Disease Elimination Program, Burnet Institute, Melbourne, VIC, Australia
- Department of Infectious Diseases, The Alfred and Monash University, Melbourne, VIC, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Irene Boo
- Disease Elimination Program, Burnet Institute, Melbourne, VIC, Australia
| | - Long Nguyen
- Disease Elimination Program, Burnet Institute, Melbourne, VIC, Australia
| | - Damian Pavlyshyn
- Disease Elimination Program, Burnet Institute, Melbourne, VIC, Australia
| | - Paul M. Dietze
- Disease Elimination Program, Burnet Institute, Melbourne, VIC, Australia
- National Drug Research Institute, Curtin University, Melbourne, VIC, Australia
| | - Heidi E. Drummer
- Disease Elimination Program, Burnet Institute, Melbourne, VIC, Australia
- The Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, VIC, Australia
- Department of Microbiology, Monash University, Melbourne, VIC, Australia
| | - Alexander J. Thompson
- Department of Gastroenterology, St Vincent’s Hospital and the University of Melbourne, Melbourne, VIC, Australia
| | - Anthony Jaworowski
- Disease Elimination Program, Burnet Institute, Melbourne, VIC, Australia
- Department of Infectious Diseases, The Alfred and Monash University, Melbourne, VIC, Australia
| | - Margaret E. Hellard
- Disease Elimination Program, Burnet Institute, Melbourne, VIC, Australia
- Department of Infectious Diseases, The Alfred and Monash University, Melbourne, VIC, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
- The Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, VIC, Australia
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Rachel Sacks-Davis
- Disease Elimination Program, Burnet Institute, Melbourne, VIC, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Joseph S. Doyle
- Disease Elimination Program, Burnet Institute, Melbourne, VIC, Australia
- Department of Infectious Diseases, The Alfred and Monash University, Melbourne, VIC, Australia
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Lau G, Ang JY, Kim N, Gabbe BJ, Mitra B, Dietze PM, Reeder S, Beck B. Approaches and reporting of alcohol and other drug testing for injured patients in hospital-based studies: A systematic review. Drug Alcohol Rev 2024. [PMID: 38316529 DOI: 10.1111/dar.13816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 12/18/2023] [Accepted: 01/02/2024] [Indexed: 02/07/2024]
Abstract
ISSUE Hospital alcohol and/or other drug (AOD) testing is important for identifying AOD-related injuries; however, testing methods vary. This systematic review aimed to examine biological AOD testing methods from hospital-based studies of injured patients and quantify what proportion reported key information on those testing methods. APPROACH Observational studies published in English from 2010 onwards involving biological AOD testing for injured patients presenting to hospital were included. Studies examining single injury causes were excluded. Extracted data included concentration thresholds for AOD detection (e.g., lower limits of detection, author-defined cut-offs), test type (e.g., immunoassay, breathalyser) and approach (e.g., routine, clinical discretion), timing of testing, sample type and the proportion of injured cases tested for AODs. KEY FINDINGS Of 83 included studies, 76 measured alcohol and 37 other drugs. Forty-nine studies defined blood alcohol concentration thresholds (ranging from 0 to 0.1 g/100 mL). Seven studies defined concentration thresholds for other drugs. Testing approach was reported in 39/76 alcohol and 18/37 other drug studies. Sample type was commonly reported (alcohol: n = 69/76; other drugs: n = 28/37); alcohol was typically measured using blood (n = 60) and other drugs using urine (n = 20). Studies that reported the proportion of cases tested (alcohol: n = 53/76; other drugs: n = 28/37), reported that between 0% and 89% of cases were not tested for alcohol and 0% and 91% for other drugs. Timing of testing was often unreported (alcohol: n = 61; other drugs: n = 30). IMPLICATIONS AND CONCLUSION Variation in AOD testing methods alongside incomplete reporting of those methods limits data comparability and interpretation. Standardised reporting of testing methods will assist AOD-related injury surveillance and prevention.
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Affiliation(s)
- Georgina Lau
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Jia Y Ang
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Nayoung Kim
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Belinda J Gabbe
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Health Data Research UK, Swansea University Medical School, Swansea University, Swansea, UK
| | - Biswadev Mitra
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Emergency and Trauma Centre, The Alfred Hospital, Melbourne, Australia
| | - Paul M Dietze
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Disease Elimination Program, Burnet Institute, Melbourne, Australia
- National Drug Research Institute, Curtin University, Perth, Australia
| | - Sandra Reeder
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Central Clinical School, Monash University, Melbourne, Australia
| | - Ben Beck
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
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3
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Lau G, Mitra B, Gabbe BJ, Dietze PM, Reeder S, Cameron PA, Smit DV, Schneider HG, Symons E, Koolstra C, Stewart C, Beck B. Prevalence of alcohol and other drug detections in non-transport injury events. Emerg Med Australas 2024; 36:78-87. [PMID: 37717234 PMCID: PMC10952644 DOI: 10.1111/1742-6723.14312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Revised: 08/15/2023] [Accepted: 08/21/2023] [Indexed: 09/19/2023]
Abstract
OBJECTIVE To measure the prevalence of alcohol and/or other drug (AOD) detections in suspected major trauma patients with non-transport injuries who presented to an adult major trauma centre. METHODS This registry-based cohort study examined the prevalence of AOD detections in patients aged ≥18 years who: (i) sustained non-transport injuries; and (ii) met predefined trauma call-out criteria and were therefore managed by an interdisciplinary trauma team between 1 July 2021 and 31 December 2022. Prevalence was measured using routine in-hospital blood alcohol and urine drug screens. RESULTS A total of 1469 cases met the inclusion criteria. Of cases with a valid blood test (n = 1248, 85.0%), alcohol was detected in 313 (25.1%) patients. Of the 733 (49.9%) cases with urine drug screen results, cannabinoids were most commonly detected (n = 103, 14.1%), followed by benzodiazepines (n = 98, 13.4%), amphetamine-type substances (n = 80, 10.9%), opioids (n = 28, 3.8%) and cocaine (n = 17, 2.3%). Alcohol and/or at least one other drug was detected in 37.4% (n = 472) of cases with either a blood alcohol or urine drug test completed (n = 1263, 86.0%). Multiple substances were detected in 16.6% (n = 119) of cases with both blood alcohol and urine drug screens (n = 718, 48.9%). Detections were prevalent in cases of interpersonal violence (n = 123/179, 68.7%) and intentional self-harm (n = 50/106, 47.2%), and in those occurring on Friday and Saturday nights (n = 118/191, 61.8%). CONCLUSION AOD detections were common in trauma patients with non-transport injury causes. Population-level surveillance is needed to inform prevention strategies that address AOD use as a significant risk factor for serious injury.
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Affiliation(s)
- Georgina Lau
- School of Public Health and Preventive MedicineMonash UniversityMelbourneVictoriaAustralia
| | - Biswadev Mitra
- School of Public Health and Preventive MedicineMonash UniversityMelbourneVictoriaAustralia
- Emergency and Trauma CentreThe Alfred HospitalMelbourneVictoriaAustralia
| | - Belinda J Gabbe
- School of Public Health and Preventive MedicineMonash UniversityMelbourneVictoriaAustralia
- Health Data Research UK, Swansea University Medical SchoolSwansea UniversitySwanseaUK
| | - Paul M Dietze
- Disease Elimination Program, Burnet InstituteMelbourneVictoriaAustralia
- National Drug Research InstituteCurtin UniversityPerthWestern AustraliaAustralia
| | - Sandra Reeder
- School of Public Health and Preventive MedicineMonash UniversityMelbourneVictoriaAustralia
- Central Clinical SchoolMonash UniversityMelbourneVictoriaAustralia
| | - Peter A Cameron
- School of Public Health and Preventive MedicineMonash UniversityMelbourneVictoriaAustralia
- Emergency and Trauma CentreThe Alfred HospitalMelbourneVictoriaAustralia
| | - De Villiers Smit
- School of Public Health and Preventive MedicineMonash UniversityMelbourneVictoriaAustralia
- Emergency and Trauma CentreThe Alfred HospitalMelbourneVictoriaAustralia
- National Trauma Research InstituteThe Alfred HospitalMelbourneVictoriaAustralia
| | - Hans G Schneider
- School of Public Health and Preventive MedicineMonash UniversityMelbourneVictoriaAustralia
- Department of PathologyThe Alfred HospitalMelbourneVictoriaAustralia
| | - Evan Symons
- Alfred Mental and Addiction HealthThe Alfred HospitalMelbourneVictoriaAustralia
| | - Christine Koolstra
- School of Public Health and Preventive MedicineMonash UniversityMelbourneVictoriaAustralia
- Emergency and Trauma CentreThe Alfred HospitalMelbourneVictoriaAustralia
| | - Cara Stewart
- School of Public Health and Preventive MedicineMonash UniversityMelbourneVictoriaAustralia
- Emergency and Trauma CentreThe Alfred HospitalMelbourneVictoriaAustralia
| | - Ben Beck
- School of Public Health and Preventive MedicineMonash UniversityMelbourneVictoriaAustralia
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4
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Lau G, Ang JY, Kim N, Gabbe BJ, Mitra B, Dietze PM, Reeder S, Scott D, Beck B. Prevalence of Alcohol and Other Drug Use in Patients Presenting to Hospital for Violence-Related Injuries: A Systematic Review. Trauma Violence Abuse 2024; 25:306-326. [PMID: 36794786 PMCID: PMC10666504 DOI: 10.1177/15248380221150951] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Substance use is a risk factor for being both a perpetrator and a victim of violence. The aim of this systematic review was to report the prevalence of acute pre-injury substance use in patients with violence-related injuries. Systematic searches were used to identify observational studies that included patients aged ≥15 years presenting to hospital after violence-related injuries and used objective toxicology measures to report prevalence of acute pre-injury substance use. Studies were grouped based on injury cause (any violence-related, assault, firearm, and other penetrating injuries including stab and incised wounds) and substance type (any substance, alcohol only, drugs other than alcohol only), and they were summarized using narrative synthesis and meta-analyses. This review included 28 studies. Alcohol was detected in 13%-66% of any violence-related injuries (five studies), 4%-71% of assaults (13 studies), 21%-45% of firearm injuries (six studies; pooled estimate = 41%, 95% CI: 40%-42%, n = 9,190), and 9%-66% of other penetrating injuries (nine studies; pooled estimate = 60%, 95% CI: 56%-64%, n = 6,950). Drugs other than alcohol were detected in 37% of any violence-related injuries (one study), 39% of firearm injuries (one study), 7%-49% of assaults (five studies), and 5%-66% of penetrating injuries (three studies). The prevalence of any substance varied across injury categories: any violence-related injuries = 76%-77% (three studies), assaults = 40%-73% (six studies), firearms = n/a, other penetrating injuries = 26%-45% (four studies; pooled estimate = 30%, 95% CI: 24%-37%, n = 319).Overall, substance use was frequently detected in patients presenting to hospital for violence-related injuries. Quantification of substance use in violence-related injuries provides a benchmark for harm reduction and injury prevention strategies.
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Affiliation(s)
| | - Jia Y. Ang
- Monash University, Melbourne, VIC, Australia
| | - Nayoung Kim
- Monash University, Melbourne, VIC, Australia
| | - Belinda J. Gabbe
- Monash University, Melbourne, VIC, Australia
- Swansea University, Swansea, UK
| | - Biswadev Mitra
- Monash University, Melbourne, VIC, Australia
- Emergency and Trauma Centre, The Alfred Hospital, Melbourne, VIC, Australia
| | - Paul M. Dietze
- Burnet Institute, Melbourne, VIC, Australia
- Curtin University, Perth, WA, Australia
| | | | - Debbie Scott
- Monash University, Melbourne, VIC, Australia
- Turning Point, Melbourne, VIC, Australia
| | - Ben Beck
- Monash University, Melbourne, VIC, Australia
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5
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Curtis SJ, Colledge-Frisby S, Stewardson AJ, Doyle JS, Higgs P, Maher L, Hickman M, Stoové MA, Dietze PM. Prevalence and incidence of emergency department presentations and hospital separations with injecting-related infections in a longitudinal cohort of people who inject drugs. Epidemiol Infect 2023; 151:e192. [PMID: 37953739 PMCID: PMC10728979 DOI: 10.1017/s0950268823001784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 10/05/2023] [Accepted: 10/26/2023] [Indexed: 11/14/2023] Open
Abstract
People who inject drugs are at risk of acute bacterial and fungal injecting-related infections. There is evidence that incidence of hospitalizations for injecting-related infections are increasing in several countries, but little is known at an individual level. We aimed to examine injecting-related infections in a linked longitudinal cohort of people who inject drugs in Melbourne, Australia. A retrospective descriptive analysis was conducted to estimate the prevalence and incidence of injecting-related infections using administrative emergency department and hospital separation datasets linked to the SuperMIX cohort, from 2008 to 2018. Over the study period, 33% (95%CI: 31-36%) of participants presented to emergency department with any injecting-related infections and 27% (95%CI: 25-30%) were admitted to hospital. Of 1,044 emergency department presentations and 740 hospital separations, skin and soft tissue infections were most common, 88% and 76%, respectively. From 2008 to 2018, there was a substantial increase in emergency department presentations and hospital separations with any injecting-related infections, 48 to 135 per 1,000 person-years, and 18 to 102 per 1,000 person-years, respectively. The results emphasize that injecting-related infections are increasing, and that new models of care are needed to help prevent and facilitate early detection of superficial infection to avoid potentially life-threatening severe infections.
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Affiliation(s)
- Stephanie J. Curtis
- Disease Elimination Program, Burnet Institute, Melbourne, VIC, Australia
- Department of Infectious Diseases, the Alfred Hospital and Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - Samantha Colledge-Frisby
- Disease Elimination Program, Burnet Institute, Melbourne, VIC, Australia
- National Drug Research Institute, Curtin University, Melbourne, VIC, Australia
| | - Andrew J. Stewardson
- Department of Infectious Diseases, the Alfred Hospital and Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - Joseph S. Doyle
- Disease Elimination Program, Burnet Institute, Melbourne, VIC, Australia
- Department of Infectious Diseases, the Alfred Hospital and Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - Peter Higgs
- Disease Elimination Program, Burnet Institute, Melbourne, VIC, Australia
- Department of Public Health, La Trobe University, Bundoora, VIC, Australia
| | - Lisa Maher
- Disease Elimination Program, Burnet Institute, Melbourne, VIC, Australia
- The Kirby Institute, Faculty of Medicine, UNSW, Wallace Wurth Building, Kensington, NSW, Australia
| | - Matthew Hickman
- Disease Elimination Program, Burnet Institute, Melbourne, VIC, Australia
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Mark A. Stoové
- Disease Elimination Program, Burnet Institute, Melbourne, VIC, Australia
- The Kirby Institute, Faculty of Medicine, UNSW, Wallace Wurth Building, Kensington, NSW, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Paul M. Dietze
- Disease Elimination Program, Burnet Institute, Melbourne, VIC, Australia
- National Drug Research Institute, Curtin University, Melbourne, VIC, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
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6
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Callinan S, Coomber K, Bury K, Wilkinson C, Stafford J, Riesenberg D, Dietze PM, Room R, Miller PG. In order to assess the impact of home delivery expansion within Australia, researchers need regulators to collect and share data on sales. Drug Alcohol Rev 2023; 42:1309-1311. [PMID: 36974378 DOI: 10.1111/dar.13648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 03/03/2023] [Accepted: 03/06/2023] [Indexed: 03/29/2023]
Affiliation(s)
- Sarah Callinan
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
| | - Kerri Coomber
- Centre for Drug Use, Addictive and Anti-social Behaviour Research, School of Psychology, Deakin University, Waterfront Campus, Geelong, Australia
| | - Keira Bury
- Cancer Council Western Australia, Perth, Australia
| | | | | | | | - Paul M Dietze
- National Drug Research Institute, Curtin University, Melbourne, Australia
- Behaviours and Health Risks, The Burnet Institute, Melbourne, Australia
| | - Robin Room
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
- Centre for Social Research on Alcohol and Drugs, Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
| | - Peter G Miller
- Centre for Drug Use, Addictive and Anti-social Behaviour Research, School of Psychology, Deakin University, Waterfront Campus, Geelong, Australia
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7
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Raggatt M, Wright CJC, Sacks-Davis R, Dietze PM, Hellard ME, Hocking JS, Lim MSC. Identifying the Most Effective Recruitment Strategy Using Financial Reimbursements for a Web-Based Peer Network Study With Young People Aged 16-18 Years: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2023; 12:e44813. [PMID: 37566448 PMCID: PMC10457703 DOI: 10.2196/44813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 06/14/2023] [Accepted: 06/15/2023] [Indexed: 08/12/2023] Open
Abstract
BACKGROUND Peers are an important determinant of health and well-being during late adolescence; however, there is limited quantitative research examining peer influence. Previous peer network research with adolescents faced methodological limitations and difficulties recruiting young people. OBJECTIVE This study aims to determine whether a web-based peer network survey is effective at recruiting adolescent peer networks by comparing 2 strategies for reimbursement. METHODS This study will use a 2-group randomized trial design to test the effectiveness of reimbursements for peer referral in a web-based cross-sectional peer network survey. Young people aged 16-18 years recruited through Instagram, Snapchat, and a survey panel will be randomized to receive either scaled group reimbursement (the experimental group) or fixed individual reimbursement (the control group). All participants will receive a reimbursement of Aus $5 (US $3.70) for their own survey completion. In the experimental group (scaled group reimbursement), all participants within a peer network will receive an additional Aus $5 (US $3.70) voucher for each referred participant who completes the study, up to a maximum total value of Aus $30 (US $22.20) per participant. In the control group (fixed individual reimbursement), participants will only be reimbursed for their own survey completion. Participants' peer networks are assessed during the survey by asking about their close friends. A unique survey link will be generated to share with the participant's nominated friends for the recruitment of secondary participants. Outcomes are the proportion of a participant's peer network and the number of referred peers who complete the survey. The required sample size is 306 primary participants. Using a multilevel logistic regression model, we will assess the effect of the reimbursement intervention on the proportion of primary participants' close friends who complete the survey. The secondary aim is to determine participant characteristics that are associated with successfully recruiting close friends. Young people aged 16-18 years were involved in the development of the study design through focus groups and interviews (n=26). RESULTS Participant recruitment commenced in 2022. CONCLUSIONS A longitudinal web-based social network study could provide important data on how social networks and their influence change over time. This trial aims to determine whether scaled group reimbursement can increase the number of peers referred. The outcomes of this trial will improve the recruitment of young people to web-based network studies of sensitive health issues. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/44813.
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Affiliation(s)
- Michelle Raggatt
- Burnet Institute, Melbourne, Australia
- School of Public Health and Preventative Medicine, Monash University, Melbourne, Australia
| | - Cassandra J C Wright
- Burnet Institute, Melbourne, Australia
- Menzies School of Health Research, Darwin, Australia
| | - Rachel Sacks-Davis
- Burnet Institute, Melbourne, Australia
- School of Public Health and Preventative Medicine, Monash University, Melbourne, Australia
- Melbourne School of Population and Global Health, University of Melbourne, Parkville, Australia
| | - Paul M Dietze
- Burnet Institute, Melbourne, Australia
- School of Public Health and Preventative Medicine, Monash University, Melbourne, Australia
- National Drug Research Institute, Curtin University, Melbourne, Australia
| | - Margaret E Hellard
- Burnet Institute, Melbourne, Australia
- School of Public Health and Preventative Medicine, Monash University, Melbourne, Australia
- Department of Infectious Diseases, Alfred Health, Melbourne, Australia
| | - Jane S Hocking
- Melbourne School of Population and Global Health, University of Melbourne, Parkville, Australia
| | - Megan S C Lim
- Burnet Institute, Melbourne, Australia
- School of Public Health and Preventative Medicine, Monash University, Melbourne, Australia
- Melbourne School of Population and Global Health, University of Melbourne, Parkville, Australia
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8
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Aung PT, Spelman T, Wilkinson AL, Dietze PM, Stoové MA, Hellard ME. Time-to-hepatitis C treatment initiation among people who inject drugs in Melbourne, Australia. Epidemiol Infect 2023; 151:e84. [PMID: 37157844 DOI: 10.1017/s0950268823000675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023] Open
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9
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Callinan S, MacLean S, Dietze PM. Drinking at home: Restricting alcohol availability is a key mechanism to reduce harms. Drug Alcohol Rev 2023. [PMID: 37159415 DOI: 10.1111/dar.13679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 03/30/2023] [Indexed: 05/11/2023]
Affiliation(s)
- Sarah Callinan
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
| | - Sarah MacLean
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
| | - Paul M Dietze
- National Drug Research Institute, Curtin University, Melbourne, Australia
- Behaviours and Health Risks, The Burnet Institute, Melbourne, Australia
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10
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Price O, Maher L, Dietze PM, Bruno R, Crawford S, Sutherland R, Salom C, Dore GJ, Peacock A. COVID-19 vaccine attitudes and facilitators among people in Australia who inject drugs. Drug Alcohol Rev 2023. [PMID: 36802338 DOI: 10.1111/dar.13621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 01/17/2023] [Accepted: 01/18/2023] [Indexed: 02/23/2023]
Abstract
INTRODUCTION We aimed to describe COVID-19 vaccination attitudes and identify potential facilitators for vaccine uptake among people who inject drugs. METHODS People who inject drugs were recruited from all eight Australian capital cities (N = 884; 65% male, mean age 44 years) and interviewed face-to-face or via telephone in June-July 2021. COVID-19 and broader vaccination attitudes were used to model latent classes. Correlates of class membership were assessed through multinomial logistic regression. Probability of endorsing potential vaccination facilitators were reported by class. RESULTS Three classes of participants were identified: 'vaccine acceptant' (39%), 'vaccine hesitant' (34%) and 'vaccine resistant' (27%). Those in the hesitant and resistant groups were younger, more likely to be unstably housed and less likely to have received the current season influenza vaccine than the acceptant group. In addition, hesitant participants were less likely to report a chronic medical condition than acceptant participants. Compared to vaccine acceptant and hesitant participants, vaccine-resistant participants were more likely to predominantly inject methamphetamine and to inject drugs more frequently in the past month. Both vaccine-hesitant and resistant participants endorsed financial incentives for vaccination and hesitant participants also endorsed facilitators related to vaccine trust. DISCUSSION AND CONCLUSION People who inject drugs who are unstably housed or predominantly inject methamphetamine are subgroups that require targeted interventions to increase COVID-19 vaccination uptake. Vaccine-hesitant people may benefit from interventions that build trust in vaccine safety and utility. Financial incentives may improve vaccine uptake among both hesitant and resistant people.
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Affiliation(s)
- Olivia Price
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Lisa Maher
- Kirby Institute, UNSW Sydney, Sydney, Australia
| | - Paul M Dietze
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia.,Behaviours and Health Risks Program, Burnet Institute, Melbourne, Australia.,National Drug Research Institute, Melbourne, Australia.,Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - Raimondo Bruno
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia.,School of Psychological Science, University of Tasmania, Hobart, Australia
| | | | - Rachel Sutherland
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Caroline Salom
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia.,Institute for Social Science Research, University of Queensland, Brisbane, Australia
| | | | - Amy Peacock
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia.,School of Psychological Science, University of Tasmania, Hobart, Australia
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11
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Leach MJ, Ward B, Kippen R, Quinn B, Agius PA, Sutton K, Peterson J, Dietze PM. Level and correlates of social support in a community-based sample of Australians who primarily smoke methamphetamine. Health Soc Care Community 2022; 30:e4950-e4960. [PMID: 35833453 PMCID: PMC10946876 DOI: 10.1111/hsc.13907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 05/06/2022] [Accepted: 07/04/2022] [Indexed: 06/15/2023]
Abstract
Little is known about the level and correlates of social support amongst people who use methamphetamine. We aimed to describe, and determine characteristics associated with, social support amongst a community-recruited cohort of Australians who primarily smoked methamphetamine. A cross-sectional study was conducted with data from the Victorian Methamphetamine Cohort Study (VMAX). Adults (aged ≥18 years) who used methamphetamine were recruited from June 2016 to March 2020 across metropolitan and non-metropolitan areas using convenience, snowball, and respondent-driven sampling. Social support was measured using the seven-item Enhancing Recovery In Coronary Heart Disease (ENRICHD) Social Support Inventory (ESSI). Characteristics independently associated with ESSI quartiles were assessed via multivariable partial proportional odds regression. Overall, 718 participants were included for complete-case analysis. Their mean (standard deviation [SD]) age was 34.7 (9.7) years and 62% were male. The mean (SD) and median (lower quartile-upper quartile) ESSI scores were 22.6 (7.6) and 24 (16-29), respectively, on a scale of 8 to 34 where higher scores denote better self-perceived social support. Characteristics independently associated with lower ESSI included past-year homelessness (adjusted odds ratio [aOR] = 0.49, 95% confidence interval [CI] = 0.36-0.66), moderate/severe depression (aOR = 0.60, 95% CI = 0.42-0.86), increasing age relative to <30 years (aOR[30-39] = 0.61, 95% CI = 0.41-0.91; aOR[≥40] = 0.56, 95% CI = 0.35-0.91) and greater than fortnightly methamphetamine use (aOR = 0.69, 95% CI = 0.52-0.91). Characteristics independently associated with higher ESSI were employment (aOR = 1.51, 95% CI = 1.06-2.14) and female gender (aOR = 1.39, 95% CI = 1.00-1.92). Social support services for people who use methamphetamine could be targeted and tailored to subgroups defined by correlates of social support, such as those who experience homelessness, depression or unemployment.
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Affiliation(s)
| | - Bernadette Ward
- School of Rural HealthMonash UniversityMelbourneAustralia
- Behaviours and Health Risks ProgramBurnet InstituteMelbourneAustralia
| | - Rebecca Kippen
- School of Rural HealthMonash UniversityMelbourneAustralia
| | - Brendan Quinn
- Behaviours and Health Risks ProgramBurnet InstituteMelbourneAustralia
- School of Public Health and Preventive MedicineMonash UniversityMelbourneAustralia
- Australian Institute of Family StudiesMelbourneAustralia
| | - Paul A. Agius
- Behaviours and Health Risks ProgramBurnet InstituteMelbourneAustralia
- School of Public Health and Preventive MedicineMonash UniversityMelbourneAustralia
- Melbourne School of Population and Global HealthUniversity of MelbourneMelbourneAustralia
| | - Keith Sutton
- School of Rural HealthMonash UniversityMelbourneAustralia
- Behaviours and Health Risks ProgramBurnet InstituteMelbourneAustralia
| | | | - Paul M. Dietze
- Behaviours and Health Risks ProgramBurnet InstituteMelbourneAustralia
- School of Public Health and Preventive MedicineMonash UniversityMelbourneAustralia
- National Drug Research InstituteCurtin UniversityMelbourneAustralia
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12
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Stam NC, Cogger S, Schumann JL, Weeks A, Roxburgh A, Dietze PM, Clark N. The onset and severity of acute opioid toxicity in heroin overdose cases: a retrospective cohort study at a supervised injecting facility in Melbourne, Australia. Clin Toxicol (Phila) 2022; 60:1227-1234. [PMID: 36200988 DOI: 10.1080/15563650.2022.2126371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
AIM To differentiate the severity of acute opioid toxicity and describe both the clinical and physiological features associated with heroin overdose in a cohort of witnessed overdose cases. METHODS Witnessed heroin overdose cases over a 12-month period (30 June 2018 - 30 June 2019) at the Medically Supervised Injecting Room (MSIR) in Melbourne, Australia were examined. The severity of acute opioid toxicity was classified according to the level of clinical intervention required to manage the overdose cases where an escalating level of care was provided. Heroin overdose cases were classified into one of three graded severity categories and a fourth complicated heroin overdose category. RESULTS A total of 1218 heroin overdose cases were identified from 60,693 supervised injecting visits over the study period. On the spectrum of toxicity, 78% (n = 955) of overdose cases were classified as Grade 1 severity, 7% (n = 83) as Grade 2 severity, and 13% (n = 161) as Grade 3 acute opioid toxicity severity cases, as well as 2% (n = 19) classified as complicated heroin overdose cases. The median onset time for heroin overdose cases was 17 min (IQR 11-28 min) from the time the individual was ready to prepare and inject heroin until clinical intervention was initiated. CONCLUSION We demonstrated that heroin overdose is a dynamic illness and cases differ in the severity of acute opioid toxicity. The risk of airway occlusion including positional asphyxia was an early and consistent feature across all levels of toxicity, while exaggerated respiratory depression together with exaggerated depression of consciousness was increasingly observed with greater levels of toxicity. We also demonstrated the importance of early intervention in overdose cases, where in a large cohort of heroin overdose cases there were no fatal outcomes, a very low hospitalisation rate and most cases were able to be managed to clinical resolution on-site.
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Affiliation(s)
- Nathan C Stam
- Medically Supervised Injecting Room, North Richmond Community Health, Melbourne, Australia.,Monash Addiction Research Centre, Monash University, Melbourne, Australia
| | - Shelley Cogger
- Medically Supervised Injecting Room, North Richmond Community Health, Melbourne, Australia
| | - Jennifer L Schumann
- Drug Intelligence Unit, Victorian Institute of Forensic Medicine, Melbourne, Australia.,Department of Forensic Medicine, Monash University, Melbourne, Australia
| | - Anthony Weeks
- Medically Supervised Injecting Room, North Richmond Community Health, Melbourne, Australia
| | - Amanda Roxburgh
- Monash Addiction Research Centre, Monash University, Melbourne, Australia.,Health Risks Program, Burnet Institute, Melbourne, Australia.,National Drug and Alcohol Research Centre, University on New South Wales, Sydney, Australia.,Discipline of Addiction Medicine, University of Sydney, Sydney, Australia
| | - Paul M Dietze
- Monash Addiction Research Centre, Monash University, Melbourne, Australia.,Health Risks Program, Burnet Institute, Melbourne, Australia.,National Drug Research Institute and enAble Institute, Curtin University, Melbourne, Australia
| | - Nicolas Clark
- Medically Supervised Injecting Room, North Richmond Community Health, Melbourne, Australia.,Department of Addiction Medicine, Royal Melbourne Hospital, Melbourne, Australia.,Department of Pharmacology, University of Adelaide, Adelaide, Australia
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13
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Man N, Sisson SA, McKetin R, Chrzanowska A, Bruno R, Dietze PM, Price O, Degenhardt L, Gibbs D, Salom C, Peacock A. Trends in methamphetamine use, markets and harms in Australia, 2003-2019. Drug Alcohol Rev 2022; 41:1041-1052. [PMID: 35604870 DOI: 10.1111/dar.13468] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 01/18/2022] [Accepted: 03/10/2022] [Indexed: 12/19/2022]
Abstract
INTRODUCTION To describe trends in methamphetamine use, markets and harms in Australia from 2003 to 2019. METHODS Data comprised patterns of use and price from sentinel samples of people who inject drugs and who use MDMA/other illicit stimulants and population-level amphetamine-related police seizures, arrests, hospitalisations, treatment episodes and deaths from approximately 2003 to 2019. Bayesian autoregressive time-series models were analysed for: no change; constant rate of change; and change over time differing in rate after one to three changepoints. Related indicators were analysed post hoc with identical changepoints. RESULTS The percentage of people who inject drugs reporting weekly use increased from 2010 to 2013 onwards, while use among samples of people who regularly use ecstasy and other illicit stimulants decreased. Seizures and arrests rose steeply from around 2009/10 to 2014/15 and subsequently plateaued. Price increased ($15.9 [95% credible interval, CrI $9.9, $28.9] per point of crystal per year) from around 2009 to 2011, plateauing and then declining from around 2017. Hospitalisation rates increased steeply from around 2009/10 until 2015/16, with a small subsequent decline. Treatment also increased (19.8 episodes [95% CrI 13.2, 27.6] with amphetamines as the principal drug of concern per 100 000 persons per year) from 2010/11 onwards. Deaths involving amphetamines increased (0.285 per 100 000 persons per year) from 2012 until 2016. DISCUSSION AND CONCLUSIONS These findings suggest that problematic methamphetamine use and harms escalated from 2010 to 2012 in Australia, with continued demand and a sustained market for methamphetamine.
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Affiliation(s)
- Nicola Man
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Scott A Sisson
- School of Mathematics and Statistics, UNSW Sydney, Sydney, Australia.,UNSW Data Science Hub, UNSW Sydney, Sydney, Australia
| | - Rebecca McKetin
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Agata Chrzanowska
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Raimondo Bruno
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia.,School of Psychological Sciences, University of Tasmania, Hobart, Australia
| | - Paul M Dietze
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia.,Behaviours and Health Risks, Burnet Institute, Melbourne, Australia.,National Drug Research Institute, Curtin University, Melbourne, Australia
| | - Olivia Price
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Louisa Degenhardt
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Daisy Gibbs
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Caroline Salom
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia.,Institute for Social Science Research, University of Queensland, Brisbane, Australia
| | - Amy Peacock
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
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14
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Lau G, Ang JY, Kim N, Gabbe BJ, Mitra B, Dietze PM, Reeder S, Beck B. Prevalence of alcohol and other drug use in patients presenting to hospital for fall-related injuries: a systematic review. Inj Prev 2022; 28:381-393. [PMID: 35508365 DOI: 10.1136/injuryprev-2021-044513] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Accepted: 04/21/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Alcohol and other drug (AOD) use is a key preventable risk factor for serious injuries. Prevention strategies to date have largely focused on transport injuries, despite AOD use being a significant risk factor for other injury causes, including falls. This systematic review aimed to report the prevalence of AOD use in patients presenting to hospital for fall-related injuries. METHODS This systematic review includes studies published in English after the year 2010 that objectively measured the prevalence of AOD use in patients presenting to hospital for a fall-related injury. Screening, data extraction and risk of bias assessments were completed by two independent reviewers. Data were presented using narrative synthesis and, where appropriate, meta-analyses. RESULTS A total of 12 707 records were screened. Full texts were retrieved for 2042 records, of which 29 were included. Four studies reported the combined prevalence of any alcohol and/or drug use, generating a pooled prevalence estimate of 37% (95% CI 25% to 49%). Twenty-two records reported on the prevalence of acute alcohol use alone and nine reported specifically on the prevalence of drugs other than alcohol, with prevalence ranging from 2% to 57% and 7% to 46%, respectively. The variation in prevalence estimates likely resulted from differences in toxicology testing methods across studies. CONCLUSIONS AOD exposure was common in hospitalised fall-related injuries. However, research addressing prevalence across different types of falls and the use of drugs other than alcohol was limited. Future research should address these areas to improve our understanding of which populations should be targeted in AOD and injury prevention strategies . PROSPERO REGISTRATION NUMBER CRD42020188746.
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Affiliation(s)
- Georgina Lau
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Jia Ying Ang
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Nayoung Kim
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Belinda J Gabbe
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.,Health Data Research UK, Swansea University, Swansea, UK
| | - Biswadev Mitra
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.,National Trauma Research Institute, The Alfred Hospital, Melbourne, Victoria, Australia.,Emergency and Trauma Centre, The Alfred Hospital, Melbourne, Victoria, Australia
| | - Paul M Dietze
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.,Behaviours and Health Risks Program, Burnet Institute, Melbourne, Victoria, Australia.,National Drug Research Institute, Curtin University, Perth, Western Australia, Australia
| | - Sandra Reeder
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.,Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Ben Beck
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia .,Faculty of Medicine, Laval University, Quebec City, Quebec, Canada
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15
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Monds LA, Bravo M, Mills L, Malcolm A, Gilliver R, Wood W, Harrod ME, Read P, Nielsen S, Dietze PM, Lenton S, Bleeker AM, Lintzeris N. The Overdose Response with Take Home Naloxone (ORTHN) project: Evaluation of health worker training, attitudes and perceptions. Drug Alcohol Rev 2022; 41:1085-1094. [PMID: 35442514 DOI: 10.1111/dar.13474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 03/27/2022] [Accepted: 03/28/2022] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Naloxone is a life-saving medication that reverses opioid overdose; naloxone can be provided on a 'take-home' basis so naloxone can be administered outside of the health-care setting. The Overdose Response and Take Home Naloxone (ORTHN) project established a model of care for take-home naloxone (THN) interventions across alcohol and other drug and harm reduction services in NSW, Australia. This paper evaluates the staff training and credentialing program, and examines staff attitudes and perspectives regarding the provision of THN interventions in these settings. METHODS Staff across seven services were trained through a 'train-the-trainer' credentialing model to deliver ORTHN, including naloxone supply. Staff were surveyed regarding their experience, attitudes and knowledge on THN prior to and after training, and after 6 months. At the 6 months follow up, staff were asked about the interventions they provided, barriers and enablers to uptake, and opinions regarding future rollout. RESULTS A total of 204 staff were trained and credentialed to provide the ORTHN intervention. Most (60%) were nurses, followed by needle syringe program workers and allied health/counsellors (32%). Linear and logistic regression analyses indicated that the training program was associated with significant improvements in staff knowledge and attitudes towards overdose and THN; however, only attitudinal improvements were maintained over time. There were high rates of staff satisfaction with the ORTHN intervention and training. DISCUSSION/CONCLUSIONS The ORTHN program is 'fit for purpose' for broad implementation in these settings. A number of potential barriers (e.g. time, medication and staffing costs) and enablers (e.g. peer engagement, regulatory framework for naloxone supply) in implementing THN interventions were identified.
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Affiliation(s)
- Lauren A Monds
- Drug and Alcohol Services, South Eastern Sydney Local Health District, Sydney, Australia.,Discipline of Addiction Medicine, Central Clinical School, The University of Sydney, Sydney, Australia.,NSW Drug and Alcohol Clinical Research and Improvement Network, Sydney, Australia
| | - Maria Bravo
- Drug and Alcohol Services, South Eastern Sydney Local Health District, Sydney, Australia.,Discipline of Addiction Medicine, Central Clinical School, The University of Sydney, Sydney, Australia.,NSW Drug and Alcohol Clinical Research and Improvement Network, Sydney, Australia
| | - Llewellyn Mills
- Drug and Alcohol Services, South Eastern Sydney Local Health District, Sydney, Australia.,Discipline of Addiction Medicine, Central Clinical School, The University of Sydney, Sydney, Australia.,NSW Drug and Alcohol Clinical Research and Improvement Network, Sydney, Australia
| | - Annie Malcolm
- Drug and Alcohol Services, South Eastern Sydney Local Health District, Sydney, Australia.,NSW Drug and Alcohol Clinical Research and Improvement Network, Sydney, Australia
| | - Rosie Gilliver
- Kirketon Road Centre, South Eastern Sydney Local Health District, Sydney, Australia
| | - William Wood
- Medically Supervised Injecting Centre, Sydney, Australia
| | | | - Phillip Read
- Kirketon Road Centre, South Eastern Sydney Local Health District, Sydney, Australia.,The Kirby Institute, UNSW Sydney, Sydney, Australia
| | - Suzanne Nielsen
- Monash Addiction Research Centre, Monash University, Melbourne, Australia
| | - Paul M Dietze
- National Drug Research Institute, Melbourne, Australia.,Behaviours and Health Risks Program, Burnet Institute, Melbourne, Australia
| | - Simon Lenton
- National Drug Research Institute, Faculty of Health Sciences, Curtin University, Perth, Australia
| | - Anne M Bleeker
- Alcohol, Tobacco and Other Drug Association, Canberra, Australia
| | - Nicholas Lintzeris
- Drug and Alcohol Services, South Eastern Sydney Local Health District, Sydney, Australia.,Discipline of Addiction Medicine, Central Clinical School, The University of Sydney, Sydney, Australia.,NSW Drug and Alcohol Clinical Research and Improvement Network, Sydney, Australia
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16
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Price O, Dietze PM, Maher L, Crawford S, Peacock A. COVID
‐19 vaccine acceptability among people in Australia who inject drugs: Update from the 2021 Illicit Drug Reporting System interviews. Drug Alcohol Rev 2022; 41:1025-1028. [PMID: 35184346 PMCID: PMC9111623 DOI: 10.1111/dar.13448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 01/28/2022] [Accepted: 01/28/2022] [Indexed: 11/28/2022]
Abstract
People who inject drugs may be at higher risk of COVID‐19 transmission and more severe negative health outcomes following COVID‐19 infection. Early research on hypothetical COVID‐19 vaccines suggests this population may be less likely to accept vaccination. This commentary extends this research by presenting vaccine intention data from Illicit Drug Reporting System interviews conducted in June–July 2021, in the early stages of vaccine rollout, with people in Australia who inject drugs (N = 888). Half the sample (48%, n = 419) reported that they were hesitant to receive the COVID‐19 vaccine, with key barriers relating to vaccine safety and side effect concerns. This level of hesitancy is substantially higher than that of the general population at a similar time. While we note that the subsequent Delta variant‐driven third wave of cases in Australia and efforts to increase population vaccination coverage may have altered intent in this group, this level of hesitancy warrants a targeted strategy to mitigate vaccine‐related concerns and maximise uptake. Ideally, this should comprise an inclusive health response that is peer‐led, with peer‐based organisations ideally positioned to direct immunisation service delivery and provide vaccine‐related messaging.
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Affiliation(s)
- Olivia Price
- National Drug and Alcohol Research Centre UNSW Sydney Sydney Australia
| | - Paul M. Dietze
- National Drug and Alcohol Research Centre UNSW Sydney Sydney Australia
- Behaviours and Health Risks Burnet Institute Melbourne Australia
- National Drug Research Institute Curtin University Melbourne Australia
- School of Public Health and Preventive Medicine Monash University Melbourne Australia
| | - Lisa Maher
- Kirby Institute UNSW Sydney Sydney Australia
| | | | - Amy Peacock
- National Drug and Alcohol Research Centre UNSW Sydney Sydney Australia
- School of Psychological Sciences University of Tasmania Hobart Australia
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17
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Vashishtha R, Holmes J, Pennay A, Dietze PM, Livingston M. An examination of the role of changes in country-level leisure time internet use and computer gaming on adolescent drinking in 33 European countries. Int J Drug Policy 2022; 100:103508. [PMID: 34736131 PMCID: PMC7614941 DOI: 10.1016/j.drugpo.2021.103508] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 10/06/2021] [Accepted: 10/08/2021] [Indexed: 12/29/2022]
Abstract
INTRODUCTION Adolescent alcohol consumption has been declining in many high-income countries since the turn of this century. Research investigating the plausible explanations for these declines has been mostly based on individual-level studies, which are largely inconclusive. Changes in leisure time internet use and computer gaming (referred to in this article as 'computer activities') have been hypothesised to play a role in declining adolescent alcohol consumption at a country-level. The aim of this study was to examine the association between country-level changes over time in computer activities and adolescent drinking in 33 European countries. METHODS This is a multi-level repeated cross-national study examining the role of changes over time in country-level and individual-level computer activities on regular drinking. We utilised four waves of the European School Survey Project on Alcohol and Drugs (ESPAD) from 2003, 2007, 2011 and 2015. At an individual-level the primary exposure of interest was daily engagement in computer activities and aggregated means were used to measure country-level daily computer activities in each included country. Data were analysed using three-level hierarchical linear probability methods. RESULTS In the fully adjusted model, for between individual effects, we found significant positive association between daily computer activities and regular drinking (β = 0.043, p-value <0.001 and 95% CI = 0.033-0.054). However, at a country-level, we did not find any association between within-country changes in daily computer activities and regular drinking (β = 0.031, p-value = 0.652 and 95% CI = -0.103-0.164. CONCLUSION Findings from this study suggest that broad cultural shifts towards increased computer-based activities among adolescents has played a little or no role in declining adolescent drinking. Future research should be directed towards examining other high-level cultural changes which may have influenced cross-national reductions in adolescent drinking.
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Affiliation(s)
- Rakhi Vashishtha
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia; Health Services and Systems Research, Duke-NUS Medical School, Singapore.
| | - John Holmes
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Amy Pennay
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
| | - Paul M Dietze
- National Drug Research Institute, Curtin University, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia; Behaviours and Health Risks Program, Burnet Institute, Australia
| | - Michael Livingston
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia; National Drug Research Institute, Curtin University, Australia; Department of Clinical Neurosciences, Karolinska Institutet, Stockholm, Sweden
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18
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Kirwan A, Winter R, Gunn J, Djordjevic F, Curtis M, Gough C, Dietze PM. The feasibility of a drug consumption room in the Australian Capital Territory. Drug Alcohol Rev 2022; 41:1440-1443. [PMID: 35038373 DOI: 10.1111/dar.13427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Revised: 12/10/2021] [Accepted: 12/10/2021] [Indexed: 11/29/2022]
Affiliation(s)
| | - Rebecca Winter
- Burnet Institute, Melbourne, Australia.,Department of Gastroenterology, St Vincent's Hospital Melbourne, Melbourne, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Jack Gunn
- Burnet Institute, Melbourne, Australia
| | - Filip Djordjevic
- Burnet Institute, Melbourne, Australia.,Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
| | - Michael Curtis
- Burnet Institute, Melbourne, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.,Monash Addiction Research Centre, Monash University, Melbourne, Australia
| | - Chris Gough
- Canberra Alliance for Harm Minimisation and Advocacy, Canberra, Australia
| | - Paul M Dietze
- Burnet Institute, Melbourne, Australia.,National Drug Research Institute and enAble Institute, Faculty of Health Sciences, Curtin University, Melbourne, Australia
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19
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Vashishtha R, Pennay A, Dietze PM, Livingston M. The Role of Parental Control and Support in Declining Adolescent Drinking: A Multi-Level Study Across 30 European Countries. Alcohol Alcohol 2022; 57:470-476. [PMID: 35015803 DOI: 10.1093/alcalc/agab083] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 11/24/2021] [Accepted: 11/26/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Adolescent drinking has declined in many high-income countries since the early 2000s. It has been suggested that changing parenting practices may have contributed to the decline. However, previous studies investigating parenting have focused on single countries and have provided conflicting evidence. This study tested the association between changes in individual- and population-level parental control and parental support and changes in past month adolescent drinking. METHODS A total of 271,823 adolescents aged 15-16 years, from 30 European countries between 2003 and 2015 were included in this study. Our key independent variables were adolescent reports of parental control and parental support. Our outcome measure was a dichotomous measure of any alcohol use in the 30 days before the survey, referred as past month drinking. Aggregated measures of parenting variables were used to estimate between-country and within-country effects of parenting on adolescent drinking. Data were analysed using three-level hierarchical linear probability methods. RESULTS At the individual-level, we found a negative association between the two parental measures, i.e. parental control (β = -0.003 and 95% CI = -0.021 to 0.017) and parental support (β = -0.008 and 95% CI = -0.010 to 0.006) and past month drinking. This suggests adolescents whose parents exert higher control and provide more support tend to drink less. At a population level, we did not find any evidence of association on between-country and within-country parenting changes and past month drinking. CONCLUSIONS It is unlikely that changes in parental control or support at the population-level have contributed to the decline in drinking among adolescents in 30 European countries.
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Affiliation(s)
- Rakhi Vashishtha
- Centre for Alcohol Policy Research, La Trobe University, Melbourne 3083, Australia.,Programme in Health Services and Systems Research, Duke-NUS Medical School, Singapore 169857, Singapore
| | - Amy Pennay
- Centre for Alcohol Policy Research, La Trobe University, Melbourne 3083, Australia
| | - Paul M Dietze
- National Drug Research Institute, Curtin University, Melbourne 3004, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne 3004, Australia.,Behaviours and Health Risks Program, Burnet Institute, Melbourne 3004, Australia
| | - Michael Livingston
- Centre for Alcohol Policy Research, La Trobe University, Melbourne 3083, Australia.,National Drug Research Institute, Curtin University, Melbourne 3004, Australia.,Department of Clinical Neurosciences, Karolinska Institutet, Stockholm 17176, Sweden
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20
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Dietze PM, Hall C, Price O, Stewart AC, Crawford S, Peacock A, Maher L. COVID-19 vaccine acceptability among people in Australia who inject drugs: Implications for vaccine rollout. Drug Alcohol Rev 2021; 41:484-487. [PMID: 34752659 PMCID: PMC8653113 DOI: 10.1111/dar.13399] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 09/17/2021] [Accepted: 10/16/2021] [Indexed: 01/06/2023]
Abstract
Introduction Vaccine acceptability is a key determinant of vaccination uptake. Despite being at risk of adverse outcomes from coronavirus‐19 disease (COVID‐19), COVID‐19 vaccine acceptability among people who inject drugs is unknown. We surveyed people who inject drugs in Melbourne, Australia to assess potential uptake of COVID‐19 vaccines prior to distribution. Methods Cross‐sectional study, comprising interviewer‐administered structured telephone interviews completed from 30 November to 22 December 2020 in Melbourne, Australia. Participants were people aged 18 years or older who injected drugs at least monthly in the past 6 months and had resided in Melbourne in the past 12 months recruited via needle‐syringe programs and word‐of‐mouth. Measurements COVID‐19 hypothetical vaccine acceptability, participants' demographic, drug use and drug treatment characteristics. Results Fifty‐eight percent (57/99) of the sample reported that they would definitely or probably be vaccinated for COVID‐19, with the remainder indicating that they would not (22%) or were undecided (20%). Among those who indicated that they would definitely or probably not be vaccinated or were undecided (n = 42), safety concerns were most often cited as a reason for not wanting to be vaccinated. Discussion and Conclusions Although a majority of sampled people who inject drugs indicated that they would definitely or probably be vaccinated, efforts to reduce hesitancy and allay COVID‐19 vaccine safety concerns will be necessary to optimise vaccine uptake among this population.
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Affiliation(s)
- Paul M Dietze
- Behaviours and Health Risks Program, Burnet Institute, Melbourne, Australia.,National Drug Research Institute, Curtin University, Melbourne, Australia
| | - Cristal Hall
- Behaviours and Health Risks Program, Burnet Institute, Melbourne, Australia
| | - Olivia Price
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Ashleigh C Stewart
- Behaviours and Health Risks Program, Burnet Institute, Melbourne, Australia
| | | | - Amy Peacock
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Lisa Maher
- Behaviours and Health Risks Program, Burnet Institute, Melbourne, Australia.,Kirby Institute, UNSW Sydney, Sydney, Australia
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21
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Lau G, Gabbe BJ, Mitra B, Dietze PM, Braaf S, Beck B. Comparison of routine blood alcohol tests and ICD-10-AM coding of alcohol involvement for major trauma patients. HEALTH INF MANAG J 2021; 52:112-118. [PMID: 34472372 DOI: 10.1177/18333583211037171] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Alcohol use is a key preventable risk factor for serious injury. To effectively prevent alcohol-related injuries, we rely on the accurate surveillance of alcohol involvement in injury events. This often involves the use of administrative data, such as International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification (ICD-10-AM) coding. OBJECTIVE To evaluate the completeness and accuracy of using administrative coding for the surveillance of alcohol involvement in major trauma injury events by comparing patient blood alcohol concentration (BAC) with ICD-10-AM coding. METHOD This retrospective cohort study examined 2918 injury patients aged ≥18 years who presented to a major trauma centre in Victoria, Australia, over a 2-year period, of which 78% (n = 2286) had BAC data available. RESULTS While 15% of patients had a non-zero BAC, only 4% had an ICD-10-AM code suggesting acute alcohol involvement. The agreement between blood alcohol test results and ICD-10-AM coding of acute alcohol involvement was fair (κ = 0.33, 95% confidence interval: 0.27-0.38). Of the 341 patients with a non-zero BAC, 82 (24.0%) had ICD-10-AM codes related to acute alcohol involvement. Supplementary factors Y90 Evidence of alcohol involvement determined by blood alcohol level codes, which specifically describe patient BAC, were assigned to just 29% of eligible patients with a non-zero BAC. CONCLUSION ICD-10-AM coding underestimated the proportion of alcohol-related injuries compared to patient BAC. IMPLICATIONS Given the current role of administrative data in the surveillance of alcohol-related injuries, these findings may have significant implications for the implementation of cost-effective strategies for preventing alcohol-related injuries.
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Affiliation(s)
| | | | - Biswadev Mitra
- Monash University, Australia.,Emergency and Trauma Centre, The Alfred Hospital, Australia.,National Trauma Research Institute, The Alfred Hospital, Australia
| | - Paul M Dietze
- Burnet Institute, Australia.,Curtin University, Australia
| | | | - Ben Beck
- Monash University, Australia.,Laval University, Canada
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22
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Van Den Boom W, Del Mar Quiroga M, Fetene DM, Agius PA, Higgs PG, Maher L, Hickman M, Stoové MA, Dietze PM. The Melbourne Safe Injecting Room Attracted People Most in Need of Its Service. Am J Prev Med 2021; 61:217-224. [PMID: 34011443 DOI: 10.1016/j.amepre.2021.02.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 01/27/2021] [Accepted: 02/15/2021] [Indexed: 11/22/2022]
Abstract
INTRODUCTION In 2018, the first Medically Supervised Injecting Room in Melbourne, Australia was officially opened. This study assessed whether this facility attracted people who inject drugs, who were socially vulnerable, and who engaged in drug-related behaviors associated with increased morbidity and mortality risk. METHODS This was a cross-sectional analysis of the frequency of Medically Supervised Injecting Room use during the first 18 months after opening (July 2018-December 2019) among 658 people who inject drugs participating in the Melbourne Injecting Drug User Cohort Study (SuperMIX). To examine the differences between no Medically Supervised Injecting Room use, infrequent use (<50% injections within the facility), and frequent use (≥50% of injections within the facility), RRRs were estimated using bivariate multinomial logistic regression analyses and postestimation Wald tests. Analyses were conducted in 2020. RESULTS A total of 451 participants (68%) reported no Medically Supervised Injecting Room use, 142 (22%) reported infrequent use, and 65 (10%) reported frequent use. Participants who reported either infrequent or frequent use of the facility were more socially vulnerable (e.g., more often homeless) and more likely to report risky drug-related behaviors and poor health outcomes than those who reported no use. Participants who reported frequent use of the facility were also more likely to live close to the facility than those reporting infrequent use. CONCLUSIONS The Melbourne Medically Supervised Injecting Room attracted socially marginalized people who inject drugs who are most at risk of harms related to injecting drug use and therefore who are most in need of the service. To determine the long-term impact use of this facility on key health outcomes such as overdose, future studies should consider the differences in vulnerability and risk behavior of people who inject drugs who use the Medically Supervised Injecting Room when examining the outcomes associated with the use of the facility.
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Affiliation(s)
| | - Maria Del Mar Quiroga
- Behaviours and Health Risks Program, Burnet Institute, Melbourne, Australia; Melbourne Data Analytics Platform (MDAP), The University of Melbourne, Melbourne, Australia
| | | | - Paul A Agius
- Behaviours and Health Risks Program, Burnet Institute, Melbourne, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Peter G Higgs
- Behaviours and Health Risks Program, Burnet Institute, Melbourne, Australia; Department of Public Health, La Trobe University, Melbourne, Australia
| | - Lisa Maher
- Behaviours and Health Risks Program, Burnet Institute, Melbourne, Australia; The Kirby Institute, UNSW Sydney, Sydney, Australia
| | - Matthew Hickman
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Mark A Stoové
- Behaviours and Health Risks Program, Burnet Institute, Melbourne, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Paul M Dietze
- Behaviours and Health Risks Program, Burnet Institute, Melbourne, Australia; National Drug Research Institute, Curtin University, Melbourne, Australia.
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23
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O'Brien H, Di Rico R, Dean E, Smoker G, Lloyd-Jones M, McKechnie M, Dietze PM, Doyle JS. Screening for risky drinkers among hospitalised inpatients using the AUDIT: A feasibility, point prevalence and data linkage study. Drug Alcohol Rev 2021; 41:293-302. [PMID: 34184348 DOI: 10.1111/dar.13343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Revised: 06/05/2021] [Accepted: 06/07/2021] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Risky drinking frequently remains undiagnosed or untreated, including in hospitalised inpatients. Using the Alcohol Use Disorders Identification Test (AUDIT), we assessed the feasibility of screening for risky drinking and whether screening results aligned with alcohol-attributable diagnoses in an inpatient population. METHODS We conducted a cross-sectional survey across a tertiary health service in Melbourne, Australia. Researchers collected demographics, AUDIT scores and acceptability from all eligible adult inpatients available on day of survey. Main outcomes were prevalence of risky drinking (AUDIT ≥8), mean AUDIT score and patient acceptability. Identification of risky drinking by the abbreviated 'AUDIT-C' or discharge diagnoses (extracted by data-linkage with medical records) was compared. RESULTS Of 473 eligible inpatients, 61% (n = 289) participated, 22% (n = 103) were unavailable and 17% (n = 81) declined. Median age was 64 years (IQR = 48, 76); 54% (n = 157) were male. Mean AUDIT score was 4.4 (SD = 5.5). Risky drinking prevalence was 20% (n = 57), 2% (n = 7) had scores suggestive of dependence (AUDIT ≥20, a subset of risky drinkers). Odds of risky drinking were reduced in females (OR 0.19, 95% CI 0.09, 0.41; P < 0.001) and participants ≥70 years (OR 0.22, 95% CI 0.07, 0.71; P = 0.01). Alcohol-attributable diagnoses did not consistently align with risky drinking, with half of inpatients with wholly attributable diagnoses classified as low risk. Most inpatients considered screening acceptable (89%, n = 256). DISCUSSION AND CONCLUSIONS Pre-admission risky drinking was evident in one-fifth of hospital inpatients, but alcohol-attributable diagnoses were unreliable proxy measures of risky drinking. Screening in-patients with the AUDIT was acceptable to inpatients and can be feasibly implemented in an Australian tertiary hospital setting.
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Affiliation(s)
- Helen O'Brien
- Program for Behaviours and Health Risks, Burnet Institute, Melbourne, Australia
| | - Rehana Di Rico
- Program for Behaviours and Health Risks, Burnet Institute, Melbourne, Australia.,Epworth Monash Rehabilitation Medicine Unit, Epworth HealthCare, Melbourne, Australia
| | - Emma Dean
- Population Health, Alfred Health, Melbourne, Australia.,Quit, Cancer Council Victoria, Melbourne, Australia
| | - Gemma Smoker
- Population Health, Alfred Health, Melbourne, Australia
| | - Martyn Lloyd-Jones
- Department of Mental and Addiction Health, Alfred Hospital, Melbourne, Australia
| | - Megan McKechnie
- Department of Mental and Addiction Health, Alfred Hospital, Melbourne, Australia
| | - Paul M Dietze
- Program for Behaviours and Health Risks, Burnet Institute, Melbourne, Australia.,Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia.,National Drug Research Institute, Curtin University, Melbourne, Australia
| | - Joseph S Doyle
- Program for Disease Elimination, Burnet Institute, Melbourne, Australia.,Department of Infectious Diseases, Alfred Health and Monash University, Melbourne, Australia
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24
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Gibbs D, Grebely J, Sutherland R, Larney S, Butler K, Dietze PM, Starr M, Peacock A. Concordance between self-reported and current hepatitis C virus infection status in a sample of people who inject drugs in Sydney and Canberra, Australia. Drug Alcohol Rev 2021; 40:1349-1353. [PMID: 33759276 DOI: 10.1111/dar.13282] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 02/10/2021] [Accepted: 02/28/2021] [Indexed: 01/07/2023]
Abstract
INTRODUCTION Awareness of hepatitis C virus (HCV) status among people who inject drugs is critical to ensure linkage to care and reduce transmission risk. Testing pathways, confusion about results and possible reinfection raise potential for discordance between perceived and actual HCV status among people who inject drugs. We evaluated self-reported and serologically confirmed HCV status concordance among a sample of Australian people who inject drugs. METHODS Data were collected in May-June 2018 from participants in Canberra and Sydney, Australia, who had injected drugs at least monthly in the past 6 months. Participants completed a structured interview assessing self-reported HCV status and provided a dried blood spot sample for HCV RNA testing. RESULTS Of 103 participants, 95% self-reported ever receiving antibody testing, 58% of whom reported having received RNA testing. Seventy-three percent of participants reported never having been told that they had HCV, 18% reported current infection and 9% did not know their current status. According to dried blood spot RNA testing, 20% were currently infected. Over a quarter of the sample (28%, n = 29) did not accurately report their HCV status, half of whom were unaware of a current infection. DISCUSSION AND CONCLUSIONS With over one-quarter of the sample in our study not accurately reporting their current HCV status, our findings reinforce the importance of regular testing for active infection, and the need for improved health literacy on HCV antibody and RNA test results, HCV status post-treatment and reinfection risk.
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Affiliation(s)
- Daisy Gibbs
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | | | - Rachel Sutherland
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Sarah Larney
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia.,Department of Family Medicine and Emergency Medicine, Université de Montréal and Centre de Recherche du CHUM, Montréal, Canada
| | - Kerryn Butler
- Discipline of Addiction Medicine, University of Sydney, Sydney, Australia
| | | | - Mitchell Starr
- NSW State Reference Laboratory for HIV, St Vincent's Centre for Applied Medical Research, St Vincent's Hospital, Sydney, Australia
| | - Amy Peacock
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
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25
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Vashishtha R, Pennay A, Dietze PM, Livingston M. Trends in adolescent alcohol and other risky health- and school-related behaviours and outcomes in Australia. Drug Alcohol Rev 2021; 40:1071-1082. [PMID: 33715243 DOI: 10.1111/dar.13269] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 01/30/2021] [Accepted: 02/04/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Adolescent drinking has been declining in Australia over the past two decades, but this trend may be part of a broader shift towards healthier lifestyles for adolescents. We examined trends in the prevalence of multiple risky health- and school-related behaviours and outcomes to test whether this was the case. METHODS Data on multiple behaviours and outcomes were collated from Australian government agencies and other relevant sources for 10-19-year-olds from the year 2000 onward. Trends were examined descriptively. RESULTS Rates of substance use, youth offending and injuries due to underage driving declined over the study period. Some health-related behaviours (physical activity and diet) worsened between 2001 and 2017; however, obesity rates remained stable. Risky sexual behaviours increased in terms of early initiation of lifetime sexual intercourse and decreased condom use. However, sexual health outcomes improved with a reduction in teenage pregnancies and there was a recent decline in sexually transmitted infection rates from 2011 onward. Suicide rates and rates of major depressive disorders increased. School attendance and engagement in full-time work or study remained stable. DISCUSSION AND CONCLUSIONS The decline in adolescent drinking does not appear to correspond with increased engagement in healthier behaviours; however, it may be related to a more risk-averse way of living. Future work could be directed towards identifying which social, economic, policy and environmental factors have impacted positive changes in risky behaviours. Public health efforts can then be directed towards behaviours or outcomes, which have not yet improved.
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Affiliation(s)
- Rakhi Vashishtha
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia.,Health Services and Systems Research, Duke-NUS Medical School, Singapore
| | - Amy Pennay
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
| | - Paul M Dietze
- National Drug Research Institute, Curtin University, Melbourne, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.,Centre of Population Health, Burnet Institute, Melbourne, Australia
| | - Michael Livingston
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia.,National Drug Research Institute, Curtin University, Melbourne, Australia.,Department of Clinical Neurosciences, Karolinska Institute, Stockholm, Sweden
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26
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Man N, Chrzanowska A, Price O, Bruno R, Dietze PM, Sisson SA, Degenhardt L, Salom C, Morris L, Farrell M, Peacock A. Trends in cocaine use, markets and harms in Australia, 2003-2019. Drug Alcohol Rev 2021; 40:946-956. [PMID: 33626201 DOI: 10.1111/dar.13252] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 11/18/2020] [Accepted: 12/31/2020] [Indexed: 11/30/2022]
Abstract
INTRODUCTION This paper aims to describe cocaine use, markets and harms in Australia from 2003 to 2019. METHODS Outcome indicators comprised prevalence of use from triennial household surveys; patterns of use from annual surveys of sentinel samples who use stimulants; and cocaine-related seizures, arrests, hospitalisations, deaths and treatment episodes. Bayesian autoregressive time-series analyses were conducted to estimate trend over time: Model 1, no change; Model 2, constant rate of change; and Model 3, change over time differing in rate after one change point. RESULTS Past-year population prevalence of use increased over time. The percentage reporting recent use in sentinel samples increased by 6.1% (95% credible interval [CrI95% ] 1.2%,16.9%; Model 3) per year from around 2017 (48%) until the end of the series (2019: 67%). There was a constant annual increase in number of seizures (count ratio: 1.1, CrI95% 1.1,1.2) and arrests (1.2, CrI95% 1.1,1.2), and percentage reporting cocaine as easy to obtain in the sentinel samples (percent increase 1.2%, CrI95% 0.5%,1.8%; Model 2). Cocaine-related hospitalisation rate increased from 5.1 to 15.6 per 100 000 people from around 2011-2012 to 2017-2018: an annual increase of 1.3 per 100 000 people (CrI95% 0.8,1.8; Model 3). While the death rate was low (0.23 cocaine-related deaths per 100 000 people in 2018; Model 2), treatment episodes increased from 3.2 to 5.9 per 100 000 people from around 2016-2017 to 2017-2018: an annual increase of 2.9 per 100 000 people (CrI95% 1.6,3.7; Model 3). DISCUSSION AND CONCLUSIONS Cocaine use, availability and harm have increased, concentrated in recent years, and accompanied by increased treatment engagement.
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Affiliation(s)
- Nicola Man
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Agata Chrzanowska
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Olivia Price
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Raimondo Bruno
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia.,School of Psychology, University of Tasmania, Hobart, Australia
| | - Paul M Dietze
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia.,Behaviours and Health Risks, Burnet Institute, Melbourne, Australia
| | - Scott A Sisson
- School of Mathematics and Statistics, UNSW Sydney, Sydney, Australia.,UNSW Data Science Hub, UNSW Sydney, Sydney, Australia
| | - Louisa Degenhardt
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Caroline Salom
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia.,Institute for Social Science Research, University of Queensland, Brisbane, Australia
| | - Leith Morris
- Institute for Social Science Research, University of Queensland, Brisbane, Australia
| | - Michael Farrell
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Amy Peacock
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia.,School of Psychology, University of Tasmania, Hobart, Australia
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27
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Douglass CH, Raggatt M, Wright CJC, Reddan H, O’Connell H, Lim MSC, Dietze PM. Alcohol consumption and illicit drug use among young music festival attendees in Australia. Drugs: Education, Prevention and Policy 2021. [DOI: 10.1080/09687637.2021.1889978] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Caitlin H. Douglass
- Burnet Institute, Melbourne, Australia
- School of Population and Global Health, University of Melbourne, Carlton, Australia
| | - Michelle Raggatt
- Burnet Institute, Melbourne, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Cassandra J. C. Wright
- Burnet Institute, Melbourne, Australia
- Centre for Alcohol Policy Research, La Trobe University, Bundoora, Australia
| | - Helen Reddan
- Transport Accident Commission, Geelong, Australia
| | | | - Megan S. C. Lim
- Burnet Institute, Melbourne, Australia
- School of Population and Global Health, University of Melbourne, Carlton, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Paul M. Dietze
- Burnet Institute, Melbourne, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
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28
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Cossar RD, Stewart AC, Winter R, Curtis M, Dietze PM, Ogloff JRP, Stoove M. Integrating episodes of imprisonment and the cascade of care for opioid use disorder. Addiction 2021; 116:427-428. [PMID: 32888211 DOI: 10.1111/add.15245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 08/14/2020] [Indexed: 11/26/2022]
Affiliation(s)
- Reece D Cossar
- Centre for Forensic Behavioural Science, Swinburne University of Technology and Forensicare, Melbourne, Victoria, Australia.,Public Health Discipline, Burnet Institute, Melbourne, Victoria, Australia
| | - Ashleigh C Stewart
- Public Health Discipline, Burnet Institute, Melbourne, Victoria, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Rebecca Winter
- Public Health Discipline, Burnet Institute, Melbourne, Victoria, Australia.,St Vincent's Hospital, Melbourne, Victoria, Australia
| | - Michael Curtis
- Public Health Discipline, Burnet Institute, Melbourne, Victoria, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Paul M Dietze
- Public Health Discipline, Burnet Institute, Melbourne, Victoria, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - James R P Ogloff
- Centre for Forensic Behavioural Science, Swinburne University of Technology and Forensicare, Melbourne, Victoria, Australia
| | - Mark Stoove
- Public Health Discipline, Burnet Institute, Melbourne, Victoria, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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29
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Quinn B, Ward B, Agius PA, Jenkinson R, Hickman M, Sutton K, Hall C, McKetin R, Farrell M, Cossar R, Dietze PM. A prospective cohort of people who use methamphetamine in Melbourne and non-metropolitan Victoria, Australia: Baseline characteristics and correlates of methamphetamine dependence. Drug Alcohol Rev 2020; 40:1239-1248. [PMID: 33176047 DOI: 10.1111/dar.13194] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 08/24/2020] [Accepted: 09/28/2020] [Indexed: 11/30/2022]
Abstract
INTRODUCTION AND AIMS Limited research has investigated methamphetamine use and related harms in rural and regional Australia. We investigated whether people who used methamphetamine in non-metropolitan Victoria differed in their sociodemographics and were more likely to be methamphetamine-dependent than those recruited in Melbourne. DESIGN AND METHODS We used baseline data from an ongoing prospective cohort study, 'VMAX'. Participants were recruited from Melbourne and three non-metropolitan Victorian regions. Sequential multivariable logistic regression of nested models assessed unadjusted and adjusted associations between residential locations and methamphetamine dependence. RESULTS The sample mostly (77%) comprised people who used methamphetamine via non-injecting means (N = 744). Thirty-nine percent were female. Melbourne-based participants were less likely than non-metropolitan participants to identify as Aboriginal and Torres Strait Islander, be heterosexual, have children and be unemployed. More frequent methamphetamine use (adjusted odds ratio 1.22, 95% confidence interval 1.12-1.34) and using crystal methamphetamine versus 'speed' powder (adjusted odds ratio 2.38, 95% confidence interval 1.26-3.64) were independently (P < 0.05) associated with being classified as methamphetamine-dependent. A significantly higher percentage of participants in every non-metropolitan region were classified as methamphetamine-dependent vs. those in Melbourne, but this relationship was attenuated when adjusting for methamphetamine use frequency and primary form used. Despite 65% of participants being classified as methamphetamine-dependent, less than half had recently (past year) accessed any professional support for methamphetamine, with minimal variation by recruitment location. DISCUSSIONS AND CONCLUSIONS VMAX participants in non-metropolitan Victoria were more likely to be methamphetamine-dependent than those living in Melbourne. Unmet need for professional support appears to exist among people using methamphetamine across the state, regardless of geographical location.
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Affiliation(s)
- Brendan Quinn
- Burnet Institute, Melbourne, Australia.,Monash University, Melbourne, Australia.,Australian Institute of Family Studies, Melbourne, Australia
| | - Bernadette Ward
- Burnet Institute, Melbourne, Australia.,School of Rural Health, Monash University, Bendigo, Australia
| | - Paul A Agius
- Burnet Institute, Melbourne, Australia.,Monash University, Melbourne, Australia
| | - Rebecca Jenkinson
- Burnet Institute, Melbourne, Australia.,Monash University, Melbourne, Australia.,Australian Institute of Family Studies, Melbourne, Australia
| | - Matthew Hickman
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Keith Sutton
- Burnet Institute, Melbourne, Australia.,School of Rural Health, Monash University, Warragul, Australia
| | | | - Rebecca McKetin
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Michael Farrell
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | | | - Paul M Dietze
- Burnet Institute, Melbourne, Australia.,Monash University, Melbourne, Australia
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30
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Quinn B, Ward B, Agius PA, Jenkinson R, Hickman M, Sutton K, Hall C, McKetin R, Farrell M, Cossar R, Dietze PM. A prospective cohort of people who use methamphetamine in Melbourne and non-metropolitan Victoria, Australia: Baseline characteristics and correlates of methamphetamine dependence. Drug Alcohol Rev 2020. [PMID: 33176047 DOI: 10.1111/dar.13194.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
INTRODUCTION AND AIMS Limited research has investigated methamphetamine use and related harms in rural and regional Australia. We investigated whether people who used methamphetamine in non-metropolitan Victoria differed in their sociodemographics and were more likely to be methamphetamine-dependent than those recruited in Melbourne. DESIGN AND METHODS We used baseline data from an ongoing prospective cohort study, 'VMAX'. Participants were recruited from Melbourne and three non-metropolitan Victorian regions. Sequential multivariable logistic regression of nested models assessed unadjusted and adjusted associations between residential locations and methamphetamine dependence. RESULTS The sample mostly (77%) comprised people who used methamphetamine via non-injecting means (N = 744). Thirty-nine percent were female. Melbourne-based participants were less likely than non-metropolitan participants to identify as Aboriginal and Torres Strait Islander, be heterosexual, have children and be unemployed. More frequent methamphetamine use (adjusted odds ratio 1.22, 95% confidence interval 1.12-1.34) and using crystal methamphetamine versus 'speed' powder (adjusted odds ratio 2.38, 95% confidence interval 1.26-3.64) were independently (P < 0.05) associated with being classified as methamphetamine-dependent. A significantly higher percentage of participants in every non-metropolitan region were classified as methamphetamine-dependent vs. those in Melbourne, but this relationship was attenuated when adjusting for methamphetamine use frequency and primary form used. Despite 65% of participants being classified as methamphetamine-dependent, less than half had recently (past year) accessed any professional support for methamphetamine, with minimal variation by recruitment location. DISCUSSIONS AND CONCLUSIONS VMAX participants in non-metropolitan Victoria were more likely to be methamphetamine-dependent than those living in Melbourne. Unmet need for professional support appears to exist among people using methamphetamine across the state, regardless of geographical location.
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Affiliation(s)
- Brendan Quinn
- Burnet Institute, Melbourne, Australia.,Monash University, Melbourne, Australia.,Australian Institute of Family Studies, Melbourne, Australia
| | - Bernadette Ward
- Burnet Institute, Melbourne, Australia.,School of Rural Health, Monash University, Bendigo, Australia
| | - Paul A Agius
- Burnet Institute, Melbourne, Australia.,Monash University, Melbourne, Australia
| | - Rebecca Jenkinson
- Burnet Institute, Melbourne, Australia.,Monash University, Melbourne, Australia.,Australian Institute of Family Studies, Melbourne, Australia
| | - Matthew Hickman
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Keith Sutton
- Burnet Institute, Melbourne, Australia.,School of Rural Health, Monash University, Warragul, Australia
| | | | - Rebecca McKetin
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Michael Farrell
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | | | - Paul M Dietze
- Burnet Institute, Melbourne, Australia.,Monash University, Melbourne, Australia
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31
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O'Brien H, Callinan S, Livingston M, Doyle JS, Dietze PM. Population patterns in Alcohol Use Disorders Identification Test (AUDIT) scores in the Australian population; 2007-2016. Aust N Z J Public Health 2020; 44:462-467. [PMID: 33104260 DOI: 10.1111/1753-6405.13043] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 08/01/2020] [Accepted: 09/01/2020] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES Despite widespread use of the Alcohol Use Disorders Identification Test (AUDIT), there are no published contemporary population-level scores for Australia. We examined population-level AUDIT scores and hazardous drinking for Australia over the period 2007-2016. METHODS Total population, age- and gender-specific AUDIT scores, and the percentage of the population with an AUDIT score of 8 or more (indicating hazardous drinking), were derived from four waves of the nationally representative National Drug Strategy Household Survey, weighted to approximate the Australian population. RESULTS In 2016, the mean AUDIT score was 4.58, and 22.22% of the population scored ≥8. Both measures remained stable from 2007 to 2010 but declined in 2013 and 2016. Scores were highest in those aged 18-24 years, the lowest in those aged 14-17 or 60+. A downward trend in AUDIT scores was seen in younger age groups, while the 40-59 and 60+ groups increased or did not change. CONCLUSIONS Despite an overall decline in AUDIT scores, nearly one-quarter of Australians reported hazardous drinking. Implications for public health: The marked declines in hazardous drinking among young people are positive, but trends observed among those aged 40-59 and 60+ years suggests targeted interventions for older Australians are needed.
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Affiliation(s)
| | - Sarah Callinan
- Centre for Alcohol Policy Research, La Trobe University, Victoria
| | | | - Joseph S Doyle
- Burnet Institute, Victoria.,Department of Infectious Diseases, The Alfred and Monash University, Victoria
| | - Paul M Dietze
- Burnet Institute, Victoria.,School of Public Health and Preventive Medicine, Monash University, Victoria.,National Drug Research Institute, Curtin University, Perth, Western Australia
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McKETIN R, Quinn B, Higgs P, Berk M, Dean OM, Turner A, Kelly PJ, Lubman DI, Carter G, Baker AL, Manning V, Thomas T, Bathish R, Raftery D, Saunders L, Wrobel A, Meehan A, Sinclair B, Reid D, Arunogiri S, Hill H, Cordaro F, Dietze PM. Clinical and demographic characteristics of people who smoke versus inject crystalline methamphetamine in Australia: Findings from a pharmacotherapy trial. Drug Alcohol Rev 2020; 40:1249-1255. [PMID: 33022140 DOI: 10.1111/dar.13183] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 08/31/2020] [Accepted: 09/02/2020] [Indexed: 11/26/2022]
Abstract
INTRODUCTION AND AIMS There has been a rapid increase in smoking crystalline methamphetamine in Australia. We compare the clinical and demographic characteristics of those who smoke versus inject the drug in a cohort of people who use methamphetamine. DESIGN AND METHODS Participants (N = 151) were dependent on methamphetamine, aged 18-60 years, enrolled in a pharmacotherapy trial for methamphetamine dependence, and reported either injecting (n = 54) or smoking (n = 97) methamphetamine. Measures included the Timeline Followback, Severity of Dependence Scale, Amphetamine Withdrawal Questionnaire, Craving Experience Questionnaire and the Brief Psychiatric Rating Scale (symptoms of depression, hostility, psychosis and suicidality). Simultaneous regression was used to identify independent demographic correlates of smoking methamphetamine and to compare the clinical characteristics of participants who smoked versus injected. RESULTS Compared to participants who injected methamphetamine, those who smoked methamphetamine were younger and less likely to be unemployed, have a prison history or live alone. Participants who smoked methamphetamine used methamphetamine on more days in the past 4 weeks than participants who injected methamphetamine (26 vs. 19 days, P = 0.001); they did not differ significantly in their severity of methamphetamine dependence, withdrawal, craving or psychiatric symptoms (P > 0.05). After adjustment for demographic differences, participants who smoked had lower craving [b (SE) = -1.1 (0.5), P = 0.021] and were less likely to report psychotic symptoms [b (SE) = -1.8 (0.7), P = 0.013] or antidepressant use [b (SE) = -1.1 (0.5), P = 0.022]. DISCUSSION AND CONCLUSIONS Smoking crystalline methamphetamine is associated with a younger less marginalised demographic profile than injecting methamphetamine, but a similarly severe clinical profile.
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Affiliation(s)
- Rebecca McKETIN
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Brendan Quinn
- Behaviours and Health Risks Program, Burnet Institute, Melbourne, Australia
| | - Peter Higgs
- Behaviours and Health Risks Program, Burnet Institute, Melbourne, Australia.,School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Michael Berk
- Deakin University, IMPACT-The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, Australia.,Florey Institute for Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia.,Department of Psychiatry, University of Melbourne, Melbourne, Australia.,Orygen, The National Centre of Excellence in Youth Mental Health, University of Melbourne, Melbourne, Australia.,Mental Health and Drug and Alcohol Services, Barwon Health, Geelong, Australia
| | - Olivia M Dean
- Deakin University, IMPACT-The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, Australia.,Florey Institute for Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia
| | - Alyna Turner
- Deakin University, IMPACT-The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, Australia
| | - Peter J Kelly
- Illawarra Health and Medical Research Institute and School of Psychology, University of Wollongong, Wollongong, Australia
| | - Dan I Lubman
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, Australia.,Turning Point, Eastern Health, Richmond, Australia
| | - Gregory Carter
- Centre for Brain and Mental Health Priority Research Centre, School of Medicine and Public Health, University of Newcastle, Newcastle, Australia
| | - Amanda L Baker
- Centre for Brain and Mental Health Priority Research Centre, School of Medicine and Public Health, University of Newcastle, Newcastle, Australia
| | - Victoria Manning
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, Australia.,Turning Point, Eastern Health, Richmond, Australia
| | - Tamsin Thomas
- Illawarra Health and Medical Research Institute and School of Psychology, University of Wollongong, Wollongong, Australia
| | - Ramez Bathish
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, Australia.,Turning Point, Eastern Health, Richmond, Australia
| | - Dayle Raftery
- Illawarra Health and Medical Research Institute and School of Psychology, University of Wollongong, Wollongong, Australia
| | - Lucy Saunders
- Deakin University, IMPACT-The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, Australia
| | - Anna Wrobel
- Deakin University, IMPACT-The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, Australia
| | - Alcyone Meehan
- Deakin University, IMPACT-The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, Australia
| | - Barbara Sinclair
- Drug and Alcohol Services, Illawarra Shoalhaven Local Health District, Wollongong, Australia
| | - David Reid
- Drug and Alcohol Services, Illawarra Shoalhaven Local Health District, Wollongong, Australia
| | - Shalini Arunogiri
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, Australia.,Turning Point, Eastern Health, Richmond, Australia
| | - Harry Hill
- Mental Health and Drug and Alcohol Services, Barwon Health, Geelong, Australia
| | - Frank Cordaro
- Drug and Alcohol Services, Illawarra Shoalhaven Local Health District, Wollongong, Australia
| | - Paul M Dietze
- Behaviours and Health Risks Program, Burnet Institute, Melbourne, Australia.,National Drug Research Institute, Faculty of Health Sciences, Curtin University, Perth, Australia
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Ward B, Kippen R, Reupert A, Maybery D, Agius PA, Quinn B, Jenkinson R, Hickman M, Sutton K, Goldsmith R, Dietze PM. Parent and child co-resident status among an Australian community-based sample of methamphetamine smokers. Drug Alcohol Rev 2020; 40:1275-1280. [PMID: 32896037 DOI: 10.1111/dar.13155] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 07/09/2020] [Accepted: 07/20/2020] [Indexed: 01/10/2023]
Abstract
INTRODUCTION Children in families where there is substance misuse are at high risk of being removed from their parents' care. This study describes the characteristics of a community sample of parents who primarily smoke methamphetamine and their child or children's residential status. DESIGN AND METHODS Baseline data from a prospective study of methamphetamine smokers ('VMAX'). Participants were recruited via convenience, respondent-driven and snowball sampling. Univariable and multivariable logistic regression analyses were used to estimate associations between parental status; fathers' or mothers' socio-demographic, psychosocial, mental health, alcohol, methamphetamine use dependence, alcohol use and child or children's co-residential status. RESULTS Of the 744 participants, 394 (53%) reported being parents; 76% (88% of fathers, 57% of mothers) reported no co-resident children. Compared to parents without co-resident children, parents with co-resident children were more likely to have a higher income. Fathers with co-resident children were more likely to be partnered and not to have experienced violence in the previous 6 months. Mothers with co-resident children were less likely to have been homeless recently or to have accessed treatment for methamphetamine use. DISCUSSION AND CONCLUSIONS The prevalence of non-co-resident children was much higher than previously reported in studies of parents who use methamphetamine; irrespective of whether in or out of treatment. There is a need for accessible support and services for parents who use methamphetamine; irrespective of their child or children's co-residency status. Research is needed to determine the longitudinal impact of methamphetamine use on parents' and children's wellbeing and to identify how parents with co-resident children (particularly mothers) can be supported.
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Affiliation(s)
- Bernadette Ward
- School of Rural Health, Monash University, Bendigo, Australia.,Burnet Institute, Melbourne, Australia
| | - Rebecca Kippen
- School of Rural Health, Monash University, Bendigo, Australia
| | - Andrea Reupert
- Faculty of Education, Monash University, Melbourne, Australia
| | - Darryl Maybery
- School of Rural Health, Monash University, Warragul, Australia
| | - Paul A Agius
- Burnet Institute, Melbourne, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Brendan Quinn
- Burnet Institute, Melbourne, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.,Australian Institute of Family Studies, Melbourne, Australia
| | - Rebecca Jenkinson
- Burnet Institute, Melbourne, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.,Australian Institute of Family Studies, Melbourne, Australia
| | - Matthew Hickman
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Keith Sutton
- Burnet Institute, Melbourne, Australia.,School of Rural Health, Monash University, Warragul, Australia
| | | | - Paul M Dietze
- Burnet Institute, Melbourne, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.,National Drug Research Institute, Curtin University, Perth, Australia
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34
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Sutherland R, Dietze PM, Gisev N, Bruno R, Campbell G, Memedovic S, Peacock A. Patterns and correlates of prescribed and non-prescribed pregabalin use among a sample of people who inject drugs in Australia. Drug Alcohol Rev 2020; 39:568-574. [PMID: 32557912 DOI: 10.1111/dar.13083] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 02/20/2020] [Accepted: 04/08/2020] [Indexed: 12/26/2022]
Abstract
INTRODUCTION AND AIMS Pregabalin is a gamma-aminobutyric acid analogue registered and subsidised for the treatment of neuropathic pain in Australia. Despite pre-clinical evidence of low abuse potential, there are increasing reports of extramedical use and overdose deaths involving pregabalin. This study aimed to describe patterns of pregabalin use among an Australian sample of people who inject drugs (PWID) and identify sociodemographic, substance use and mental/physical health correlates of prescribed and non-prescribed use. DESIGN AND METHODS Data were obtained from the 2018 Illicit Drug Reporting System, comprising a cross-sectional sample of 905 PWID recruited from Australian capital cities. Multinomial logistic regression was used to identify correlates of past 6-month prescribed and non-prescribed pregabalin use. RESULTS One-quarter (25%) of participants reported any past 6-month pregabalin use, with 10% reporting prescribed use and 15% non-prescribed use. Past 6-month use of prescribed benzodiazepines and non-prescribed pharmaceutical opioids were associated with both prescribed and non-prescribed pregabalin use compared to no recent pregabalin use. Pain/discomfort on the day of interview was significantly associated with prescribed pregabalin use. Recent use of non-prescribed benzodiazepines and illicit stimulants and past year non-fatal overdose were significantly associated with non-prescribed pregabalin use (compared to no recent pregabalin use). DISCUSSION AND CONCLUSIONS Pregabalin use was relatively common among an Australian sample of PWID. Benzodiazepine and pharmaceutical opioid use were positively correlated with both prescribed and non-prescribed pregabalin use, suggesting that education campaigns regarding the risks of harm associated with concomitant use of these substances are warranted (targeting both health professionals and consumers).
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Affiliation(s)
- Rachel Sutherland
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Paul M Dietze
- Behaviours and Health Risks, Burnet Institute, Melbourne, Australia
| | - Natasa Gisev
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Raimondo Bruno
- Division of Psychology, School of Medicine, University of Tasmania, Hobart, Australia
| | - Gabrielle Campbell
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Sonja Memedovic
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Amy Peacock
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
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35
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Dietze PM, Peacock A. Illicit drug use and harms in Australia in the context of COVID-19 and associated restrictions: Anticipated consequences and initial responses. Drug Alcohol Rev 2020; 39:297-300. [PMID: 32445265 PMCID: PMC7283853 DOI: 10.1111/dar.13079] [Citation(s) in RCA: 68] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 04/13/2020] [Indexed: 01/20/2023]
Affiliation(s)
- Paul M Dietze
- Behaviours and Health Risks Program, Burnet Institute, Melbourne, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Amy Peacock
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia.,School of Psychology, University of Tasmania, Hobart, Australia
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36
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Wright C, Dietze PM, Kuntsche E, Livingston M, Agius PA, Room R, Raggatt M, Hellard M, Lim MSC. Effectiveness of an Ecological Momentary Intervention for Reducing Risky Alcohol Consumption Among Young Adults: Protocol for a Three-Arm Randomized Controlled Trial. JMIR Res Protoc 2020; 9:e14190. [PMID: 32229471 PMCID: PMC7157500 DOI: 10.2196/14190] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 08/16/2019] [Accepted: 10/09/2019] [Indexed: 11/29/2022] Open
Abstract
Background Recent research has investigated the utility of mobile phone–delivered interventions for reducing risky single-occasion drinking, also known as binge drinking. In the past five years, focus has been placed on ecological momentary interventions (EMIs), which aim to deliver intervention content in correspondence to real-time assessments of behavior, also known as ecological momentary assessments (EMAs). Objective This study aims to assess the effect of a fully automated, tailored, mobile phone–delivered EMI termed Mobile Intervention for Drinking in Young people (MIDY) on young people's risky single-occasion drinking behavior. Methods We will use a three-armed randomized controlled trial design to determine the impact of MIDY on peak consumption of alcohol among young people. A list of mobile telephone numbers for random digit dialing will be generated, and researchers will telephone potential participants to screen for eligibility. Participants will be randomized into one of three intervention groups. For 6 weeks, EMI, EMA, and attention control groups will complete hourly EMA surveys on their mobile phones on Friday and Saturday nights. EMI participants will receive personalized feedback in the form of text messages corresponding to their EMA survey responses, which focus on alcohol consumption, spending, and mood. EMA participants will not receive feedback. A third group will also complete EMA and receive feedback text messages at the same time intervals, but these will be focused on sedentary behavior and technology use. All groups will also complete a short survey on Saturday and Sunday mornings, with the primary outcome measure taken on Sunday mornings. A more detailed survey will be sent on the final Sunday of the 6-week period, and then again 1 year after recruitment. Results The primary outcome measure will be an observed change (ie, reduction) in the mean peak number of drinks consumed in a single night over the 6-week intervention period between the EMI and attention control groups as measured in the weekly EMA. We expect to see a greater reduction in mean peak drinking in the EMI group compared to that in the attention control group. As a secondary aim, we will assess whether mean peak drinking is reduced in the EMA group compared to the attention control group. We will use a random-effects mixed-modeling approach using maximum-likelihood estimation to provide estimates of differences in peak drinking across time periods between those receiving the intervention (EMI) and attention control participants. An intention-to-treat approach will be taken for the analysis. Individuals and study groups will be modeled as random and fixed factors, respectively. Conclusions This study extends our previous work investigating the efficacy of a mobile EMI (MIDY) for reducing risky drinking among young adults in Australia, and will add to the expanding literature on the use of mobile interventions for reducing risky alcohol consumption. Trial Registration Australian New Zealand Clinical Trials Registration (ANZCTR): ACTRN12617001509358p; http://www.anzctr.org.au/ACTRN12617001509358p.aspx International Registered Report Identifier (IRRID) DERR1-10.2196/14190
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Affiliation(s)
- Cassandra Wright
- Burnet Institute, Melbourne, Australia.,Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Paul M Dietze
- Burnet Institute, Melbourne, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Emmanuel Kuntsche
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia.,Behavioural Science Institute, Radboud University, Nijmegen, Netherlands
| | - Michael Livingston
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia.,Department of Clinical Neurosciences, Karolinska Institutet, Stockholm, Sweden
| | - Paul A Agius
- Burnet Institute, Melbourne, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.,Judith Lumley Centre, La Trobe University, Melbourne, Australia
| | - Robin Room
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia.,Centre for Social Research on Alcohol and Drugs, Stockholm University, Stockholm, Sweden
| | - Michelle Raggatt
- Burnet Institute, Melbourne, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Margaret Hellard
- Burnet Institute, Melbourne, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Megan S C Lim
- Burnet Institute, Melbourne, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.,Melbourne School of Population and Global Health, University of Melbourne, Parkville, Australia
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37
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Lintzeris N, Monds LA, Bravo M, Read P, Harrod ME, Gilliver R, Wood W, Nielsen S, Dietze PM, Lenton S, Shanahan M, Jauncey M, Jefferies M, Hazelwood S, Dunlop AJ, Greenaway M, Haber P, Ezard N, Malcom A. Designing, implementing and evaluating the overdose response with take-home naloxone model of care: An evaluation of client outcomes and perspectives. Drug Alcohol Rev 2019; 39:55-65. [PMID: 31774221 DOI: 10.1111/dar.13015] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Revised: 10/28/2019] [Accepted: 10/30/2019] [Indexed: 11/30/2022]
Abstract
INTRODUCTION AND DESIGNS Take-home naloxone (THN) interventions are an effective response to preventing overdose deaths, however uptake across Australia remains limited. This project designed, implemented and evaluated a model of care targeting opioid users attending alcohol and other drug (AOD) treatment, needle and syringe programs (NSP) and related health services targeting people who inject drugs. DESIGN AND METHODS Service providers, consumers and regulators collaboratively designed a THN brief intervention (ORTHN, Overdose Response with Take-Home Naloxone) involving client education and supply of naloxone in pre-filled syringes, delivered by nursing, allied health and NSP workers. ORTHN interventions were implemented in over 15 services across New South Wales, Australia. The evaluation included client knowledge, attitudes, substance use and overdose experiences immediately before and 3 months after ORTHN intervention in a subsample of participants. RESULTS Six hundred and sixteen interventions were delivered, with 145 participants recruited to the research subsample, of whom 95 completed the three-month follow up. Overdose-related attitudes amongst participants improved following ORTHN, with no evidence of increased substance use or failure to implement other 'first responses' (e.g. calling an ambulance). Nine participants (10%) reversed an overdose using THN in the follow-up period. Participants identified a willingness to access THN from a range of services. While a minority (16%) indicated they were unwilling to pay for THN, the median price that participants were willing to pay was $AUD20 (IQR $10.40). DISCUSSION AND CONCLUSIONS The ORTHN model of care for THN appears an effective way to disseminate THN to people who use opioids attending AOD, NSP and related health-care settings.
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Affiliation(s)
- Nicholas Lintzeris
- Drug and Alcohol Services, South Eastern Sydney Local Health District, Sydney, Australia.,Discipline of Addiction Medicine, Central Clinical School, The University of Sydney, Sydney, Australia.,NSW Drug and Alcohol Clinical Research and Improvement Network, Sydney, Australia
| | - Lauren A Monds
- Drug and Alcohol Services, South Eastern Sydney Local Health District, Sydney, Australia.,Discipline of Addiction Medicine, Central Clinical School, The University of Sydney, Sydney, Australia.,NSW Drug and Alcohol Clinical Research and Improvement Network, Sydney, Australia
| | - Maria Bravo
- Drug and Alcohol Services, South Eastern Sydney Local Health District, Sydney, Australia.,Discipline of Addiction Medicine, Central Clinical School, The University of Sydney, Sydney, Australia.,NSW Drug and Alcohol Clinical Research and Improvement Network, Sydney, Australia
| | - Phillip Read
- Kirketon Road Centre, South Eastern Sydney Local Health District, Sydney, Australia.,The Kirby Institute, UNSW Sydney, Sydney, Australia
| | | | - Rosie Gilliver
- Kirketon Road Centre, South Eastern Sydney Local Health District, Sydney, Australia
| | - William Wood
- Medically Supervised Injecting Centre, Sydney, Australia
| | - Suzanne Nielsen
- Monash Addiction Research Centre, Monash University, Melbourne, Australia
| | - Paul M Dietze
- Behaviours and Health Risks Program, Burnet Institute, Melbourne, Australia
| | - Simon Lenton
- National Drug Research Institute, Curtin University, Perth, Australia
| | - Marian Shanahan
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | | | - Meryem Jefferies
- NSW Drug and Alcohol Clinical Research and Improvement Network, Sydney, Australia.,Drug Health, Western Sydney Local Health District, Sydney, Australia
| | - Susan Hazelwood
- NSW Drug and Alcohol Clinical Research and Improvement Network, Sydney, Australia.,Drug and Alcohol Services, Hunter New England Local Health District, Newcastle, Australia
| | - Adrian J Dunlop
- NSW Drug and Alcohol Clinical Research and Improvement Network, Sydney, Australia.,Drug and Alcohol Services, Hunter New England Local Health District, Newcastle, Australia
| | | | - Paul Haber
- Discipline of Addiction Medicine, Central Clinical School, The University of Sydney, Sydney, Australia.,NSW Drug and Alcohol Clinical Research and Improvement Network, Sydney, Australia.,Drug Health Services, Sydney Local Health District, Sydney, Australia
| | - Nadine Ezard
- NSW Drug and Alcohol Clinical Research and Improvement Network, Sydney, Australia.,Drug and Alcohol Services, St. Vincent's Local Health Network, Sydney, Australia.,National Centre for Clinical Research in Emerging Drugs, Sydney, Australia
| | - Annie Malcom
- Drug and Alcohol Services, South Eastern Sydney Local Health District, Sydney, Australia.,NSW Drug and Alcohol Clinical Research and Improvement Network, Sydney, Australia
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38
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Nielsen S, Dietze PM. What can Australia learn from the North American opioid crisis? The role of opioid regulation and other evidence-based responses. Drug Alcohol Rev 2019; 38:223-225. [PMID: 30860307 DOI: 10.1111/dar.12916] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 02/06/2019] [Accepted: 02/06/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Suzanne Nielsen
- Monash Addiction Research Centre, Monash University, Melbourne, Australia
| | - Paul M Dietze
- Monash Addiction Research Centre, Monash University, Melbourne, Australia.,The Centre for Population Health, Burnet Institute, Melbourne, Australia.,The School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
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39
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O'Keefe D, Bluthenthal RN, Kral AH, Aitken CK, McCormack A, Dietze PM. Measures of harm reduction service provision for people who inject drugs. Bull World Health Organ 2019; 97:605-611. [PMID: 31474773 PMCID: PMC6705510 DOI: 10.2471/blt.18.224089] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2018] [Revised: 05/28/2019] [Accepted: 05/29/2019] [Indexed: 12/18/2022] Open
Abstract
Coverage is an important dimension in measuring the effectiveness of needle and syringe programmes in providing sterile injecting equipment for people who inject drugs. The World Health Organization (WHO), the United Nations Office on Drugs and Crime (UNODC) and the Joint United Nations Programme on HIV/AIDS (UNAIDS) currently recommend methods for measuring coverage at the population level, that is, across an estimated population of people who inject drugs within a given geographical area. However, population-level measures of coverage rely on highly uncertain population estimates and cannot capture the different levels of syringe acquisition and injecting episodes among individual users. Consequently, such measures only broadly evaluate the extent of programme service delivery, rather than describe how people who inject drugs as individuals and sub-groups interact with needle and syringe programmes. In response to these limitations, several researchers have proposed measuring coverage at the individual level, by the percentage of injecting episodes in relation to the number of sterile needles and syringes acquired. These measures evaluate coverage according to each individual’s needs. Such measures provide enhanced information for planning and monitoring of harm reduction programmes and have now been used in multiple international research studies. We advise that WHO, UNODC and UNAIDS add individual-level coverage measurement methods to their international monitoring guidelines for harm reduction programmes. By doing this, more responsive and effective programmes can be created to better reduce injecting risk behaviours and blood-borne virus transmission among people who inject drugs.
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Affiliation(s)
- Daniel O'Keefe
- Behaviours and Health Risks, Burnet Institute, 85 Commercial Rd, Melbourne, Victoria, 3004, Australia
| | - Ricky N Bluthenthal
- Institute for Health Promotion and Disease Prevention, University of Southern California, Los Angeles, United States of America (USA)
| | - Alex H Kral
- Behavioural Health Research Division, RTI International, San Francisco, USA
| | - Campbell K Aitken
- Behaviours and Health Risks, Burnet Institute, 85 Commercial Rd, Melbourne, Victoria, 3004, Australia
| | - Angus McCormack
- Behaviours and Health Risks, Burnet Institute, 85 Commercial Rd, Melbourne, Victoria, 3004, Australia
| | - Paul M Dietze
- Behaviours and Health Risks, Burnet Institute, 85 Commercial Rd, Melbourne, Victoria, 3004, Australia
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40
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Wright CJC, Schwarzman J, Dietze PM, Crockett B, Lim MSC. Barriers and opportunities in the translation of mobile phone and social media interventions between research and health promotion practice in Australia: a qualitative study of expert perspectives. Health Res Policy Syst 2019; 17:5. [PMID: 30630497 PMCID: PMC6329110 DOI: 10.1186/s12961-018-0406-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2017] [Accepted: 12/11/2018] [Indexed: 12/03/2022] Open
Abstract
Background Newer technologies, such as smartphones and social networking sites, offer new opportunities for health promotion interventions. There is evidence to show that these technologies can be effectively and acceptably used for health promotion activities. However, most interventions produced in research do not end up benefitting non-research populations, while the majority of technology-facilitated interventions which are available outside of research settings are either undocumented or have limited or no evidence to support any benefit. We therefore aimed to explore the perspectives of researchers and health promotion experts on efforts to translate technology-facilitated prevention initiatives into practice, and the barriers to achieving translation. Methods We utilised a qualitative study design, involving in-depth interviews with researchers experienced with technology-facilitated prevention interventions and prominent health promotion experts. Results Some barriers mirror the findings of other studies into health promotion practice, which have found that competing priorities, resource limitations and organisational capacity are important in determining use of evidence in programme planning, engagement in translation and evaluation practice. We add to this literature by describing barriers that are more specifically related to technology-facilitated prevention, such as the pace of developments in technology, and how this clashes with the time taken to develop and ready evidence for translation. Conclusions In order to maximise the vast potential of technology-facilitated prevention interventions to promote population health, it is essential that translation is at the forefront of consideration for both researchers and practitioners. We suggest actions that can be taken by both researchers and practitioners to improve translation of technology-facilitated prevention interventions, and also highlight how funding schemes can be modified to facilitate translation.
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Affiliation(s)
- Cassandra J C Wright
- Centre for Population Health, Burnet Institute, 85 Commercial Rd, Melbourne, Victoria, 3004, Australia. .,Department of Epidemiology and Preventive Medicine, Monash University, 99 Commercial Rd, Melbourne, Victoria, Australia.
| | - Joanna Schwarzman
- Department of Epidemiology and Preventive Medicine, Monash University, 99 Commercial Rd, Melbourne, Victoria, Australia
| | - Paul M Dietze
- Centre for Population Health, Burnet Institute, 85 Commercial Rd, Melbourne, Victoria, 3004, Australia.,Department of Epidemiology and Preventive Medicine, Monash University, 99 Commercial Rd, Melbourne, Victoria, Australia
| | - Belinda Crockett
- Department of Epidemiology and Preventive Medicine, Monash University, 99 Commercial Rd, Melbourne, Victoria, Australia
| | - Megan S C Lim
- Centre for Population Health, Burnet Institute, 85 Commercial Rd, Melbourne, Victoria, 3004, Australia.,Department of Epidemiology and Preventive Medicine, Monash University, 99 Commercial Rd, Melbourne, Victoria, Australia.,Melbourne School of Population and Global Health, University of Melbourne, 235 Bouverie St, Carlton, Victoria, Australia
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41
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Stone J, Fraser H, Lim AG, Walker JG, Ward Z, MacGregor L, Trickey A, Abbott S, Strathdee SA, Abramovitz D, Maher L, Iversen J, Bruneau J, Zang G, Garfein RS, Yen YF, Azim T, Mehta SH, Milloy MJ, Hellard ME, Sacks-Davis R, Dietze PM, Aitken C, Aladashvili M, Tsertsvadze T, Mravčík V, Alary M, Roy E, Smyrnov P, Sazonova Y, Young AM, Havens JR, Hope VD, Desai M, Heinsbroek E, Hutchinson SJ, Palmateer NE, McAuley A, Platt L, Martin NK, Altice FL, Hickman M, Vickerman P. Incarceration history and risk of HIV and hepatitis C virus acquisition among people who inject drugs: a systematic review and meta-analysis. Lancet Infect Dis 2018; 18:1397-1409. [PMID: 30385157 PMCID: PMC6280039 DOI: 10.1016/s1473-3099(18)30469-9] [Citation(s) in RCA: 129] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 05/30/2018] [Accepted: 07/12/2018] [Indexed: 01/01/2023]
Abstract
BACKGROUND People who inject drugs (PWID) experience a high prevalence of incarceration and might be at high risk of HIV and hepatitis C virus (HCV) infection during or after incarceration. We aimed to assess whether incarceration history elevates HIV or HCV acquisition risk among PWID. METHODS In this systematic review and meta-analysis, we searched MEDLINE, Embase, and PsycINFO databases for studies in any language published from Jan 1, 2000 until June 13, 2017 assessing HIV or HCV incidence among PWID. We included studies that measured HIV or HCV incidence among community-recruited PWID. We included only studies reporting original results and excluded studies that evaluated incident infections by self-report. We contacted authors of cohort studies that met the inclusion or exclusion criteria, but that did not report on the outcomes of interest, to request data. We extracted and pooled data from the included studies using random-effects meta-analyses to quantify the associations between recent (past 3, 6, or 12 months or since last follow-up) or past incarceration and HIV or HCV acquisition (primary infection or reinfection) risk among PWID. We assessed the risk of bias of included studies using the Newcastle-Ottawa Scale. Between-study heterogeneity was evaluated using the I2 statistic and the P-value for heterogeneity. FINDINGS We included published results from 20 studies and unpublished results from 21 studies. These studies originated from Australasia, western and eastern Europe, North and Latin America, and east and southeast Asia. Recent incarceration was associated with an 81% (relative risk [RR] 1·81, 95% CI 1·40-2·34) increase in HIV acquisition risk, with moderate heterogeneity between studies (I2=63·5%; p=0·001), and a 62% (RR 1·62, 95% CI 1·28-2·05) increase in HCV acquisition risk, also with moderate heterogeneity between studies (I2=57·3%; p=0·002). Past incarceration was associated with a 25% increase in HIV (RR 1·25, 95% CI 0·94-1·65) and a 21% increase in HCV (1·21, 1·02-1·43) acquisition risk. INTERPRETATION Incarceration is associated with substantial short-term increases in HIV and HCV acquisition risk among PWID and could be a significant driver of HCV and HIV transmission among PWID. These findings support the need for developing novel interventions to minimise the risk of HCV and HIV acquisition, including addressing structural risks associated with drug laws and excessive incarceration of PWID. FUNDING Engineering and Physical Sciences Research Council, National Institute for Health Research, National Institutes of Health.
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Affiliation(s)
- Jack Stone
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
| | - Hannah Fraser
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Aaron G Lim
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Josephine G Walker
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Zoe Ward
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Louis MacGregor
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Adam Trickey
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Sam Abbott
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Steffanie A Strathdee
- Division of Infectious Diseases and Global Public Health, University of California San Diego, La Jolla, CA, USA
| | - Daniela Abramovitz
- Division of Infectious Diseases and Global Public Health, University of California San Diego, La Jolla, CA, USA
| | - Lisa Maher
- Kirby Institute for Infection and Immunity, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Jenny Iversen
- Kirby Institute for Infection and Immunity, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Julie Bruneau
- Department of Family Medicine, Université de Montréal, Montréal, QC, Canada; Centre hospitalier de l'Université de Montreal, Montréal, QC, Canada
| | - Geng Zang
- Centre hospitalier de l'Université de Montreal, Montréal, QC, Canada
| | - Richard S Garfein
- Division of Infectious Diseases and Global Public Health, University of California San Diego, La Jolla, CA, USA
| | - Yung-Fen Yen
- Section of Infectious Diseases, Taipei City Hospital, Taipei City Government, Taipei, Taiwan
| | - Tasnim Azim
- James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| | - Shruti H Mehta
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Michael-John Milloy
- BC Centre for Excellence in HIV/AIDS and Division of AIDS, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Margaret E Hellard
- Burnet Institute, Melbourne, VIC, Australia; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Rachel Sacks-Davis
- Burnet Institute, Melbourne, VIC, Australia; Department of Medicine, University of Melbourne, Melbourne, VIC, Australia
| | | | | | - Malvina Aladashvili
- Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia
| | - Tengiz Tsertsvadze
- Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia; Faculty of Medicine, Tbilisi State University, Tbilisi, Georgia
| | - Viktor Mravčík
- National Monitoring Centre for Drugs and Addiction, Prague, Czech Republic; Department of Addictology, The First Medical Faculty, Charles University and General University Hospital in Prague, Prague, Czech Republic; National Institute of Mental Health, Klecany, Czech Republic
| | - Michel Alary
- University Hospital Centre of Québec Research Centre-Laval University, QC, Canada; National Institute of Public Health of Québec, QC, Canada
| | - Elise Roy
- National Institute of Public Health of Québec, QC, Canada; Faculty of Medicine and Health Sciences, University of Sherbrooke, Longueuil, QC, Canada
| | - Pavlo Smyrnov
- International Charitable Foundation Alliance for Public Health, Kiev, Ukraine
| | - Yana Sazonova
- International Charitable Foundation Alliance for Public Health, Kiev, Ukraine
| | - April M Young
- Department of Epidemiology, University of Kentucky College of Public Health, KY, USA; Center on Drug and Alcohol Research, University of Kentucky, KY, USA
| | - Jennifer R Havens
- Center on Drug and Alcohol Research, University of Kentucky, KY, USA
| | - Vivian D Hope
- Public Health Institute, Liverpool John Moores University, Liverpool, UK; National Infection Service, Public Health England, London, UK
| | - Monica Desai
- National Infection Service, Public Health England, London, UK
| | | | - Sharon J Hutchinson
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK; Health Protection Scotland, National Health Service National Services Scotland, Glasgow, UK
| | - Norah E Palmateer
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK; Health Protection Scotland, National Health Service National Services Scotland, Glasgow, UK
| | - Andrew McAuley
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Lucy Platt
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Natasha K Martin
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; Division of Infectious Diseases and Global Public Health, University of California San Diego, La Jolla, CA, USA
| | - Frederick L Altice
- Yale School of Medicine, Department of Medicine, Section of Infectious Diseases, AIDS Program, New Haven, CT, USA
| | - Matthew Hickman
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Peter Vickerman
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
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Crossin R, Scott D, Arunogiri S, Smith K, Dietze PM, Lubman DI. Pregabalin misuse‐related ambulance attendances in Victoria, 2012–2017: characteristics of patients and attendances. Med J Aust 2018; 210:75-79. [DOI: 10.5694/mja2.12036] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 07/11/2018] [Indexed: 12/25/2022]
Affiliation(s)
- Rose Crossin
- Turning Point Alcohol and Drug Centre, Eastern Health Clinical SchoolMonash University Melbourne VIC
| | - Debbie Scott
- Turning Point Alcohol and Drug Centre, Eastern Health Clinical SchoolMonash University Melbourne VIC
| | - Shalini Arunogiri
- Turning Point Alcohol and Drug Centre, Eastern Health Clinical SchoolMonash University Melbourne VIC
| | | | - Paul M Dietze
- Centre for Epidemiology and Population Health ResearchBurnet Institute Melbourne VIC
| | - Dan I Lubman
- Turning Point Alcohol and Drug Centre, Eastern Health Clinical SchoolMonash University Melbourne VIC
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43
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Wright C, Dietze PM, Agius PA, Kuntsche E, Livingston M, Black OC, Room R, Hellard M, Lim MS. Mobile Phone-Based Ecological Momentary Intervention to Reduce Young Adults' Alcohol Use in the Event: A Three-Armed Randomized Controlled Trial. JMIR Mhealth Uhealth 2018; 6:e149. [PMID: 30030211 PMCID: PMC6076370 DOI: 10.2196/mhealth.9324] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Revised: 03/19/2018] [Accepted: 04/04/2018] [Indexed: 12/30/2022] Open
Abstract
Background Real-time ecological momentary interventions have shown promising effects in domains other than alcohol use; however, only few studies regarding ecological momentary interventions for alcohol use have been conducted thus far. The increasing popularity of smartphones offers new avenues for intervention and innovation in data collection. Objective We aimed to test the efficacy of an ecological momentary intervention, comprising mobile Web-based ecological momentary assessments (EMAs) and text messaging (short message service, SMS) brief interventions, delivered during drinking events using participants’ mobile phones. Methods We conducted a three-armed randomized controlled trial to assess the effect of a mobile Web-based ecological momentary assessment with texting feedback on self-reported alcohol consumption and alcohol-related harms in young adults. Participants were enrolled from an existing observational cohort study of young adults screened for risky drinking behavior. The intervention group (ecological momentary intervention group) completed repeated ecological momentary assessments during 6 drinking events and received immediate texting-based feedback in response to each ecological momentary assessment. The second group (ecological momentary assessment group) completed ecological momentary assessments without the brief intervention, and the third did not receive any contact during the trial period. Recent peak risky single-occasion drinking was assessed at the baseline and follow-up using telephone interviews. We used a random effects mixed modeling approach using maximum likelihood estimation to provide estimates of differences in mean drinking levels between groups between baseline and 12-week follow-up. Results A total of 269 participants were randomized into the 3 groups. The ecological momentary intervention group exhibited a small and nonsignificant increase between baseline and follow-up in (geometric) the mean number of standard drinks consumed at the most recent heavy drinking occasion (mean 12.5 vs 12.7). Both ecological momentary assessment and control groups exhibited a nonsignificant decrease (ecological momentary assessment: mean 13.8 vs 11.8; control: mean 12.3 vs 11.6); these changes did not differ significantly between groups (Wald χ22 1.6; P=.437) and the magnitude of the effects of the intervention were markedly small. No other significant differences between groups on measures of alcohol consumption or related harms were observed. The intervention acceptability was high despite the technical problems in delivery. Conclusions With a small number of participants, this study showed few effects of an SMS-based brief intervention on peak risky single-occasion drinking. Nevertheless, the study highlights areas for further investigation into the effects of EMI on young adults with heavy alcohol consumption. Trial Registration Australian New Zealand Clinical Trials Registry ACTRN12616001323415; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=369534 (Archived by WebCite at http://www.webcitation.org/7074mqwcs)
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Affiliation(s)
- Cassandra Wright
- Burnet Institute, Melbourne, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Paul M Dietze
- Burnet Institute, Melbourne, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Paul A Agius
- Burnet Institute, Melbourne, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.,Judith Lumley Centre, La Trobe University, Melbourne, Australia
| | - Emmanuel Kuntsche
- Addiction Switzerland, Lausanne, Switzerland.,Behavioural Science Institute, Radboud University, Nijmegen, Netherlands.,Faculty of Education and Psychology, Eötvös Loránd University, Budapest, Hungary
| | - Michael Livingston
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia.,Department of Clinical Neurosciences, Karolinska Institutet, Stockholm, Sweden
| | - Oliver C Black
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Robin Room
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia.,Centre for Social Research on Alcohol and Drugs, Stockholm University, Stockholm, Sweden
| | - Margaret Hellard
- Burnet Institute, Melbourne, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Megan Sc Lim
- Burnet Institute, Melbourne, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
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44
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Hainsworth SW, Dietze PM, Wilson DP, Sutton B, Hellard ME, Scott N. Hepatitis C virus notification rates in Australia are highest in socioeconomically disadvantaged areas. PLoS One 2018; 13:e0198336. [PMID: 29912897 PMCID: PMC6005510 DOI: 10.1371/journal.pone.0198336] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2017] [Accepted: 05/17/2018] [Indexed: 11/25/2022] Open
Abstract
Background Poor access to health services is a significant barrier to achieving the World Health Organization’s hepatitis C virus (HCV) elimination targets. We demonstrate how geospatial analysis can be performed with commonly available data to identify areas with the greatest unmet demand for HCV services. Methods We performed an Australia-wide cross-sectional analysis of 2015 HCV notification rates using local government areas (LGAs) as our unit of analysis. A zero-inflated negative binomial regression was used to determine associations between notification rates and socioeconomic/demographic factors, health service and geographic remoteness area (RA) classification variables. Additionally, component scores were extracted from a principal component analysis (PCA) of the healthcare service variables to provide rankings of relative service coverage and unmet demand across Australia. Results Among LGAs with non-zero notifications, higher rates were associated with areas that had increased socioeconomic disadvantage, more needle and syringe services (incidence rate ratio [IRR] 1.022; 95%CI 1.001, 1.044) and more alcohol and other drug services (IRR 1.019; 1.005, 1.034). The distribution of PCA component scores indicated that per-capita healthcare service coverage was lower in areas outside of major Australian cities. Areas outside of major cities also contained 94% of LGAs in the lowest two socioeconomic quintiles, as well as 35% of HCV notifications despite only representing 29% of the population. Conclusions As countries aim for HCV elimination, routinely collected data can be used to identify geographical areas for priority service delivery. In Australia, the unmet demand for HCV treatment services is greatest in socioeconomically disadvantaged and non-metropolitan areas.
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Affiliation(s)
- Samuel W. Hainsworth
- Disease Elimination Program, Burnet Institute, Melbourne, Victoria, Australia
- * E-mail:
| | - Paul M. Dietze
- Behaviours and Health Risks, Burnet Institute, Melbourne, Victoria, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Clayton, Victoria, Australia
| | - David P. Wilson
- Disease Elimination Program, Burnet Institute, Melbourne, Victoria, Australia
| | - Brett Sutton
- Victorian Department of Health and Human Services, Melbourne, Victoria, Australia
| | - Margaret E. Hellard
- Disease Elimination Program, Burnet Institute, Melbourne, Victoria, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Clayton, Victoria, Australia
- Department of Infectious Diseases, The Alfred Hospital and Monash University, Melbourne, Victoria, Australia
| | - Nick Scott
- Disease Elimination Program, Burnet Institute, Melbourne, Victoria, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Clayton, Victoria, Australia
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45
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Agius PA, Aitken CK, Breen C, Dietze PM. Repeat participation in annual cross-sectional surveys of drug users and its implications for analysis. BMC Res Notes 2018; 11:349. [PMID: 29866161 PMCID: PMC5987568 DOI: 10.1186/s13104-018-3454-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Accepted: 05/30/2018] [Indexed: 01/06/2023] Open
Abstract
Objective We sought to establish the extent of repeat participation in a large annual cross-sectional survey of people who inject drugs and assess its implications for analysis. Results We used “porn star names” (the name of each participant’s first pet followed by the name of the first street in which they lived) to identify repeat participation in three Australian Illicit Drug Reporting System surveys. Over 2013–2015, 2468 porn star names (96.2%) appeared only once, 88 (3.4%) twice, and nine (0.4%) in all 3 years. We measured design effects, based on the between-cluster variability for selected estimates, of 1.01–1.07 for seven key variables. These values indicate that the complex sample is (e.g.) 7% less efficient in estimating prevalence of heroin use (ever) than a simple random sample, and 1% less efficient in estimating number of heroin overdoses (ever). Porn star names are a useful means of tracking research participants longitudinally while maintaining their anonymity. Repeat participation in the Australian Illicit Drug Reporting System is low (less than 5% per annum), meaning point-prevalence and effect estimation without correction for the lack of independence in observations is unlikely to seriously affect population inference.
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Affiliation(s)
- P A Agius
- Burnet Institute, 85 Commercial Rd, Melbourne, VIC, 3004, Australia.,School of Public Health and Preventive Medicine, Monash University, 99 Commercial Rd, Melbourne, VIC, 3004, Australia
| | - C K Aitken
- Burnet Institute, 85 Commercial Rd, Melbourne, VIC, 3004, Australia. .,School of Public Health and Preventive Medicine, Monash University, 99 Commercial Rd, Melbourne, VIC, 3004, Australia.
| | - C Breen
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, 2052, Australia
| | - P M Dietze
- Burnet Institute, 85 Commercial Rd, Melbourne, VIC, 3004, Australia.,School of Public Health and Preventive Medicine, Monash University, 99 Commercial Rd, Melbourne, VIC, 3004, Australia
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Hill P, O'Keefe D, Dietze PM. Are there differences in individual-level needle and syringe coverage across Australian jurisdictions related to program policy? A preliminary analysis. Drug Alcohol Rev 2018; 37:653-657. [PMID: 29851167 DOI: 10.1111/dar.12821] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Revised: 04/25/2018] [Accepted: 05/10/2018] [Indexed: 11/26/2022]
Abstract
INTRODUCTION AND AIMS Services provided by needle and syringe programs (NSP) within Australia are easily accessible by international standards. However, important variation in NSP policy remains across Australian jurisdictions. The potential impacts of these variations on program operation for clients have not been systematically analysed in Australia. In this paper we conduct a preliminary examination to compare individual-level syringe coverage between and within Australian capital cities. DESIGN AND METHODS Participants were 2498 people who inject drugs (PWID) recruited from all Australian capital cities as part of the annual Illicit Drug Reporting System PWID survey over the period 2014-2016. Insufficient coverage was defined when <100% of a participant's injecting episodes were 'covered' by sterile needles and syringes. We report the percentage of insufficient coverage for each capital city for each year, and present descriptive statistics for coverage parameters, and an alternative measure for insufficient coverage, as Supporting Information. RESULTS Differences in behaviours that have the potential to impact syringe coverage were highly variable over time and place leading to variations in levels of insufficient coverage between and within all cities. Overall, insufficient coverage was most evident in larger cities where insufficient coverage varied between 19% and 23% (Sydney) over time, compared to smaller cities with variation from 9% to 12% (Adelaide). DISCUSSION AND CONCLUSIONS We found no consistent pattern of differences in individual-level needle and syringe coverage between and within Australian capital cities. Further work is needed to fully evaluate whether policy variation between Australian jurisdictions impacts on NSP coverage.
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Affiliation(s)
- Penelope Hill
- Behaviours and Health Risks Program, Burnet Institute, Melbourne, Australia.,School of Public Health and Preventative Medicine, Monash University, Melbourne, Australia
| | - Daniel O'Keefe
- Behaviours and Health Risks Program, Burnet Institute, Melbourne, Australia.,School of Public Health and Preventative Medicine, Monash University, Melbourne, Australia
| | - Paul M Dietze
- Behaviours and Health Risks Program, Burnet Institute, Melbourne, Australia.,School of Public Health and Preventative Medicine, Monash University, Melbourne, Australia
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Dietze PM, Draper B, Olsen A, Chronister KJ, van Beek I, Lintzeris N, Dwyer R, Nelson M, Lenton S. Does training people to administer take-home naloxone increase their knowledge? Evidence from Australian programs. Drug Alcohol Rev 2018; 37:472-479. [DOI: 10.1111/dar.12680] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Revised: 12/10/2017] [Accepted: 01/25/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Paul M. Dietze
- Behaviours and Health Risks Program; Burnet Institute; Melbourne Australia
- School of Public Health and Preventive Medicine; Monash University; Melbourne Australia
| | - Bridget Draper
- Behaviours and Health Risks Program; Burnet Institute; Melbourne Australia
| | - Anna Olsen
- Research School of Population Health; Australian National University; Canberra Australia
| | - Karen J. Chronister
- South Eastern Sydney Local Health District; Sydney Australia
- Kirby Institute, UNSW Sydney; Sydney Australia
| | - Ingrid van Beek
- South Eastern Sydney Local Health District; Sydney Australia
- Kirby Institute, UNSW Sydney; Sydney Australia
| | - Nicholas Lintzeris
- South Eastern Sydney Local Health District; Sydney Australia
- Division Addiction Medicine; University of Sydney; Sydney Australia
| | - Robyn Dwyer
- Social Studies of Addiction Concepts; National Drug Research Institute, Curtin University; Melbourne Australia
- Centre for Cultural Diversity and Wellbeing; Victoria University; Melbourne Australia
- Centre for Alcohol Policy Research; Curtin University; Melbourne Australia
| | - Marina Nelson
- National Drug Research Institute; Curtin University; Perth Australia
| | - Simon Lenton
- National Drug Research Institute; Curtin University; Perth Australia
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48
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Dietze PM, Stare M, Cogger S, Nambiar D, Olsen A, Burns L, Lenton S. Knowledge of naloxone and take-home naloxone programs among a sample of people who inject drugs in Australia: Variations across capital cities. Drug Alcohol Rev 2017; 37:457-463. [DOI: 10.1111/dar.12644] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2017] [Revised: 10/11/2017] [Accepted: 11/19/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Paul M. Dietze
- Centre for Research Excellence into Injecting Drug Use and Burnet Institute; Melbourne Australia
- School of Public Health and Preventive Medicine, Monash University; Melbourne Victoria
| | | | - Shelley Cogger
- Centre for Research Excellence into Injecting Drug Use and Burnet Institute; Melbourne Australia
| | - Dhanya Nambiar
- Centre for Research Excellence into Injecting Drug Use and Burnet Institute; Melbourne Australia
- School of Public Health and Preventive Medicine, Monash University; Melbourne Victoria
| | - Anna Olsen
- Australian National University; Canberra Australia
| | - Lucinda Burns
- National Drug and Alcohol Research Centre; Sydney Australia
| | - Simon Lenton
- National Drug Research Institute; Curtin University; Perth Australia
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49
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Stam NC, Gerostamoulos D, Dietze PM, Parsons S, Smith K, Lloyd B, Pilgrim JL. The attribution of a death to heroin: A model to help improve the consistent and transparent classification and reporting of heroin-related deaths. Forensic Sci Int 2017; 281:18-28. [DOI: 10.1016/j.forsciint.2017.10.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Revised: 09/11/2017] [Accepted: 10/10/2017] [Indexed: 10/18/2022]
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Livingston M, Callinan S, Raninen J, Pennay A, Dietze PM. Alcohol consumption trends in Australia: Comparing surveys and sales-based measures. Drug Alcohol Rev 2017; 37 Suppl 1:S9-S14. [PMID: 28741874 DOI: 10.1111/dar.12588] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Revised: 06/22/2017] [Accepted: 06/30/2017] [Indexed: 01/24/2023]
Abstract
INTRODUCTION AND AIMS Survey data remain a crucial means for monitoring alcohol consumption, but there has been limited work done to ensure that surveys adequately capture changes in per-capita consumption in Australia. In this study, we explore how trends in consumption from two major Australian surveys compare with an official measure of per-capita consumption between 2001 and 2014 and examine age-specific trends in drinking. DESIGN AND METHODS Data were from five waves of the cross-sectional National Health Survey (total n = 113 279) and 12 waves of the longitudinal Household Income and Labour Dynamics in Australia Study (average n = 12 347). Overall and age-specific estimates of annual alcohol consumption were derived and compared with official per-capita consumption and previous analyses of the National Drug Strategy Household Survey. RESULTS In terms of overall consumption, both surveys broadly reflected trends in per-capita consumption, especially the decline that has been observed since 2007/2008. Age-specific trends were broadly similar, with the recent decline in consumption clearly concentrated among teenagers and young adults. DISCUSSION AND CONCLUSIONS The main Australian monitoring surveys remain useful monitoring tools for alcohol consumption in Australia. There is consistent evidence that the recent declines in Australian per-capita consumption have been driven by sharp falls in drinking among young people, a trend that requires further study. [Livingston M, Callinan S, Raninen J, Pennay A, Dietze PM. Alcohol consumption trends in Australia: Comparing surveys and sales-based measures. Drug Alcohol Rev 2017;00:000-000].
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Affiliation(s)
- Michael Livingston
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia.,Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Sarah Callinan
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
| | - Jonas Raninen
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,The Swedish Council for Information on Alcohol and Other Drugs (CAN), Stockholm, Sweden
| | - Amy Pennay
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
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