Paramedic perceptions of decision-making when managing mental health-related presentations: a qualitative study.

Background: Mental health presentations account for a considerable proportion of paramedic workload; however, the decision-making involved in managing these cases is poorly understood. This study aimed to explore how paramedics perceive their clinical decision-making when managing mental health presentations.

Methods: A qualitative descriptive study design was employed.

Differences in ambulance attendances between children with and without an identified history of out-of-home-care.

Background: Children in out-of-home-care (OOHC) are a vulnerable population, typically with complex needs, however there is minimal research examining the behavioural presentations that lead to the increased use of acute emergency care by OOHC children.

Objective: This study aimed to describe differences in lifetime complexity factors identified during ambulance attendances between children with and without an identified history of OOHC. Further, this study aimed to describe whether having an identified history of being in OOHC was associated with increased utilisation of emergency care resources and increased likelihood of multiple ambulance attendances.

Rotation from methadone to buprenorphine using a micro-dosing regime in patients with opioid use disorder and serious mental illness: A case series.

Introduction: Inducting buprenorphine from methadone has traditionally involved initial opioid withdrawal, with risk of mental state deterioration in patients with serious mental illness (SMI). Micro-dosing of buprenorphine, with small incremental doses, is a novel off-label approach to transitioning from methadone and does not require a period of methadone abstinence. Given the limited literature about buprenorphine microdosing, we aimed to evaluate the feasibility and safety of inducting buprenorphine in a series of patients on methadone with SMI.

Web-Based Forums for People Experiencing Substance Use or Gambling Disorders: Scoping Review.

Background: For people experiencing substance use or gambling disorders, web-based peer-supported forums are a space where they can share their experiences, gather around a collective goal, and find mutual support. Web-based peer support can help to overcome barriers to attending face-to-face meetings by enabling people experiencing addiction to seek support beyond their physical location and with the benefit of anonymity if desired. Understanding who participates in web-based peer-supported forums (and how), and the principles underpinning forums, can also assist those interested in designing or implementing similar platforms.

The dynamics of more-than-human care in depot buprenorphine treatment: A new materialist analysis of Australian patients' experiences.

Background: Long-acting injectable depot buprenorphine has become an important treatment option for the management of opioid dependence. However, little is known about patients' experiences of depot buprenorphine and its embodied effects. This qualitative study aims to explore patients' experiences of depot buprenorphine treatment, including how it feels within the body, experiences of dosing cycles across time, and how this form of treatment relies on wider ecologies of care beyond the clinical encounter.

Using ambulance surveillance data to characterise blood-borne viral infection histories among patients presenting with acute alcohol and other drug-related harms.

Objective: Preventable transmission of blood-borne viruses (BBV), including human immunodeficiency virus (HIV), hepatitis C virus (HCV) and hepatitis B virus (HBV), continue in at-risk populations, including people who use alcohol and drugs (AODs). To our knowledge, no studies have explored the use of ambulance data for surveillance of AOD harms in patients with BBV infections.

Methods: We used electronic patient care records from the National Ambulance Surveillance System for people who were attended by an ambulance in Victoria, Australia between July 2015 and July 2016 for AOD-related harms, and with identified history of a BBV infection.

Predictors of cognitive functioning in presentations to a community-based specialist addiction neuropsychology service.

Introduction: Cognitive impairment is common in individuals presenting to alcohol and other drug (AOD) settings and the presence of biopsychosocial complexity and health inequities can complicate the experience of symptoms and access to treatment services. A challenge for neuropsychologists in these settings is to evaluate the likely individual contribution of these factors to cognition when providing an opinion regarding diagnoses such as acquired brain injury (ABI). This study therefore aimed to identify predictors of cognitive functioning in AOD clients attending for neuropsychological assessment.

Experiences of telehealth among people receiving alcohol and other drug treatment during the COVID-19 pandemic: Implications for future telehealth delivery.

Introduction: The novel coronavirus (COVID-19) pandemic necessitated the rapid uptake of telehealth to deliver treatment for alcohol and other drug (AOD) concerns. However, little is known about how the move from in-person to telehealth delivery impacted clients' experience of care. This qualitative study aimed to explore experiences of telehealth among people receiving alcohol and other drug treatment during the COVID-19 pandemic, and their preferences regarding future telehealth care.

Determining the Impact of Opioid Policy on Substance Use and Mental Health-Related Harms: Protocol for a Data Linkage Study.

Background: Increasing harms related to prescription opioids over the past decade have led to the introduction of a range of key national and state policy initiatives across Australia. These include introducing a mandatory real-time prescription drug-monitoring program in the state of Victoria from April 2020 and a series of changes to subsidies for opioids on the Pharmaceutical Benefit Scheme from June 2020. Together, these changes aim to influence opioid supply and reduce harms related to prescription opioids, yet few studies have specifically explored how these policies have influenced opioid prescribing and related harms in Australia.

Opioid-related ambulance attendances during the first 2 years of the COVID-19 pandemic in Victoria, Australia.

Background And Aims: Public health measures introduced to contain the spread of the SARS-CoV-2 virus likely affected opioid supply and demand, as well as the patterns and contexts of opioid use. We measured opioid-related harms during the first 2 years of COVID-19 restrictions in Victoria, Australia.

Design: We adopted an interrupted time series analysis design using interventional autoregressive integrated moving average (ARIMA) models.

Changes in opioid agonist treatment initiation among people prescribed opioids for pain following voluntary and mandatory prescription drug monitoring program implementation: A time series analysis.

Introduction: Prescription drug monitoring programs (PDMP) are increasingly used to identify people prescribed high-dose opioids. However, little is known about whether PDMPs impact opioid agonist treatment (OAT) uptake, the gold standard for opioid use disorder. This study examined the impact of PDMP implementation on OAT initiation among people prescribed opioids, in Victoria, Australia.

Enriching qualitative alcohol and other drug research by engaging lived experience peer researchers in a dual-interview approach: A case study.

Introduction: Engaging people with lived experience of alcohol and other drug use as peer researchers in qualitative research is becoming more common. However, there are differing opinions on how to best engage and support peer researchers.

Case Presentation: Through this case study the researchers aimed to illustrate the potential benefits of a peer/academic researcher dual-interview approach as a qualitative method in research.

Impact of work and coping factors on mental health: Australian truck drivers' perspective.

Introduction: Truck driving is one of the most common male occupations worldwide. Drivers endure long working hours, isolation, separation from family, compromised sleep, and face rigid regulatory requirements. Studies have documented the work factors contributing to poor health outcomes, however these have not been explored in the Australian context.

A brief intervention for improving alcohol literacy and reducing harmful alcohol use by women attending a breast screening service: a randomised controlled trial.

Objectives: To assess the effectiveness of a brief alcohol intervention for improving awareness of alcohol as a breast cancer risk factor, improving alcohol literacy, and reducing alcohol consumption by women attending routine breast screening.

Design: Single-site, double-blinded randomised controlled trial.

Setting: Maroondah BreastScreen (Eastern Health, Melbourne), part of the national breast cancer screening program.

Changes in opioid and other analgesic prescribing following voluntary and mandatory prescription drug monitoring program implementation: A time series analysis of early outcomes.

Background: Australian prescription drug monitoring programs (PDMPs) provide information about a patient's recent medication history for controlled drugs at the point of prescribing and dispensing. Despite their increasing use, the evidence for PDMPs is mixed, and is almost exclusively from the United States. This study examined the impact of PDMP implementation on opioid prescribing among general practitioners in Victoria, Australia.

How does a family history of psychosis influence the risk of methamphetamine-related psychotic symptoms: Evidence from longitudinal panel data.

Aims: To determine whether the risk of psychotic symptoms during weeks of methamphetamine use was dependent on, increased by, or independent of having a family history of psychosis.

Design: Secondary analysis of 13 contiguous 1-week periods of data (1370 weeks). A risk modification framework was used to test each scenario.

Staying with the silence: Silence as affording care in online alcohol and other drug counselling.

As the name 'talk therapy' suggests, a key aim of alcohol and other drug counselling, psychotherapy and other talk therapies is to discuss issues, concerns and feelings with a health professional. Implicit here is the therapeutic value of talking through issues with a trained professional. But as with all interactions, therapeutic encounters involve silences and pauses as key aspects of the communicative process.