Opioid-related harms and experiences of care among people in justice settings in New South Wales, Australia: evidence from the National Ambulance Surveillance System.

Background: People in justice settings experience higher rates of psychiatric morbidity, including alcohol and drug use disorders, compared with the general population. However, our understanding of opioid-related harms in justice settings is limited. This study used ambulance data to examine opioid-related harms and experiences of care in New South Wales (NSW), Australia, during periods of incarceration or detention.

Lisdexamfetamine in the treatment of methamphetamine dependence: A randomised, placebo-controlled trial.

Aims: This study tested the efficacy and safety of a 12-week course of lisdexamfetamine in reducing methamphetamine use, an outcome which is associated with improvements in health and wellbeing, in people dependent on methamphetamine.

Design, Setting And Participants: This study was a randomised double-blind placebo-controlled trial conducted in six specialist outpatient clinics in Adelaide, Melbourne, Newcastle and Sydney, Australia (2018-2021). Participants were164 adults with methamphetamine dependence, reporting at least 14 use days out of the previous 28 days (62% male, 38% female, < 1% other; mean age 39 years).

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.

A qualitative study of using nicotine products for smoking cessation after discharge from residential drug and alcohol treatment in Australia.

Introduction: Tobacco smoking is highly prevalent among alcohol and other drugs (AOD) service clients and, despite interest in quitting, abstinence is rarely sustained. Nicotine products may assist after discharge from residential treatment services, but little is known about client receptivity to them. This study examined AOD withdrawal service clients' experiences of two types of nicotine products for smoking cessation post-discharge, combination nicotine replacement therapy (cNRT) and nicotine vaping products (NVP).

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.

Evaluation of an SMS Based Alcohol Intervention for Same Sex Attracted Women: A Randomized Controlled Trial to Examine Feasibility, Acceptability, and Efficacy.

Purpose: The purpose of this randomized controlled trial (Trial registration ID: redacted) was to examine the feasibility, acceptability, and efficacy of the Step One program, an SMS-based alcohol intervention for same-sex attracted women (SSAW).

Methods: Ninety-seven SSAW who scored ≥8 on the Alcohol Use Disorders Identification Test (AUDIT) were randomly allocated to receive the Step One program ( = 47; mean age = 36.79) or a weekly message containing a link to a website with health information and support services for LGBT individuals ( = 50; mean age = 34.

Leveraging Online Treatment to Re-examine the Association Between Alcohol Use and Disinhibition.

Background: Cognitive disinhibition underpins alcohol and drug use problems. Although higher-risk substance use is consistently associated with poorer disinhibition, current findings may be limited by narrow recruitment methods, which over-represent individuals engaged in traditional treatment services with more severe presentations. We embedded a novel gamified disinhibition task (the Cognitive Impulsivity Suite; CIS) in a national online addiction support service ( https://www.

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.

Economic evaluations of alcohol pharmacotherapy: Systematic review of economic evaluations of pharmacotherapy for the treatment of alcohol use disorder.

Objective: Alcohol use disorders confer a significant burden of disease and economic cost worldwide. However, the utilisation of pharmacotherapies to manage alcohol use disorder is poor. We aimed to conduct a systematic review of economic evaluation studies of alcohol use disorder pharmacotherapies.

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.