Publications by authors named "Paul Dietze"

Background: We aimed to identify motivators for people who inject drugs to pursue treatment for hepatitis C virus (HCV) infection and uncover opportunities that could make treatment more appealing.

Methods: Between November 2023 and January 2024, we conducted semi-structured interviews with 15 HCV RNA-positive individuals with a history of injecting drug use and self-reported as either untreated or treated but delayed treatment for more than 6 months. Thematic and framework data analysis was employed and interpreted using the Capability, Opportunity and Motivation (COM-B) framework of behaviour change.

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  • The study examines factors influencing the completion of alcohol and other drug (AOD) treatment, focusing on both demographic and service-level aspects among a large cohort in New South Wales, Australia.
  • It found that around 69.8% of participants completed treatment at least once, with differences in completion rates based on the type of substance, treatment modality, and referral source.
  • Specifically, amphetamine treatments had the lowest completion rates, while mandated treatments through criminal justice agencies and certain AOD modalities, like involuntary treatments, showed significantly higher completion rates.
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  • The study evaluated changes in anxiety and depression over three years among regular methamphetamine users in Victoria, Australia, and explored the relationship between these changes and patterns of meth use.
  • Using surveys from 849 participants, findings indicated that changes in mental health symptoms were linked to the shift from non-injecting to injecting meth, severity of dependence, and starting treatment for other drugs.
  • The results revealed that while anxiety and depression scores changed with various factors, they were not significantly influenced by how often participants used methamphetamine.
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  • People who inject drugs generally experience worse health outcomes, and this study aimed to analyze the factors leading to participant attrition in a cohort study in Victoria, Australia.
  • The research utilized data from the Melbourne Injecting Drug User Cohort Study (SuperMIX) and found that 36.8% of participants were lost to follow-up within two years, particularly among younger individuals and those facing social and economic challenges.
  • The results indicate that while attrition rates have been stable, vulnerable groups may be underrepresented in the data, highlighting the need for strategies to keep these high-risk individuals engaged in the study.
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Background: Opioid overdose is a global health crisis, affecting over 27 million individuals worldwide, with more than 100,000 drug overdose deaths in the United States in 2022-2023. This protocol outlines the development of the PneumoWave chest biosensor, a wearable device being designed to detect respiratory depression in real time through chest motion measurement, intending to enhance early intervention and thereby reduce fatalities.

Objective: The study aims to (1) differentiate opioid-induced respiratory depression (OIRD) from nonfatal opioid use patterns to develop and refine an overdose detection algorithm and (2) examine participants' acceptability of the chest biosensor.

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Background: Examining take-home naloxone (THN) uptake using a 'cascade of care' framework could help identify targets for increasing THN training and carriage among people who may witness or experience opioid overdose. We describe the THN cascade and factors associated with engagement among people who inject drugs.

Methods: People aged ≥18 years in Australia who inject drugs were interviewed from 2020 to 2022, reporting lifetime THN awareness and acquisition and past-month carriage.

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Introduction: Alcohol is commonly detected in patients presenting to hospital after major trauma and is a key preventable risk factor for injury. While it has been suggested that alcohol intoxication at the time of injury results in worse acute patient outcomes, there is currently limited knowledge on the impact of alcohol on health outcomes following hospital discharge. The aim of this study was to examine the relationship between acute pre-injury alcohol exposure and the self-reported health outcomes of survivors of major trauma 12-months post-injury.

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  • Over the past two decades, methamphetamine-related deaths in Australia have risen significantly, prompting a comprehensive analysis of mortality trends across various causes from 2001 to 2023.
  • The study found that nearly half of these deaths were due to unintentional drug toxicity, with other causes including self-harm and injuries, revealing fluctuating trends over time with periods of both increase and decrease in mortality rates.
  • The latest data indicate a slight rise in unintentional drug toxicity deaths, a stabilization in intentional self-harm rates, and continued growth in deaths attributed to natural causes like circulatory diseases.
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Introduction: Despite universal access to government-funded direct-acting antivirals (DAAs) in 2016, the rate of hepatitis C treatment uptake in Australia has declined substantially. Most hepatitis C is related to injecting drug use; reducing the hepatitis C burden among people who inject drugs (PWID) is, therefore, paramount to reach hepatitis C elimination targets. Increasing DAA uptake by PWID is important for interrupting transmission and reducing incidence, as well as reducing morbidity and mortality and improving quality of life of PWID and meeting Australia's hepatitis C elimination targets.

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Introduction: People who inject drugs experience stigma across multiple settings, including when accessing health-care services, however, comparatively little is known about experiences of stigma towards other groups of people who use illegal drugs. This paper examines experience of, and factors associated with, stigma among two samples of people who use illegal drugs when visiting both specialist alcohol and other drug (AOD) and general health-care services.

Methods: Australians who regularly (i.

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  • A study was conducted in Australia to assess COVID-19 vaccine coverage and the motivations and barriers to vaccination among people who inject drugs, finding that 84.1% had received at least one dose.
  • Key motivations for vaccination included personal and community protection; mistrust in vaccines and government were significant barriers.
  • Factors associated with receiving higher doses included opioid agonist treatment, current influenza vaccination, stable housing, and being aged 40 or older or having a chronic health condition.
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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.

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Background: Primary needle and syringe programs (NSPs) have been integral for the prevention of blood-borne virus (BBV) transmission among people who inject drugs. Despite this, many people who inject drugs face barriers accessing these services, particularly after-hours when most services are closed. To our knowledge, the St Kilda NSP, in Melbourne, Victoria, is the only primary NSP providing 24/7 dedicated stand-alone face-to-face services for people who inject drugs in Australia.

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Objective: Anxiety and depression are prevalent mental health problems in people who use illicit stimulants. Improved understanding of the temporal relationship between methamphetamine, ecstasy/MDMA, or cocaine use with anxiety or depression informs public health interventions and treatment options for those experiencing this co-occurrence. This narrative systematic review sought to examine associations and temporality between the use of methamphetamine, ecstasy/MDMA, or cocaine, with anxiety or depressive symptoms.

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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.

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Recent guidance from the World Health Organization strongly recommended hepatitis C virus (HCV) self-testing. We implemented the Vend-C pilot study to explore the effectiveness and feasibility of distributing rapid HCV antibody self-test kits to people who inject drugs via needle/syringe dispensing machines (SDMs). Over a 51-day study period between August and September 2022, we distributed HCV antibody self-test kits via two SDMs.

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Introduction: Children in families affected by substance use disorders are at high risk of being placed in out-of-home care (OOHC). We aimed to describe the characteristics of parents who inject drugs and identify correlates associated with child placement in OOHC.

Methods: We used baseline data from a community-based cohort of parents who inject drugs (SuperMIX) from Melbourne, Australia.

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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.

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The National Naloxone Reference Group has played a key role in the development of take-home naloxone programs, policy and practice in Australia. In this commentary we detail the origins of the group, some of its main achievements since its inception and its future directions in light of the major policy changes around naloxone that have recently occurred in Australia.

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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.

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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.

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Background: In-hospital alcohol testing provides an opportunity to implement prevention strategies for patients with high risk of experiencing repeated alcohol-related injuries. However, barriers to alcohol testing in emergency settings can prevent patients from being tested. In this study, we aimed to understand potential biases in current data on the completion of blood alcohol tests for major trauma patients at hospitals in Victoria, Australia.

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  • * The study analyzed 10 years of survey data (2012-2022) to identify five polysubstance use profiles and found a significant decline in opioid-depressant use, correlating with reduced pharmaceutical opioid usage and treatment, while single drug class use increased.
  • * Various polysubstance use profiles showed associations with psychosocial issues like unstable housing and high psychological distress, along with risky behaviors such as needle sharing and non-fatal overdoses, highlighting the complex nature of
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Importance: Concerns that take-home naloxone (THN) training may lead to riskier drug use (as a form of overdose risk compensation) remain a substantial barrier to training implementation. However, there was limited good-quality evidence in a systematic review of the association between THN access and subsequent risk compensation behaviors.

Objective: To assess whether THN training is associated with changes in overdose risk behaviors, indexed through injecting frequency, in a cohort of people who inject drugs.

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Objectives: Methamphetamine use impacts oral health, but little is known about its impacts on oral health related quality of life (OHRQoL). In this study we examined OHRQoL in a cohort of people who use methamphetamine and assessed associations with sociodemographic, behavioural, psychosocial and dental service utilisation correlates. A secondary aim was to examine the relationship between methamphetamine route of administration and OHRQoL, to test whether smoking the drug is associated with reduced OHRQoL.

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