Screening and early intervention for substance use during pregnancy: A retrospective case note review of antenatal care records.

Introduction: Screening for substance use during pregnancy is critical for enhancing maternal health and perinatal outcomes. However, disparities persist in screening and intervention rates within maternity services. This retrospective case note review explored contemporaneous practices around screening and interventions for substance use among pregnant women during routine antenatal care.

Improving the quality of antenatal screening and early intervention for alcohol and other drug use: protocol for a multi-stage approach to systems reform.

Background: Alcohol, tobacco and illicit drug use during pregnancy can cause significant harm to women and their developing fetuses. Despite recommendations for abstinence during pregnancy, some women continue to use, making screening for substance use during antenatal clinic attendances an important strategy for reducing risk. This study aims to improve the rates of screening and intervention for substance use among pregnant women, including appropriate referral for those who may be substance-dependent.

Building workforce capacity to address substance use in primary health care: preliminary results from a mixed-methods pilot program.

Background: Primary health care is critical to the prevention of alcohol, tobacco and other drug-related harms. Scaling-up screening, brief intervention and referral to treatment (SBIRT) within primary health care can reduce the burden of substance-related diseases, and improve downstream healthcare services. Building knowledge, skills and confidence among general practitioners (GPs), particularly in rural, regional and remote areas, to deliver SBIRT is an essential step.

Substance use in the emergency department: Screening for risky drug use, using the ASSIST-Lite.

Introduction: Substance use is a common contributing factor to emergency department (ED) presentations. While screening, brief intervention, and referral to treatment for alcohol and tobacco is common in ED settings, it is not routinely conducted for illicit substances. This study aimed to deploy the ASSIST-Lite to screen for risky use of alcohol and other drugs in the ED, to identify differences in risk based on between demographic characteristics.

Revision of the Australian guidelines to reduce health risks from drinking alcohol.

Introduction: The Australian guidelines to reduce health risks from drinking alcohol were released in 2020 by the National Health and Medical Research Council. Based on the latest evidence, the guidelines provide advice on how to keep the risk of harm from alcohol low. They refer to an Australian standard drink (10 g ethanol).

Analysis of qualitative data from the investigation study in pregnancy of the ASSIST Version 3.0 (the Alcohol, Smoking and Substance Involvement Screening Test).

Objective: to utilise qualitative data from investigation of the screening tool ASSIST Version 3.0 with pregnant women to help determine its appropriateness for this cohort, thus informing potential innovations to enhance the questionnaire׳s utility.

Design: pregnant women were co-administered the ASSIST Version 3.

Global statistics on addictive behaviours: 2014 status report.

Background And Aims: Addictive behaviours are among the greatest scourges on humankind. It is important to estimate the extent of the problem globally and in different geographical regions. Such estimates are available, but there is a need to collate and evaluate these to arrive at the best available synthetic figures.

Pharmacogenomics of methadone maintenance treatment.

Methadone is the major opioid substitution therapy for opioid dependence. Dosage is highly variable and is often controlled by the patient and prescriber according to local and national policy and guidelines. Nevertheless many genetic factors have been investigated including those affecting its metabolism (CYP2B6-consistent results), efflux transport (P-gp-inconsistent results), target μ-opioid receptor (μ-opioid receptor-inconsistent results) and a host of other receptors (DRD2) and signaling elements (GIRK2 and ARRB2; not replicated).

Dose-related psychotic symptoms in chronic methamphetamine users: evidence from a prospective longitudinal study.

Context: Methamphetamine is associated with psychotic phenomena, but it is not clear to what extent this relationship is due to premorbid psychosis among people who use the drug.

Objective: To determine the change in the probability of psychotic symptoms occurring during periods of methamphetamine use.

Design: Longitudinal prospective cohort study.

Injection of medications used in opioid substitution treatment in Australia after the introduction of a mixed partial agonist-antagonist formulation.

Objectives: To examine the levels and predictors of injection of buprenorphine-naloxone (BNX)--a combination of a partial opioid agonist and an opioid antagonist for treating opioid dependence--which was specifically developed to limit injecting. Comparison was made with injecting of two other opioid substitution treatment medications, methadone and buprenorphine (BPN); severe harms have been documented after injection of the latter.

Design And Participants: Injecting was studied in regular injecting drug users ("IDUs") and current opioid substitution treatment clients ("clients").

Abstinence-orientated buprenorphine replacement therapy for young adults in out-patient counselling.

This study assessed treatment retention, compliance and completion of a 9-month buprenorphine replacement programme. In addition, changes in drug use and other relevant variables, as well as predictors of completion, were examined. Seventy-five opioid-dependent out-patients (mean age 26 years; 33% females) who aimed for opioid abstinence were enrolled into the study.

The place of detoxification in treatment of opioid dependence.

Purpose Of Review: This review summarizes current research on the management of opioid withdrawal and considers the selection of the approach in different situations.

Recent Findings: The recent publication of three controlled trials makes firm conclusions about the relative effectiveness of newer approaches (antagonist-induced withdrawal under anaesthesia or with minimal sedation; buprenorphine) to the management of opioid withdrawal possible.

Summary: Antagonist-induced withdrawal under anaesthesia should not be pursued as it has an increased risk of life-threatening adverse events and has no additional benefits relative to antagonist-induced withdrawal under minimal sedation.

Brief report: Methadone treatment of injecting opioid users for prevention of HIV infection.

Objective: To assess the effects of oral substitution treatment for opioid-dependent injecting drug users on HIV risk behaviors and infections.

Data Sources: Multiple electronic databases were searched. Reference lists of retrieved articles were checked.

Impact of the heroin 'drought' on patterns of drug use and drug-related harms.

Since late 2000, anecdotal reports from drug users and health professionals have suggested that there was a reduction in the supply of heroin in Adelaide in the first half of 2001, referred to as a heroin 'drought'. The aim of this paper was to critically review evidence for this, using data obtained from 100 injecting drug users surveyed for the 2001 Illicit Drug Reporting System (IDRS). This project is carried out annually in all Australian jurisdictions, and collects up-to-date information on the markets for heroin, methamphetamine, cocaine and cannabis.

Heroin users in Australia: population trends.

The aim of this paper is to identify certain important population trends among heroin users in Australia for the period 1971 - 97, such as: population growth, initiation, i.e. the number who were initiated to heroin in a given year, and quitting, i.

The health effects of ecstasy: a literature review.

Ecstasy (3,4-methylenedioxymethamphetamine, MDMA) is the third most used illicit drug, after cannabis and amphetamines. There has been considerable interest in the adverse effects of use, with particular attention given to a small number of deaths related to ecstasy use, and the neurotoxic effects of MDMA. This paper reviews case reports of adverse effects attributed to ecstasy use, and the findings of animal and human studies, so as to identify the health effects of ecstasy use, and factors contributing to their occurrence.

Relationship between LAAM-methadone preference and treatment outcomes.

Studies of relative LAAM-methadone preference have indicated that a significant proportion of patients prefer levo-alpha-acetylmethadol (LAAM). The present study was designed to determine whether this preference is associated with better treatment outcomes. Sixty-two stable methadone patients participated in a randomised crossover clinical trial.

Alpha2-adrenergic agonists in opioid withdrawal.

Objectives: This paper presents the main findings of a systematic (Cochrane) review of the effectiveness of alpha2-adrenergic agonists in managing opioid withdrawal.

Design: The original systematic review included controlled trials that compared alpha2-adrenergic agonists with another form of treatment (or placebo) in participants who were primarily opioid-dependent.

Main Findings: Ten studies compared a treatment regime based on an alpha2-adrenergic agonist with one based on reducing doses of methadone.