Patterns and trends in alcohol-related hospitalizations in Victoria, Australia, 1987/88-1995/96.

The objective of this study was to examine patterns and yearly trends in alcohol-related hospitalization rates during the period 1987/88-1995/96 for men and women living in metropolitan and rural/remote Victoria. Alcohol-related hospitalizations were extracted from the Victorian Inpatient Minimum Dataset (VMD) for the years 1987/88-1995/96 (public hospitals) and 1993/94-1995/96 (private hospitals), and adjusted by the appropriate aetiological fractions. Sex-specific age-adjusted rates we expressed per 10000 residents/year.

The incidence and characteristics of volatile substance use related ambulance attendances in metropolitan Melbourne, Australia.

While there has been substantial community discussion and concern expressed about volatile substance use (VSU), there has been little research on the use and related harms of these substances compared to other drugs. In this study we address a need in existing epidemiological research on VSU harms by describing the incidence and characteristics of VSU ambulance attendances between August 1998 and May 2004 across metropolitan Melbourne relative to heroin attendances, a drug class that has received more research attention. Our analysis showed that the crude rate of VSU attendance (5.

Applied communitarian ethics for harm reduction: promoting a dialogue within the field.

This piece responds to critical points raised in commentaries on our 2005 HRD paper on the topic of harm reduction ethics, and clarifies other aspects of our original arguments that were misinterpreted. In our view, the goal of ethical engagement in harm reduction is not necessarily the production of an agreed moral framework, but instead reflection and awareness raising around the various values and beliefs underlying harm reduction, and consideration of how these influence policy, practice and research decisions and outcomes. This 'discursive authenticity' as Hathaway has called it, can help to define a new territory of authority for drug users as participants in harm reduction policy, practice and research.

The ethics of paying drug users who participate in research: a review and practical recommendations.

THE PAYMENT OF RESEARCH PARTICIPANTS raises ethical and empirical questions that have special importance in addictions research involving drugdependent participants. Despite a now large literature on human subjects payment, what is still needed is practical guidance for investigators and ethics committees. This paper reviews the literature on: current payment practices and guidelines; defining features of undue and due incentives and fair reimbursement; and the significance of risks and harms that may arise from paying drug using participants.

Paying research participants: a study of current practices in Australia.

Objective: To examine current research payment practices and to inform development of clearer guidelines for researchers and ethics committees.

Design: Exploratory email based questionnaire study of current research participant reimbursement practices. A diverse sample of organisations and individuals were targeted.

Transient changes in behaviour lead to heroin overdose: results from a case-crossover study of non-fatal overdose.

Background And Aims: Heroin overdose is a serious consequence of heroin use and one of the leading causes of premature death and illness in Australia. Despite considerable research effort little is known about the effects of transient changes in heroin user behaviour and the links to overdose. This research is the first to use a suitable methodology to allow such ephemeral changes and their effects on non-fatal heroin overdose to be examined.

Characteristics of non-fatal opioid overdoses attended by ambulance services in Australia.

Objective: To examine the feasibility of establishing a database on non-fatal opioid overdose in order to examine patterns and characteristics of these overdoses across Australia.

Methods: Unit record data on opioid overdose attended by ambulances were obtained from ambulance services in the five mainland States of Australia for available periods, along with information on case definition and opioid overdose management within these jurisdictions. Variables common across States were examined including the age and sex of cases attended, the time of day and day of week of the attendance, and the transportation outcome (whether the victim was left at the scene or transported to hospital).

Buprenorphine diversion and injection in Melbourne, Australia: an emerging issue?

Aims: To examine indicators of buprenorphine diversion and injection among injecting drug users in Melbourne, Australia and to determine the factors associated with buprenorphine injection.

Design: Melbourne arm of the 2002 Illicit Drug Reporting System (IDRS) cross-sectional study.

Setting: Five Needle and Syringe Programme sites in Melbourne, Australia.

The impact of injecting drug use status on hepatitis C-related referral and treatment.

More than 160,000 people are living with chronic hepatitis C virus (HCV) infection in Australia, however, rates of medical treatment are low. The aim of this study is to examine uptake and predictors of HCV-related health care services among a community-based sample of people with HCV. A self-administered questionnaire was completed by a largely non-clinical sample of 362 women and 308 men with HCV living in the state of Victoria.

Recent trends in benzodiazepine use by injecting drug users in Victoria and Tasmania.

To address the lack of data on patterns of benzodiazepine use among injecting drug users (IDU) in Victoria and Tasmania, convenience samples of 152 Melbourne and 100 Hobart IDU were recruited from needle and syringe programme outlets and administered a structured survey on patterns of benzodiazepine use, injection-related health problems and drug use history. Most respondents had used benzodiazepines during the preceding 6 months, and more than one-third (Melbourne 36%, 95% CI, 28-44; Hobart 37%, 95% CI, 27-47) had injected benzodiazepines during this period. Diazepam was the preferred benzodiazepine for those using orally, while intravenous benzodiazepine users preferred to inject temazepam.

Psychometric properties of the Blood-borne Virus Transmission Risk Assessment Questionnaire (BBV-TRAQ).

Aims: To develop a standard measure of blood-borne virus transmission risk behaviour, and examine the underlying psychometric properties.

Design: The Blood-borne Virus Transmission Risk Assessment Questionnaire (BBV-TRAQ) was developed over three consecutive phases of the original BBV-TRAQ study in adherence to classical scale development procedures, culminating in the recruitment of a development sample of current injecting drug users via convenience and snowball sampling.

Setting: Needle and syringe programmes (NSPs), medical clinics, alcohol/drug agencies, peer-based and outreach organizations across inner and outer metropolitan Melbourne.

Interpreting changes in heroin supply in Melbourne: droughts, gluts or cycles?

In this Harm Reduction Digest Paul Dietze and John Fitzgerald provide another possible way of understanding what has come to be referred to as Australia's heroin 'drought'. They examine evidence from Melbourne, Victoria and suggest that the apparent downturn in heroin availability in 2000 may, in part, be the result of an end of a heroin 'glut' and that perceptions of this phenomenon may be coloured by the development of more sophisticated indicators of the heroin market. They conclude with claims that the reasons for the reduction in drug consumption and adverse health outcomes, such as those attributed to interdiction, are thus premature

Bystander resuscitation attempts at heroin overdose: does it improve outcomes?

Study Objective: To document the characteristics and effectiveness of cardiopulmonary resuscitation (CPR) at non-fatal heroin overdose events in Melbourne, Australia.

Methods: A retrospective analysis of a computerised database of ambulance attendance records at non-fatal heroin overdose cases for the period 1/12/1998 to 31/7/2000 was undertaken.

Main Outcome Measures: The main outcome measure was the rate of patient hospitalisation.

For love or money? An exploratory study of why injecting drug users participate in research.

Aims: To examine injecting drug user (IDU) motivations as research participants.

Design: Convenience sampling facilitated by recruitment notices distributed through needle and syringe programmes (NSPs), and snowballing within peer networks.

Setting: NSPs in six suburbs throughout the Melbourne metropolitan area.

Report of an integrated brief intervention with self-defined problem cannabis users.

A range of strategies have been employed elsewhere to treat cannabis dependency, but until recently few treatment options were available in Australia. This article discusses the development and evaluation of the trial on a Integrated Brief Intervention (IBI) with self-defined problem cannabis users in Melbourne. Sixty-one people were recruited to the intervention between December 1997 and June 1998.

"That original tension". Negotiating abstinence in clinicians' accounts of harm reduction in nonresidential treatment of heroin withdrawal.

The aim of this article is to examine how drug and alcohol clinicians, guided by a policy of harm reduction, approach their withdrawal work in their encounter with injecting heroin users seeking nonmethadone withdrawal treatment. The study, qualitative in design, involved detailed interviews with all seven clinicians who worked in the nonmethadone withdrawal program of a nonresidential drug and alcohol center in Melbourne, Australia. I draw attention to the difficulties that these clinicians have in their withdrawal work, especially concerning the place of abstinence in withdrawal and in harm reduction.