The Risk Factors For Ecstasy And Related Drug Overdose: A Case-crossover Study
Funder
National Health and Medical Research Council
Funding Amount
$406,755.00
Summary
Our ability to respond to the emergent harms of Ecstasy and Related Drug (ERD) use is hampered by our lack of understanding of the practices users engage in that place them at risk of harm. This study will examine the risk factors for non-fatal ERD Emergency Department (ED) admission in a sample of non-fatal ERD overdose victims recruited through two hospital EDs in Melbourne. The research involves a case-crossover study of the risk factors for ERD-related ED admission, as well as a detailed cas ....Our ability to respond to the emergent harms of Ecstasy and Related Drug (ERD) use is hampered by our lack of understanding of the practices users engage in that place them at risk of harm. This study will examine the risk factors for non-fatal ERD Emergency Department (ED) admission in a sample of non-fatal ERD overdose victims recruited through two hospital EDs in Melbourne. The research involves a case-crossover study of the risk factors for ERD-related ED admission, as well as a detailed case series of ERD-related ED admissions. The case-crossover investigation will involve a comparison between behaviours occurring prior to the critical drug use episode with typical drug use behaviours and more specifically those occurring prior to a control use episode (another occasion on which ERDs were used). Data will be collected by Researchers positioned in the ED, with information collected on the specifics of the critical and control use episodes through interviews with participants following stabilisation and a return to consciousness. The case series will be established from all ERD-related ED admissions flagged as such by triage nurses. Potential risk factors under study will include the environmental conditions in which the drug was used (eg time of day, physical location), other drug taking behaviour, personal factors (eg asthma, depression) and other dose-related issues (eg amount purchased, source of purchase). Statistical analysis will establish the major differences between the critical, typical and control use episodes. The proposed research will examine risk factors for ERD-related harms within the context of an understanding of the usual practices and behaviour of users of these drugs. Identifying transient change in risk behaviours will provide a foundation for developing contextually-sensitive strategies for harm minimisation. The development of a detailed case series will impact upon the treatment and management of acute ERD-related harms.Read moreRead less
Mortality Among Opioid Dependent Persons In Pharmacotherapy, NSW 1985-2006
Funder
National Health and Medical Research Council
Funding Amount
$148,757.00
Summary
Heroin dependence is a long term condition associated with high rates of death, illness and injury. Death rates are much higher than the general Australian population and the causes of death include drug intoxication or overdose, trauma, suicide, complications from blood born viruses such as Hepatitis C and HIV-AIDS and other medical complications of a chaotic drug-using lifestyle. As a part of a harm minimisation approach to heroin dependence, maintenance opioid pharmacotherapies seek to stabil ....Heroin dependence is a long term condition associated with high rates of death, illness and injury. Death rates are much higher than the general Australian population and the causes of death include drug intoxication or overdose, trauma, suicide, complications from blood born viruses such as Hepatitis C and HIV-AIDS and other medical complications of a chaotic drug-using lifestyle. As a part of a harm minimisation approach to heroin dependence, maintenance opioid pharmacotherapies seek to stabilise a chaotic heroin-using lifestyle by providing a regular dose of a legal, high quality opioid under medical supervision. Maintenance treatment uses long-acting opioids such as methadone and buprenorphine to provide consistent blood opioid levels so the client avoids the constant and disruptive cycles of opioid intoxication and withdrawal. Clients in regular maintenance treatments have lower death rates than untreated heroin dependent people and better outcomes with regards to drug use. However, death still occurs in methadone and buprenorphine treatment and minimising death rates is an important goal of treatment programs. This is a large longitudinal study looking at all NSW methadone and buprenorphine clients between 1985 and 2006, an estimated 44,000 people. In particular, the study looks at their mortality. It is a data linkage project, in that it uses two existing databases (a treatment database and a mortality database) and combines the information for each subject to get a better picture of how long methadone and buprenorphine clients survive, how much maintenance treatment they have received, and what the clients die of. This is the first time the mortality of all NSW methadone and buprenorphine recipients will be examined in a systematic way. It will allow us to compare the mortality of subjects receiving methadone and buprenorphine treatments and look at changes in mortality rates and causes of death over time. This will be an important policy resource.Read moreRead less
Mortality Among Injecting Drugs Users - A Follow-up Study Of Injecting Drug User Cohorts.
Funder
National Health and Medical Research Council
Funding Amount
$47,500.00
Summary
This study will follow-up injecting drug users that participated in research in the 1990s and 2000s to examine mortality rates in these groups over time. Identifying information from these studies will be cross-referenced with National Death Index data to determine participants that died and the dates of their death. This study will be the first in Australia to determine mortality rates over time in a defined cohort of injecting drug users outside drug treatment settings. Studying a defined grou ....This study will follow-up injecting drug users that participated in research in the 1990s and 2000s to examine mortality rates in these groups over time. Identifying information from these studies will be cross-referenced with National Death Index data to determine participants that died and the dates of their death. This study will be the first in Australia to determine mortality rates over time in a defined cohort of injecting drug users outside drug treatment settings. Studying a defined group overcomes some of the problems associated with mortality rate estimates based simply on the number of injecting drug-related deaths. Although the number of deaths can be found, the number of people at risk of injecting drug-related death is unclear because of the hidden nature of drug use and the dynamic characteristics of drug use and drug markets. The examination of mortality trends among injecting drug users over time can provide insights regarding changes in drug use patterns and markets. For example, this study will examine changes in injecting drug use mortality across periods of high heroin availability in the late '90s and periods of interrupted heroin supply - the heroin 'drought' - from 2000 onwards. In addition, factors related to injecting drug-related mortality can be explored by comparing the characteristics of injecting drug users that died and those that survived, such as drug use and drug treatment histories, co-morbidities such as mental illness and socio-demographic backgrounds. This information can inform overdose prevention and harm reduction strategies by identifying individuals most at risk of injecting drug-related mortality. This study will also draw attention to the significant public health burden of injecting drug use. In addition, by comparing the results from this study with other similar studies from overseas, we can more reliably compare mortality among groups of Australian injecting drug users with their peers in other countries.Read moreRead less
Investigating The Relationships Between Cannabis And Other Drug Use, Mental Health, Early-life Factors And Life-course Outcomes: Integrative Analyses Of Data From Four Australasian Cohort Studies
Funder
National Health and Medical Research Council
Funding Amount
$292,097.00
Summary
The current study will be the first of its kind to use integrative data analyses _ a highly innovative approach _ to pool data from four large and long-running Australasian cohort studies to better understand the link between cannabis use and later-life outcomes. Dramatically improved knowledge of these relationships will create a clearer picture of the interventions required to reduce the harms associated with cannabis use.
Injecting Drug Use, Incarceration, Infection: Investigating Opportunities For Public Health Interventions In Disadvantaged Populations
Funder
National Health and Medical Research Council
Funding Amount
$329,564.00
Summary
New knowledge required to address infectious diseases and mental illness among two disadvantaged and overlapping groups -people who inject drugs (PWID) and prisoners – will be produced: Cross sectional and longitudinal studies will examine HIV risk in specific populations; A system to track the emergence of injecting will be developed; The global scale of mental illness and TB among PWID will be determined; and how to improve coverage and delivery of TB prevention and treatment will be explored.
Prevention Of Multi-drug Resistant Tuberculosis In A High Prevalence Setting: ‘Connecting The DOTS’ In Vietnam
Funder
National Health and Medical Research Council
Funding Amount
$3,382,020.00
Summary
The close contacts of people with multi-drug resistant tuberculosis (MDR-TB) have a high risk of developing the disease. The V-QUIN MDR-TB Trial will evaluate the effectiveness of an oral antibiotic (levofloxacin) in preventing drug resistant TB among infected household contacts of TB patients. Household contacts from 10 Provinces in Vietnam will be randomly allocated to receive six-months of either levofloxacin or a placebo, and then followed for two years to see if they develop tuberculosis.
Reducing The Burden Of Alcohol And Other Drug Use In Australia
Funder
National Health and Medical Research Council
Funding Amount
$250,805.00
Summary
Innovative research undertaken during the Fellowship program will provide new evidence of how best to respond to alcohol and other drug use. Partnerships with policymakers will ensure this evidence underpins Australian alcohol and other drug policy.