Comparing The Role Of Takeaways In Methadone Maintenance Treatment In NSW And Victoria
Funder
National Health and Medical Research Council
Funding Amount
$291,000.00
Summary
This project will make a direct and major contribution to improving methadone maintenance treatment (MMT) provision in Australia. The recent announcement of the continuation of funding for the Federal Government's Illicit Drug Diversion Initiative demonstrates an ongoing commitment to make drug treatment programs more accessible. MMT is currently the primary treatment for opioid addiction in Australia. However, concerns about the potential negative effects of aspects of the programs, in particul ....This project will make a direct and major contribution to improving methadone maintenance treatment (MMT) provision in Australia. The recent announcement of the continuation of funding for the Federal Government's Illicit Drug Diversion Initiative demonstrates an ongoing commitment to make drug treatment programs more accessible. MMT is currently the primary treatment for opioid addiction in Australia. However, concerns about the potential negative effects of aspects of the programs, in particular, takeaway dosing and diversion of methadone to street sale (which has been linked to accidental fatal overdose (Lintzeris, et al., 1999)), remain unresolved. This study will map clients', healthcare workers' and policy makers' attitudes towards takeaways in NSW and Victoria, and investigate the dynamics of methadone diversion in relation to the different takeaway policies in the two states. In doing so, the project will consider how the two different state policies on takeaways stack up. It will contribute essential and detailed data on takeaways and diversion, from which effective, safe and socially responsible methadone maintenance treatment policy can be developed.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
Clinical Pharmacology Of Methadone During Induction Onto Maintenance Treatment.
Funder
National Health and Medical Research Council
Funding Amount
$422,310.00
Summary
Heroin addiction can be very successfully treated by substituting heroin with methadone. The transition of stopping heroin and starting methadone is risky and can be associated with death. This application seeks to explore the mechanisms of the increased risk during this transition period so that appropriate management strategies might be instituted.
Methadone Maintenance Treatment In Prisons In Indonesia
Funder
National Health and Medical Research Council
Funding Amount
$58,117.00
Summary
The aim of this research is to assess the effectiveness of methadone maintenance treatment in Indonesian prisons in improving outcomes for heroin dependent inmates. This is the first study of methadone in prisons in Asia. It is expected that treated prisoners will inject drugs less often, leading to a reduction in HIV transmission. It is also expected that, once released, treated prisoners will be less likely to re-offend and be re-imprisoned.
Distribution Kinetics Of Opioids Used In Substitution Programs
Funder
National Health and Medical Research Council
Funding Amount
$196,527.00
Summary
Heroin addiction is a major national and international problem costing hundreds of millons of dollars to Australia alone. The major form of treatment is methadone taken as maintenance treatment once a day. While methadone is effective in most addicts, about one third of them complain that it does not last long enough and they either tolerate this inadequate form of treatment or are prescribed a newer drug as part of a clinical trial or drop out and revert to heroin. We have previously shown that ....Heroin addiction is a major national and international problem costing hundreds of millons of dollars to Australia alone. The major form of treatment is methadone taken as maintenance treatment once a day. While methadone is effective in most addicts, about one third of them complain that it does not last long enough and they either tolerate this inadequate form of treatment or are prescribed a newer drug as part of a clinical trial or drop out and revert to heroin. We have previously shown that the blood levels of methadone are important in determining its best use and specifically, that those addicts for whom methadone does not hold have a greater drop in their blood levels after methadone has been absorbed into the body. This drop in blood levels is mainly due to methadone's redistribution throughout the body. Very little is known about how methadone distributes and redistributes throughout the body but it appears that the lung is the most important organ. A number of questions need to be answered to improve methadone's use: 1. How quickly is methadone taken up into the lung compared to the brain; 2. Why is the lung able to take up and release a large amount of methadone; 3. How does decreased respiration influence the lung and brain uptake of methadone; 4. What happens when another drug is prescribed (such as an antidepressant) which reduces the lung uptake of methadone; 5. Do some of the newer drugs for heroin addiction have better lung distribution and binding properties. We will perform studies of the concentrations of methadone and newer drugs in sheep that will provide the scientific basis for answering these questions and permit better use of drug treatment for heroin addiction.Read moreRead less