Pharmacogenetics Of Methadone Maintenance Treatment
Funder
National Health and Medical Research Council
Funding Amount
$355,564.00
Summary
There is large amount of inter-individual variability in response to methadone use in dependence programmes. Many factors are involved including age, disease and the use of other drugs. Until recently a person's genetic makeup was not amongst these factors. Our study will show how genetic variability that alters the transport or the drug target in the body impacts on a person's drug response and side effects to methadone used to treat opioid dependence.
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.
Increasing Global And National Knowledge About Illicit Drug Use, Harms And Effective Interventions
Funder
National Health and Medical Research Council
Funding Amount
$431,000.00
Summary
This Fellowship aims to increase global and national knowledge about drug use and related harms, and interventions to prevent harm and improve public health. It will create new knowledge that will be used by UN and international agencies, and national governments, to monitor changes in drug use and harms, and guide policy and planning for drug treatment and harm reduction services.
A Trial Of Therapeutic Drug Monitoring In Methadone Maintenance Treatment
Funder
National Health and Medical Research Council
Funding Amount
$542,025.00
Summary
Heroin addiction is an established and increasing problem in developed countries and in many developing nations. Although there have been several new treatments for heroin addiction, methadone maintenance remains the most effective way to minimize the harms associated with heroin addiction. The current research proposal seeks to test a new approach to setting of methadone dose, using monitoring of methadone blood levels, effects and side-effects in determining when to increase doses, and when to ....Heroin addiction is an established and increasing problem in developed countries and in many developing nations. Although there have been several new treatments for heroin addiction, methadone maintenance remains the most effective way to minimize the harms associated with heroin addiction. The current research proposal seeks to test a new approach to setting of methadone dose, using monitoring of methadone blood levels, effects and side-effects in determining when to increase doses, and when to switch to alternative therapies. This provides an objective method of planning treatment that focuses on suppressing heroin use. The potential subjects of the study are the 50% of patients who continue to use heroin regularly during treatment. All will undergo assessment involving measurement of blood levels of methadone, testing of effects and side-effects of methadone, and monitoring of safety. Half will be randomly allocated to usual care, and half to therapeutic drug monitoring, with dose adjustments according to the results of testing. At 3 and 6 months all subjects will undergo repeat test sessions. It is hypothesized that those in the experimental group will be using less heroin (confirmed by hair testing). It is expected that the study will also identify a small group of subjects with genetically different opioid receptors, who will require very high doses of methadone to be stabilized. The study will allow a detailed analysis of how best to monitor dose adequacy; the relationship between withdrawal symptoms, methadone blood levels, and heroin use, and will provide the first clear investigation of the relationship between changes in methadone blood concentration and certain potentially dangerous changes in the electrical activity of the heart. The intended outcome of this research project is a model for a higher standard methadone program that is more effective in reducing the problems of heroin use in our community.Read moreRead less
Effect Of Naltrexone Treatment On Mental Health And Other Health Outcomes : A Record Linkage Study.
Funder
National Health and Medical Research Council
Funding Amount
$111,625.00
Summary
Research has shown that heroin use is an increasing habit of Australia's youth with morbidity and mortality rates for regular heroin users significantly greater than that for the general population. Despite the introduction of a number of treatment options to combat the problem, the management of dependent heroin use has proved problematic. This application addresses an issue of considerable importance and controversy in recent years, namely, the impact of naltrexone and methadone treatment on m ....Research has shown that heroin use is an increasing habit of Australia's youth with morbidity and mortality rates for regular heroin users significantly greater than that for the general population. Despite the introduction of a number of treatment options to combat the problem, the management of dependent heroin use has proved problematic. This application addresses an issue of considerable importance and controversy in recent years, namely, the impact of naltrexone and methadone treatment on morbidity and mortality among persons who are heroin dependent. The study will be carried out using a unique system of linked hospital records from the Western Australian Health Services Research Linkage Unit at the Department of Health Western Australia (DHWA). Through this system hospital, mental health and death records derived from different sources, but related to the same individual are electronically linked. Hence, record linkage provides an independent method for obtaining information on treatment outcomes which is free from subjective bias. In the current study records from heroin users who entered naltrexone maintenance and a smaller group who entered methadone maintenance will be linked to the DHWA database. Collectively these data will be used to quantify morbidity, hospital episodes, mental health issues and mortality in heroin users following commencement of naltrexone maintenance treatment. Data will also be used to compare positive and negative outcomes for individuals on naltrexone with those on methadone. The results will be used to advocate on behalf of this vulnerable population in a country that prides itself on universal access to high quality health services. It is anticipated that this study will have a substantial beneficial impact on the management of illicit drug use policy and as well as contributing new research methods, findings and international knowledge.Read moreRead less