Australian Longitudinal Study Of Heroin Dependence: A 11 Year Prospective Cohort Study Of Mortality, Abstinence, Criminality And Psychiatric Comorbidity Among Heroin Users
Funder
National Health and Medical Research Council
Funding Amount
$372,295.00
Summary
To conduct the longest and most comprehensive prospective follow-up of Australian heroin users. A 11 year follow-up presents the unique opportunity to examine: Mortality rates, remission rates, criminal histories and levels of psychopathology ; Predictive factors of long term remission, mortality, criminality and the health service utilisation associated with heroin use careers.
Determining Patterns Of Cessation And Relapse In A Cohort Of People Who Inject Drugs
Funder
National Health and Medical Research Council
Funding Amount
$1,189,791.00
Summary
Harms related to injecting drug use represent the bulk of the burden attributable to illicit drugs in Australia. In this study we will determine rates of long term cessation of injecting drug use, and relapse, and key drivers of these outcomes such as drug treatment or housing provision. Findings will inform policy and practice around injecting drug use in Australia over the coming decade.
Australian Longitudinal Study Of Heroin Dependence: An 18-20yr Prospective Cohort Study Of Mortality, Abstinence, And Psychiatric And Physical Health Comorbidity
Funder
National Health and Medical Research Council
Funding Amount
$1,210,319.00
Summary
The burden associated with heroin dependence is undeniable. But little is known about the natural history and long-term course of heroin dependence; knowledge that is critical for informing the development of new treatment interventions, health care planning and service delivery. We propose to extend our study of 615 Australians with heroin dependence, recruited in 2001-2002, to 18-20 years follow-up to answer critical questions about the long-term impact of this condition.
A Randomised Double Blind Placebo Controlled Clinical Trial Of Naltrexone Implants For The Treatment Of Heroin Addiction
Funder
National Health and Medical Research Council
Funding Amount
$558,675.00
Summary
GoMedical Industries has developed a formulation of sustained release naltrexone, suitable for subcutaneous depot administration (International Patent Application Number: PCT-AU01-01107, GoMedical Industries Pty Ltd, Australia). Currently, implants are inserted by minor surgery under local anaesthetic in high risk patients under the Therapeutic Goods Administration (TGA) Special Access Category A scheme (SAS) through the Australian Medical Procedures Research Foundation (AMPRF), Western Australi ....GoMedical Industries has developed a formulation of sustained release naltrexone, suitable for subcutaneous depot administration (International Patent Application Number: PCT-AU01-01107, GoMedical Industries Pty Ltd, Australia). Currently, implants are inserted by minor surgery under local anaesthetic in high risk patients under the Therapeutic Goods Administration (TGA) Special Access Category A scheme (SAS) through the Australian Medical Procedures Research Foundation (AMPRF), Western Australia. Although there is a preliminary basis for believing that this naltrexone implant treatment may offer significant benefits over oral and other naltrexone depot preparations thus far reported for managing the heroin dependent patient, this needs to be verified through an empirically designed study such a clinical trial. Lack of complete Commonwealth TGA approval to date has been a major impediment to widespread adoption of this naltrexone preparation as an alternative treatment. Hence, the main objective of this study is to provide rigorous clinical data on the efficacy of this naltrexone implant compared to oral naltrexone in the management of heroin dependent persons by primarily monitoring: Maintenance of blood naltrexone and 6-b-naltrexol concentrations above therapeutic levels Retention in treatment assessed by detection of blood naltrexone or 6-b-naltrexol Reduced frequency and quantity of opiate use Prevention of accidental opiate overdose Reduced opiate related morbidity and mortality Reduced craving for heroin and secondarily monitoring: Frequency and quantity of other drug use Other drug related accidental overdose, other morbidity or mortality Level of social functioning . General health Monitoring of implant insertion site healingRead moreRead less
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
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