The Extent And Impact Of Pharmaceutical Opioids For Chronic Non-cancer Pain
Funder
National Health and Medical Research Council
Funding Amount
$318,768.00
Summary
There have been dramatic increases in the use of pharmaceutical opioids (PO) for chronic non-cancer pain (CNCP), despite limited data on their long-term effectiveness and an increase in associated harm. This Fellowship provides critical new data to inform both clinicians and policymakers on the global extent of PO for CNCP, trajectories of problematic use and associated morbidity and a unique evaluation of the impact of real-time prescription monitoring program to reduce these harms.
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.
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.
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
Opioid Dependent Persons In Pharmacotherapy: Blood Borne Viruses And Cancer Risk
Funder
National Health and Medical Research Council
Funding Amount
$88,495.00
Summary
Opioid dependent persons in pharmacotherapy in NSW are at increased risk of death from cancer. We will examine the occurrence of infection with hepatitis and HIV among this high-risk population using data linkage. We will define the relationship between infection, the duration, frequency and type of pharmacotherapy, and cancer risk. The findings will guide effective strategies that will reduce cancer incidence and mortality among this group, and minimise the associated health care costs.
Young Adult Social Transitions - Course Of Mental And Behavioural Disorders:The Victorian Adolescent Health Cohort Study
Funder
National Health and Medical Research Council
Funding Amount
$560,750.00
Summary
The paths young people follow into adulthood have changed markedly in the past three decades. Traditionally the adoption of a role as marital partner, parent and fulltime employee in the late teens and early twenties was accompanied by a diminution or 'maturing out' of health risk behaviours and emotional problems arising in adolescence. The social transitions into adulthood are now both delayed and in many instances changed with higher rates of cohabitation, extended teriary educational partici ....The paths young people follow into adulthood have changed markedly in the past three decades. Traditionally the adoption of a role as marital partner, parent and fulltime employee in the late teens and early twenties was accompanied by a diminution or 'maturing out' of health risk behaviours and emotional problems arising in adolescence. The social transitions into adulthood are now both delayed and in many instances changed with higher rates of cohabitation, extended teriary educational participation and part-time employment. The effect of these social changes on health risk behaviours, behavioural and mental disorders is uncertain. This proposal will undertake a further follow-up in the late twenties of a group of just under 2000 young Victorians, already studied from the age of 14 years through to the age of 24 years. This study will assess the persistence of behavioural problems such as smoking and nicotine dependence, excessive alcohol consumption and dependence, cannabis dependence, illicit drug use, risk sexual behaviour, depression and anxiety disorders. The extent to which these may be associated with successful negotiation of transitions in education, employment, relationships, parenthood and establishing an independent home will be evaluated. Alternative explanations including the severity of dependence syndrome, personality, social background and genetic risk factors will also be explored.Read moreRead less