Assessing Naltrexone Implant Or Methadone Maintenance Treatment On Mental And Physical Health Outcomes In Heroin Users
Funder
National Health and Medical Research Council
Funding Amount
$216,200.00
Summary
The WA hospital data linkage system (DLS) will be used to assess differences in the mental and physical health of dependent heroin users prior to and post naltrexone implant or methadone maintenance treatment (MMT). MMT is the best established pharmacotherapy for the management of heroin dependence but oral naltrexone is gaining some acceptance. Currently funded by NHMRC, we are looking at outcomes with oral naltrexone using DLS data. Although effective in blocking heroin, management via oral na ....The WA hospital data linkage system (DLS) will be used to assess differences in the mental and physical health of dependent heroin users prior to and post naltrexone implant or methadone maintenance treatment (MMT). MMT is the best established pharmacotherapy for the management of heroin dependence but oral naltrexone is gaining some acceptance. Currently funded by NHMRC, we are looking at outcomes with oral naltrexone using DLS data. Although effective in blocking heroin, management via oral naltrexone has proved problematic, with medicine non compliance and relapse common. Surgical insertion of subcutaneous implants is an alternative method of naltrexone delivery. 441 heroin users have received naltrexone implants (3.4g) under Special Access in WA. Although naltrexone implants have yet to be comprehensively assessed, early results are encouraging. Pilot study data has shown a significant reduction in hospital emergency department (ED) attendance for accidental overdose, and mental health events following implant. The aim of this study is to more rigorously assess outcomes associated with implants compared to heroin dependent persons treated by MMT . The DLS collates general hospital and mental health admissions plus mortality data for individuals. This allows the health of an individual to be monitored over time. An electronic version of hospital ED data has recently become available. The study will validate these records by comparing the electronic data against hospital ED records for the implant group. We will then combine the electronic ED and DLS data. Morbidity and mortality rates for heroin users are significantly greater than those for the general population. If the preliminary findings are replicated, naltrexone implants may offer significant benefits over current pharmacotherapies in reducing general and psychiatric morbidity in dependent heroin users.Read moreRead less
Mortality In Young Offenders Who Have Had Custodial Sentences
Funder
National Health and Medical Research Council
Funding Amount
$60,448.00
Summary
The proposal seeks funding to investigate the death rate in young people who have received custodial sentences. There is evidence in the literature and anecdotal evidence from workers in the field that young offenders are at particularly high risk of dying from drug overdose, violently or by suicide, yet deaths in this group have not yet been investigated in Australia. As far as we are aware, there are also no reports worldwide of standardised mortality rates for young offenders who have been in ....The proposal seeks funding to investigate the death rate in young people who have received custodial sentences. There is evidence in the literature and anecdotal evidence from workers in the field that young offenders are at particularly high risk of dying from drug overdose, violently or by suicide, yet deaths in this group have not yet been investigated in Australia. As far as we are aware, there are also no reports worldwide of standardised mortality rates for young offenders who have been incarcerated. A group of young people who have received their first custodial sentences between 1988 and 1999 in Victoria will be identified, starting with 10 year olds in 1988. Their details will then be matched with data held by The National Death index, housed at the Australian Institute of Health and Welfare, and with the Victorian Coroner's data in order to identify deaths that have occurred, the cause of death and the circumstances of death. This will provide an index of the excess deaths experienced by this group of young offenders compared with Victorian population data for the same age group and gender. Further analysis will elucidate cause specific mortality, will enable the identification of subgroups at particular risk and the examination of trends over time. The study will provide a solid foundation for health priorities, the development of interventions and policy in relation to young offenders. It will provide a resource for Australasia and be of worldwide interest. Juvenile offenders are a well-defined group who has extended contact with support services. There is a unique opportunity for the delivery of interventions aimed at improving the welfare and adult outcomes of this enormously disadvantaged and marginalised section of our community. The Centre for Adolescent Health, as the auspicing body for the Adolescent Forensic Health Service is in an excellent position to respond to this challenge.Read moreRead less
Deaths In Young People Involved In The Youth Justice System: Towards Evidence-based Prevention
Funder
National Health and Medical Research Council
Funding Amount
$620,705.00
Summary
Young offenders have complex health needs and are at dramatically increased risk of preventable death due to drug overdose, suicide and injury. In order to inform effective prevention, a more detailed understanding of mortality in these young people is required. This project will examine all deaths in young offenders in Queensland from 1993 to 2015, identify targets for prevention, and recommend policy reforms and interventions that are supported by evidence and are culturally appropriate.
Enabling Evidence-informed Policy To Address Australia's Opioid Crisis
Funder
National Health and Medical Research Council
Funding Amount
$607,538.00
Summary
Australia has seen a near doubling of opioid-related mortality in the past decade. Recently, a range of state and national policy changes have been made to address the growing number of opioid-related deaths, yet the evidence for these kinds of policy changes is conflicting. This study will use prescribing data from general practice in combination with hospital data to understand the impact of three types of Australian policy interventions on opioid prescribing and opioid-related harm.
Preventing Mortality In Adults After Release From Prison: Advancing Global Knowledge Through An International, Individual Participant Data Meta-analysis
Funder
National Health and Medical Research Council
Funding Amount
$613,687.00
Summary
Ex-prisoners are at increased risk of death, but not enough is known about the incidence, timing, causes, context or risk factors for preventable death in this population. In this project we have compiled 18 cohorts of ex-prisoners (total number=1,159,290) and will analyse the data to determine exactly which ex-prisoners are at the greatest risk from what, and when. This new knowledge will inform policy changes to reduce the unnecessary loss of life in this vulnerable population.
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.
Increasing Knowledge Of Mental And Physical Harms Among People Who Inject Drugs
Funder
National Health and Medical Research Council
Funding Amount
$88,502.00
Summary
People who inject drugs (PWID) commonly experience a range of health problems. These include injecting-related injuries and non-viral diseases (e.g. endocarditis), drug overdose and mental health problems. With a focus on reducing the presence of these harms among the injecting population, the proposed research aims to better understand the factors that contribute to PWID experiencing, or not experiencing, such harms.
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.
Mechanisms Underlying Adaptation To Reactive Balance Training For Falls Prevention
Funder
National Health and Medical Research Council
Funding Amount
$83,832.00
Summary
Reactive balance training using unpredictable trips and slips can reduce fall rates in older people by 60%, a significant improvement on current interventions. This project will determine the optimal dose to and physiological adaptations underlying reactive balance training. It will also determine how older people with a high fall risk benefit by this training. This study has the potential to enhance clinical practice and assist older people in maintaining independence and quality of life.