A Investigation Of The Public Health Effects Of Retail Heroin Markets From A Consumer Perspective
Funder
National Health and Medical Research Council
Funding Amount
$189,106.00
Summary
The health problems associated with heroin use within our community are a major public health issue. Within the past decade there has been an increase in heroin-related deaths and evidence of the continuing spread of hepatitis C among individuals who inject heroin. Within this period there have been substantial changes in the heroin market in Australia, with street prices decreasing and purity increasing and we have witnessed the emergence of street markets in a number of major cities. The aim o ....The health problems associated with heroin use within our community are a major public health issue. Within the past decade there has been an increase in heroin-related deaths and evidence of the continuing spread of hepatitis C among individuals who inject heroin. Within this period there have been substantial changes in the heroin market in Australia, with street prices decreasing and purity increasing and we have witnessed the emergence of street markets in a number of major cities. The aim of the proposed research is to improve our understanding of the retail heroin market (that part of the market which is accessed by heroin users) by examining how the consumers (heroin users) use this market. The project will examine the relationship between the heroin market and the health problems associated with heroin use including dependence. The research will be conducted at 6 sites within metropolitan Melbourne which have been chosen on the basis that they have established street markets and high levels of non-fatal and fatal overdose. At each site interviews and surveys will be conducted with injecting drug users and others with knowledge of the local market and detailed observations will be made of street markets in each of these areas. This information will be combined with indicators of purity of heroin seized by police, fatal and non fatal-overdoses, police operations and arrests, and needle-syringe distribution and return. The information gathered in this research will be used to develop an understanding of the retail heroin market as a consumer market place and the impact of the market upon the health status of the individuals who use this market. The knowledge that we gain from this research will provide the foundation for developing more effective approaches to reducing the health problems associated with heroin use and for predicting the impact of changes in the market such as a reduction in price upon these problems.Read moreRead less
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.
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.
The Risk Factors For Ecstasy And Related Drug Overdose: A Case-crossover Study
Funder
National Health and Medical Research Council
Funding Amount
$406,755.00
Summary
Our ability to respond to the emergent harms of Ecstasy and Related Drug (ERD) use is hampered by our lack of understanding of the practices users engage in that place them at risk of harm. This study will examine the risk factors for non-fatal ERD Emergency Department (ED) admission in a sample of non-fatal ERD overdose victims recruited through two hospital EDs in Melbourne. The research involves a case-crossover study of the risk factors for ERD-related ED admission, as well as a detailed cas ....Our ability to respond to the emergent harms of Ecstasy and Related Drug (ERD) use is hampered by our lack of understanding of the practices users engage in that place them at risk of harm. This study will examine the risk factors for non-fatal ERD Emergency Department (ED) admission in a sample of non-fatal ERD overdose victims recruited through two hospital EDs in Melbourne. The research involves a case-crossover study of the risk factors for ERD-related ED admission, as well as a detailed case series of ERD-related ED admissions. The case-crossover investigation will involve a comparison between behaviours occurring prior to the critical drug use episode with typical drug use behaviours and more specifically those occurring prior to a control use episode (another occasion on which ERDs were used). Data will be collected by Researchers positioned in the ED, with information collected on the specifics of the critical and control use episodes through interviews with participants following stabilisation and a return to consciousness. The case series will be established from all ERD-related ED admissions flagged as such by triage nurses. Potential risk factors under study will include the environmental conditions in which the drug was used (eg time of day, physical location), other drug taking behaviour, personal factors (eg asthma, depression) and other dose-related issues (eg amount purchased, source of purchase). Statistical analysis will establish the major differences between the critical, typical and control use episodes. The proposed research will examine risk factors for ERD-related harms within the context of an understanding of the usual practices and behaviour of users of these drugs. Identifying transient change in risk behaviours will provide a foundation for developing contextually-sensitive strategies for harm minimisation. The development of a detailed case series will impact upon the treatment and management of acute ERD-related harms.Read moreRead less
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.
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