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Health related issues among people who inject drugs in Australia
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Abstract / Drug and Alcohol Dependence 156 (2015) e183–e245
features and practices of the PMPs in Canada was obtained by reviewing program websites and telephone interviews conducted with key contacts from each program. Results: PMPs have varied features and practices, including models of administrative oversight, drugs targeted for monitoring, methods of data collection, types of interventions and degree of information sharing. There are very few research studies evaluating the effectiveness of PMP features or overall performance; primarily observational studies are available. Several best practice recommendations have been suggested based on opinion and experience. In Canada, there are currently seven provinces operating some form of a PMP and two provinces with programs in development; all have different histories and features and are not linked. Conclusions: There is limited supporting research evidence for most aspects of PMPs at this time, although there is growing research attention in the area, and the number of research reports is increasing each year. As programs across Canada continue to be developed and expanded, further work is needed to evaluate the various features of PMPs to determine their impact, and to establish the overall value of PMPs in promoting the safe and effective use of prescription products that are associated with significant harms. Financial Support: Alberta Health. http://dx.doi.org/10.1016/j.drugalcdep.2015.07.565 Health related issues among people who inject drugs in Australia Jennifer Stafford ∗ , Lucy Burns National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia Aims: The Illicit Drug Reporting System (IDRS) monitors the price, purity and availability and use of illicit drugs annually in Australia. The IDRS focuses mainly on: heroin and other opioids, methamphetamines, cocaine and cannabis. The IDRS also looks at other issues related to drug use including injection-related problems and mental health. This presentation provides a closer look at health-related issues among people who inject drugs interviewed in the 2014 IDRS. Methods: The IDRS involves the collection and analysis of three data sources: (1) interviews with people who inject drugs (IDRS), (2) interviews with experts who work with drug users such as treatment personnel and (3) existing databases on drug-related issues such as customs and overdose data. Results: Nationally, around 900 people who inject drugs were interviewed for the IDRS in 2014. Less than one-fifth of people who injected drugs reported lending a needle or using a needle after somebody else. Around one-quarter reported sharing injecting equipment (not including needles), around half re-used their own needle and over half re-used injecting equipment. Over half reported an injection-related issue in the last month, mainly scarring/bruising. Self-reported mental health problems in the last six months were reported by around half of the national sample. The most common mental health problem reported was depression followed by anxiety. IDRS participants reported higher levels of distress on the Kessler Psychological Distress Scale 10 compared to the Australian general population. Conclusions: A greater understanding of the health-related issues among people who inject drugs regularly is required to better inform policy decisions and treatment delivery.
Financial Support: The IDRS Project is supported by funding from the Australian Government under the Substance Misuse Prevention and Service Improvement Grants Fund. http://dx.doi.org/10.1016/j.drugalcdep.2015.07.566 Does urban size and region predict outpatient substance abuse treatment completion? Gerald Stahler ∗ , Jeremy Mennis Geography & Urban Studies, Temple University, Philadelphia, PA, United States Aims: This study examines the influence of urban size and region on the likelihood of treatment completion for outpatient settings using the 2011 SAMHSA TEDS-D dataset. Methods: Logistic regression was employed using treatment completion as the dependent variable (N = 897,888). Two geographic variables served as independent variables. ‘City size’ is a five-class ordinal variable representing the population of the U.S. Census metropolitan or micropolitan region in which the subject resides, ranging from areas with a population of less than 50,000 to greater than 750,000. ‘Geographic division’ distinguishes among the ten U.S. Census-defined regional divisions of the U.S. (e.g. Mid-Atlantic, New England). The Mid-Atlantic division (New York, Pennsylvania, and New Jersey), which is the division with the highest number of subjects in the data set, served as the reference category. We also controlled for the subject’s age, race, sex, primary substance use problem, and severity of use. Results: The resulting model had an overall percentage correct = 60.4%, and a Receiver Operating Curve (ROC) analysis resulted in an Area Under the Curve = 0.63, p < 0.005). Results indicate that larger city size is associated with a greater likelihood of treatment completion, and while the city size odds ratio is relatively small (OR = 1.05, p < 0.005), it is of greater magnitude than the odds ratio for sex (where males are significantly more likely to complete treatment). Geographic division was also highly significant, with certain divisions such as the Mountain division (e.g. Colorado, Utah) showing a particularly higher likelihood of treatment completion (OR = 2.07, p < 0.005) compared to the Mid- Atlantic division. Other divisions, such as the East North Central division (e.g., Ohio and Michigan) showed a significantly lower likelihood (OR = 0.73, p < 0.005). Conclusions: Treatment effectiveness at a system level may be improved by examining these geographic variations in outpatient outcomes. Further research needs to identify the reasons for these locational differences in treatment completion. Financial Support: None. http://dx.doi.org/10.1016/j.drugalcdep.2015.07.567 Effects of varenicline and GZ-793A on methamphetamine and food self-administration under a multiple schedule of reinforcement in rats Dustin J. Stairs 1,∗ , Megan Kangiser 1 , Markus N. Pfaff 1 , Sarah Ewin 1 , Linda P. Dwoskin 2 1 Psychology, Creighton University, Omaha, NE, United States 2 Pharmaceutical Sciences, University of Kentucky, Lexington, KY, United States
Aims: Currently there is no FDA pharmacological treatment for methamphetamine (METH) addiction. A widely accepted
Abstract / Drug and Alcohol Dependence 156 (2015) e183–e245
features and practices of the PMPs in Canada was obtained by reviewing program websites and telephone interviews conducted with key contacts from each program. Results: PMPs have varied features and practices, including models of administrative oversight, drugs targeted for monitoring, methods of data collection, types of interventions and degree of information sharing. There are very few research studies evaluating the effectiveness of PMP features or overall performance; primarily observational studies are available. Several best practice recommendations have been suggested based on opinion and experience. In Canada, there are currently seven provinces operating some form of a PMP and two provinces with programs in development; all have different histories and features and are not linked. Conclusions: There is limited supporting research evidence for most aspects of PMPs at this time, although there is growing research attention in the area, and the number of research reports is increasing each year. As programs across Canada continue to be developed and expanded, further work is needed to evaluate the various features of PMPs to determine their impact, and to establish the overall value of PMPs in promoting the safe and effective use of prescription products that are associated with significant harms. Financial Support: Alberta Health. http://dx.doi.org/10.1016/j.drugalcdep.2015.07.565 Health related issues among people who inject drugs in Australia Jennifer Stafford ∗ , Lucy Burns National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia Aims: The Illicit Drug Reporting System (IDRS) monitors the price, purity and availability and use of illicit drugs annually in Australia. The IDRS focuses mainly on: heroin and other opioids, methamphetamines, cocaine and cannabis. The IDRS also looks at other issues related to drug use including injection-related problems and mental health. This presentation provides a closer look at health-related issues among people who inject drugs interviewed in the 2014 IDRS. Methods: The IDRS involves the collection and analysis of three data sources: (1) interviews with people who inject drugs (IDRS), (2) interviews with experts who work with drug users such as treatment personnel and (3) existing databases on drug-related issues such as customs and overdose data. Results: Nationally, around 900 people who inject drugs were interviewed for the IDRS in 2014. Less than one-fifth of people who injected drugs reported lending a needle or using a needle after somebody else. Around one-quarter reported sharing injecting equipment (not including needles), around half re-used their own needle and over half re-used injecting equipment. Over half reported an injection-related issue in the last month, mainly scarring/bruising. Self-reported mental health problems in the last six months were reported by around half of the national sample. The most common mental health problem reported was depression followed by anxiety. IDRS participants reported higher levels of distress on the Kessler Psychological Distress Scale 10 compared to the Australian general population. Conclusions: A greater understanding of the health-related issues among people who inject drugs regularly is required to better inform policy decisions and treatment delivery.
Financial Support: The IDRS Project is supported by funding from the Australian Government under the Substance Misuse Prevention and Service Improvement Grants Fund. http://dx.doi.org/10.1016/j.drugalcdep.2015.07.566 Does urban size and region predict outpatient substance abuse treatment completion? Gerald Stahler ∗ , Jeremy Mennis Geography & Urban Studies, Temple University, Philadelphia, PA, United States Aims: This study examines the influence of urban size and region on the likelihood of treatment completion for outpatient settings using the 2011 SAMHSA TEDS-D dataset. Methods: Logistic regression was employed using treatment completion as the dependent variable (N = 897,888). Two geographic variables served as independent variables. ‘City size’ is a five-class ordinal variable representing the population of the U.S. Census metropolitan or micropolitan region in which the subject resides, ranging from areas with a population of less than 50,000 to greater than 750,000. ‘Geographic division’ distinguishes among the ten U.S. Census-defined regional divisions of the U.S. (e.g. Mid-Atlantic, New England). The Mid-Atlantic division (New York, Pennsylvania, and New Jersey), which is the division with the highest number of subjects in the data set, served as the reference category. We also controlled for the subject’s age, race, sex, primary substance use problem, and severity of use. Results: The resulting model had an overall percentage correct = 60.4%, and a Receiver Operating Curve (ROC) analysis resulted in an Area Under the Curve = 0.63, p < 0.005). Results indicate that larger city size is associated with a greater likelihood of treatment completion, and while the city size odds ratio is relatively small (OR = 1.05, p < 0.005), it is of greater magnitude than the odds ratio for sex (where males are significantly more likely to complete treatment). Geographic division was also highly significant, with certain divisions such as the Mountain division (e.g. Colorado, Utah) showing a particularly higher likelihood of treatment completion (OR = 2.07, p < 0.005) compared to the Mid- Atlantic division. Other divisions, such as the East North Central division (e.g., Ohio and Michigan) showed a significantly lower likelihood (OR = 0.73, p < 0.005). Conclusions: Treatment effectiveness at a system level may be improved by examining these geographic variations in outpatient outcomes. Further research needs to identify the reasons for these locational differences in treatment completion. Financial Support: None. http://dx.doi.org/10.1016/j.drugalcdep.2015.07.567 Effects of varenicline and GZ-793A on methamphetamine and food self-administration under a multiple schedule of reinforcement in rats Dustin J. Stairs 1,∗ , Megan Kangiser 1 , Markus N. Pfaff 1 , Sarah Ewin 1 , Linda P. Dwoskin 2 1 Psychology, Creighton University, Omaha, NE, United States 2 Pharmaceutical Sciences, University of Kentucky, Lexington, KY, United States
Aims: Currently there is no FDA pharmacological treatment for methamphetamine (METH) addiction. A widely accepted