Health service utilisation attributable to methamphetamine use in Australia: Patterns, predictors and national impact

McKetin, Rebecca; Degenhardt, Louisa; Shanahan, Marian; Baker, Amanda; Lee, Nicole K.; Lubman, Dan I.

doi:10.1111/dar.12518

Cited by 72 publications

(70 citation statements)

References 40 publications

(48 reference statements)

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“…Methamphetamine was identified as the primary drug of concern in just 4.4% of cases over the 5-year study period. This relatively low number of methamphetamine-related calls is consistent with previous research identifying that people with more problematic use of methamphetamine present less frequently to non-acute health services, such as general practice [49]; conversely, while more problematic methamphetamine use is associated with greater use of emergency health services [49], presentations for emergency care are less likely to generate a call to DACAS. Additionally, while there are medical treatments available for opioid and alcohol use disorders, for which practitioners often seek advice, there are currently no approved pharmacotherapies for methamphetamine use disorder.…”

Section: Discussionsupporting

confidence: 86%

The Drug and Alcohol Clinical Advisory Service: A model of telephone‐delivered addiction specialist support

Grigg

Arunogiri

Manning

et al. 2020

Drug and Alcohol Review

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Introduction and Aims People with substance use problems frequently present to mainstream health services with a variety of health issues. However, many medical and allied health‐care providers feel under‐equipped to respond to this population. We describe the Drug and Alcohol Clinical Advisory Service (DACAS), an established 24/7 telephone‐delivered model of addiction specialist consultation, and examine recent call data to identify drug use issues for which health practitioners seek support. Design and Methods Methods of DACAS service provision and call data collection are provided. A retrospective review of routinely collected call data between July 2013 and June 2018 was performed, extracting information on call and caller characteristics, and consultation details. Results During 2013–2018, DACAS responded to 6565 calls, providing access to specialist alcohol and other drug support for more than 1200 practitioners across Victoria, Tasmania and the Northern Territory annually. Higher rates of service use were found among practitioners located in regional and remote areas, relative to those in metropolitan areas. Opioid agonist treatment was the most common drug class for which practitioners sought consultation (39.5%), followed by other opioids (19.4%). Advice‐seeking patterns differed according to caller profession, service setting and location. Discussion and Conclusions DACAS is providing a multistate‐level response to the challenges of accessing specialist addiction treatment, particularly for opioid agonist treatment and other opioid issues, with demonstrated uptake in regional and remote areas. This telephone‐delivered service provides an opportunity to expand access to treatment for opioid use disorder and other substance use problems, particularly in areas with less equitable access to specialist addiction care.

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Section: Discussionsupporting

confidence: 86%

The Drug and Alcohol Clinical Advisory Service: A model of telephone‐delivered addiction specialist support

Grigg

Arunogiri

Manning

et al. 2020

Drug and Alcohol Review

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“…Conversely, individuals who use methamphetamine in a regular or dependent manner may aim to use the sedative effects of GHB to manage stimulant withdrawal symptoms [16,17]. The latter is potentially the most probable driver, given the growing proportion of dependent methamphetamine-using adults in the Australian population during the time-period in this study [18] and mirrored in other markers of acute health burden, such as ambulance [19], emergency and psychiatric in-patient presentations [20]. For instance, data from the Ambo Project suggest that methamphetamine-related ambulance attendances in Victoria increased significantly during the 2012-18 time-period, from 872 in 2012 to 3024 in 2018.…”

Section: Discussionmentioning

confidence: 96%

Trends in gamma‐hydroxybutyrate‐related harms based on ambulance attendances from 2012 to 2018 in Victoria, Australia

et al. 2019

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Background and aims Although the prevalence of gamma‐hydroxybutyrate (GHB) use is relatively low globally, harms related to the drug appear to be increasing. Few existing studies present reliable, representative, population‐level data on GHB‐related harms. The aim of this study was to investigate trends in acute GHB‐related harms within an ambulance database in Australia. Design, setting and participants Cross‐sectional, retrospective analysis of data on all GHB‐related ambulance attendances in the state of Victoria, Australia during a 7‐year period (January 2012–December 2018) Measurements Presentations were characterized based on patient demographics, transport to hospital, co‐occurring substance use (i.e. GHB only, alcohol, methamphetamine, heroin, benzodiazepine and cannabis) and clinical presentation (e.g. symptoms of anxiety, psychosis, depression). Findings There were 5866 GHB‐related ambulance attendances between 2012 and 2018, with the prevalence rate increasing from 8.8 per 100 000 population in 2012 to a maximum of 21.7 per 100 000 population in 2017. Methamphetamine [odds ratio (OR) = 6.23, P < 0.001] and benzodiazepine‐related (OR = 1.43, P < 0.001) co‐occurrences; ages between 18–29 (OR = 6.58, P < 0.001) and 30–39 years (OR = 2.02, P < 0.001); and male gender (OR = 1.23, P < 0.001) were significant predictors of GHB‐related attendances. Conclusions There has been a 147% increase in the prevalence of GHB‐related ambulance attendances in Victoria, Australia between 2012 and 2019, largely attributable to a growth in the proportions of people using gamma‐hydroxybutyrate alone or concurrently with methamphetamine.

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“…Half of the services had specific guidelines for the management of violent psychostimulant patients although the management strategies differed and essentially reflected the services' guidelines for managing severely agitated patients. In Australasia, one of the most common psychostimulants associated with agitation and violence in acute care services is crystal methamphetamine . Methamphetamine‐related psychosis represented 93% of all stimulant‐related psychosis attended by AV, and patients were largely young males in metropolitan areas who required police co‐attendance because of the risk of violence .…”

Section: Discussionmentioning

confidence: 99%

Variations in the care of agitated patients in Australia and New Zealand ambulance services

Nambiar

Pearce²,

Bray

et al. 2019

Emerg Medicine Australasia

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Health service utilisation attributable to methamphetamine use in Australia: Patterns, predictors and national impact

Cited by 72 publications

References 40 publications

The Drug and Alcohol Clinical Advisory Service: A model of telephone‐delivered addiction specialist support

The Drug and Alcohol Clinical Advisory Service: A model of telephone‐delivered addiction specialist support

Trends in gamma‐hydroxybutyrate‐related harms based on ambulance attendances from 2012 to 2018 in Victoria, Australia

Variations in the care of agitated patients in Australia and New Zealand ambulance services

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