You probably wouldn’t be surprised to hear that people who use heroin, methamphetamine or crack cocaine are heavy users of emergency departments. The daily challenges of using these drugs mean that appointment-only services are difficult to navigate, and health is not always the top priority. Hospital-based studies appear to support this view, showing that frequent patients often use drugs and alcohol.
In the last twenty years there have been substantial increases in the use of pharmaceutical opioids in many countries, including Australia which has one of the highest levels of opioid utilisation globally 1. Almost 15 million opioid prescriptions were dispensed in 2015 and our use of high-potency opioids has also increased 2. One of the main drivers is the increased use of prescription opioids for chronic non-caner pain (CNCP) 3. In parallel to escalating use, opioid-related harms have also increased.
The advent of novel extended release depot buprenorphine formulations has the potential to transform opiate substitution therapy in a variety of settings and benefit the lives of people living with opioid dependence. CoLAB is an open-label cohort study of depot buprenorphine evaluating patient outcomes and process, and cost implications in a variety of models of care.
Co-occurring mental health and substance use disorders are common, are harmful to people’s wellbeing and social functioning, and are associated with disproportionately high costs to healthcare systems 1-9. The prevalence of co-occurring disorders in mental health (MH) and Alcohol and other Drug (AoD) treatment settings is sufficiently high that they are described as an ‘expectation rather than an exception’ 3.
The impact of research that actively engages with communities, non-government organisations and clinical services can be fundamentally influenced by the engagement processes that researchers devise and implement. The corollary of this proposition is that establishing a pragmatic, or even evidence-based, process of change is likely to improve outcomes for communities and clients of services. So is it feasible to establish an evidence-based process for engaging communities and services in research?
Professor Maree Teesson was appointed as a Companion of the Order of Australia in the Australia Day 2018 Honours List. Here, Maree shares her journey from rural NSW to world-leading research.
Many discussions between health economists and their clinical and policy research colleagues begin with comments such as ‘we want to know what X costs or what will it cost to fund Y? But these questions, while useful and interesting, do not fully encapsulate what health economics and economics have to offer more broadly.
Understanding how many people inject drugs is critically important for the effective provision of public health and harm reduction services. However, the severe stigma that is often attached to injecting drug use, and illicit nature of this behaviour, means that it is often difficult to have a clear picture of how many people inject drugs in a given nation or region.