Evidence of HIV transmission in an Australian prison.
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Adult↗
Biomedical subjects
W Hall
Publications and source records attributed to W Hall.
Lipid intolerance does not account for susceptibility to alcoholic and gallstone pancreatitis.
BACKGROUND/AIMS: Hypertriglyceridemia is an established cause of pancreatitis and has been suggested as a predisposing factor in alcohol and gallstone-induced pancreatitis. The aims of this study were to determine fasting and postprandial triglyceride levels of alcoholics with pancreatitis, alcoholics without pancreatitis, patients with previous gallstone pancreatitis, patients with choledocholithiasis, and healthy controls. METHODS: Oral lipid tolerance studies were performed in the above groups. RESULTS: No relationship was found between alcoholic pancreatitis and hypertriglyceridemia, regardless of whether subjects were studied in the fasting state, after ingestion of fat, or after ingestion of fat with ethanol. Plasma triglyceride levels of alcoholics with pancreatitis remained similar to those of alcoholics without pancreatitis, but levels in both groups varied in relation to recent alcohol intake. Plasma triglyceride levels from both groups of alcoholics were greater than those of nonalcoholic healthy subjects. In addition, the previously reported association between postprandial hypertriglyceridemia and gallstone pancreatitis was not observed. CONCLUSIONS: Plasma triglyceride levels do not account for individual susceptibility to either alcoholic or gallstone pancreatitis.
Alcoholism↗
Prevalence, symptoms and correlates of antisocial personality disorder among methadone maintenance clients.
A sample of 222 methadone maintenance (MM) clients were tested for a diagnosis of antisocial personality disorder (ASPD). The majority (60.8%) of clients qualified for a lifetime diagnosis of ASPD, 25.7% received a current diagnosis of ASPD, and a conduct disorder of childhood was diagnosed for 68.5% of subjects. The most common symptoms of ASPD among MM clients were unlawful behaviours, aggressiveness and recklessness. Lack of remorse was reported by less than a third of subjects with a lifetime diagnosis of ASPD. Subjects with a current diagnosis of ASPD had been retained in treatment as long as other clients, and were no more likely to be currently injecting or sharing injecting equipment. It is concluded that clients with ASPD can be retained in MM treatment, and can respond to MM treatment as well as other clients.
Adolescent↗
Meta-analytic review of the efficacy of smoking cessation interventions.
A meta-analysis of randomized and controlled evaluations of the efficacy of smoking cessation interventions compared 146 estimates of the difference in abstinence rates between treated and control conditions (effect sizes) from 85 publications. Simple advice to quit and other brief intervention techniques, nicotine chewing gum and behavioural techniques were all found to be significantly better than relevant control conditions in promoting abstinence, although the results were not homogeneous. In five studies of acupuncture compared with control, consistent results were found showing no benefit for acupuncture.
Journal Article↗
Route of administration and adverse effects of amphetamine use among young adults in Syndney, Australia.
The relationship between route of administration and the adverse effects of amphetamine use (dependence symptoms, treatment-seeking, adverse psychological symptoms and violence) were examined among 231 Australian amphetamine users, half of whom usually injected amphetamine. Although 87% of users were recruited from non-treatment sources, a third had experienced symptoms of dependence on amphetamine, and a third had experienced an amphetamine-related health problem for which one in four had sought medical attention. There was also a high prevalence of psychological symptoms, such as depression, anxiety, paranoia, hallucinations and violence which were related to frequency of amphetamine use, and use by injection. Amphetamine users need to be better informed about the potential adverse effects of amphetamine use, and about ways in which they can reduce their risks of experiencing these harms by avoiding injecting use, and the regular use of high doses of amphetamines.
Journal Article↗
Geographical differences in risk-taking among Sydney methadone maintenance patients: a comparison of inner city and outer south western methadone maintenance patients.
The study compared the demographic profiles, treatment factors, current drug use, injecting behaviour and psychological functioning of inner city (ICS) and south-west Sydney (SWS) methadone patients. A total of 104 patients from two clinics in the inner city, and 118 patients from two clinics in the outer south-western suburbs of Sydney were interviewed using a structured interview. SWS patients were more likely to be married or de facto, to have a regular sexual partner who was an injecting drug user, and to have children in their care. While they were no more likely to have recently injected, SWS patients were twice as likely to have recently shared a needle. While SWS patients were more likely to have had sex in the month preceding interview, ICS patients were more likely to have had more than one partner in that period. Patients from the south-western clinics were twice as likely to receive a diagnosis of antisocial personality disorder, and had poorer social functioning. The clinical implications of these differences are discussed.
Journal Article↗
A summary of recommendations for the management of opioid dependence: the quality assurance in the treatment of drug dependence project.
This report presents outlines for approaches to intervening with opioid-dependent individuals. These recommendations are based on a review of the extant treatment-outcome literature, a survey of treatment practices used in Australia, and the views of a panel of experts. Recommendations for appropriate treatment goals, assessment, detoxification and intervention are made.
Journal Article↗
The effectiveness of methadone maintenance treatment: an overview.
This paper reviews the evidence for the effectiveness of methadone maintenance as used in the treatment of opioid dependence. Findings from randomized controlled trials and observational studies suggest that methadone maintenance reduces heroin use, crime, injection-related risk behaviours and premature mortality among people dependent on opioids. The research further suggests that two aspects of treatment are important in ensuring this effectiveness. Methadone treatment is more effective when higher doses (>50 mg) are employed and, overall, the evidence suggests that a treatment goal of successful maintenance on methadone rather than total abstinence is appropriate. The importance of ancillary services in treatment outcome is less clear and is the subject of current research and debate.
Journal Article↗
HIV risk-taking behaviour among amphetamine users in Sydney, Australia.
A survey was undertaken of needle-sharing and sexually risky behaviour among 231 Australian amphetamine users, half of whom usually injected amphetamine. The prevalence of risky needle use and sexual behaviour was similar to that observed in recent Australian surveys of opioid injectors. About a third of those who had ever injected had shared needles, and the variables that best predicted frequency of sharing needles were having an injecting drug user as a partner, having experienced symptoms of dependence on amphetamines, and having sought medical treatment for an amphetamine related problem. Regular condom use with either regular or causal partners was low; only the minority employed in the sex industry regularly used condoms. Sexual risk-taking was not related to needle-sharing or amphetamine use. Although Australian amphetamine and opioid users have reduced their risks of transmitting HIV, there remains a substantial minority of both types of drug injector who continue to place themselves and others at risk by sharing needles and engaging in unsafe sexual behaviour.
Adult↗
Prevalence, severity and correlates of psychological morbidity among methadone maintenance clients.
A sample of 222 methadone maintenance clients was tested for levels of depression, anxiety, and anti-social personality disorder. The prevalence of each type of psychopathology was high. There were large proportions of subjects exhibiting extremely severe depression, anxiety and a majority were classified as "psychiatric cases". Depression and anxiety were strongly related, but anti-social behaviour was unrelated to personal distress. Personal distress levels were predicted by benzodiazepine use, poorer social functioning and poorer health. Anti-social personality disorder was predicted by younger age, being male, poorer social functioning, and current criminality.
Adolescent↗
Predictors of injecting and injecting risk-taking behaviour among methadone-maintenance clients.
A sample of 222 methadone maintenance clients were interviewed regarding current injecting and needle risk-taking in order to ascertain factors associated with these behaviours. Just over half (55%) of subjects had injected in the month preceding interview. Current injecting was associated with being female, having a regular sexual partner who was a current injecting drug user, polydrug use and higher levels of global psychopathology. Approximately 15% of subjects had shared needles in the month preceding interview, predominantly with one other person. Needle sharing was associated with having a regular sexual partner who was a current injecting drug user, current criminality and injecting at places other than home. Needle-sharing episodes in the study period were considered safe by practically all sharers. The implications of these findings are discussed.
Adolescent↗
Transitions between routes of administration of regular amphetamine users.
A sample of 301 regular amphetamine users was interviewed regarding transitions between routes of administration of amphetamines. Use of amphetamines by injecting was widespread, with two-thirds (67%) of subjects having injected the drug during the preceding 6 months. Needle-sharing was common, with 41% of injectors having shared a needle in the month preceding interview. A transition to regular amphetamine injecting from other routes of administration was reported by 40% of subjects, with males being twice as likely to report such a transition. The median number of such transitions was one. The main reasons given by subjects for the transition to injecting were liking the "rush" from injecting, and seeing it as a more economical and a healthier way to use. A small proportion of subjects (9%) reported a transition away from injecting amphetamines, with a median of one such transition. The most common reason given for abandoning injecting was concern about vascular damage. Interventions to encourage safer use of amphetamines need to address the misconceptions that injecting is more economical and more healthy, and to emphasize the vascular problems associated with injecting.
Adolescent↗
An experience with the Sprotte needle.
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Anesthesia, Epidural↗
When is a behavioural phenotype not a phenotype?
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Child↗
Illicit amphetamine use as a public health problem in Australia.
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Adolescent↗
A comparison of a specialist women's alcohol and other drug treatment service with two traditional mixed-sex services: client characteristics and treatment outcome.
Eighty subjects from a specialist women's service (SWS) and eighty subjects from two traditional mixed-sex treatment services (TMS) were recruited to a comparative, longitudinal study of changes in alcohol and other drug associated problems. Both the SWS and the TMS programs were principally based on the traditional disease model and the 12-step philosophy but the SWS employed only female staff and provided residential childcare. The SWS succeeded in attracting significantly more lesbian women, women with dependent children, women sexually abused in childhood and with a maternal history of substance dependence than the TMS. Six months following treatment there were no significant differences in any measure of treatment outcome between the two treatment groups. The results suggest that the simple provision of women-only treatment and childcare without changing treatment content does not substantially improve treatment outcome in women with severe alcohol and other drug related problems.
Adult↗
Drug use, HIV risk-taking and psychosocial correlates of benzodiazepine use among methadone maintenance clients.
Methadone maintenance clients who used benzodiazepines were compared with other methadone maintenance clients on a range of drug use and psychosocial treatment outcome measures. Despite being on higher methadone doses, benzodiazepine users were more likely to have recently injected, to have used cocaine and amphetamines, to have borrowed or lent used needles and syringes, and to have reported polydrug use in the preceding month. Benzodiazepine users also exhibited higher levels of psychopathology and social dysfunction than other methadone maintenance clients. It is concluded that benzodiazepine-using methadone maintenance clients are a dysfunctional subgroup of the methadone population, who may require more clinical intervention than other clients.
Adolescent↗
Crime and drug use among applicants for methadone maintenance.
The relationship between crime and drug use was examined in 313 Australian opioid addicts who applied for entry to methadone treatment. More than 90% of them had recorded one or more convictions for property or drug offences. Subjects' self-reported convictions were moderately correlated with convictions recorded by the police. Men were more likely to begin their opioid use at or after their first criminal conviction, while women were more likely to begin offending after they used opioids. The rate at which subjects accrued convictions for property offences declined as they grew older and the earlier a subject's first exposure to the criminal justice system the higher the rate at which they accrued convictions.
Adult↗