Drug Health - Bankstown Hospital - Grand Rounds - Further Reading - LibGuides at South Western Sydney Local Health District

INTRODUCTION

Welcome to the Grand Rounds Further Reading List, Drug Health edition, brought to you by the Clinical Library, on Level 4, next to the Auditorium.

This library guide is to help support you in your professional development. Please give us feedback so we can improve this list in the future.

If you have any questions, please contact the Clinical Library on 9722 8250 or email SWSLHD-BankstownLibrary@health.nsw.gov.au or visit us Monday to Fridays, 8.30am - 5.00pm. (closed Wednesday afternoons from 1.00pm to 5.00pm)

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TOPIC OF THE WEEK

“Care Navigation DHS: Showcase of Service and

Case Presentation”

Articles

Acheson, L. S., et al. (2023). "Pharmacological treatment for methamphetamine withdrawal: A systematic review and meta-analysis of randomised controlled trials." Drug and Alcohol Review 42(1): 7-19. https://onlinelibrary.wiley.com/doi/full/10.1111/dar.13511 PDF @LINK

Abstract Issues Cessation of methamphetamine use may result in a characteristic withdrawal syndrome, no medication has been approved for this indication. This systematic review aims to assess the efficacy of pharmacotherapy for methamphetamine withdrawal, the first comprehensive meta-analysis since 2008. Approach MEDLINE (1966–2020), CINAHL (1982–2020), PsychINFO (1806–2020) and EMBASE (1947–2020) were systematically searched. Studies were included if they were randomised controlled trials (RCT) investigating pharmacological treatments for methamphetamine withdrawal, reviewing outcomes of treatment discontinuation, mental health outcomes, withdrawal symptoms (including craving) and patient safety. The relative risk (RR) and weighted mean difference (MD) were used to meta-analyse dichotomous and continuous data respectively, with 95% confidence intervals. Risk of bias and Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) assessments were conducted. Key Findings Nine RCTs of six medications (n = 242 participants) met inclusion criteria, however, only six trials of four medications (n = 186) could be meta-analysed. Mean sample size across studies was 27 participants, and 88% of participants were male. The quality of evidence in this review varies from low to very low on GRADE assessments. Amineptine may reduce discontinuation rates (RR 0.22, 95% confidence interval [CI] 0.07, 0.72, p = 0.01), and improve global state (MD −0.49, 95% CI −0.80, −0.17), compared with placebo, however, this medication is no longer approved. No other medications improved any domain when compared with placebo. Due to lack of reporting safety profiles could not be established. Conclusions There is insufficient evidence to indicate any medication is effective for the treatment of methamphetamine withdrawal. The poor quality of the evidence indicates a need for better powered, high-quality trials.

Clay, S., et al. (2024). "The reflections of health service providers on implementing contingency management for methamphetamine use disorder in Australia." Drug and Alcohol Review

https://onlinelibrary.wiley.com/doi/full/10.1111/dar.13853 PDF @ LINK

Abstract Introduction Contingency management (CM) is the most effective treatment for reducing methamphetamine use. We sought to understand why CM has not been taken up to manage methamphetamine use disorder in Australia. Methods Six focus groups (4–8 participants per group) were conducted with health workers from agencies in Australia that provided drug-related health care to people who use methamphetamine. These agencies had no previous experience delivering CM for substance use. The potential acceptability and feasibility of implementing CM in their services were discussed. Results Participants felt that it would be beneficial to have an evidence-based treatment for methamphetamine use disorder. This sentiment was offset by concerns that CM conflicted with a client-centred harm-reduction approach and that it dictated the goal of treatment as abstinence. It was also perceived as potentially coercive and seen to reify the power imbalance in the therapeutic relationship and therefore potentially reinforce stigma. There was also concern about the public's perception and the political acceptability of CM, who would fund CM, and the inequity of providing incentives only to clients with a methamphetamine use disorder. Some concerns could be ameliorated if the goals and structure of CM could be tailored to a client's needs. Discussion and Conclusions Many healthcare workers were keen to offer CM as an effective treatment option for people with methamphetamine use disorder, but CM would need to be sufficiently flexible to allow it to be tailored to client needs and implemented in a way that did not adversely impact the therapeutic relationship.

Lee, K. S. K., et al. (2023). "Beliefs and attitudes of drug and alcohol clinicians when considering referral of Aboriginal clients to involuntary drug and alcohol treatment: A qualitative study." Drug and Alcohol Review 42(1): 169-180. https://onlinelibrary.wiley.com/doi/full/10.1111/dar.13853 PDF @ LINK

Abstract Introduction Involuntary drug and alcohol treatment occurs in many countries and its role is often controversial. This can be a particular concern in relation to First Nations or other culturally distinct populations. This study explores beliefs and attitudes of drug and alcohol clinicians when considering referral of Aboriginal Australians to involuntary drug and alcohol treatment in New South Wales (NSW), Australia. Methods The Involuntary Drug and Alcohol Treatment program (IDAT) is legislated by the NSW Drug and Alcohol Treatment Act 2007. There are two IDAT units—in urban (Sydney, four beds) and regional NSW (Orange, eight beds). NSW Health drug and alcohol clinicians who had referred clients to IDAT between 2016 and 2018 were invited to participate in a semi-structured 1:1 interview. Eleven clinicians (n = 2, male) from six local health districts (urban through to remote) agreed to participate. A descriptive qualitative analysis of responses was conducted. Results Two key themes summarised the beliefs and attitudes that clinicians reported influencing them when considering referral of Aboriginal Australians to involuntary drug and alcohol treatment in NSW: (i) dilemma between saving someone's life and being culturally safe; and (ii) need for holistic wrap-around care. Discussion and Conclusions Almost all clinicians were worried that being in IDAT would further erode their Aboriginal client's autonomy and be retraumatising. Strategies are needed to support the involvement of Aboriginal-specific services in IDAT processes and ensure local support options for clients on discharge. Future research should examine the effectiveness, acceptability and feasibility of involuntary drug and alcohol treatment programs.

Paulus, M. P. and J. L. Stewart (2020). "Neurobiology, Clinical Presentation, and Treatment of Methamphetamine Use Disorder: A Review." JAMA Psychiatry 77(9): 959-966. https://jamanetwork.com/journals/jamapsychiatry/article-abstract/2763797 REQUEST THIS ARTICLE

IMPORTANCE: The prevalence of and mortality associated with methamphetamine use has doubled during the past 10 years. There is evidence suggesting that methamphetamine use disorder could be the next substance use crisis in the United States and possibly worldwide. OBSERVATION: The neurobiology of methamphetamine use disorder extends beyond the acute effect of the drug as a monoaminergic modulator and includes intracellular pathways focused on oxidative stress, neurotoxic and excitotoxic effects, and neuroinflammation. Similarly, the clinical picture extends beyond the acute psychostimulatory symptoms to include complex cardiovascular and cerebrovascular signs and symptoms that need to be identified by the clinician. Although there are no pharmacologic treatments for methamphetamine use disorder, cognitive behavioral therapy, behavioral activation, and contingency management show modest effectiveness. CONCLUSIONS AND RELEVANCE: There is a need to better understand the complex neurobiology of methamphetamine use disorder and to develop interventions aimed at novel biological targets. Parsing the disorder into different processes (eg, craving or mood-associated alterations) and targeting the neural systems and biological pathways underlying these processes may lead to greater success in identifying disease-modifying interventions. Finally, mental health professionals need to be trained in recognizing early cardiovascular and cerebrovascular warning signs to mitigate the mortality associated with methamphetamine use disorder.

Quinn, B., et al. (2021). "A prospective cohort of people who use methamphetamine in Melbourne and non-metropolitan Victoria, Australia: Baseline characteristics and correlates of methamphetamine dependence." Drug and Alcohol Review 40(7): 1239-1248. https://onlinelibrary.wiley.com/doi/abs/10.1111/dar.13194 PDF @ LINK

Abstract Introduction and Aims Limited research has investigated methamphetamine use and related harms in rural and regional Australia. We investigated whether people who used methamphetamine in non-metropolitan Victoria differed in their sociodemographics and were more likely to be methamphetamine-dependent than those recruited in Melbourne. Design and Methods We used baseline data from an ongoing prospective cohort study, ‘VMAX’. Participants were recruited from Melbourne and three non-metropolitan Victorian regions. Sequential multivariable logistic regression of nested models assessed unadjusted and adjusted associations between residential locations and methamphetamine dependence. Results The sample mostly (77%) comprised people who used methamphetamine via non-injecting means (N = 744). Thirty-nine percent were female. Melbourne-based participants were less likely than non-metropolitan participants to identify as Aboriginal and Torres Strait Islander, be heterosexual, have children and be unemployed. More frequent methamphetamine use (adjusted odds ratio 1.22, 95% confidence interval 1.12–1.34) and using crystal methamphetamine versus ‘speed’ powder (adjusted odds ratio 2.38, 95% confidence interval 1.26–3.64) were independently (P < 0.05) associated with being classified as methamphetamine-dependent. A significantly higher percentage of participants in every non-metropolitan region were classified as methamphetamine-dependent vs. those in Melbourne, but this relationship was attenuated when adjusting for methamphetamine use frequency and primary form used. Despite 65% of participants being classified as methamphetamine-dependent, less than half had recently (past year) accessed any professional support for methamphetamine, with minimal variation by recruitment location. Discussions and Conclusions VMAX participants in non-metropolitan Victoria were more likely to be methamphetamine-dependent than those living in Melbourne. Unmet need for professional support appears to exist among people using methamphetamine across the state, regardless of geographical location.

Siefried, K. J., et al. (2020). "Pharmacological Treatment of Methamphetamine/Amphetamine Dependence: A Systematic Review." CNS Drugs 34(4): 337-365. https://link.springer.com/article/10.1007/s40263-020-00711-x REQUEST THIS ARTICLE

Stimulant drugs are second only to cannabis as the most widely used class of illicit drug globally, accounting for 68 million past-year consumers. Dependence on amphetamines (AMPH) or methamphetamine (MA) is a growing global concern. Yet, there is no established pharmacotherapy for AMPH/MA dependence. A comprehensive assessment of the research literature on pharmacotherapy for AMPH/MA dependence may inform treatment guidelines and future research directions.

Books

Cocaine and Methamphetamine Dependence by Thomas R. Kosten (Editor); Thomas F. Newton (Editor); Richard de De La Garza (Editor); Colin N. Haile (Editor)
Call Number: Proquest E-books (Athens login required)
ISBN: 9781585629756
Publication Date: 2012
While the APA's Textbook of Addiction Psychiatry covers material that a general psychiatrist or primary care physician needs for the appropriate referral and initial management of stimulant dependence, Cocaine and Methamphetamine Dependence: Advances in Treatment goes beyond this basic knowledge and addresses the rapid evolution of both the understanding and the treatment of stimulant abusers. It also sheds light on how the epidemiology of cocaine, amphetamine and methamphetamine abuse and dependence have substantial differences in geographic distribution both here and abroad, and how treatments are evolving to help these complex patients benefit from emerging pharmacological and behavioral therapies. Cocaine dependence complications account for one out of every three drug-related emergency room visits. Coroners' reports relate stimulants to the direct cause of death in 25% of cocaine overdoses and 68% of methamphetamine overdoses or as antecedents causing cardiovascular or medical problems leading to death in 20% of these abusers. Additionally, cocaine and methamphetamine abuse and dependence frequently co-occur with other major mental illnesses such as schizophrenia, major depression, and posttraumatic stress disorder. This makes a greater understanding of stimulant dependence among the psychiatric community an integral part of providing effective evaluation and treatment. Cocaine and Methamphetamine Dependence provides: * An introduction of the DSM-5 plan to drop the distinction between abuse and dependence and add craving as a criterion. * An overview of how the epidemiology of stimulant abuse is changing and pharmaceutical abuse is rising due to factors such as greater availability through family and friends who are increasingly being prescribed stimulants for conditions like weight loss or attention deficit disorder.* The insight that even after long abstinence, stimulant users may remain vulnerable to amphetamine-induced psychosis, with delusions, paranoia and compulsive behavior.* The insight that a comprehensive assessment of the patient involves the management of aberrant behaviors such as intoxication, violence, suicide, impaired cognitive function, and uncontrolled affective displays. * A focus on treatment, emphasizing that the most important component of stimulant treatment involves behavioral therapies, often in combination with adjunctive medications. * A review of the criminal justice system's shift away from punitive action and towards more human treatment, including the far-reaching benefits of medical management and treatment. Fortunately, our understanding of stimulant abuse and dependence is growing at a time when a steady stream of new users and casualties is still accumulating. Constant vigilance regarding changes in epidemiology, fluctuations in drug availability, and changes in drug trafficking patterns are essential to recognition of new drug abuse patterns and their identification and treatment. Cocaine and Methamphetamine Dependence should be on the bookshelf of residents, physicians and psychiatrists who are highly likely to come into contact with one of the millions using and abusing stimulants today.
Drug use and mental health : effective responses to co-occurring drug and mental health problems by Allsop, Steven.
Call Number: BANKSTOWN Medical Library WM 270/DRU/2
ISBN: 9780980458619
Publication Date: 2008
Mental Disorders in Primary Care by Andre F. Carvalho (Editor); Roger S. McIntyre (Editor); Oxford Editor; André F. Carvalho (Editor)
Call Number: BANKSTOWN Medical Library WM 140/MEN/1
ISBN: 9780198746638
Publication Date: 2017
Mental disorders are highly prevalent in the primary care setting, yet are frequently misdiagnosed and often inappropriately treated. The presence of unrecognized or misdiagnosed mental disorders is associated with increased service utilization and health care costs, and can significantly impact the patient's quality of life and risk of suicide. Written by experts from around the world, Mental Disorders in Primary Care offers readers with a comprehensive and evidence-based guide to the diagnosis and treatment of mental disorders in the primary care setting. Containing 21 chapters on a variety of psychiatric disorders, such as depressive disorders and substance use disorders, and key topics for discussion such as drug interactions, and collaborative care, Mental Disorders in Primary Care is essential reading for clinicians treating patients in a primary care setting.Fully up-to-date to reflect DSM-5's taxonomy of psychiatric disorders, this resource provides readers with a global and comprehensive guide to the diagnosis and treatment of patients with mental disorders.

Journals and e-Journals

Online Resources

Care Navigation: A Competency Framework
The navigation guidelines developed by the NHS
Clinical Care Standards: Alcohol and Other Drug Treatment
The NSW Clinical Care Standards for Alcohol and Other Drug Treatment (The Standards) outline the core elements of care that underpin treatment within NSW alcohol and other drug (AOD) treatment services. The Standards have been developed as a result of the excellent work of Professor Nicholas Lintzeris and the Clinical Outcomes and Quality Indicator (COQI) team, in partnership with the Centre for Alcohol and Other Drugs, NSW Ministry of Health, consumers, senior clinicians and addiction medicine specialists working in NSW government and non-government treatment services.
These standards apply to all drug and alcohol service treatment types and locations and do not identify specific interventions used in treatment. The intention is to detail the foundational elements of care,support clinical decision-making and complement rather than replicate other sources of information that guide the delivery of high-quality and safe treatment.
Comorbidity guidelines
Developed by Sydney University Matilda Centre and funded by the Federal Government, Department of Health and Aged Care.
Consent to Health Care Treatment Manual
This is the second edition of the NSW Health Consent to Medical and Healthcare Treatment Manual (Consent Manual) which includes the specific and additional consent requirements for Minors accessing gender affirming medical treatment.
The Consent Manual provides operational guidance and procedures to support compliance with the NSW law on obtaining consent to medical treatment from patients or their substitute consent providers.
The Consent Manual incorporates changes in legislation and NSW Health policy which impact on the legal obligations for obtaining consent to medical treatment.
Drug Health Sevices (SWSLHD)
Drug Health Services operates across South Western Sydney Local Health District (SWSLHD), providing a range of treatments and interventions at hospitals and community health centres to support individuals, their families and carers who have problems associated with alcohol and other drug use.
IDAT
The IDAT Program provides involuntary treatment as an option of last resort to people with severe substance dependence.
The NSW Drug and Alcohol Treatment Act 2007 (the Act) provides the legislative basis for assessment, stabilisation and treatment in an involuntary capacity, and outlines the criteria for admission into the program.
The intention of IDAT is to protect the health and safety of people with severe substance dependence who are at risk of serious harm while also safeguarding their human rights.
IDAT provides medically supervised withdrawal management and post-withdrawal assessment and treatment in a specialised inpatient unit. This is followed by a voluntary community care component provided by the patient's local health district for up to six months. There are 12 IDAT beds across two hospital-based treatment centres: one at Royal North Shore Hospital campus with four beds, and Bloomfield Hospital campus in Orange with eight beds.
Mental Health Act 2007 No 8
NSW Mental Health Act 2007 No 8
NSW HEALTH Alcohol and other drugs unit.
The Centre for Alcohol and Other Drugs is responsible for coordinating the NSW Health contribution to whole-of-government policy development and implementation in alcohol and other drugs.