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NCCRED Clinical Research Seed Funding

Examining the effects of Amphetamine-Type-Substance use on clinical outcomes among clients receiving opioid agonist treatment

Amount awarded: $42,536.78

Principal Investigator: Dr Llewellyn Mills, South Eastern Sydney Local Health District

Examining the effects of Amphetamine-Type-Substance use on clinical outcomes among clients receiving opioid agonist treatment

Amount awarded: $42,536.78

Principal Investigator: Dr Llewellyn Mills, South Eastern Sydney Local Health District

Dependence on Amphetamine-Type-Stimulants (ATS) is associated with a range of harms1, but we still know very little about how using ATS while being treated for dependence on other drugs might affect the outcomes of that treatment.

The recent MAData project (funded by NCCRED) used routinely-collected clinical outcomes data from electronic medical records (eMR) to report upon characteristics and outcomes from clients in drug and alcohol treatment in six local health districts across NSW. It revealed that over a quarter of clients enrolled in Opioid Agonist Treatment (OAT) use amphetamine use at least once a week, with over 6% using three or more days each week. A retrospective longitudinal analysis of treatment outcomes among 920 OAT clients over 12 months revealed that, providing they remained in treatment for 6 months or more, substance use and general health and wellbeing were not significantly worse for those using ATS at the start of treatment than for those who were not using ATS.

These results were encouraging but there were less than 100 people who had been using ATS at baseline who had an ATOP at 12 months. 18 more months of data have since been collected, data which will greatly improve both the duration of treatment we can follow and our confidence in results we obtain. It is vital that work on this project continues in order to effectively describe and understand this vulnerable sub-population of OAT users.

This value-add project will consolidate and extend the findings of the original MAData project. The goal of the project will be to use co-design alongside cutting-edge quantitative and qualitative analysis techniques to examine:

  1. The effect of ATS use at baseline on change in substance use, health, and wellbeing over the course of OAT treatment?
  2. The effect ATS use at baseline on duration of retention in OAT treatment?
  3. The effect of concurrent ATS use, that is ATS use during treatment, on frequency of substance use health and wellbeing among OAT clients.
  4. Which baseline demographic, substance use, environmental, and treatment factors predict successful outcomes among OAT clients who use ATS.
  5. The different ‘treatment response profiles’ of ATS-using OAT clients based on trajectories of opioid and ATS use during treatment.
  6. The goals, challenges and limitations, and opportunities for improving treatment among OAT clients who use ATS.

 

Dr Llewellyn Mills,Chief investigator

D&A Services, South Eastern Sydney Local Health District (SESLHD) and The University of Sydney Central Clinical School – Discipline of Addiction Medicine

Prof Nicholas Lintzeris, Investigator

D&A Services, SESLHD

Prof Adrian Dunlop, Investigator

D&A Clinical Services, Hunter New England Local Health District (HNELHD)

Prof Michael Farrell, Investigator

NDARC, UNSW

Dr Rachel Deacon, Investigator

Division Addiction Medicine, University Sydney

Prof Anthony Shakeshaft, Investigator

NDARC, UNSW

Ms Kristie Mammen, Investigator

D&A Services, SESLHD

Ms Jennifer Holmes, Investigator

Centre for Alcohol and Other Drugs, NSW MoH

Dr Michelle Cretikos, Investigator

Centre Population Health, NSW Health

Dr Emma Black,Investigator

D&A Services, SESLHD and The University of Sydney Central Clinical School – Discipline of Addiction Medicine

Mr Steven Childs, Investigator

Central Coast Local Health District (CCLHD)

Dr David Reid, Investigator

Illawarra and Shoalhaven Local Health District (ISLHD)

Dr Mark Montebello, Investigator

North Sydney Local Health District (NSLHD)

SESLHD

Ms Sophie Maiolo, Investigator Consumer representative

SESHD

Ms L Jansen, Investigator Consumer representative

SESLHD