The Australasian Professional Society on Alcohol and other Drugs

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Comprehensive Review

Drinking contexts and their association with acute alcohol‐related harm: A systematic review of event‐level studies on adults' drinking occasions
Abigail K. Stevely, John Holmes, Simon McNamara, Petra S. Meier
17 February 2020 | DOI: https://doi.org/10.1111/dar.13042

 

Original Papers

Injecting drug use among gay and bisexual men in New Zealand: Findings from national human immunodeficiency virus epidemiological and behavioural surveillance
Peter J. W. Saxton, Susan M. McAllister, Geoffrey E. Noller, David A. L. Newcombe, Kathryn A. Leafe
26 February 2020 | DOI: https://doi.org/10.1111/dar.13046

How to ask about the use of new psychoactive substances to increase the validity of results in self‐report prevalence surveys
Eva Drapalova, Vendula Belackova, Agnès Cadet‐Taïrou
20 February 2020 | DOI: https://doi.org/10.1111/dar.13036

Understanding risk‐based licensing schemes for alcohol outlets: A key informant perspective
Peter G. Miller, Ashlee Curtis, Kathryn Graham, Kypros Kypri, Kate Hudson, Tanya Chikritzhs
16 February 2020 | DOI: https://doi.org/10.1111/dar.13043

Understanding motivations for large US cannabis firms' participation in the cannabis space: Qualitative study exploring views of key decision‐makers
Navin Kumar, Cheneal Puljević, Robert Heimer
13 February 2020 | DOI: https://doi.org/10.1111/dar.13040

Health‐care providers' concern regarding smoking cessation pharmacotherapies during pregnancy: Calls to a teratology information service
Mei Lin Lee, Duong T. Tran, Alec Welsh, Debra Kennedy, Alys Havard
26 January 2020 | DOI: https://doi.org/10.1111/dar.13033

The Drug and Alcohol Clinical Advisory Service: A model of telephone‐delivered addiction specialist supportt
Jasmin Grigg, Shalini Arunogiri, Victoria Manning, Vicky Phan, Samuel Campbell, Matthew Frei, Dan I. Lubman
23 January 2020 | DOI: https://doi.org/10.1111/dar.13035

Examining beverage‐specific trends in youth drinking in Australia before and after the implementation of the alcopops tax
Yvette Mojica‐Perez, Sarah Callinan, Michael Livingston
22 January 2020 | DOI: https://doi.org/10.1111/dar.13038

Contingency management treatment for methamphetamine use disorder in South Africa
Chukwuemeka N. Okafor, Dan J. Stein, Lisa Dannatt, Jonathan Ipser, Lara J. van Nunen, Marilyn T. Lake, Tamar Krishnamurti, Edythe D. London, Steve Shoptaw
21 December 2019 | https://doi.org/10.1111/dar.13019

How did a lower drink‐drive limit affect bar trade and drinking practices? A qualitative study of how alcohol retailers experienced a change in policy
Colin Sumpter, Andrea Mohan, Jennifer McKell, James Lewsey, Carol Emslie, Niamh Fitzgerald
8 December 2019 | DOI: https://doi.org/10.1111/dar.12999


Commentaries

Could vaping help lower smoking rates in Australia?
Colin Mendelsohn, Wayne Hall, Ron Borland
27 January 2020 | DOI: https://doi.org/10.1111/dar.13039

Opioid agonist treatment in the time of fentanyl: What can we learn from emerging evidence?
Shalini Arunogiri, Suzanne Nielsen
9 January 2020 | DOI: https://onlinelibrary.wiley.com/doi/10.1111/dar.13029


Brief Reports

Substance use treatment clinician attitudes to care for chronic disease health risk behaviours and associations of attitudes with care provision
Danika Tremain, Megan Freund, Jenny Bowman, Luke Wolfenden, Paula Wye, Adrian Dunlop, Kate Bartlem, Kathleen McElwaine, Karen Gillham, John Wiggers
20 February 2020 | DOI: https://doi.org/10.1111/dar.13044


Special Issue - Impact of alcohol on mortality in Eastern Europe

Spatial patterns of male alcohol‐related mortality in Belarus, Lithuania, Poland and Russia
Pavel Grigoriev, Domantas Jasilionis, Sebastian Klüsener, Sergey Timonin, Evgeny Andreev, France Meslé, Jacques Vallin
27 January 2020 | DOI: https://onlinelibrary.wiley.com/doi/full/10.1111/dar.13037

Alcohol control policies and mortality trends in Belarus
Pavel Grigoriev, Anastacia Bobrova
20 January 2020 | DOI: https://onlinelibrary.wiley.com/doi/10.1111/dar.13032

The changing relation between alcohol and life expectancy in Russia in 1965–2017
Inna Danilova, Vladimir M. Shkolnikov, Evgeny Andreev, David A. Leon
18 January 2020 | DOI: https://doi.org/10.1111/dar.13034

Alcohol consumption and alcohol policy in Estonia 2000–2017 in the context of Baltic and Nordic countries
Kersti Pärna
4 November 2019 | DOI: https://doi.org/10.1111/dar.13008

Holding policy makers to account: Monitoring voting patterns on alcohol and tobacco policy in the Lithuanian Parliament
Mindaugas Štelemėkas, Lukas Galkus, Vaida Liutkutė, Gumarov Nijolė, Goštautaitė Midttun, Laura Miščikienė
13 August 2019 | DOI: https://doi.org/10.1111/dar.12972

 

 

Clinician's Corner - February 2020

DAR Front Cover

Clinician's Corner | February 2020      

Clinician’s Corner

The Drug and Alcohol Clinical Advisory Service: A Model of Telephone‐Delivered Addiction Specialist Support

 


Studies have shown that alcohol and other drug (AOD) consumption is a leading preventable cause of injury, chronic disease and mortality, and a major contributor to the global burden of disease. While only a minority of people with substance use problems access AOD treatment, they do frequently use primary care and other mainstream health services, so it is important that mainstream services have the capacity to help people with AOD problems.

However, mainstream health practitioners may have limited experience, skill or confidence in treating AOD use, leaving a gap in treatment services. A recent paper by Grigg et al describes the Drug and Alcohol Clinical Advisory Service (DACAS), an established 24/7 telephone‐delivered model of addiction specialist consultation for health practitioners designed to address this gap.

DACAS was established by Turning Point and it covers Victoria, Tasmania and the Northern Territory. It is currently staffed by 14 addiction medicine specialists and addiction psychiatrists on a rotating roster, accepting referrals 24 hours per day, 7 days per week. Calls are answered by an AOD counsellor who provides immediate assistance, including psychosocial management, referral and information if the issue does not require medical specialist support. If medical advice is required, the call is triaged to a DACAS consultant who will respond to the call within an hour. The service provides medical and prescribing advice and support in relation to AOD presentations but cannot offer clinical oversight of patient care.

The study examined five years of call data. Between July 2013 and June 2018, DACAS responded to 6565 calls, with over 1200 calls being received per year. The majority of callers were general practitioners (44.5%), and also included medical practitioners (23.1%) and allied health professionals (non-pharmacists, 17.3% and pharmacists, 10.7%). The rate of calls, per 100,000 population, were higher for outer regional, inner regional, remote and very remote areas than major cities. The majority of calls were triaged for a consultant call back (83.3%) and 16.7% of calls were provided with advice/referral information from AOD counsellors. Calls showed that the primary substances of concern were opioid agonist treatment (39.5%), other opioids (19.4%) and alcohol (17.6%).

One of the important findings from this study was the higher rates of service use in regional and remote areas, particularly by practitioners more likely to have previously used the service. Studies have shown that Australians in regional and remote areas are disproportionately affected by AOD use and harms and that they also receive less treatment.

The study also showed that while opioid agonist treatment was the most common drug class asked about, general practitioners (the most frequent users of DACAS) were less likely to seek consultation on this than pharmacists and other prescribers. In Australia, relatively few general practitioners prescribe opioid agonist treatment and having access to professional support could help to improve this and increase treatment for opioid use disorder.

Grigg et al suggest that the DACAS model could be used to expand access to treatment for opioid use disorder and other substance use problems, offering critical addiction specialist support, especially in regional and remote areas that have less access to AOD care. DACAS can also be used to help monitor the impact of new policies and current trends in the health workforce. It is important to raise awareness of DACAS to increase access to AOD experts and reduce the burden of AOD problems and associated costs.

SHALINI ARUNOGIRI
Turning Point, Eastern Health and Monash Addiction Research Centre and Eastern Health Clinical School, Monash University, Melbourne, Australia


A complimentary PDF of the article is available to APSAD members by emailing This email address is being protected from spambots. You need JavaScript enabled to view it..

Grigg J, Arunogiri S, Manning V, Phan V, Campbell S, Frei M, Lubman, DI. The Drug and Alcohol Clinical Advisory Service: A model of telephone‐delivered addiction specialist support. Drug Alcohol Rev 2020 [Epub ahead of print] doi:10.1111/dar.13035