The National Addiction & Mental Health Surveillance Unit team at APSAD 2023

Last week in Adelaide, more than a dozen Turning Point researchers presented their latest work as part of the 2023 Australasian Professional Society on Alcohol and other Drugs (APSAD) Conference.

APSAD is Australasia’s leading multidisciplinary organisation for AOD professionals, and has been bringing together diverse perspectives on research, policy and practice for the sector since 1981.

Turning Point’s National Addiction and Mental Health Surveillance Unit (NAMHSU) looks for trends and patterns in population health and latest surveillance data, aiming to ensure that policies and interventions to reduce the impact of addiction, self-harm and mental ill health are informed by evidence.

The NAMHSU team has recently been using ambulance attendance data to provide new analyses on the North Richmond MSIR, the impact of COVID-19 lockdowns on alcohol harms, and to explore the relationships between public holidays and alcohol and drug-related road traffic incidents.

How COVID-19 lockdowns impacted “complex” alcohol-related ambulance attendances

Presenter: Rowan Ogeil

Researchers: Rowan Ogeil, Michael McGrath, Ziad Nehme, Dan Lubman, Debbie Scott

Led by Dr Rowan Ogeil, this team of researchers examined alcohol-related ambulance attendances during Victoria’s lockdowns in 2020 and 2021.

In particular, they focused on how lockdowns impacted “complex” attendances - those involving mental health, suicide and self-harm and violence comorbidities.

There were fewer alcohol-related attendances overall during lockdowns when compared to matched days in 2018 and 2019.

But crucially, there was a 37% increase in the number of attendances involving mental health symptoms, and a 9% increase in attendances involving suicide and self-harm behaviours.

Primarily, these findings demonstrate that ambulance services were under an increased burden during lockdowns. They may also reflect a reluctance to seek help via other services, or a lack of alternative options,

In future lockdowns, providing ample alternative services should be a key consideration, thereby avoiding overburdening the ambulance service.

Paper title:Complexity in alcohol-related ambulance attendances: the role of comorbid mental health, suicide, and self-harm presentations during COVID-19 lockdowns

Abstract available here.

Ambulance call-outs in North Richmond with and without the MSIR

Presenter: Jessica Killian

Researchers: Jessica Killian, Debbie Scott, Michael McGrath, Ziad Nehme, Dan Lubman, Rowan Ogeil

In June 2018, Victoria opened its first medically supervised injecting room (MSIR) in North Richmond.

To date, most analysis of this type of service has used mortality, survey, or ambulance dispatch data.

Led by Jessica Killian, NAMHSU researchers coded paramedic notes, identifying whether or not drugs were involved in each ambulance attendance across Victoria during MSIR opening hours between July 2015 and June 2022.

This enabled the researchers to see whether the number of heroin-related ambulance attendances changed once the MSIR opened.

The results show that heroin-related ambulance attendances across Victoria decreased once the Richmond MSIR opened in June 2018. There was an initial decrease in Victoria-wide attendances when the MSIR opened, a further decrease when opening hours were extended by three hours per day in June 2019.

In the MSIR vicinity, attendances have also decreased since the facility opened. Though there was initially minimal change in monthly attendances in the MSIR vicinity, the extension of opening hours led to a 40% reduction.

The results not only demonstrate the potential for MSIR facilities to reduce the burden on ambulance services across Victoria, but also highlights the importance of longer opening hours to ensure these services best fit different population groups.

Paper title:A pre-post evaluation of heroin-related ambulance attendances within the vicinity of the Richmond medically supervised injecting room.

Abstract available here.

The relationship between public holidays & AOD-related road incidents

Presenter: Jessica Killian

Researchers: Jessica Killian, Debbie Scott, Michael McGrath, Ziad Nehme, Dan Lubman, Rowan Ogeil

Data on how alcohol and other drugs impact non-fatal road crashes is limited, particularly around large-scale social events, like public holidays.

To assess the relationship between public holidays or events and AOD-related ambulance attendances, the team compared the number of these attendances on each public holiday to the average for “matched” days in 2022.

This means the data for a public holiday on a Tuesday would be compared to the average AOD-related ambulances attendance on Tuesdays throughout the year.

The baseline data showed more attendances on Fridays, Saturdays and Sundays - averages of five, seven and six respectively - while all other days of the week averaged three attendances.

The 2022 data showed there were four more AOD-related ambulance attendances than average on Good Friday, and there were eight more incidents attended on ANZAC Day than average.

In contrast, there was a decline in attendances on AFL Grand Final Day.

The NAMHSU team will carefully code and interrogate the 2023 data when it becomes available to see if these trends reoccur.

Overall, the 2022 dataset showed there were 1667 AOD-related traffic crashes attended by an emergency ambulance in Victoria in 2022. 72% of patients were male, while 39% of patients were aged 26 - 39. The majority (54%) involved alcohol, while amphetamines were involved 11% of the time, and cannabis 10% of the time.

Paper title:AOD-related road traffic crashes attended by emergency ambulances around public holidays and events

Abstract available here.

The societal cost of heroin dependence

Presenter: Natasha Hall

Researchers: Natasha Hall, Long Le, Julie Abimanyi-Ochom, Christina Marel, Katherine Mills, Maree Teesson, Cathy Mihalopoulos

As part of her PhD, Natasha Hall set out to determine the societal cost of heroin dependence Australia-wide and per person who uses heroin.

The results are astounding. Annually, the societal cost of heroin dependence in Australia was AUD$139,213 per person using heroin.

When these mean per person costs were extrapolated to Australian populations who are estimated to be dependent on heroin, the total annual Australia-wide cost of heroin dependence ranged from AUD$2.2 billion to 7.4 billion.

Crime was the highest cost contributor at 52% of the total costs, followed by lost productivity, which comprised 20% of the total costs.

The number of life years lost over the 11-year study period due to heroin dependence equaled 2,703 years, which equates to 213 million dollars.

As well as highlighting the need for resources and attention to be dedicated to heroin dependence, it is also notable that crime and the cost of heroin contributed to more than 70% of the total costs.

Natasha’s work highlights the fact that the illicit nature of heroin dependence as an illness contributes to higher costs to society.

Paper title: Estimating the societal cost of heroin dependence in an Australian population engaged in treatment

Abstract available here.

You can read more information about Turning Point’s presentations at APSAD via our website, LinkedIn, or via our X page.