Last afternoon of #APSAD40! It is a joy to chair this session on #overdose - lots of key learnings and great work in the prevention space. Here are a couple of highlights from the session 1/
2/ Louisa Durrant (NUM at Melaleuca, @qldhealthnews) spoke about lessons learned supplying take-home naloxone in the opioid treatment program in QLD. Despite many having experienced an overdose, few had access to naloxone before the pilot, and consumers valued being offered THN.
3/ Dr Eleanor Black presented on the ONE study, a pilot study looking at ED delivery of #naloxone - a key opportunity to offer naloxone to people at risk of overdose. Most (not all) staff through they should offer #naloxone, with common misconception of naloxone increased OD risk
3/ Low provision of naloxone in ED suggest more work is needed to address barriers to supply in the ED
4/ Eleanor Black also described a more severe cohort with prescription opioid overdose
5/ @DrTinaLam_AU presented at #APSAD40 on ED poisonings with prescription opioids .. work which has just been published in @AddictionJrnl (if you want to read more) onlinelibrary.wiley.com/doi/full/10.11…
6/ @DrTinaLam_AU - most poisonings were with more accessible opioids (codeine&oxycodone), with lower rates of harm for tapentadol & fentanyl relative to supply. Fentanyl&methadone more likely to be accidental poisonings, with intentional harm seen more with most other opioids
7/ Dr Rachel Sutherland spoke on take-home fentanyl test strips. Most found FTS acceptable and were interested in drug checking. Some issues with misreading the strips (false positives). Harm reduction actions taken as a result of testing. Acceptable, but maybe not reliable?
8/ Rapid Preso from Rosie Gilliver (Kirketon Road Centre) rapid review from a primary healthcare setting in Kings Cross, Sydney - exciting to see lots of outreach to supply naloxone outside the clinic, with strong staff support!
9/ Rapid preso from PhD researcher Anna Conway (@KirbyInstitute) on opioid OD and naloxone access among people who recently used opioids or received opioid agonist treatment.. polysubstance use assoc with more OD and more THN access, TM associated with less OD and more THN!
10/ @JMoullin talked about the importance normalising pharmacists attitudes towards naloxone, highlighting the importance of targeted implementation strategies.. and the challenges of implementation during a pandemic (sorry my slide short was fuzzy)

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More from @DrSuziNielsen

10 Nov
Last session for me today at @APSAD40 on prescription opioids, treatment, and prescription drug monitoring programs. First up - a mini-symposium with @PPrathivadi , @LouisaPicco and @Sarah_Haines_ .. lets see if I can pull out a few key findings 1/
2/ First up @PPrathivadi talking about GPs use of PDMP, benefits for informing prescribing but challenges with reluctance to use technology - also check out this super commentary with @Sarah_Haines_ in the @AusJPrimHealth on evaluation considerations
publish.csiro.au/py/PY20296
3/ Next is @LouisaPicco talking about implementation of prescription monitoring with #pharmacists. Alerts seem to really drive responses (over other clinical risk factors).. are automatic alerts replacing clinical judgement? Conclusion: PDMP should not replace clinical decisions
Read 8 tweets
9 Nov
What's new in take-home #naloxone in Australia? 1/ Ange Matheson from @NSWHealth explains the NSW model which allows a whole range of workers and non-medical services across the NSW (e.g. those working NGOs without pharmacists or doctors on staff) to supply naloxone #APSAD40
2/ Tegan Nuckey from Queensland (QuIHN) talks about their #naloxone program, adapted from the WA model.. now funded until 2023 (but no recurrent funding). Hopefully a national program will be funded by then! No cost, script, no ID - addressing key barriers.
3/ Robin Greaves (Tasmania) presented on the Tasmanian gov program where poisons regulations were changed to allow supply by NPS workers as part of their pilot. With limited funding, the pilot focused on people who use heroin, now ongoing funding provides FREE naloxone from NSPs
Read 4 tweets
9 Nov
Big last day of #APSAD40 today for #opioid research. I'll be presenting in a symposium of #naloxone today, and then super excited to chair two sessions on #overdose and prescription #opioid treatment ... a couple of highlights include ... 1/
2/ New research on the implementation of prescription monitoring in Victoria with @LouisaPicco @PPrathivadi and @Sarah_Haines_ (all superstar PhD researchers in the @MonashAddiction crew)
3/ @DrTinaLam_AU (also from @MonashAddiction) presenting on prescription opioid overdose using emergency department data and @JMoullin from @CurtinUni talking about pharmacists and naloxone supply in Western Australia
Read 6 tweets
8 Aug
It's that time of year again, when I score grant apps for much of the weekend, and late into the weeknights too. Again, as I do each year, I implore you, grant writers, please do not use lots of acronyms in your grants, and don't make up your own acronyms. 1/ #AcademicTwitter
2/ This is particularly so for multidisciplinary grants. It is impossible that a panel member will be expert in every discipline, and you would be surprised how many acronyms mean different things in different disciplines.
3/ If you need to use acronyms to jam more words onto your page, forming the dreaded 'wall of text' ... think again. No one thanks you for this. It is really hard to find the key points you are making when every square cm of every page is jammed-packed with text.
Read 4 tweets
7 Apr 20
Advice from the DHHS about maintaining continuity for pharmacotherapy treatment is here. Key principals include writing prescriptions for longer (with regular phone check-ins with patients) and increased TA doses where clinically appropriate (1/3)
bit.ly/3e4EpSu
Guidance to support assessing appropriateness for additional takeaways are here. Where clinically appropriate, increasing takeaways means that people can stay safe at home and travel pharmacies. #Naloxone is recommended with takeaways bit.ly/2UQgmiy (2/3)
Documents to support dose delivery are here bit.ly/2RilpGe (3/3) Much credit to the dedicated staff at @VicGovDHHS @VAADAENEWS and the broader sector in developing these resources for those providing #methadone and #buprenorphine @psa_vic @HRV_Aust @RACGP @DrGrinzi
Read 4 tweets

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