Abstracts
PROJECT PROFILES
Recent trends in alcohol consumption, related harm and societal attention to alcohol in Victoria
Michael Livingston, Claire Wilkinson
This study examines how Victorians’ relationship with alcohol has changed in the last decade. Making use of data from hospitals, emergency departments, police, the ambulance service and the treatment system, along with survey data and media monitoring information, this study presents recent trends in drinking patterns, rates of harm, media attention and attitudes and norms related to alcohol in Victoria. The trends present some interesting puzzles with, for example, rates of harm and media attention increasing sharply, while estimates of consumption remain unchanged. The study discusses the implications of these trends with respect to social and policy responses to alcohol in Victoria.
Drinking cultures and social occasions: Alcohol harms in the context of major public holidays, sporting and cultural events
Belinda Lloyd, Sharon Matthews, Michael Livingston
Whilst recent media and public interest has focused on problematic alcohol consumption and perceived harms associated with sporting events, little evidence exists to assess the relationship between major events, and alcohol related harms. The timing of major social events (sporting, cultural and public holidays) occurring in Melbourne, Australia, and their association with alcohol related harms will be explored through analysis of hospital emergency presentations and ambulance attendances.
This paper utilises time series analysis to explore trends in alcohol related harms in the context of major social events. Data utilised in analyses included the Victorian Emergency Minimum Dataset (VEMD) which details hospital emergency presentations, the Victorian Admitted Episode Dataset (VAED) which details hospital admissions, and the Ambo Project dataset which includes all drug and alcohol related ambulance attendances in Melbourne. These datasets were analysed in terms of alcohol related harms associated with selected major social events, including investigation of lead and lag effects. In addition, analyses included harms in relation to day of week and month of year to account for temporal and seasonal variations.
Increased rates of alcohol related harms are evident in the context of different social and sporting events. Opportunities exist for the development of innovative intervention approaches, as well as targeted service responses to prevent and minimise alcohol related harms in the community.
Reducing Risky Drinking in Culturally and Linguistically Diverse Communities
Dr Kieran Connolly, Amy Pennay, Sandra Roeg, Sanja Pahoki
Collaborators: Multicultural Centre for Women’s Health; Northern Division of General Practice
This project is concerned with the early identification and management of alcohol problems among culturally and linguistically diverse (CALD) communities. There is overwhelming evidence that brief interventions in primary care are effective and efficacious in reducing risky drinking; however their uptake and utilisation by General Practitioners (GPs) has been limited, and there has been little research of their effectiveness in CALD communities. This study will evaluate the effectiveness of a community development and awareness raising strategy among CALD communities, supported by the promotion of brief intervention through the primary health care system. We are one year into this 3-year project. The presentation will discuss some of the successes and barriers of project thus far.
Alcohol’s effects on children: A comparison between survey and system data
Anne-Marie Laslett
This paper describes the adverse effects of drinking on children in two separate studies. The first focuses on children in the Victorian Child Protection system and the second utilizes data from the national survey of alcohol’s harm to others. The work compares rates of alcohol related child abuse in the two studies and examines the socio-demographic backgrounds and types of families within which alcohol-related child maltreatment occurs and looks for groups at greater risk. System data tells us that 0.32% of children in 2005 were victims of alcohol related substantiated child abuse, while in the Australian Alcohol’s harm to others survey 17% carers with children reported that their child/ren had been physically hurt, emotionally abused (yelled at), left unsupervised, or exposed to domestic violence because of someone else’s drinking. In introducing and discussing the findings the paper explores the alternate social theories that underlie the social location and construction of alcohol related child abuse.
Young people in Victorian AOD treatment: Preliminary findings from the Victorian youth cohort study
Angela Harney, Suzi Nielsen, Melissa Reed, Sanja Pahoki, Prof Dan Lubman
Young people comprise a substantial group within Victorian Alcohol and Other Drug (AOD) treatment. The Youth Cohort Study has recruited 150 young people (16-21 years) involved with Victorian AOD treatment agencies, for a series of interviews. This study aims to examine treatment pathways and experiences for young people and provides a snapshot of this client group and their service use.
The sample was 60% male, mean age of 18.5 years, 54% self-reported a mental health diagnosis. Primary drugs were commonly cannabis (55%) and alcohol (19.5%). Forty percent of participants had no previous AOD experience. Pathways and connectivity with the services system varied but reliance on multiple services and the need for connectivity with mental health and housing services is highlighted.
Exploring alcohol and drug related harms across acute settings: What can we learn from linked ambulance, emergency department and hospital admissions?
Belinda Lloyd, Paul McElwee, Sharon Matthews
The nature of medical care in relation to acute alcohol and other drug presentations is not currently adequately documented or understood. Whilst routine monitoring of drug and alcohol harms is an integral aspect of the identification of changing trends of concern, and also the development of responsive and appropriate policy, prevention and intervention, the examination of alcohol and drug related hospital emergency presentations and admissions is problematic due to limitations in complete and accurate identification of drug and alcohol related cases. There is a need to explore innovative and cross-sector methods to understand and respond to alcohol and drug related harms.
This paper describes patterns in alcohol and drug related harms through linkage of five years of data of ambulance attendances and hospital emergency presentations. These datasets were linked using a unique identifier and a number of validation techniques. The linked data set was analysed in terms of alcohol and other drug related attendance and presentation characteristics, patient demographics, and treatment and diagnostic categories.
In order to develop a more complete picture of the true extent and nature of alcohol and drug related harms in the population, use of multiple and complementary data sources is necessary. Such approaches will contribute to policy, prevention and treatment across acute and treatment settings, and also the health and community sectors.
Enhancing readiness for screening, brief intervention and referral into treatment in hospital settings
Lynda Berends, Bridget Roberts
In Victoria, Australia, as in other parts of the world, there is considerable momentum for large scale practice change in relation to screening, brief intervention and referral to treatment (SBIRT) for risky alcohol use. While advances have been made at policy and practice levels, full integration has not been realised. In this presentation we consider strategies for primary care settings and specialist alcohol and other drug agencies that will support the integration of SBIRT into daily practice, including quality assurance processes and workforce development.
Gambling Help Online: Site development and client engagement
Simone Rodda
Rising levels of household internet access have seen the proliferation of a range of new health care services across the globe. Emerging service types include guided-assistance and self-paced programs in addition to online therapist-assisted counselling via asynchronous and synchronous interaction. The purpose of this paper is to outline the process of development for Australia’s first national online counselling program for those affected by gambling related harms. Gambling Help Online (GHO) is an initiative of the Ministerial Council on Gambling (MCG) and is funded as part of an agreement between all State and Territory Governments and the Australian Government. Launched in August 2009, GHO provides immediate, free, 24/7 online counselling in real time and via email support. This paper describes key development processes including focus group testing, literature review and environmental scanning undertaken to inform program development. Initial data for the first six months of service delivery is presented. It is expected that GHO will enhance the range and flexibility of gambling treatment supports by providing (1) a ‘soft’ entry point for those who are reluctant or unable to access face-to-face services (2) a flexible adjunct for those in treatment and (3) access to self-help and other educational resources for gamblers and concerned significant others.
How to support effective implementation and enable project outcomes: strategies for community projects on alcohol-related harm
Lynda Berends, Sarah Maclean, Barbara Hunter, Janette Mugavin
Effective project implementation is critical to the achievement of desired outcomes. Key enabling and barrier mechanisms of implementation were identified from a review of 127 projects designed to reduce the burden of harm arising from alcohol and/or inhalant misuse. Findings can be translated into performance measures to identify organisational readiness for new projects and explore implementation effectiveness as these projects are established. This information is useful for funders, in selecting projects that are likely to succeed, and for organisations, in the adoption of strategies that will enhance their readiness for project implementation.
Old drug, new treatments: Alcohol, the VAAP and Turning Point
Matthew Frei
Over the past decade, alcohol and other drug treatment services have increased their focus on alcohol treatments. This may be due to changes in illicit drug markets, expectations and understanding about alcohol-related harm, pharmacotherapeutic advances and public health policies.
The Victorian Alcohol Action Plan 2008-2013 outlines directions for treatment services, including engaging primary care and provision of secondary addiction medicine consultancy. Turning Point is well-placed to advance shared care of alcohol use problems through its clinical services and state wide consultancy service, Drug and Alcohol Clinical Advisory Service (DACAS).
This presentation discusses challenges of providing a statewide alcohol treatment service, along with some early experiences of the TP clinic model, which provides assessment and support for general practitioner referred patients with alcohol use disorders. The presentation will also look at future roles for DACAS, in particular the optimization of limited specialist addiction medicine resources over regional and rural Victoria.
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