Greg Rumbold

Ambulance attendance at heroin overdose in Melbourne: the establishment of a database of Ambulance Service records

This paper presents some of the preliminary data extracted from a database of non-fatal heroin overdoses attended by ambulances in metropolitan Melbourne. The database has been developed in order to provide interested parties with reliable, high quality and timely data on heroin-related harm. Heroin overdose victims were defined as those people who were unconscious at the time the ambulance arrived and subsequently responded positively to the administration of naloxone. There were 388 heroin overdoses attended by ambulances in Melbourne over the period 1 November 1997-31 January 1998. The majority of victims were male (74 %) with an estimated mean age of 27.1 years. The overdoses occurred most commonly during the afternoon and evening, with Thursdays and Fridays most prominent. Police attendance was low (12%) and the vast majority of victims were not transported to hospital. An analysis by postcode revealed that the overdoses tended to be concentrated around a number of locations which have identified str...

Establishing safe injecting rooms in Australia: attitudes of injecting drug users.

Objective: To investigate the attitudes of injecting drug users (IDUs) towards the establishment of safe injecting rooms (SIRs) in Melbourne, Australia.

Attitudes and Experiences of People Who Use Cannabis and Drive: implications for drugs and driving legislation in Victoria, Australia

This paper describes a study that was conducted in Melbourne to examine the attitudes of cannabis users to proposed changes to the drugs and driving legislation in Victoria, Australia. The frequency with which young cannabis users drive while affected by cannabis was also examined. A pilot survey of 67 young cannabis users was conducted in which participants were questioned about their patterns of cannabis and alcohol use and driving, and their attitudes towards driving while intoxicated. A large portion of the sample indicated that they perceived cannabis to be a safe drug for driving. These cannabis users do regularly drive while impaired by cannabis, and around half of the sample reported that their cannabis use and driving patterns would not change when proposed changes to the drugs and driving legislation were introduced. In light of the pending legislative change in Victoria in the area of drugs and driving, such as the introduction of roadside testing procedures, further road safety educative initi...This paper describes a study that was conducted in Melbourne to examine the attitudes of cannabis users to proposed changes to the drugs and driving legislation in Victoria, Australia. The frequency with which young cannabis users drive while affected by cannabis was also examined. A pilot survey of 67 young cannabis users was conducted in which participants were questioned about their patterns of cannabis and alcohol use and driving, and their attitudes towards driving while intoxicated. A large portion of the sample indicated that they perceived cannabis to be a safe drug for driving. These cannabis users do regularly drive while impaired by cannabis, and around half of the sample reported that their cannabis use and driving patterns would not change when proposed changes to the drugs and driving legislation were introduced. In light of the pending legislative change in Victoria in the area of drugs and driving, such as the introduction of roadside testing procedures, further road safety educative initiatives are required that highlight the potential risks of driving while impaired by cannabis.

The Context, Management and Prevention of Heroin Overdose in Victoria, Australia: The Promise of a Diverse Approach

Heroin overdose is a common experience amongst heroin users in Victoria, Australia and presents an increasingly serious public health problem for the Victorian community. The number of heroin-related fatalities has increased from 49 in 1991 to 268 in 1998 while the numbers of non-fatal heroin overdoses attended by ambulances in the capital city, Melbourne, increased from 157 per month in June 1998 to a peak of 382 per month in March 1999. These large increases in heroin related mortality and morbidity derive from a variety of factors including recent changes in the heroin market as well as particular risk behaviours heroin users engage in. Widespread recognition of the urgency of the problem of heroin overdose has resulted in a diversity of effort aimed at minimising this key heroin-related harm in Victoria. A Victorian Heroin Overdose Working Group has been established with representation from a variety of government and nongovernment sectors. Prevention and education focused initiatives have been undertaken ranging from peer education about overdose prevention and training in resuscitation techniques to a new service provides individuals who have recently experienced a non-fatal overdose with counselling and referral. A number of new initiatives are either currently being trialed or under consideration including a service targeting those who have recently experienced non-fatal heroin overdose, the provision of supervised injecting facilities, and the establishment of a recovery space for young people who are either intoxicated or have experienced a heroin overdose. While evidence as to the effectiveness of these initiatives has yet to be collected, the diverse nature of the approach taken in Victoria is an appropriate response to what is a complex problem.

Associations between alcohol related hospital admissions and alcohol consumption in Victoria: Influence of socio‐demographic factors

Objective: To examine the cross‐sectional ecologic associations between apparent per‐capita alcohol consumption, alcohol‐related hospital admission rates, and the distributions of socio‐demographic factors for people residing in 76 Local Government Areas (LGAs) in Victoria, during the 1995–1996 fiscal year.

Using ambulance attendances to recruit people who have experienced non-fatal heroin overdose

AIMS To trial two novel methods of recruiting people who experience non-fatal heroin overdose through the ambulance service. SETTING Melbourne and Sydney, Australia. METHODS In Melbourne potential participants were given numbered contact cards by ambulance paramedics after revival, while in Sydney potential participants were approached after revival by a researcher who travelled with ambulance paramedics to the overdose scene. RESULTS In Melbourne 281 cards were distributed during the period 1 June 1998-31 December 1998 and a subsequent contact rate of 24% was achieved with 14% attending a subsequent interview. In Sydney there were 170 initial contacts of which 139 (82%) answered a series of questions asked at the scene (the remainder either ineligible or incapable of answering questions) with 48 (35%) also attending for follow-up interviews. CONCLUSIONS Recruitment through contact with ambulance services is a novel method of recruiting heroin users for research into non-fatal heroin overdose with advantages over other methods of sampling for research on non-fatal heroin overdose.

Patterns and trends in alcohol-related hospitalizations in Victoria, Australia, 1987/88–1995/96

The objective of this study was to examine patterns and yearly trends in alcohol-related hospitalization rates during the period 1987/88-1995/96 for men and women living in metropolitan and rural/remote Victoria. Alcohol-related hospitalizations were extracted from the Victorian Inpatient Minimum Dataset (VMD) for the years 1987/88-1995/96 (public hospitals) and 1993/94-1995/96 (private hospitals), and adjusted by the appropriate aetiological fractions. Sex-specific age-adjusted rates we expressed per 10000 residents/year. During 1993/94-1995/96, alcohol-related hospitalizations comprised 1.0% of all Victorian hospitalizations (about 12000/year), with men accounting for over two-thirds of alcohol-related hospitalizations. Approximately half of the alcohol-related hospitalizations were for disease conditions and the other half for external cause (injury) conditions. About 80% of all alcohol-related hospitalizations were to public hospitals, with the exception of alcohol dependence (63% to private hospitals). Alcohol-related hospitalization rates were generally higher for people living in rural/remote areas compared to urban areas. During 1987/88-1995/96, the age-adjusted alcohol-related hospitalization rates in public hospitals did not change significantly for disease conditions (14.8-14.7 for men and 6.3-6.4 for women) or female external cause conditions (6.7-6.1), but decreased for external cause conditions (18.4-15.5). In private hospitals during 1993/94-1995/96, the age-adjusted alcohol-related hospitalization rates for disease conditions decreased (5.4-4.1 for men and 3.7-3.0 for women) but increased for external cause conditions (1.8-2.4 for men and 1.0-1.2 for women). These patterns and time-trends in Victorian alcohol-related hospitalizations reflect a combination of alcohol-related morbidity levels, hospital admission practices and patterns and levels of service provision. They suggest a potential need to focus on services and programmes in rural/remote Victoria.