Friday, 30 August 2013

International Overdose Awareness day

Tomorrow, Saturday 31st, is International Overdose Awareness day.  The day is an opportunity to remember those who have died or been permenantly injured due to overdose, and acknowledge the hardships of friends and family who have lost a loved one.

The official website has information on:
There is much talk about Naxolone this Overdose Awareness day.  Naxolone is a drug that is used by paramedics to revive people who have overdosed on opioids.  Countries such as the US, Italy, Russia and the UK are operating Naxolone distribution programs for "at risk" populations.  A number of small scale programs are also operating in Australia, but advocates are pushing for further distribution.  You can find more information about Naxolone here

The following ad is form the Overdose Awareness website.  There are further videos available from the site.

Tuesday, 27 August 2013

"Be the influence" campaign

Over the coming weeks the Australian Preventative Health Agency will launch their "Be the Influence - Tackling Binge Drinking" campaign.  The campaign targets 16-25y/o and aims for a cultural shift encouraging young people to be more responsible in their attitude towards drinking.

Image: ANPHA website 27/08/13
You can view the website here:

The "Help/Links" tab leads to some useful websites around drinking including:

Information and resources for making decisions about drinking

and Hello Sunday Morning
A free online program that helps people take a break from drinking and assess their relationship with alcohol.

Thursday, 22 August 2013

Quality Assurance

Quality Assurance (QA) audits are looming and you may be wondering what quality management is all about and what an audit may look like.  Here are some introductory resources that may help explain what QA is, why its important, and how it affects you.

Firstly, here are two items that have been published by the Queensland government.  They deal with the Disability Sector Quality System specifically, but all quality systems have common themes that make the information applicable to our situation.

Section 2: An introduction to Quality Management
Some key points:
- QA is focused on outcomes
- It's about establishing systems and measuring progress (e.g. policies and procedures are documented, internal audits, reporting systems)
- Continuous improvement of processes and systems are core (e.g. fix-it diary, feedback collection and analysis, evaluations)
- QA should be embedded in the organisational culture and advocated by management (e.g. everyone uses the appropriate policies and procedures - we do what we say we do, everyone identifies opportunities for improvement, top level management supports, enforces and is accountable for maintaining quality standards)

Section 3: Implementing the Quality System
A good introduction about what goes into implementing quality systems; worth a read if you'd like to get your head around the "how" of quality assurance

If you're interested in the specific standards that the organisation is audited against (ISO9001:2008) Wikipedia had a nice overview article here:
Note the points in the auditing section:
- Quality audit asks: Tell me what you do? Tell me where it says that? (documented procedures) Prove to me you do that (show me a file, report etc. that demonstrates you use the procedure)
- The 9001 standard is also about identifying the most effective way to do something. Will this way of doing it (the documented way) get you to meet your outcomes? Have you tried to improve this process/ documented ways to improve this process (e.g. used the fix-it diary)?  What happened when you tried to improve it?
- Essentially, policies and procedures are followed.  If they are not effective, steps are taken to improve them.  An individual worker or work team wouldn't stop using a policy or procedure if it didn't work for them, they would pass on suggestions so the whole organisation could benefit.
Factors that influence the effectiveness of ISO9001
1) Senior management commitment to monitor, control and improve quality
2) Integration of ISO and current practice
3) How well the system focuses on improving customer (client) experience
4) How well auditors and others in the organisation identify and communicate areas for improvement  

Additional reading:
Sousa-Poza, A., Altinkilinc, M., & Searcy, C. (2009). Implementing a functional ISO9001 quality management system in small and medium sized enterprises. International Journal of Engineering, 3(3), 220-228.
This item steps through the process of implementing QA and emphasizes the point that it won't be effective without management commitment and employee involvement.

Many thanks to Bronwyn and Sarah (now gone!) for their amazing work in QA!

Tuesday, 13 August 2013

Journal club follow-up: Self medication and comorbid anxiety and substance use disorders

This month's journal club update was provided by Sarah.


Journal Article Citation: Robinson, J., Sareen, J, Cox, B.J., & Bolton, J.M. (2011). Role of Self-Medication in the Development of Comorbid Anxiety and Substance Use Disorders: A Longitudinal Investigation. Archives of General Psychiatry, 68(8), pp. 800-807.

Link for abstract:

This month’s article raised some interesting points for discussion though there were no learnings made from the reading that were directly applicable to practice. There was some great critical analysis of the article – particularly what was missing from their article and it’s applicability to Australia.

Discussion Points:

 · The findings of the article confirmed the experience of the frontline workers – that those with symptoms of anxiety (whether know to the individual or not) are likely to be self-medicating using alcohol or other drugs.

· There was a comparison between participants who had a ‘diagnosable disorder’ and those who have ‘subclinical’ substance use or anxiety symptoms which was an interesting characteristic. Though this was likely because the writers were psychiatrists.

· There were some distinct limitations in the article (though the data seemed to quite robust with a large sample) – the majority of the participants were from rural areas, white and middle aged and it was discussed that this may have skewed some of their findings (e.g. that substance use disorders were predictive of social phobias). 

· Another limitation that was discussed was that there was likely to have been recall bias for the data collected on self-medication.

Also, Carina (from Goondiwindi) has suggested this article to read for those who are interested:

Journal Article Citation: Burns, L. & Teesson, M. (2002). Alcohol use disorders comorbid with anxiety, depression and drug use disorders. Findings from the Australian National Survey of Mental Health and Well Being. Drug and Alcohol Dependence 68(3), 299-307.

Link to abstract:
For a break-down of treatment types for anxiety disorder, including the use of substances for self medication, you may be interested in this resource from beyondblue:
Reavley NJ, Allen NB, Jorm AF, Morgan AJ, Purcell R. (2010) A Guide to What Works for Anxiety Disorders. beyondblue, Melbourne.


Wednesday, 7 August 2013

AOD & breastfeeding

Today is the last day of World Breastfeeding Week, with this year's theme being "support".  With this in mind, here are some resources to support clients who are breastfeeding with information or increase community awareness around AOD use and breastfeeding.

The Drug Arm Prevention Team developed a nice and concise poster a couple of months ago outlining the National Drinking Guidelines around drinking and pre-pregnancy, pregnancy and breastfeeding.  Most offices should have one, but you can print out more from this link or direct others there to print out their own copy.

Australian Breastfeeding Association pamphlet “Alcohol and Breastfeeding: a guide for mothers” has a good overview of the affect of alcohol on breastmilk.  Please be aware that the ABA's agenda is to promote breastfeeding (as it should be), this might not reflect the individual needs of a client.

Australian Government Department of Health and Ageing: “If you are breastfeeding the safest option is not to drink alcohol”.  Quick two page overview covering similar points to the ABA pamphlet 

Drugs and Lactation Database (LactMed) can be used to find information a drug's effect on breastfeeding by drug type, this includes prescription medication.  However, this is quite medically based and therefore may use more technical language.

New South Wales Department of Health (2006) National clinical guidelines for the management of drug use during pregnancy, birth and the early development years of the newborn – Breastfeeding (p19-22) - a guide to inform workers

Anyone seeking information on how to breastfeed and issues they may experience with breastfeeding should be directed to the Australian Breastfeeding Association's Breastfeeding hotline: 1800 mum 2 mum (1800 686 268), a lactation consultant, or a child health nurse.  Government funded breastfeeding clinics may operate in your area too.

Friday, 2 August 2013

Substance misuse skills consortium

If you had a look at the drugs and alcohol matrices discussed in the post "Where's the evidence base?" you may have noticed reference to the Substance Misuse Skills Consortium.  If you haven't been to their website before (it's been up since 2010), it is well worth a visit.

From their "About us" page:

"The Substance Misuse Skills Consortium is an independent, sector-led initiative to harness the ideas, energy and talent within the substance misuse treatment field, to maximise the ability of the workforce, and to help more drug and alcohol misusers recover"

The matrices are on the website, but you'll also find some great stuff in the Skills Hub including resources sorted by substance type and by treatment phase.

Substance Misuse Skills Consortium - access point to resources based on treatment phase. Image accessed 08/2013
As with the matrices this is quite UK material heavy, but a useful website nonetheless.