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There has been a growing literature documenting the high prevalence of co-occurring mental health disorders among clients of substance use treatment services and the challenges clinicians face when treating comorbid clients. To assist alcohol and other drug (AOD) workers in working with these clients, the Australian Government Department of Health and Ageing funded the development of ‘Guidelines on the management of co-occurring alcohol and other drug and mental health conditions in alcohol and other drug treatment settings.’ Too often guidelines are produced but not evaluated. The present study aimed to examine the extent to which this resource is perceived to be relevant and useful to clinical practice. Ninety-seven AOD workers from across Australia completed an online survey. A series of questions asked respondents to rate the relevance and usefulness of the Guidelines to their clinical practice. Overall, the responses received were overwhelmingly positive. The vast majority of respondents perceived the Guidelines to be relevant and useful to their clinical practice. Almost all respondents (91%) indicated that they will use some of the things they learnt from the Guidelines in their work. The findings indicate that the Guidelines are an acceptable resource to the AOD field, and have broad applicability across AOD workers representing a range of occupations, from various service types in different geographic locations, who service a variety of client groups. The findings are encouraging, and suggest that the Guidelines may have the potential to lead to improvements in a treatment provision. [ABSTRACT FROM AUTHOR]

Aim. To examine the extent of physical health impairment among a community sample of methamphetamine users in comparison with the general population, and factors associated with impairment among this group. Method. A cross-sectional survey of 309 regular methamphetamine users from Sydney. The Physical Component Scale of the Short Form 12 (SF-12) was used to measure impairment in physical health (score < 40). Age-matched general population data for the SF-12 were derived from the Australian National Survey of Mental Health and Well-Being. Results. Participants had a higher prevalence of impaired physical health compared to the Australian general population (20% vs. 10%, p < 0.05), but this effect occurred among only dependent methamphetamine users over 24 years of age (25 - 34 years, 23% vs. 10%; 35 - 44 years, 41% vs. 12%). Methamphetamine dependence remained significantly predictive of impaired physical health after adjusting for age and other confounding factors. Opioid pharmacotherapy was also related strongly to poor physical health, accounting for 63% of participants with physical impairment. Other factors associated with impaired physical health were being female, having less than 10 years of schooling, and having been diagnosed previously with an anxiety disorder (p < 0.05). Conclusion. Methamphetamine users are more likely to report impaired physical health than the general population, but this impairment is specific to older methamphetamine users who are dependent on the drug, particularly those who are enrolled in opioid pharmacotherapy. [McKetin R, Kelly E, McLaren J, Proudfoot H. Impaired physical health among methamphetamine users in comparison with the general population: the role of methamphetamine dependence and opioid use. Drug Alcohol Rev 2008;27:482-489] [ABSTRACT FROM AUTHOR]

Background This paper presents findings from the Australian National Survey of Mental Health and Wellbeing (NSMHWB) regarding prevalence and treatment seeking for Australians with DSM-IV alcohol dependence and examines the influence of alcohol use variables on treatment seeking. Method A standardised interview (including CIDI 2.1) was administered to a stratified random sample of 10,641 Australians aged 18 years and over. Demographic variables, common DSMIV mental disorders, physical health status, perceived disability and treatment-seeking behaviour were assessed. Multiple logistic regression was used to ascertain the independent effects of all variables considered. Results The prevalence of DSM-IV alcohol dependence was 4.1% in this population, with 75 % being male and nearly 60% in the 18-34 year age group. Variables that correlated independently with alcohol dependence were sex (male), age (young), not being in a married or de facto relationship and having any affective, anxiety or other substance use disorder. Functional disability did not correlate with a dependence diagnosis. Correlates of treatment seeking for those with dependence were sex (female) and having a comorbid affective disorder. Having a diagnosis of dependence and/or abuse and having more dependence symptoms did not predict treatment seeking. However, meeting either of two criteria assessing psychological, physical or social problems due to alcohol use tended to increase service use. Conclusions People with alcohol dependence do not perceive themselves as disabled and do not seek treatment. However, having a comorbid affective disorder or other problems directly attributable to alcohol use increases the likelihood that such individuals will seek treatment. Efforts should be made at the primary care level to encourage those engaged in harmful drinking practices to recognise the risks of such drinking and reduce it or seek treatment. Similarly, it is recommended that integrated services are... [ABSTRACT FROM AUTHOR]