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9. A multicentre case series of analytically confirmed gamma‐hydroxybutyrate intoxications in Western Australian emergency departments: Pre‐hospital circumstances, co‐detections and clinical outcomes.

Author

Smith, Jennifer L., Greene, Shaun, McCutcheon, David, Weber, Courtney, Kotkis, Ellie, Soderstrom, Jessamine, Douglas, Bianca, Lenton, Simon, Grigg, Jodie, Dessauer, Paul, Ezard, Nadine, Fatovich, Daniel M., Alfred, Sam, Brown, David, Burrows, Sally, Dawson, Andrew, Fatovich, Daniel, Gardner, Craig, Griffiths, Andrew, and Harris, Keith

Subjects
GAMMA-hydroxybutyrate, HOSPITAL emergency services, EMERGENCY room visits, MEDICAL records, TREATMENT effectiveness, DRUG toxicity
Abstract

Introduction: Gamma‐hydroxybutyrate (GHB) use is associated with high risk of accidental overdose. This study examined the pre‐hospital circumstances, demographic characteristics and clinical outcomes of analytically confirmed GHB emergency department (ED) presentations in Western Australia (WA). Methods: This case series was conducted across three WA EDs involved in the Emerging Drugs Network of Australia, from April 2020 to July 2022. Patient demographics, pre‐hospital drug exposure circumstances and ED presentation and outcome characteristics were collected from ambulance and hospital medical records of GHB‐confirmed cases. Results: GHB was detected in 45 ED presentations. The median age was 34 years and 53.3% (n = 24) were female. Most patients arrived at the ED by ambulance (n = 37, 85.7%) and required immediate emergency care (Australasian Triage Score 1 or 2 = 97.8%). One‐third of patients were admitted to intensive care (n = 14, 31.1%). Methylamphetamine was co‐detected in 37 (82.2%) GHB‐confirmed cases. Reduced conscious state was indicated by first recorded Glasgow Coma Scale of ≤8 (n = 29, 64.4%) and observations of patients becoming, or being found, 'unresponsive' and 'unconscious' in various pre‐hospital settings (n = 28, 62.2%). 'Agitated' and/or 'erratic' mental state and behavioural observations were recorded in 20 (44.4%) cases. Discussion and Conclusions: Analytically verified data from ED presentations with acute toxicity provides an objective information source on drug use trends and emerging public health threats. In our study, patients presenting to WA EDs with GHB intoxication were acutely unwell, often requiring intensive care treatment. The unexpectedly high proportion of female GHB intoxications and methylamphetamine co‐ingestion warrants further exploration. [ABSTRACT FROM AUTHOR]

Published
2024
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12. Are cannabis use problems comparable across individuals using for recreational and medical purposes? An international cross-sectional study of individuals who use self-grown cannabis

Author

Sznitman, Sharon R, primary, Potter, Gary R., additional, Grigg, Jodie, additional, Granville, Ashely, additional, Hakkarainen, Pekka, additional, Decorte, Tom, additional, Lenton, Simon, additional, Fortin, Davide, additional, Bear, Daniel, additional, Kirtadze, Irma, additional, Jauffret-Roustide, Marie, additional, Barratt, Monica J., additional, and Sevigny, Eric L., additional

Published
2023
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18. The challenges of adapting hospital care for children

Author

Ehrich, Jochen, primary, Pettoello-mantovani, Massimo, additional, Molloy, Eleanor, additional, Kerbl, Reinhold, additional, Vural, Mehmet, additional, Lenton, Simon, additional, Del Torso, Stefano, additional, Hadjipanayis, Adamos, additional, Wettergren, Björn, additional, and Grossman, Zachi, additional

Published
2020
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19. Introduction

Author

Decorte, Tom, primary, Lenton, Simon, additional, and Wilkins, Chris, additional

Published
2020
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20. Conclusion

Author

Wilkins, Chris, primary, Lenton, Simon, additional, and Decorte, Tom, additional

Published
2020
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35. Are Cannabis Use Problems Comparable Across Individuals Using for Recreational and Medical Purposes? : An International Cross-Sectional Study of Individuals Who Use Self-Grown Cannabis

Author

Sznitman, Sharon, Potter, Gary, Grigg, Jodie, Granville, Ashely, Hakkarainen, Pekka, Decorte, Tom, Lenton, Simon, Fortin, Davide, Bear, Daniel, Kirtadze, Irma, Jauffret-Roustide, Marie, Barratt, Monica, Sevigny, Eric, Sznitman, Sharon, Potter, Gary, Grigg, Jodie, Granville, Ashely, Hakkarainen, Pekka, Decorte, Tom, Lenton, Simon, Fortin, Davide, Bear, Daniel, Kirtadze, Irma, Jauffret-Roustide, Marie, Barratt, Monica, and Sevigny, Eric

Abstract

Background: Little is known about cannabis use problems among individuals who use cannabis for medical purposes and whether rates and determinants of cannabis use problems in medical users differ to those observed among individuals using for recreational reasons. This study examines whether Severity of Dependence Scale (SDS) scores differ across individuals who use self-grown cannabis for the following reasons: “recreational only”, “medical and recreational” and “medical only”. Furthermore, the study tests whether cannabis use frequency, cannabis strain, and type of cannabis influences the strength of the association between purpose of use and cannabis use problems. Methods: Data (n = 5,347) were collected from a subsample of the Global Cannabis Cultivation Research Consortium project, focusing on small-scale cannabis growers in 18 countries. Robust regressions analyzed differences in SDS scores across the three use motivation groups. Results: Compared with respondents reporting only recreational motivations of cannabis use, those with medical (with and without recreational) motivations were associated with lower SDS scores (B: -0.190 and B: -0.459, p < 0.001 respectively). Daily use was associated with significantly higher SDS scores across all cannabis motivation groups, albeit the magnitude of the association was significantly smaller among individuals with medical motivations of use. Conclusion: The extent to which people experience cannabis use problems, and the determinants of these problems may differ depending on whether cannabis use is motivated by recreational or medical purposes. As such, the findings of the current study suggest that public education efforts, harm reduction approaches and policy responses should be tailored depending on whether cannabis is used for recreational or medical purposes.

Published
2023

36. Developing a single-session strategy for the implementation of take-home naloxone by community pharmacists using COM-B and design-thinking

Author

Eldh, Ann Catrine, Moullin, Joanna, Ely, Philip, Uren, Hannah, Staniland, Lexy, Nielsen, Suzanne, Lenton, Simon, Eldh, Ann Catrine, Moullin, Joanna, Ely, Philip, Uren, Hannah, Staniland, Lexy, Nielsen, Suzanne, and Lenton, Simon

Abstract

Background: Despite the overwhelming evidence of its effectiveness, there is poor implementation of take-home naloxone by pharmacists. Barriers have been explored and mapped to the capability, opportunity, motivation—behaviour (COM-B) model of behaviour change, yet no theoretically informed implementation strategies that target known barriers have been developed. Single-session implementation strategies have been proposed as a simple, scalable way to target multiple barriers. Methods: Qualitative participatory methods, incorporating design-thinking principles, were used to develop the key messages of a single-session implementation strategy. The key messages were drafted against COM-B mapped implementation barriers identified in the literature. A participatory workshop involving a pre-mortem exercise and incorporating design-thinking principles were used to refine the messages and generate methods for dissemination. Messages were mapped to interview questions to naturally illicit stories and delivered via storytelling from a pharmacist, a general practitioner, and a person with lived experience of using naloxone. Results: A 3 minute 40 second video and a two-page printable infographic were developed and hosted on a website, with links to additional downloadable resources as a single-session implementation strategy. Email was the preferred method for receiving simple professional development communications, with social media also widely accessed. Discussion: Implementation science, behavioural change theory, and participatory design methods are a complementary combination to develop implementation strategies. Some pharmacists questioned the participatory design approach to developing an implementation strategy, as it was outside of their comfort zone. However, the participatory process involving end-users resulted in unique ideas that are unlikely to have been generated using more traditional consultative approaches. The delivery as a single-session implementation st

Published
2023

42. Hidden Populations, Online Purposive Sampling, and External Validity: Taking off the Blindfold

Author

Barratt, Monica J., Ferris, Jason A., and Lenton, Simon

Abstract

Online purposive samples have unknown biases and may not strictly be used to make inferences about wider populations, yet such inferences continue to occur. We compared the demographic and drug use characteristics of Australian ecstasy users from a probability (National Drug Strategy Household Survey, n = 726) and purposive sample (online survey conducted as part of a mixed-methods study of online drug discussion, n = 753) using nonparametric (bootstrap) and meta-analysis techniques. We found significant differences in demographics and drug use prevalence. Ideally, online purposive samples of hidden populations should be interpreted in conjunction with probability samples and ethnographic fieldwork.

Published
2015
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