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RACGP Specific Interests newsletter

14 February 2019

From where I sit

Dr Lara Roeske, Chair RACGP Specific Interests

6252 Specific Interests Chair Video - E DM Image

Addiction medicine in focus

From Dr Hester Wilson, Chair RACGP Specific Interests Addiction Medicine

As GPs, we commonly see patients with smoking, alcohol and other drug use and/or addiction in our practices. This can be a challenge. Addiction is a chronic relapsing and remitting illness with highly significant effects on the wellbeing and health of individuals, families and communities. We, as GPs, can make a difference. We are ideally placed to intervene early; however, this requires skill, time and, often, specialist support.

Every two years the RACGP and the RACGP Specific Interests Addiction Medicine collaborate with the Chapter of Addiction Medicine in the Royal Australian College of Physicians and the Faculty of Addiction Psychiatry at the Royal Australian and New Zealand College of Psychiatrists (RANZCP) to present the International Medicine in Addiction Conference (IMiA).

IMiA began nine years ago in response to many doctors who work in the field of addiction and were asking for a conference that focused on the clinical, upskilling and networking needs of all doctors.

This biennial conference has been held in either Melbourne or Sydney and has seen success to success. In 2017, 250 GPs attended the conference, thus representing a third of the attendees. GP attendees informed us that the conference was useful and well regarded. One delegate noted that IMiA was the ‘best conference for medical practitioners when it comes to practical implementation and patient care’.

I’ve been one of the RACGP representatives on the IMiA scientific committee since the conference’s inception and am strongly committed to ensuring this conference builds on its successes and supports the needs of doctors who work in the important area of addiction, particularly GPs.

In 2019, we have five overseas experts talking about a diverse range of topics from gambling, treating stress pathophysiology, new developments in medication and, very topically in Australian now, pill testing, as well as a host of local experts. This year, we’re focusing on sleep, psychoactive prescription medicines, driving, cognitive impairment, overdose, violence, and the role of consumers (to name a few). There are a range of presentations, including plenaries, keynotes and smaller skills-based workshops.

The next conference in on Friday to Sunday 1–3 of March 2019 in Melbourne. I warmly invite you to attend and look forward to chatting with you at the conference.

International Medicine in Addiction Conference 2019

Friday to Sunday 1–3 March 2019

The IMiA19 program is currently in development and will include a mix of presentations from Australian and international clinical and research experts.

Already confirmed, the program highlights include:

  • Prof Jon E Grant – Gambling and behavioural addictions
  • Prof Rajita Sinha – Stress and resilience
  • Dr Iván Montoya – New horizons/approaches in the USA
  • Dr Marc Auriacombe – Opiate and addiction update from Europe
  • Dr Edward Ogden – Driving impairment
  • Dr David Cunnington – Sleep, and alcohol and prescription drugs
  • Prof Peter Miller – Alcohol and violence

Stay informed of program updates on the IMiA website.

IMiA19 will be held at the Melbourne Convention and Exhibition Centre. Registration is now open.

IMi19 is accredited for 30 Category 2 Quality Improvement and Continuing Professional Development (QI&CPD) points for the 2017–19 triennium.

RACGP President backs the calls for pill testing

Due to recent deaths at music festivals, RACGP President Dr Harry Nespolon (pictured) added his voice to a growing chorus of calls to implement further pill testing trials at music festivals.

Dr Nespolon believes it is an issue of health and safety, rather than one of law enforcement.

 ‘At the end of the day, pill testing is nothing to do with legalising and condoning drug use, but reducing harm and ultimately saving lives,’ he said.

According to Dr Nespolon, pill testing is a harm-minimisation strategy worthy of consideration that considers the reality of people’s behaviour, rather than the ideal.

‘Of course, it would be preferable if people did not engage in potentially dangerous drug-taking behaviour, but the fact of the matter is that they do, as recent events have made very clear,’ he said. ‘I believe it is important to make every effort to ensure that families see their children come home, rather than suffer overdose death as a result of drug-taking.’

Dr Nespolon also notes that the positive effects of pill testing can extend beyond simply detecting harmful substances within illicit drugs.

‘It can also bring young people into contact with health professionals and help play a strong part in education about drug use and its risks for a group that might otherwise be hard to reach,’ he said.

The full article was first published on the RACGP’s newsGP and reproduced with its permission.

Australian and New Zealand Addiction Conference

Gold Coast, Monday to Wednesday 13–15 May 2019

The Australian and New Zealand Mental Health Association is presenting a two-day education program of speakers and a half day of workshops. The aim of the conference is to broaden the understanding of the range of addictions, comorbidity, pain management, harm reduction, mental health and wellbeing, and consider solutions in prevention, treatment and recovery through evidence-based research, programs and practical models.

The conference will be held at Sea World Conference Centre on the Gold Coast.

Registration is now open. An early registration discount applies until Friday 29 March 2019.

Recent research*

Tackling opioid dependence in Ireland – The role of general practice 
Opioid dependence, characterised by socioeconomic disadvantage and significant morbidity and mortality, remains a major public health problem in Ireland. Researchers from the Irish College of General Practice (ICGP) and John Moores University, Liverpool, United Kingdom, present a narrative review on 20 years of the methadone treatment protocol (MTP) in Ireland, which has been the mainstay of harm reduction services in Ireland. It has provided a network of specially trained GPs who provide methadone to over 10,000 patients across Ireland within a structured framework of training, quality assurance and remuneration.

Delargy I, Crowley D, Van Hout MC. Twenty years of the methadone treatment protocol in Ireland: Reflections on the role of general practice. Harm Reduct J. 2019;16(1):5. doi:10.1186/s12954-018-0272-4

Prescription drug misuse among women 
Women represent half of the world’s population and pose a unique risk for prescription drug misuse (PDM), including a greater burden of addiction and relapse. Researchers from the University of Cincinnati have conducted a systematic review of the literature exploring PDM among adult women. It examines gender differences in PDM and finds that although women tend to use fewer drugs than men do across most classes of drugs, this pattern is not as clear with prescription drugs. For example, research reveals that women misuse prescription pain relievers more than males; men who engage in PDM also tend to abuse other substances, whereas women are more likely to solely abuse prescription medications.

Peteet B, Mosley C, Miller-Roenigk B, McCuistian C, Dixon S. Transnational trends in prescription drug misuse among women: A systematic review. Int J Drug Policy 2019;63:56–73. doi.10.1016/j.drugpo.2018.10.005.

Videogame addiction and ADHD 
Videogame addiction has been suggested as a tentative disorder in 2013 by the American Psychiatric Association and was recently officially recognised as a mental health disorder by the World Health Organization (WHO). Although a few studies have identified attention deficit and hyperactivity disorder (ADHD) as a key risk factor for internet gaming disorder (IGD), the interplay between ADHD and IGD symptoms with gender differences across cultures remains to be further examined. This study examines the moderating effects of gender in the association between ADHD and IGD across a combined sample of Australian and American gamers.

Stavropoulos V, Adams BLM, Beard, CL, et al. Associations between attention deficit hyperactivity and internet gaming disorder symptoms: Is there consistency across types of symptoms, gender and countries? Addict Behav Rep 2019 doi:10.1016/j.abrep.2018.100158

Addiction medicine in the news

Increasing numbers of children have internet addiction – How worried should parents really be? 
South Korea is one of the world’s most highly connected societies. A recent government survey on smartphone and internet addiction put the share of three to nine-year-old children at high risk of addiction at 1.2% and teenagers at 3.5%. That may not seem a lot, but when it happens, the effects can be devastating. Some of these children are on their phones for at least eight hours a day and lose interest in offline life. Having tried and failed to wean them from their devices, their desperate parents turn to the government, which offers various kinds of counselling, therapy and, in extreme cases, remedial boot camps.

 (The Economist, 4 January 2019)

Companies continue to develop treatments for opioid addiction
In 2018, the United States Food and Drug Administration (FDA) issued a draft guidance that outlined new ways for drug developers to consider measuring and demonstrating the effectiveness and benefits of new or existing medication-assisted treatments (MAT) for patients battling opioid addiction. MAT includes popular drugs, such as buprenorphine, methadone and naltrexone. The medications are prescribed to curb the euphoric effects of opioids and reduce the body’s cravings. Several companies have focused on developing treatments to combat addiction and withdrawal symptoms.

(BioSpace, 22 January 2019)

Cancer patients face opioid addiction risk
The orthodox view is that cancer patients with real pain won't become addicted. This idea arose from the historic fact that patients did not survive long enough to develop an addiction. Today, close to 70% of Australians diagnosed with cancer survive and the reality is that they can become addicted. This means that once they have dealt with their cancer, they may have a new problem on their hands.

(Financial Review, 4 January 2019)

Vaping has created teen nicotine addicts with few treatment options
The US FDA will try to address the spike of young people using e-cigarettes (vaping). According to the US National Youth Tobacco Survey, more than 20% of high school students admitted to using an e-cigarette within the last 30 days – an increase of than 77% since 2017. It is a disturbing trend and one that has parents and doctors scrambling for a reasonable solution.

(CBS News 18 January 2019)

*Inclusion does not imply RACGP endorsement.

RACGP Specific Interests Addiction Medicine and Pain Management on shareGP

RACGP Specific Interests Addiction Medicine has combined with Pain Management to establish a shareGP space. The space provides a platform for members to discuss issues in addiction and pain. It is also an ideal place to share your news and opinions and provide research, clinical or conference updates with like-minded GPs.

The RACGP Specific Interests Addiction Medicine and Pain Management shareGP space is open to all members. Log in to shareGP (you will need your RACGP log in and password).

Specific Interests news

RACGP Specific Interests and Emerging Minds webinar series

There are three webinars remaining in the RACGP Specific Interests / Emerging Minds – National Workforce Centre for Child Mental Health series of on mental health issues for infants and children. 

All webinars will be held at 7.00–8.30 pm AEDT / AEST.

Responding to the mental health needs of infants and toddlers
Thursday 7 March 2019

This webinar examines presentations of mental health difficulties in infants and toddlers, from newborn to three years of age. It explores GP interactions with infants, toddlers and their parents/guardians in ways that effectively support coordinated service responses.

Responding to the mental health needs of school-aged children 
Thursday 4 April 2019

The 2015 Young Minds Matter survey showed that 13.6% of Australian children between four and eleven years old met the criteria for at least one mental health disorder. The ability of GPs to assess issues for school-aged children is critical. This webinar examines the kinds of issues with which school-aged children present, how these issues can be affected by adverse family or schooling circumstances, and how GPs can open helpful and supportive conversations with children and parents/guardians.

The effects of trauma on children’s mental health
Thursday 23 May 2019

A child’s psychological recovery from experiences of trauma, loss and other adverse experiences is often dependent on their network of supportive and nurturing relationships. This webinar examines frameworks that GPs use to remain curious about the circumstances of children affected by trauma, while establishing support networks that assist in recovery.

The webinars are accredited for three Category 2 QI&CPD points for the 2017–19 triennium and are complimentary for RACGP members.

More information and registrations for these webinars are available on the RACGP Specific Interests events page.

Save the date: RACGP / ASPM combined conference

Saturday and Sunday 1–2 June 2019 Melbourne

The RACGP and the Australian Society for Psychological Medicine (ASPM) combined conference 'Trauma-informed care in general practice: Skills for everyday practice' will be held at The Victoria Hotel in Melbourne.

Program and registration details will be available soon.

National news and opportunities

RACGP Foundation grants and awards applications open 5 March

This year, RACGP Foundation is proud to offer 16 research grants and awards to GPs and registrars. Up to half a million dollars is available in general practice research funding. You could play a vital role in shaping the health of Australia.

RACGP Foundation is where general practice research begins.

Online applications open on Tuesday 5 March 2019.

National Close the Gap Day 2019 – Get involved

Thursday 21 March 2019

Most Australians enjoy one of the highest life expectancies of any country in the world, but this is not true for Aboriginal and Torres Strait Islander people.

The Close the Gap campaign was established over a decade ago to work towards closing the health gap and achieving Aboriginal and Torres Strait Islander health equality within a generation. It has transformed from a popular movement into a force that has shaped government policy.

But, there is more to be done!

You can join in and support change during the National Close the Gap Day on Thursday 21 March 2019.

To participate, you can:

  • register your own event
  • attend a Close the Gap event in your area
  • sign the online petition calling for action from governments, or
  • share information with your networks via social media.

No matter how big or small, every action is important to help raise awareness.

For more information and advice, visit the Australians for Native Title and Reconciliation website or email RACGP Aboriginal and Torres Strait Islander Health.  

External news and opportunities*

2019 Oceanic Palliative Care Conference – Call for abstracts closes on Wednesday 6 March 2019

The theme for the inaugural Oceanic Palliative Care Conference (OPCC) is ‘Universal access: Oceans of opportunities’. This conference will examine palliative care as a human right, what can be done to ensure people from underserved populations can access palliative care, and have their pain and other symptoms managed at the end of life.

The conference will promote the concept that palliative care should be available to everyone, regardless of their location, age, income, diagnosis, prognosis, gender, sexual orientation, social background or cultural origin.

Anyone with an interest in palliative care is invited to submit an abstract on the conference theme by Wednesday 6 March 2019.

The conference will be held in Perth, Tuesday to Friday 10–13 September 2019.

2019 Australian Pain Society Annual Scientific Meeting

Sunday to Wednesday 7–10 April 2018

The International Association for the Study of Pain (IASP) has declared 2019 the ‘IASP year against pain in the most vulnerable’. The 2019 Australian Pain Society (APS) Annual Scientific Meeting will reflect on this theme.

This year's meeting will be held on the Gold Coast. Registration is now open. An early registration discount will apply until Friday 22 February 2019.

Disclaimer

*Inclusion does not imply RACGP endorsement

Disclaimer: Every care is taken to reproduce articles accurately, but the publisher accepts no responsibility for errors, omissions or inaccuracies contained therein or for the consequences of any action taken by any person as a result of anything contained in this publication. The content of any advertising or promotional material contained within or mailed with the RACGP Specific Interests newsletter is not necessarily endorsed by the publisher.

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