Drug and Alcohol

Nurses of Australasia

14th Annual Conference

Best Practice:

New Treatments or

Tried and True Methods?

28 & 29 June 2001

AVILLION HOTEL

SYDNEY

WELCOME

The DANA Conference Committee I will like to express our thanks to

Dr Jennifer Gray

Director

Drug Programs Bureau

NSW Health

For financial assistance towards the organisation of this conference.

Members of the DANA Conference Committee are

Meredith Adams

CNC, Department of Drug Health, Concord Hospital

Jennifer Holmes

Nurse Manager, The Langton Centre, Surry Hills

Deb Arthur

CNC, Drug & Alcohol Service, St George Hospital Kogarah

Clare Capus

CNC, Drug and Alcohol, Juvenile Justice

Anthea Brunker

CNC, Drug and Alcohol, Sydney Hospital


Thursday 28 June 2001

Morning Session

0800 Registration / Coffee

0900 Welcome

Charlotte de Crespigny DANA President

0930 Opening & Keynote Address

Professor Lydia Bennet

1000  The Health of Drug Court Participants

Sandra Sunjic

1030 Refreshments

1100 Pharmacotherapy for Nicotine Dependence

Dr Renee Bittoun

1130 What has Buprenorphine to offer?

Kerri Beaumont

1200 Safer Injecting rooms: Harm Minimisation and the Nurse’s role.

Colette McGrath

1230 Lunch


Thursday 28 June 2001

Afternoon Session

1400 Two Concurrent Sessions

A. Community Detoxification Symposium

Gayle Hartley & Helen Taylor

B. Free Papers

Dealing with Aboriginal Clients

Kerrie Doyle

Gaining Perspectives on Psychotropic Medication Use by Diverse Groups of Women in a Rural Community

Julie Watkinson

The Setting up of a “Double Trouble Group”

Norma Christian

A Model for Interventions Involving GPs and D&A Nurses in Rural Settings

Gareth Daniels

1515 Refreshments

1545 Two Concurrent Sessions con’t

A. Workshop: Are you Nervous about Methadone Accreditation?

Mary-Louise White & Jennifer Holmes

B. Free Papers

Using Buprenorphine in an Outpatient Settings

Christine Webster

Rapid Induction to Antagonist

Maryska Wargenau

The Benzodiazepine Withdrawal Project

Kerry Doyle & Fiona Duignan

Odyssey House Detoxification,

Fiona McAllister

1700 Close

1715 DANA Annual General Meeting

Friday 29 June 2001

Morning Session

0800 Registration / Coffee

“The Young Ones”

0900 Families First

Jenny McDonald

0945 Facing the Reality of Adolescent Substance Use

David Leary

1030 Refreshments

1100 Engaging Young People Into Treatment

Gerry McShane

1115 Adolescent Stages of Development

Linda Pfeiffer

1130 Developing Treatment Services for Adolescents

Fran Cole

1145 Dealing with the reality - Adolescents, substance use, Juvenile Justice

Una Champion

1200  Panel Discussion

1230 Lunch


Friday 29 June 2001

Afternoon Session

1400  Two Concurrent Sessions

A.  Learning from Diversity Workshop

Esme Holmes & Max Harrison

B.  Free Papers

Alcohol Dependence Treatment with Acamprosate in an Outpatient Setting

Andrew Taylor

Hospital Experiences of Elderly Men Who Drink Excessively

Nam Dang

Alcohol and the Family

Lorraine Miller

Access, Equity & Best Practice

Justine Bromley

The Pilot Project: initiation of smoking cessation by generalist nurses in the hospital setting.

Robert Ashwood & Sylvia Cowles

1550  Comments & Conference Close

1600 Refreshments


Thursday 28 June 2001

Opening Session – Speaker Biographies & Abstracts

Professor Lydia Bennet

Director, Urban Health Research Unit,

The University of Sydney and Sydney Hospital and Sydney Eye Hospital

Opening & Keynote Address


Notes


Thursday 28 June 2001

Opening Session – Speaker Biographies & Abstracts

Sandra Sunjic - Biography

Coordinator/Senior Nurse Manager

Court Diversion Programs

South Western Sydney Area Health Service

Sandra is a Registered Nurse with 11 years experience in the Drug and Alcohol field. She has a Bachelors Degree in Nursing, a Masters Degree in Clinical Drug Dependence studies, and is now submitting her PhD on “Pathways to Opioid Dependence.” Sandra has worked in a range of clinical settings. More recently, she established and coordinated the Drugs and Pregnancy Service in South Western Sydney. She is currently on secondment to manage the Adult Drug Court, the Youth Drug Court and the Merit Programs in South Western Sydney. Her research on methadone and heroin related deaths has been published in international journals, and she has presented her work at international conferences. She is currently conducting research on chronic pain and opioid dependence, outcomes for neonates of methadone maintained women, and continuing her work on methadone related deaths. Sandra represents the NSW Health Department for the Drugs Module of the National Coroner’s Information, and is a representative on the National Methadone and Other Treatments Committee. In 1999, Sandra was presented with the Inaugural Tedd Noffs Award for her contribution as an Individual to the Drug and Alcohol field.

How healthy are Drug Court Participants?

The NSW Drug Court Program that commenced in February 1999 is undergoing an extensive evaluation by the Bureau of Crime Statistics and Research. This evaluation is primarily focussed on program outcomes and recidivism, with little attention to health issues. Preliminary findings of the small component on health and wellbeing have been positive; showing an improvement in health during participation on the program (Freeman, 2001). However, physical, social, psychological health, and multiple trauma experienced by Drug Court participants has not been addressed in any detail. Therefore, the impact these experiences may have on the individual's ability to address their drug use and crime, and to achieve lifestyle change has not been considered.

The Drug Court team in South Western Sydney has been consistently collecting data on health related issues among its participants. This presentation will outline the prevalence of different forms of abuse experienced during childhood and as an adult, as well as experiences of major physical illness, and mental health problems. Prevalence of sexual and reproductive health problems among women, and men's health problems will be discussed. Specific health issues, such as the prevalence of head injuries and history of overdose will also be presented. The data will be summarised by outlining the multiple trauma experienced by many Drug Court Program participants, and the complexities of providing a comprehensive treatment program to this population will be discussed.

Notes

Thursday 28 June 2001

Morning Session – Speaker Biographies & Abstracts

Dr Renee Bittoun

Director, Smoking Research Unit

Department of Psychological Medicine

University of Sydney

Pharmacotherapy for Nicotine Dependence


Notes


Thursday 28 June 2001

Morning Session – Speaker Biographies & Abstracts

Kerri Beaumont - Biography

Kerri Beaumont is an international marketing consultant and is working with Reckitt Benckiser in their preparations for the launch of Subutex® (buprenorphine) in Australia.

Prior to this Kerri trained as a nurse at St Vincent’s in Sydney and worked in A&E at RNSH before joining the pharmaceutical industry, firstly in sales and marketing in Australia before being seconded to the UK in the early 1990s.

As a consultant she has worked with other pharmaceutical companies in the area of CNS – mainly psychosis and substance abuse.

What has Buprenorphine to offer?

Notes

Thursday 28 June 2001

Morning Session – Speaker Biographies & Abstracts

Colette McGrath - Biography

Colette trained as a RN/ RMN in London UK and has worked in the Alcohol and Drugs area for over 10 years. She has worked in the HIV/AIDS area before becoming interested in working with Injecting Drug Users. She then took up a post in the Community working under a harm Minimisation model followed by an appointment as the Deputy Manager in a community drug team in north London setting up a needle syringe, methadone and outreach service.

In 1995 she migrated to Australia where she took up a Clinical Nurse Consultant position at a private clinic in the Eastern Suburbs. In 1997 she was employed at the Kirketon Road Centre as Nurse unit Manager. For the past 2 years she has been working in the capacity of Acting Assistant Director at the Kirketon Road Centre and more recently as Project Manager. Colette is very familiar with the Kings Cross area having worked with the local population there for the past five years.

Safer Injecting rooms: Harm Minimisation and the Nurse’s role.

In May 1999, the Carr Government held the NSW Drug Summit. One of the most innovative and controversial recommendations was that a Medically Supervised Injecting Centre [MSIC] be trialed in Kings Cross. A MSIC is a legally sanctioned facility where injecting drug users can use drugs under medical supervision gaining access to treatment in case of overdose, being able to access clean injecting equipment, and safe disposal of injecting equipment. The aim of the MSIC is to, reduce deaths from overdose, reduce the spread of blood borne viruses, reduce problems associated with public injecting, and provide access to treatment.

The MSIC if successful is likely to be adopted as part of accepted treatment within the Alcohol and other Drugs field. If so, how do we as professionals prepare ourselves for this type of work and extension of the role? Nurses will ultimately play a crucial role in their operation and developing the model for further MSICs if the trial is successful.

Issues that the Registered Nurse will need to consider if working in an MSIC include having, up to date knowledge of pharmacology and drug trends especially on the local street scene. What advice to give re injecting specific types of drugs e.g.: Methadone, Tablets. Good knowledge of anatomy and physiology, in relation to giving safe injecting advice. Ability to assess for intoxication. CPR and overdose management skills. Counselling and crisis/aggression management skills. Knowledge of HIV, Hep B &C.

This is without doubt one of the biggest challenges that Nurses have had to face in the Alcohol and Drugs field to date and to many it will be the next logical step in Harm Minimisation. Nurses will have much to consider re: their role in MSICs and it is important to get it right from the outset both professionally and for the sake of the success of the project.

Notes


Thursday 28 June 2001

Afternoon Session – Speaker Biographies & Abstracts

Helen Taylor – Biography

Qualified in Dietetics, Vocational Education and Public Health. Formerly
Policy Analyst, Hepatitis, NSW Health. Currently working in Hepatitis
projects at Albion Street Centre, and evaluation of Community Detox
Services, Central Coast Health. Previous projects include piloting
hepatitis screening and HB vaccination for methadone clients in South
Western Sydney, and lack of) for claims made about nutrition and hepatitis C
and making evidence-based nutrition advice for people with hepatitis C
(supported by the Dietitians Association of Australia) on the web via the
Albion Street Centre website.

Community Detoxification Symposium

Organised by Central Coast Community Detox Service (CDS)

Facilitator: Helen Taylor, Research & Evaluation Offr, Central Coast CDS

Presenter 1: Mario Fantini, Nurse Manager, A& OD, Central Coast Health

Presenter 2: Gayle Hartley, CNE, Central Coast Community Detox Service Presenter 3: Lorraine Gaunt, NUM, Ambulatory Detox, Western Sydney AHS

Presenter 4: Brett Ross, NUM, Assessment Unit, Langton Centre

Purpose of symposium : gathering together professionals with experience in detox service provision to share experiences and note any consensus.

Speakers from detox programs using various models of service:

1.  Overview of issues in detoxification, Mario Fantini,

2.  Central Coast Home detox program, Gayle Hartley

3.  Ambulatory Detox Services, Western Sydney, Lorraine Gaunt

4.  Detox Services at Langton Centre, Brett Ross

Question time/Panel discussion and participant brainstorm

  1. Issues that need to be considered when considering implementing a home detox service?
  2. Circumstances in which home or outpatient detox works and when it doesn’t work?

3.  What kinds of professionals have been involved to date / might potentially be involved to assist in the process of detoxification and aftercare or support?

4.  Identify if possible, any training needs for staff at commencement of working in detox services; are these needs best met “on the job” or could a short course or workshop be developed to prepare staff for this work?

  1. What do we think are the priorities for future service-implementation research in this area or work?

Summary, evaluation and close (10mins).

Notes


Thursday 28 June 2001

Afternoon Session – Speaker Biographies & Abstracts

Kerrie Doyle - Biography

I was born on an Aboriginal mission in the Northern Territory, leaving at the age of 8. I completed general nursing training in 1977 at Gosford Hospital, psychiatric nursing at Gladesville in 1979, and Mental Retardation in 1982. Since then, I have completed a BA (Psychology), a Grad Dip App Sci (Clinical Drug Dependence Studies), M. Indigenous Health, M. Health Management, and am currently a PhD Candidate (Aboriginal Studies). I am currently NUM III of the Surgical Units at Wyong Hospital, on secondment as the Project Coordinator of Benzodiazepine Withdrawal Project with the AODS, CCH. I am the regional representative of CATSIN, and was a member of the NSW Nursing Project on AODS. I am married to a Maori, live on the central coast of NSW with my sons and a poodle named Tumatauenga. The rest is subject to change without notice.

Dealing with Aboriginal Clients

Aboriginal and Torres Strait Islander people remain alienated from mainstream society by numerous sociological methods. This can make dealing with Aboriginal clients especially challenging. The critical issue is cultural safety, that is, the ability to move across cultural borders in an appropriate manner. In order to do this, the clinician needs to be aware of black communication methods, and fit a model of interaction to the needs of the client. The most appropriate model of interaction is Egan’s unconditional positive regard. This paper presents a workable model of interaction between non-Aboriginal and Aboriginal people we tried at Wyong hospital. We evaluated it by measures of non-specific objectivity and found the introduction and education of the model to be significant (p>0.5) in Aboriginal client satisfaction, and clinician satisfaction. However, each clinician must needs remember that each Aboriginal person is distinct, and no one style will ensure effective pan-Aboriginal communication.


Notes


Thursday 28 June 2001

Afternoon Session – Speaker Biographies & Abstracts

Julie Watkinson - Biography

Flinders University, Adelaide, Australia.

Currently employed as Lecturer in School of Nursing and Midwifery, Flinders University. Coordinate the Graduate Certificate in Health (Alcohol and Other Drugs). Also employed by Drug and Alcohol Services Council, working in inpatient detox areas in Adelaide. Qualifications: BN, Grad Cert in Health (Alcohol and Other Drugs), MEd. In progress to PhD at Flinders University. This conference paper relates to PhD Women’s Well-being Study, which is concerned with women’s health and psychotropic drug use in middle-age.