Who Are Dispensed the Bulk Amount of Prescription Opioids?

M. Islam; Dennis Wollersheim

doi:10.3390/jcm8030293

Who Are Dispensed the Bulk Amount of Prescription Opioids?

Journal of Clinical Medicine ◽

10.3390/jcm8030293 ◽

2019 ◽

Vol 8 (3) ◽

pp. 293 ◽

Cited By ~ 5

Author(s):

M. Islam ◽

Dennis Wollersheim

Keyword(s):

Multilevel Models ◽

New South ◽

Prescription Opioids ◽

Defined Daily Dose ◽

Health Crisis ◽

Public Health Crisis ◽

Adverse Health Outcomes ◽

South Wales ◽

Daily Dose ◽

Chronic Use

Background: Excessive and non-medical use of prescription opioids is a public health crisis in many settings. This study examined the distribution of user types based on duration of use, trends in and associated factors of dispensing of prescription opioids in New South Wales and Victoria, Australia. Methods: 10% sample of unit-record data of four-year dispensing of prescription opioids was analysed. Quantities dispensed were computed in defined daily dose (DDD). Multilevel models examined factors associated with the duration of dispensing and the quantity dispensed in local government areas. Results: Overall, 53% were single-quarter, 37.3% medium-episodic (dispensed 2–6 quarters), 5% long-episodic (dispensed 7–11 quarters) and 5% were chronic users (dispensed 12–14 quarters). More than 80% of opioids in terms of DDD/1000 people/day were dispensed to long-episodic and chronic users. Codeine and oxycodone were most popular items—both in terms of number of users and quantity dispensed. Duration of dispensing was significantly higher for women than men. Dispensing quantity and duration increased with increasing age and residence in relatively poor neighborhoods. Conclusions: Although only 5% were chronic users, almost 60% of opioids (in DDD/1000 people/day) were dispensed to them. Given that chronic use is linked to adverse health outcomes, and there is a progression toward chronic use, tailored interventions are required for each type of users.

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Protest, policing and law during COVID-19: On the legality of mass gatherings in a health crisis

Alternative Law Journal ◽

10.1177/1037969x211029963 ◽

2021 ◽

pp. 1037969X2110299

Author(s):

Greg Martin

Keyword(s):

Legal Status ◽

New South ◽

Community Safety ◽

Health Crisis ◽

Mass Gatherings ◽

Terror Attacks ◽

Public Health Crisis ◽

Protest Policing ◽

South Wales ◽

Emergency Measures

This article considers the legal status of protest rights in Australia during the COVID-19 public health crisis. It discusses jurisprudence of the New South Wales Supreme Court regarding the legality of mass gatherings for the purpose of protest during the COVID pandemic. Balancing protest rights with risks to community safety posed by possible coronavirus transmission at public assemblies, the Court has sometimes allowed and sometimes prohibited protests. The article critically examines the policing of protest during the pandemic and explores some of the implications of comparing emergency measures introduced during the COVID crisis with similar measures introduced in the wake of the 9/11 terror attacks.

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Trends and Variations in Concurrent Dispensing of Prescription Opioids and Benzodiazepines in Australia: A Retrospective Analysis

Contemporary Drug Problems ◽

10.1177/0091450920919443 ◽

2020 ◽

Vol 47 (2) ◽

pp. 136-148

Author(s):

M. Mofizul Islam ◽

Dennis Wollersheim

Keyword(s):

Age Groups ◽

Population Level ◽

Prescription Opioids ◽

Defined Daily Dose ◽

Structural Factors ◽

Multilevel Regression ◽

Individual Level ◽

Adverse Health Outcomes ◽

Concurrent Use ◽

Yearly Average

Objective: Concurrent use of opioids and benzodiazepines may cause a range of adverse health outcomes including fatal overdose. However, little is known about levels of concurrent use and its variation across jurisdictions. This study examined the population-level prevalence of concurrent use in Australia. Methods: We analyzed a 10% sample of unit record data of prescription opioids and benzodiazepines dispensed between January 2013 and December 2016. Using dispensing dates and days of supply in terms of defined daily dose (DDD), the concurrent users were identified as those for whom the supply in DDD quantity for one medicine overlapped with the supply day of the other. Multivariable and multilevel regression models were developed. Results: During the 4 years, almost a million (12.41% of 7.96 million) individuals were identified as concurrent users. Significantly more women were concurrent users than men across all age groups. On average, 1,750 per 100,000 people were concurrent users per year. There was substantial variation in the yearly average of concurrent users across jurisdictions, ranging from less than 1 to 5,400 per 100,000 people (standardized). Much of this variation was attributed to individual-level circumstances rather than structural factors. Conclusion: Concurrent use of opioid and benzodiazepine was common in Australia. There was considerable variation across jurisdictions in terms of the number of concurrent users. Women, older people, or those living in socioeconomically disadvantaged areas were dominant groups of concurrent users. Further research is needed to examine the precise reasons for concurrent use.

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Quantifying Waterfowl Numbers: Comparison of Drone and Ground-Based Survey Methods for Surveying Waterfowl on Artificial Waterbodies

Drones ◽

10.3390/drones5010005 ◽

2021 ◽

Vol 5 (1) ◽

pp. 5

Author(s):

Shannon J. Dundas ◽

Molly Vardanega ◽

Patrick O’Brien ◽

Steven R. McLeod

Keyword(s):

Multilevel Models ◽

New Technologies ◽

New South ◽

Survey Methods ◽

Survey Method ◽

Informative Priors ◽

South Wales ◽

The Difference ◽

Large Groups ◽

Aerial Perspective

Drones are becoming a common method for surveying wildlife as they offer an aerial perspective of the landscape. For waterbirds in particular, drones can overcome challenges associated with surveying locations not accessible on foot. With the rapid uptake of drone technology for bird surveys, there is a need to compare and calibrate new technologies with existing survey methods. We compared waterfowl counts derived from ground- and drone-based survey methods. We sought to determine if group size and waterbody size influenced the difference between counts of non-nesting waterfowl and if detection of species varied between survey methods. Surveys of waterfowl were carried out at constructed irrigation dams and wastewater treatment ponds throughout the Riverina region of New South Wales (NSW), Australia. Data were analyzed using Bayesian multilevel models (BMLM) with weakly informative priors. Overall, drone-derived counts of waterfowl were greater (+36%) than ground counts using a spotting scope (β_ground= 0.64 [0.62–0.66], (R2 = 0.973)). Ground counts also tended to underestimate the size of groups. Waterbody size had an effect on comparative counts, with ground counts being proportionally less than drone counts (mean = 0.74). The number of species identified in each waterbody type was similar regardless of survey method. Drone-derived counts are more accurate compared to traditional ground counts, but drones do have some drawbacks including initial equipment costs and time-consuming image or photo processing. Future surveys should consider using drones for more accurately surveying waterbirds, especially when large groups of birds are present on larger waterbodies.

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