Biomedical subjects

Toni Makkai

Publications and source records attributed to Toni Makkai.

4 recordsLinked to original sources

PubMed2003

Supply control and harm reduction: lessons from the Australian heroin 'drought'.

AIMS: To examine the effects of supply-side drug law enforcement on the dynamics of the Australian heroin market and the harms associated with heroin. SETTING: Around Christmas 2000, heroin users in Sydney and other large capital cities in Australia began reporting sudden and significant reductions in the availability of heroin. The changes, which appear to have been caused at least in part by drug law enforcement, provided a rare opportunity to examine the potential impact of such enforcement on the harm associated with heroin. DESIGN: Data were drawn from a survey of 165 heroin users in South-Western Sydney, Australia; from the Drug Use Monitoring in Australia (DUMA) project; from NSW Health records of heroin overdoses; and from the Computerized Operational Policing System (COPS) database. FINDINGS: Heroin price increased, while purity, consumption and expenditure on the drug decreased as a result of the shortage. The fall in overall heroin use was accompanied by a significant reduction in the rate of overdose in NSW. However, the health benefits associated with the fall in overdose may have been offset by an increase in the use of other drugs (mainly cocaine) since the onset of the heroin shortage. There does not appear to have been any enduring impact on crime rates as a result of the heroin 'drought'. CONCLUSION: Supply control has an important part to play in harm reduction; however, proponents of supply-side drug law enforcement need to be mindful of the unintended adverse consequences that might flow from successfully disrupting the market for a particular illegal drug.

Adult↗

PubMed2003

The monitoring of drug trends in Australia.

Recently, there has been increased recognition of the importance of drug information systems (DIS), highlighting the need for an internationally coordinated approach to data collection and advocating the regular assessment of a range of areas. Accurate information provides policy makers with the evidence to evaluate current strategies and to plan future strategies. An effective drug information system (DIS) must collect comprehensive, detailed and in-depth data, while also being sensitive to emergent trends and placing these changes into the context of longer-term trends. An integrated and comprehensive system combines both sensitive (or lead) and slower but more reliable lag indicators. This article reviews conceptual frameworks for DIS and developments in international systems. It then considers the range of DIS in Australia and then describes two integrated monitoring systems with an early warning function: the Illicit Drug Reporting System (IDRS) and the Drug Use Monitoring Australia (DUMA) Programme. Both systems collate sensitive lead indicators, and provide timely information about emerging drug trends in Australia. Together, these two systems are best-placed to provide effective early warning of new trends in illicit drug markets, and constitute an important component of the overall approach to the monitoring of drug use and associated harms in Australia.

Australia↗

PubMed2003

Computerisation in Australian general practice.

AIM: To assess the current levels of computer use in Australian general practice, and identify clinical and administrative tasks for which computers are most commonly used by general practitioners. METHODS: A telephone survey of a nationally representative sample of Australian GPs in active practice (n = 1202). RESULTS: The national response rate was 55.5%, with New South Wales, Tasmania and the Australian Capitol Territory recording lower than national rates, and Queensland, Western Australia and the Northern Territory recording higher rates. Australian general practices were highly computerised (86%). General practitioners practising in capital cities were less likely to be computerised than their rural colleagues (p < .001). There were no significant differences in general computerisation among practices in the Australian states and territories (p > .05). Three task sets for which computers were used were identified: general administrative functions, patient oriented administrative functions and clinical functions. Computers were more likely to be used for administrative than clinical tasks. Use for administrative tasks increased with the size of the practice (p < .001) and with years of computer use (p < .001). DISCUSSION: The results suggest that within two years 95% of Australian general practices will be computerised. While use of computers for clinical functions is less common than for administrative purposes, electronic script writing packages are widely employed. However, other theoretically valuable functions for improving clinical outcomes for patients, such as patient educational material and decision support systems, are the least commonly used.

Australia↗

PubMed2002

The emergence of drug treatment courts in Australia.

The paper begins by placing the emergence of drug treatment courts within the context of rising property crime rates, the development of open-air illicit drug markets, and the rise in opiate overdoses in Australia. The paper then highlights the way in which the U.S. concept of drug treatment courts was adopted and adapted by state politicians in attempts to deal with drug-use-related offenders. This response has been specifically targeted at repeat property offenders "at risk" of imprisonment, and comes within the broad brush of harm minimization strategies for diverting offenders with a drug-use-related problem away from the traditional criminal justice response of imprisonment. The prospects for the future of drug treatment courts in a Federalist system are also discussed.

Australia↗