Large-scale data analysis studies
Physical health in people receiving treatment for substance use
People treated for substance use problems also have an increased risk of many physical and mental health problems. Some of these problems, such as hepatitis C viral infection or the risk of suicide, have been researched extensively. However, long-term, potentially preventable, conditions such as skin and soft-tissue infections, liver disease, and breathing problems are poorly researched, despite becoming more common in this group. We are investigating the morbidity, mortality, and healthcare utilisation attributable to these conditions, and associated risk factors, in people treated for substance use.
Substance use in emergency psychiatric care
Alcohol and drug intoxication is a serious problem in emergency psychiatric care. Around a third of people detained using emergency police powers under the Mental Health Act (1983 amended 2007) and taken to a health-based Place of Safety are intoxicated. These service users are significantly more likely to be detained again compared to those not intoxicated at detention. Despite this, there are no specific care pathways for people who are intoxicated when detained. This is likely due to difficulties in assessing substance use type and severity during detention, and lack of evidence on which to base guidelines. Our research addresses this using a combination of electronic health record research and service model development, collaborating with the new South London and Maudsley NHS Foundation Trust (SLaM) centralised Place of Safety staff and service users.
Polysubstance use and risk behaviours
Polysubstance use, the use of multiple substances within a given timeframe, is associated with increased risk of acute toxicity including overdose, adverse psychological experiences and engaging in high-risk behaviours such as violence and unprotected sex. We are interested in characterising patterns of polysubstance use and differential relationships with risk behaviours. Much of this work has been done in collaboration with Dr Adam Winstock, using the Global Drug Survey.
Impact of cannabinoid use on opioid substitution treatment
In the United States, rates of opioid related deaths are lower in those states where medical cannabis is available, raising the question of whether cannabis use has an impact on opioid substitution treatment. The aim of this study is to investigate whether service users receiving OST who also use cannabis have better treatment outcomes. We are using the SLaM NIHR Biomedical Research Centre electronic health record collection for this work.