TracyS 💉💉💉💉💉

AI can help identify pharmacological targets to either develop new pharmacotherapies or repurpose existing medications.

#IMiA25 session on AI in clinical practice. AI can do the "grunt work" allowing clinicians to focus on higher level work - as long as we know how to use it. Why do we need AI - there is so much more data that work with in health and AI will make it more effective and efficient.

AI potential for personally targeting treatment for patients by phenotyping patients. In addiction medicine phenotyping patients can assist in selection of therapies more likely to work. In adolescent health AI has been used to help identify young people at risk of substance use.

How can AI help? Automating clinical documentation. Improve clinical safety by better identifying high risk patients and situations. Gathering information to improve evidence based practice.

Consider using a compounding pharmacy to arrange non standard doses to facilitate a slow reduction/taper in dose.

#IMiA25 session on benzodiazepine deprescribing

Comorbidities common in elderly patients. Important not to attribute all of the issues to benzodiazepines. Role of aged care services and "end of life" care.

case discussion - elderly patient prescribed diazepam for general anxiety disorder now having increasing problems with cognition, falls and drowsiness. Planned approach focussing on what the patient's concerns priorities are. Importance of reaching a shared understanding.

exploring clinician views on benzodiazepine deprescribing - many clinicians find it challenging for various reasons

Chronic benzodiazepine treatment in elderly patient with increasing falls and cognitive decline. Importance of not forgetting other causes of falls and cognitive issues - don't blame everything on benzodiazepines.

#IMiA25 session on complex comorbidities

Managing comorbid alcohol use disorder and mood disorder. If the antidepressant is not effective is it worth changing dose/agent where the patient is still drinking? Importance of providing psychosocial options as well before changing medication.

Management of acute pain in patients on depot buprenorphine treatment. Challenge in achieving analgesia in context of opioid blockade from buprenorphine.

Increase in cannabis related hospital presentations; increase in mental health presentations. Increase in child presentations related to edibles.

#IMiA25 session on cannabis legalisation in Canada from Dr Janni Leung

Increased risk in cannabis related road traffic risks following legalisation. Increase in THC found in toxicology tests on impaired drivers.

Increase in daily/regular use following legalisation. Increase in proportion of cannabis users who would meet the criteria for cannabis use disorder.

Following legalisation: Reduction in cannabis related arrests. Reduction in illegal purchasing and increase in purchasing from legal sourced; reduction in household expenditure on cannabis; reduction in price. Increased potency of cannabis. Increase in proportion of edibles.

Low threshold, flexible buprenorphine treatment improved retention in care. Telemedicine has improved accessibility but there are still barriers to some - digital divide.

#IMiA25 #Addiction treatment conference. Session on mobile care of addiction treatment to improve access given by Dr Kathleen Page. Low threshold buprenorphine treatment. In USA methadone much more heavily regulated so harder to provide in a mobile model.

Evaluating effectiveness. Governments are intrested in impact population wide - health costs, social impact. For clinicians how do we know whether the treatment is helping our individual patients?