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Addiction psychiatry training: Lessons WA can learn from NSW

Monday July 27, 2020

Dr Kavita Seth, Senior Consultant Psychiatrist Addiction Medicine Specialist

The use of substances including nicotine, cannabis, methamphetamines, alcohol and other illicit drugs remains an enormous public health issue in Western Australia.

According to the 2019 National Drug Strategy Household Survey, 15.6 per cent of Western Australians aged 14 and above were reported to have used an illicit drug in the past 12 months.1

A plethora of studies has emphasised the correlation of substance use and mental health disorders especially amongst the youth,2,3 causing short-term social problems, violence and long-term effects on physical health and cognition.4

Due to the major impacts of substance addiction on patients, their families and the wider community, there has been increased recognition of the significance of education in Addiction Psychiatry in order to improve clinical care delivery to patients with substance use and comorbid mental health disorders.5

In New South Wales, there is a robust Addiction Psychiatry training structure that enables psychiatric trainees to complete their advanced training in each of the five basic training networks in the State.6 There is also a state-wide director of advanced training in Addiction Psychiatry who oversees the quality of training delivered within each network and monitors the progress of every Addiction Psychiatry registrar during their training journey in NSW.

Having been part of the Subcommittee of Advanced Training in Addiction Psychiatry in NSW and a deputy clinical director of Drug and Alcohol in Justice Health NSW, I have realised that the Addiction Psychiatry training program is unfortunately not replicated here in Western Australia.

WA has the highest methamphetamine use compared to other states (2.7 per cent in WA, well above the national average of 1.4 per cent)7 leading to serious public health concerns.

Inadequate knowledge and training in the treatment of substance use with comorbid mental health disorders could contribute to the deficient management of this highly vulnerable patient cohort.8

It couldn’t be more crucial, therefore, for WA to have a well mapped out and properly resourced training program for psychiatric trainees who are passionate about Addiction Medicine. The alternative is a high price for Western Australians to pay – valuable trainees moving to other states for training and eventually securing Addiction Psychiatry jobs outside of WA.

Health services within WA have the responsibility to create accredited Addiction Psychiatry training positions to expose psychiatric trainees to hospital drug and alcohol liaison, outpatient drug and alcohol clinics, opioid substitution therapies, chronic pain management, gambling and other behavioural addiction treatments as seen in NSW.

Having been a supervisor to many Addiction Psychiatry advanced trainees and GP trainees with a special interest in addiction in NSW, I strongly believe WA should review its training program in Addiction Psychiatry in order to retain its valuable accredited trainees within our State and ultimately, improve clinical care delivery to addiction patients with comorbid mental health disorders.

 

References available upon request.