trends in alcohol and drug related ambulance attendances in

Ambo Project: Alcohol and Drug Related Ambulance Attendances

TRENDS IN ALCOHOL AND DRUG RELATED AMBULANCE ATTENDANCES

IN VICTORIA 2012/13

Belinda Lloyd

Sharon Matthews

Caroline X.Gao

December 2013

Ambo Project: Alcohol and Drug Related Ambulance Attendances

TRENDS IN ALCOHOL AND DRUG RELATED

AMBULANCE ATTENDANCES IN

VICTORIA 2012/13

Belinda Lloyd

Sharon Matthews

Caroline X.Gao

May 2014

Ambo Project: Alcohol and Drug Related Ambulance Attendances is a collaboration between Turning Point and Ambulance Victoria, and is funded by the Victorian Department of Health

Trends in alcohol and drug related ambulance attendances in Victoria: 2012/13. Copyright 2014

State of Victoria. Produced with permission from the Victorian Minister for Mental Health.

Unauthorised reproduction and other uses comprised in the copyright are prohibited without

permission.

This work is copyright. Apart from any use as permitted under the Copyright Act 1968, no part may be

reproduced by any process without permission. Copyright enquiries can be made to the

Communications and Publications Unit, Turning Point, 54-62 Gertrude Street, Fitzroy, Victoria 3065,

Australia. ‘Ambo project: alcohol and drug related ambulance attendances’ is funded by the Mental

Health, Drugs and Regions Division of the Department of Health.

Published by Turning Point

May 2014

ISBN: 978-1-74001-011-5 (ebook)

The correct citation for this publication is: Lloyd B., Matthews S., Gao X.C. (2014). Trends in alcohol

and drug related ambulance attendances in Victoria: 2012/13. Fitzroy, Victoria: Turning Point

Ambo Project: Alcohol and Drug related Ambulance Attendances – 2012/13 Annual Report Page v

Contents

Contents ........................................................................................................................... v

List of Tables ................................................................................................................... ix

List of Figures .................................................................................................................. xi

List of Maps ................................................................................................................... xiii

Preface ........................................................................................................................... xiv

Acknowledgements ........................................................................................................ xv

Acronyms ....................................................................................................................... xvi

Summary .......................................................................................................................... 1

Chapter 1: Introduction..................................................................................................... 6

Non-fatal versus fatal heroin overdose ..................................................................................... 6

Ambulance service records ....................................................................................................... 6

The current report .................................................................................................................... 7

Chapter 2: Methods .......................................................................................................... 8

Data generated from VACIS® .................................................................................................... 8

Data auditing and quality control .............................................................................................. 8

Definition of drug involvement/overdose used in this report ..................................................... 9

Mapping of alcohol- and drug-related ambulance attendances ................................................ 11

Population estimates ............................................................................................................. 11

Chapter 3: Alcohol-Related Attendances (Alcohol Only)................................................... 12

Characteristics of alcohol-related attendances ........................................................................ 12

Day of week and time of day of alcohol-related attendances ................................................... 12

Alcohol-related attendances in local government areas ........................................................... 14

Trends over time in alcohol-related attendances ..................................................................... 20

Chapter 4: Cannabis-Related Attendances ...................................................................... 22

Characteristics of cannabis-related attendances ...................................................................... 22

Day of week and time of day of cannabis-related attendances ................................................ 22

Cannabis-related attendances in local government areas ........................................................ 24

Trends over time in cannabis-related attendances .................................................................. 30

Chapter 5: Ecstasy-Related Attendances ......................................................................... 32

Characteristics of ecstasy-related attendances ........................................................................ 32

Day of week and time of day of ecstasy-related attendances ................................................... 32

Ecstasy-related attendances in local government areas ........................................................... 34

Trends over time in ecstasy-related attendances ..................................................................... 38

Ambo Project: Alcohol and Drug related Ambulance Attendances – 2012/13 Annual Report Page vi

Chapter 6 All Amphetamine-Related Attendances ........................................................... 40

Characteristics of all amphetamine-related attendances ......................................................... 40

Day of week and time of day of all amphetamine-related attendances .................................... 41

All amphetamine-related attendances in local government areas ............................................ 42

Trends over time in all amphetamine-related attendances ...................................................... 48

Chapter 7 Crystal Methamphetamine-Related Attendances ............................................ 50

Characteristics of crystal methamphetamine-related attendances ........................................... 50

Day of week and time of day of crystal methamphetamine-related attendances ...................... 51

Crystal methamphetamine-related attendances in local government areas ............................. 52

Trends over time in crystal methamphetamine-related attendances ....................................... 54

Chapter 8: Other Amphetamine-Related Attendances ..................................................... 56

Characteristics of other amphetamine-related attendances..................................................... 56

Day of week and time of day of other amphetamine-related attendances ............................... 56

Other amphetamine-related attendances in local government areas ....................................... 58

Trends over time in other amphetamine-related attendances ................................................. 59

Chapter 9: Benzodiazepine-Related Attendances ............................................................ 61

Characteristics of benzodiazepine-related attendances ........................................................... 61

Day of week and time of day of benzodiazepine-related attendances ...................................... 61

Benzodiazepine-related attendances in local government areas .............................................. 63

Trends over time in benzodiazepine-related attendances ........................................................ 69

Chapter 10: Inhalant-Related Attendances ...................................................................... 71

Characteristics of inhalant-related attendances ...................................................................... 71

Day of week and time of day of inhalant-related attendances ................................................. 71

Inhalant-related attendances in local government areas ......................................................... 73

Trends over time in inhalant-related attendances ................................................................... 77

Chapter 11: All Heroin-Related Attendances ................................................................... 79

Characteristics of all heroin-related attendances ..................................................................... 79

Day of week and time of day of all heroin-related attendances ............................................... 79

All heroin-related attendances in local government areas ....................................................... 81

Trends over time in all heroin-related attendances ................................................................. 86

Chapter 12: Heroin Overdose (Responding to Naloxone) Attendances ............................. 88

Characteristics of heroin overdose attendances (responding to naloxone) ............................... 88

Day of week and time of day of heroin overdose attendances (responding to naloxone) .......... 88

Heroin overdose attendances (responding to naloxone) in local government areas .................. 90

Trends over time in heroin overdose attendances (responding to naloxone) ............................ 91

Ambo Project: Alcohol and Drug related Ambulance Attendances – 2012/13 Annual Report Page vii

Chapter 13: Other Heroin-Related Attendances ............................................................... 93

Characteristics of other heroin-related attendances ................................................................ 93

Day of week and time of day of other heroin-related attendances ........................................... 93

Other heroin-related attendances in local government areas .................................................. 95

Trends over time in other heroin-related attendances ............................................................. 96

Chapter 14: GHB-Related Attendances ............................................................................ 98

Characteristics of GHB-related attendances ............................................................................ 98

Day of week and time of day of GHB-related attendances ....................................................... 98

GHB-related attendances in local government areas ............................................................. 100

Trends over time in GHB-related attendances ....................................................................... 105

Chapter 15: Anticonvulsant-Related Attendances .......................................................... 107

Characteristics of anticonvulsant-related attendances........................................................... 107

Day of week and time of day of anticonvulsant-related attendances ..................................... 107

Anticonvulsant-related attendances in local government areas ............................................. 109

Trends over time in anticonvulsant-related attendances ....................................................... 114

Chapter 16: Antidepressant-Related Attendances ......................................................... 116

Characteristics of antidepressant-related attendances .......................................................... 116

Day of week and time of day of antidepressant-related attendances ..................................... 116

Antidepressant-related attendances in local government areas ............................................. 118

Trends over time in antidepressant-related attendances ....................................................... 124

Chapter 17 Antipsychotic-Related Attendances ............................................................. 126

Characteristics of antipsychotic-related attendances ............................................................. 126

Day of week and time of day of antipsychotic-related attendances........................................ 126

Antipsychotic-related attendances in local government areas ............................................... 128

Trends over time in antipsychotic-related attendances ......................................................... 134

Chapter 18 Opioid Analgesic-Related Attendances ........................................................ 136

Characteristics of opioid analgesic-related attendances ......................................................... 136

Day of week and time of day of opioid analgesic-related attendances ................................... 136

Opioid analgesic-related attendances in local government areas ........................................... 138

Trends over time in opioid analgesic-related attendances ..................................................... 144

Chapter 19: Other Analgesic-Related Attendances ........................................................ 146

Characteristics of other analgesic-related attendances .......................................................... 146

Day of week and time of day of other analgesic-related attendances ..................................... 146

Other analgesic-related attendances in local government areas ............................................ 148

Trends over time in other analgesic-related attendances ....................................................... 154

Ambo Project: Alcohol and Drug related Ambulance Attendances – 2012/13 Annual Report Page viii

Chapter 20: Cocaine-Related Attendances ..................................................................... 156

Characteristics of cocaine-related attendances...................................................................... 156

Day of week and time of day of cocaine-related attendances ................................................ 156

Cocaine-related attendances in local government areas ........................................................ 158

Trends over time in cocaine-related attendances .................................................................. 162

Chapter 21: Summary of findings .................................................................................. 164

References.................................................................................................................... 168

Appendix ...................................................................................................................... 169

Ambo Project: Alcohol and Drug related Ambulance Attendances – 2012/13 Annual Report Page ix

List of Tables

Table 1: Alcohol- and drug-related attendances in metropolitan Melbourne, regional Victoria, and Victoria - 2012/13 ................................................................................................................................................... 1

Table 2: Numbers of metropolitan Melbourne and regional Victoria attendances by drug - 2012/13 compared with 2011/12 .......................................................................................................................... 2

Table 3: Characteristics of alcohol-related attendances - 2011/12 and 2012/13 ............................................ 12 Table 4: Numbers of alcohol-related attendances by local government area in metropolitan Melbourne -

2011/12 and 2012/13 ............................................................................................................................ 15 Table 5: Numbers of alcohol-related attendances by local government area in regional Victoria - 2011/12

and 2012/13 .......................................................................................................................................... 16 Table 6: Characteristics of cannabis-related attendances - 2011/12 and 2012/13.......................................... 22 Table 7: Numbers of cannabis-related attendances by local government area in metropolitan Melbourne -

2011/12 and 2012/13 ............................................................................................................................ 25 Table 8: Numbers of cannabis-related attendances by local government area in regional Victoria - 2011/12

and 2012/13 .......................................................................................................................................... 26 Table 9: Characteristics of ecstasy-related attendances - 2011/12 and 2012/13 ............................................ 32 Table 10: Numbers of ecstasy-related attendances by local government area in metropolitan Melbourne -

2011/12 and 2012/13 ............................................................................................................................ 34 Table 11: Numbers of ecstasy-related attendances by local government area in regional Victoria - 2011/12

and 2012/13 .......................................................................................................................................... 34 Table 12: Characteristics of all amphetamine-related attendances - 2011/12 and 2012/13 ........................... 40 Table 13: Numbers of all amphetamine-related attendances by local government area in metropolitan

Melbourne - 2011/12 and 2012/13 ........................................................................................................ 43 Table 14: Numbers of all amphetamine-related attendances by local government area in regional Victoria -

2011/12 and 2012/13 ............................................................................................................................ 44 Table 15: Characteristics of crystal methamphetamine-related attendances - 2011/12 and 2012/13 ............ 50 Table 16: Numbers of crystal methamphetamine-related attendances by local government area in

metropolitan Melbourne - 2011/12 and 2012/13 .................................................................................. 53 Table 17: Numbers of crystal methamphetamine-related attendances by local government area in regional

Victoria - 2011/12 and 2012/13 ............................................................................................................. 54 Table 18: Characteristics of other amphetamine attendances - 2011/12 and 2012/13 .................................. 56 Table 19: Numbers of other amphetamine-related attendances by local government area in metropolitan

Melbourne - 2011/12 and 2012/13 ........................................................................................................ 58 Table 20: Numbers of other amphetamine-related attendances by local government area in regional Victoria

- 2011/12 and 2012/13 .......................................................................................................................... 59 Table 21: Characteristics of benzodiazepine-related attendances - 2011/12 and 2012/13 ............................. 61 Table 22: Numbers of benzodiazepine-related attendances by local government area in metropolitan

Melbourne - 2011/12 and 2012/13 ........................................................................................................ 64 Table 23: Numbers of benzodiazepine-related attendances by local government area in regional Victoria -

2011/12 and 2012/13 ............................................................................................................................ 65 Table 24: Characteristics of inhalant-related attendances - 2011/12 and 2012/13 ........................................ 71 Table 25: Numbers of inhalant-related attendances by local government area in metropolitan Melbourne -

2011/12 and 2012/13 ............................................................................................................................ 73 Table 26: Numbers of inhalant-related attendances by local government area in regional Victoria - 2011/12

and 2012/13 .......................................................................................................................................... 73 Table 27: Characteristics of heroin-related attendances - 2011/12 and 2012/13 ........................................... 79 Table 28: Numbers of all heroin-related attendances by local government area in metropolitan Melbourne -

2011/12 and 2012/13 ............................................................................................................................ 82 Table 29: Numbers of all heroin-related attendances by local government area in regional Victoria - 2011/12

and 2012/13 .......................................................................................................................................... 82 Table 30: Characteristics of heroin overdose attendances (responding to naloxone) - 2011/12 and 2012/13 88 Table 31: Numbers of heroin overdose attendances (responding to naloxone) by local government area in

metropolitan Melbourne - 2011/12 and 2012/13 .................................................................................. 90 Table 32: Numbers of heroin overdose attendances (responding to naloxone) by local government area in

Ambo Project: Alcohol and Drug related Ambulance Attendances – 2012/13 Annual Report Page x

regional Victoria - 2011/12 and 2012/13 ............................................................................................... 91 Table 33: Characteristics of other heroin-related attendances - 2011/12 and 2012/13 .................................. 93 Table 34: Numbers of other heroin-related attendances by local government area in metropolitan

Melbourne - 2011/12 and 2012/13 ........................................................................................................ 95 Table 35: Numbers of other heroin-related attendances by local government area in regional Victoria -

2011/12 and 2012/13 ............................................................................................................................ 96 Table 36: Characteristics of GHB-related attendances - 2011/12 and 2012/13 ............................................... 98 Table 37: Numbers of GHB-related attendances by local government area in metropolitan Melbourne -

2011/12 and 2012/13 .......................................................................................................................... 101 Table 38: Numbers of GHB-related attendances by local government area in regional Victoria - 2011/12 and

2012/13 ............................................................................................................................................... 101 Table 39: Characteristics of anticonvulsant-related attendances - 2011/12 and 2012/13 ............................ 107 Table 40: Numbers of anticonvulsant-related attendances by local government area in metropolitan

Melbourne - 2011/12 and 2012/13 ...................................................................................................... 109 Table 41: Numbers of anticonvulsant-related attendances by local government area in regional Victoria -

2011/12 and 2012/13 .......................................................................................................................... 110 Table 42: Characteristics of antidepressant-related attendances - 2011/12 and 2012/13 ............................ 116 Table 43: Numbers of antidepressant-related attendances by local government area in metropolitan

Melbourne - 2011/12 and 2012/13 ...................................................................................................... 119 Table 44: Numbers of antidepressant-related attendances by local government area in regional Victoria -

2011/12 and 2012/13 .......................................................................................................................... 120 Table 45: Characteristics of antipsychotic-related attendances - 2011/12 and 2012/13............................... 126 Table 46: Numbers of antipsychotic-related attendances by local government area in metropolitan

Melbourne - 2011/12 and 2012/13 ...................................................................................................... 129 Table 47: Numbers of antipsychotic-related attendances by local government area in regional Victoria -

2011/12 and 2012/13 .......................................................................................................................... 130 Table 48: Characteristics of opioid analgesic-related attendances - 2011/12 and 2012/13 .......................... 136 Table 49: Numbers of opioid analgesic-related attendances by local government area in metropolitan

Melbourne - 2011/12 and 2012/13 up to here .................................................................................... 139 Table 50: Numbers of opioid analgesic-related attendances by local government area in regional Victoria -

2011/12 and 2012/13 .......................................................................................................................... 140 Table 51: Characteristics of other analgesic-related attendances - 2011/12 and 2012/13 ............................ 146 Table 52: Numbers of other analgesic-related attendances by local government area in metropolitan

Melbourne - 2011/12 and 2012/13 ...................................................................................................... 149 Table 53: Numbers of other analgesic-related attendances by local government area in regional Victoria -

2011/12 and 2012/13 .......................................................................................................................... 150 Table 54: Characteristics of cocaine-related attendances - 2011/12 and 2012/13........................................ 156 Table 55: Numbers of cocaine-related attendances by local government area in metropolitan Melbourne -

2011/12 and 2012/13 .......................................................................................................................... 158

Ambo Project: Alcohol and Drug related Ambulance Attendances – 2012/13 Annual Report Page xi

List of Figures

Figure 1: Proportion of alcohol-related attendances by time of day of week, metropolitan Melbourne - 2011/12 and 2012/13 ............................................................................................................................ 13

Figure 2: Proportion of alcohol-related attendances by time of day of week, regional Victoria - 2011/12 and 2012/13 ................................................................................................................................................. 13

Figure 3: Alcohol-related attendances by month - 2011/12 and 2012/13 ...................................................... 20 Figure 4: Alcohol-related attendances by year - 2003/04 to 2012/13 ............................................................. 21 Figure 5: Proportion of cannabis-related attendances by time of day of week, metropolitan Melbourne -

2011/12 and 2012/13 ............................................................................................................................ 23 Figure 6: Proportion of cannabis-related attendances by time of day of week, regional Victoria - 2011/12 and

2012/13 ................................................................................................................................................. 23 Figure 7: Cannabis-related attendances by month - 2011/12 and 2012/13 .................................................... 30 Figure 8: Cannabis-related attendances by year - 2003/04 to 2012/13 .......................................................... 31 Figure 9: Proportion of ecstasy-related attendances by time of day of week, metropolitan Melbourne -

2011/12 and 2012/13 ............................................................................................................................ 33 Figure 10: Proportion of ecstasy-related attendances by time of day of week, regional Victoria - 2011/12 and

2012/13 ................................................................................................................................................. 33 Figure 11: Ecstasy-related attendances by month - 2011/12 and 2012/13 ..................................................... 38 Figure 12: Ecstasy-related attendances by year - 2003/04 to 2012/13 ........................................................... 39 Figure 13: Proportion of all amphetamine-related attendances by time of day of week, metropolitan

Melbourne - 2011/12 and 2012/13 ........................................................................................................ 41 Figure 14: Proportion of all amphetamine-related attendances by time of day of week - 2011/12 and

2012/13 ................................................................................................................................................. 42 Figure 15: All amphetamine-related attendances by month - 2011/12 and 2012/13 ..................................... 48 Figure 16: All amphetamine-related attendances by year - 2003/04 and 2012/13 ......................................... 49 Figure 17: Proportion of crystal methamphetamine-related attendances by time of day of week,

metropolitan Melbourne - 2011/12 and 2012/13 .................................................................................. 51 Figure 18: Proportion of crystal methamphetamine-related attendances by time of day of week, regional

Victoria - 2011/12 and 2012/13 ............................................................................................................. 52 Figure 19: Crystal methamphetamine-related attendances by month - 2011/12 and 2012/13 ...................... 55 Figure 20: Crystal methamphetamine-related attendances by year - 2003/04 and 2012/13 .......................... 55 Figure 21: Proportion of other amphetamine-related attendances by time of day of week, metropolitan

Melbourne - 2011/12 and 2012/13 ........................................................................................................ 57 Figure 22: Proportion of other amphetamine-related attendances by time of day of week, regional Victoria -

2011/12 and 2012/13 ............................................................................................................................ 57 Figure 23: Other amphetamine-related attendances by month - 2011/12 and 2012/13 ................................ 59 Figure 24: Other amphetamine-related attendances by year - 2003/04 to 2012/13 ...................................... 60 Figure 25: Proportion of benzodiazepine-related attendances by time of day of week, metropolitan

Melbourne - 2011/12 and 2012/13 ........................................................................................................ 62 Figure 26: Proportion of benzodiazepine-related attendances by time of day of week, regional Victoria -

2011/12 and 2012/13 ............................................................................................................................ 62 Figure 27: Benzodiazepine-related attendances by month - 2011/12 and 2012/13 ........................................ 69 Figure 28: Benzodiazepine-related attendances by year - 2003/04 and 2012/13 ........................................... 70 Figure 29: Proportion of inhalant-related attendances by time of day of week, metropolitan Melbourne -

2011/12 and 2012/13 ............................................................................................................................ 72 Figure 30: Proportion of inhalant-related attendances by time of day of week, regional Victoria - 2011/12

and 2012/13 .......................................................................................................................................... 72 Figure 31: Inhalant-related attendances by month - 2011/12 and 2012/13 ................................................... 77 Figure 32: Inhalant-related attendances by year - 2003/04 to 2012/13 ......................................................... 78 Figure 33: Proportion of heroin-related attendances by time of day of week, metropolitan Melbourne -

2011/12 and 2012/13 ............................................................................................................................ 80 Figure 34: Proportion of heroin-related attendances by time of day of week, regional Victoria - 2011/12 and

2012/13 ................................................................................................................................................. 80 Figure 35: Heroin-related attendances by month - 2011/12 and 2012/13 ...................................................... 86

Ambo Project: Alcohol and Drug related Ambulance Attendances – 2012/13 Annual Report Page xii

Figure 36: Heroin-related attendances by year - 2003/04 to 2012/13 ............................................................ 87 Figure 37: Proportion of heroin overdose attendances (responding to naloxone) by time of day of week,

metropolitan Melbourne - 2011/12 and 2012/13 .................................................................................. 89 Figure 38: Proportion of heroin overdose attendances (responding to naloxone) by time of day of week,

regional Victoria - 2011/12 and 2012/13 ............................................................................................... 89 Figure 39: Heroin overdose attendances (responding to naloxone) by month - 2011/12 and 2012/13 .......... 91 Figure 40: Heroin overdose attendances (responding to naloxone) by year - 2003/04 and 2012/13 .............. 92 Figure 41: Proportion of other heroin-related attendances by time of day of week, metropolitan Melbourne -

2011/12 and 2012/13 ............................................................................................................................ 94 Figure 42: Proportion of other heroin-related attendances by time of day of week, regional Victoria -

2011/12 and 2012/13 ............................................................................................................................ 94 Figure 43: Other heroin-related attendances by month - 2011/12 and 2012/13 ............................................ 96 Figure 44: Other heroin-related attendances by year - 2003/04 to 2012/13 .................................................. 97 Figure 45: Proportion of GHB-related attendances by time of day of week, metropolitan Melbourne -

2011/12 and 2012/13 ............................................................................................................................ 99 Figure 46: Proportion of GHB-related attendances by time of day of week, regional Victoria - 2011/12 and

2012/13 ................................................................................................................................................. 99 Figure 47: GHB-related attendances by month - 2011/12 and 2012/13 ....................................................... 105 Figure 48: GHB-related attendances by year - 2003/04 to 2012/13 .............................................................. 106 Figure 49: Proportion of anticonvulsant-related attendances by time of day of week, metropolitan

Melbourne - 2011/12 and 2012/13 ...................................................................................................... 108 Figure 50: Proportion of anticonvulsant-related attendances by time of day of week, regional Victoria -

2011/12 and 2012/13 .......................................................................................................................... 108 Figure 51: Anticonvulsant-related attendances by month - 2011/12 and 2012/13 ....................................... 114 Figure 52: Anticonvulsant-related attendances by year - 2003/04 to 2012/13 ............................................. 115 Figure 53: Proportion of antidepressant-related attendances by time of day of week, metropolitan

Melbourne - 2011/12 and 2012/13 ...................................................................................................... 117 Figure 54: Proportion of antidepressant-related attendances by time of day of week, regional Victoria -

2011/12 and 2012/13 .......................................................................................................................... 117 Figure 55: Antidepressant-related attendances by month - 2011/12 and 2012/13 ...................................... 124 Figure 56: Antidepressant-related attendances by year - 2003/04 to 2012/13 ............................................ 125 Figure 57: Proportion of antipsychotic-related attendances by time of day of week, metropolitan Melbourne

- 2011/12 and 2012/13 ........................................................................................................................ 127 Figure 58: Proportion of antipsychotic-related attendances by time of day of week, regional Victoria -

2011/12 and 2012/13 .......................................................................................................................... 127 Figure 59: Antipsychotic-related attendances by month - 2011/12 and 2012/13 ......................................... 134 Figure 60: Antipsychotic-related attendances by year - 2003/04 to 2012/13 ............................................... 135 Figure 61: Proportion of opioid analgesic-related attendances by time of day of week, metropolitan

Melbourne - 2011/12 and 2012/13 ...................................................................................................... 137 Figure 62: Proportion of opioid analgesic-related attendances by time of day of week, regional Victoria -

2011/12 and 2012/13 .......................................................................................................................... 137 Figure 63: Opioid analgesic-related attendances by month - 2011/12 and 2012/13..................................... 144 Figure 64: Opioid analgesic-related attendances by year - 2003/04 to 2012/13 ........................................... 145 Figure 65: Proportion of other analgesic-related attendances by time of day of week, metropolitan

Melbourne - 2011/12 and 2012/13 ...................................................................................................... 147 Figure 66: Proportion of other analgesic-related attendances by time of day of week, regional Victoria -

2011/12 and 2012/13 .......................................................................................................................... 147 Figure 67: Other analgesic-related attendances by month - 2011/12 and 2012/13 ...................................... 154 Figure 68: Other analgesic-related attendances by year - 2003/04 to 2012/13 ............................................ 155 Figure 69: Proportion of cocaine-related attendances by time of day of week, metropolitan Melbourne -

2011/12 and 2012/13 .......................................................................................................................... 157 Figure 70: Proportion of cocaine-related attendances by time of day of week - 2011/12 and 2012/13........ 157 Figure 71: Cocaine-related attendances by month - 2011/12 and 2012/13 .................................................. 162 Figure 72: Cocaine-related attendances by year - 2003/04 to 2012/13 ........................................................ 163

Ambo Project: Alcohol and Drug related Ambulance Attendances – 2012/13 Annual Report Page xiii

List of Maps

Map 1: Alcohol-related attendances by Victorian LGA, numbers of attendances - 2012/13 ........................... 17 Map 2: Alcohol-related attendances by Victorian LGA, rates per 100,000 ERP - 2012/13 ............................... 18 Map 3: Alcohol-related attendances by Victorian postcode, numbers of attendances - 2012/13................... 19 Map 4: Cannabis-related attendances by Victorian LGA, numbers of attendances - 2012/13 ........................ 27 Map 5: Cannabis-related attendances by Victorian LGA, rates per 100,000 ERP - 2012/13 ............................ 28 Map 6: Cannabis-related attendances by Victorian postcodes, numbers of attendances - 2012/13 ............... 29 Map 7: Ecstasy -related attendances by Victorian LGA, numbers of attendances - 2012/13 .......................... 35 Map 8: Ecstasy -related attendances by Victorian LGA, rates per 100,000 ERP - 2012/13 .............................. 36 Map 9: Ecstasy -related attendances by Victorian postcode, numbers of attendances - 2012/13 .................. 37 Map 10: Amphetamine-related attendances by Victorian LGA, numbers of attendances - 2012/13 .............. 45 Map 11: Amphetamine-related attendances by Victorian LGA, rates per 100,000 ERP - 2012/13 .................. 46 Map 12: Amphetamine-related attendances by Victorian postcode, numbers of attendances - 2012/13 ...... 47 Map 13: Benzodiazepine-related attendances by Victorian LGA, numbers of attendances - 2012/13 ............ 66 Map 14: Benzodiazepine-related attendances by Victoria LGA, rates per 100,000 ERP - 2012/13 ................. 67 Map 15: Benzodiazepine-related attendances by Victorian postcode, numbers of attendances - 2012/13 .... 68 Map 16: Inhalant-related attendances by Victorian LGA, numbers of attendances - 2012/13........................ 74 Map 17: Inhalant-related attendances by Victorian LGA, rates per 100,000 ERP - 2012/13............................ 75 Map 18: Inhalant-related attendances by Victorian postcode, numbers of attendances - 2012/13 ............... 76 Map 19: Heroin-related attendances by metropolitan Victorian LGA, numbers of attendances - 2012/13 .... 83 Map 20: Heroin-related attendances by regional Victorian LGA, rates per 100,000 ERP - 2012/13 ................ 84 Map 21: Heroin-related attendances by Victorian postcode, numbers of attendances - 2012/13 .................. 85 Map 22: GHB-related attendances by Victorian LGA, numbers of attendances - 2012/13 ............................ 102 Map 23: GHB-related attendances by Victorian LGA, rates per 100,000 ERP - 2012/13 ................................ 103 Map 24: GHB-related attendances by Victorian postcode, numbers of attendances - 2012/13.................... 104 Map 25: Anticonvulsant-related attendances by Victorian LGA, numbers of attendances - 2012/13 ........... 111 Map 26: Anticonvulsant-related attendances by Victorian LGA, rates per 100,000 ERP - 2012/13 ............... 112 Map 27: Anticonvulsant-related attendances by Victorian LGA, postcode, numbers of attendances - 2012/13

............................................................................................................................................................ 113 Map 28: Antidepressant-related attendances by Victorian LGA, numbers of attendances - 2012/13 ........... 121 Map 29: Antidepressant -related attendances by Victorian LGA, rates per 100,000 ERP - 2012/13 .............. 122 Map 30: Antidepressant-related attendances Victorian postcode, numbers of attendances - 2012/13 ....... 123 Map 31: Antipsychotic-related attendances by Victorian LGA, numbers of attendances - 2012/13 ............. 131 Map 32: Antipsychotic-related attendances by Victorian LGA, rates per 100,000 ERP - 2012/13 ................. 132 Map 33: Antipsychotic-related attendances by Victorian postcode, numbers of attendances - 2012/13 ..... 133 Map 34: Opioid analgesic-related attendances by Victorian LGA, numbers of attendances - 2012/13 ......... 141 Map 35: Opioid analgesic -related attendances by Victorian LGA, rates per 100,000 ERP - 2012/13 ............ 142 Map 36: Opioid analgesic-related attendances by Victorian postcode, numbers of attendances - 2012/13 . 143 Map 37: Other analgesic-related attendances by Victorian LGA, numbers of attendances - 2012/13 .......... 151 Map 38: Other analgesic-related attendances by Victorian LGA, rates per 100,000 ERP - 2012/13 .............. 152 Map 39: Other analgesic-related attendances by Victorian postcode, numbers of attendances - 2012/13 .. 153 Map 40: Cocaine-related attendances by Victorian LGA, numbers of attendances - 2012/13 ...................... 159 Map 41: Cocaine-related attendances by Victorian LGA, rates per 100,000 ERP - 2012/13 .......................... 160 Map 42: Cocaine-related attendances by Victorian postcode, numbers of attendances - 2012/13 .............. 161 Map 43: LGAs of outer metropolitan Melbourne ........................................................................................ 169 Map 44: LGAs of inner metropolitan Melbourne ......................................................................................... 170 Map 45: LGAs of regional Victoria ................................................................................................................ 171

Ambo Project: Alcohol and Drug related Ambulance Attendances – 2012/13 Annual Report Page xiv

Preface

This examination of non-fatal drug related events attended by ambulance in Victoria is a collaborative

project between Turning Point’s Population Health Research Program and Ambulance Victoria, and is

funded by the Victorian Department of Health.

Turning Point strives to promote and maximise the health and wellbeing of individuals and

communities living with and affected by alcohol and other drug-related harms. Our work is essential to

understanding the complexities of alcohol and drug use in our community and in developing effective

approaches to prevent and treat dependence and other related harms.

Turning Point was opened in 1994 and operates from a unique organisational model that combines

excellence in research with best practice approaches to education and training, alongside clinical

service delivery. This model means we operate from within the alcohol and other drug (AOD) sector

while benefiting from specialist skills and knowledge across research, education, and service delivery

disciplines.

The organisation amalgamated with public health provider Eastern Health in October 2009 and is

formally affiliated with Monash University. Turning Point is part of the International Network of Drug

Treatment and Rehabilitation Resource Centres for The United Nations Office of Drugs and Crime

(UNODC) and is a member of the International Harm Reduction Association. The organization is

unique among alcohol and drug agencies for its mission to combine clinical services with research

and training, and brings together a broad base of expert, experienced professionals in each of these

three areas. The staff at Turning Point have specialist expertise in the design, implementation and

monitoring of alcohol and drug related research and evaluation, and have experience in the

development of practice standards and guidelines which have been packaged for use by a range of

services.

Turning Point has established a number of innovative programs and plays a key role in influencing

government policy. A range of clinical services are provided by the organization including a state-wide

24-hour telephone assessment and referral service (DirectLine), withdrawal, opioid pharmacotherapy,

and counselling treatment programs. Among its achievements, Turning Point has provided key input

to advisory bodies such as the Premier’s Drug Advisory Council and the Premier’s Drug Prevention

Council. Current research projects include the examination of the patterns of alcohol and other drug

use and related harm in the Victorian community, and the development and evaluation of a number of

treatment programs.

The Turning Point Population Health Research Program is responsible for investigating patterns of

alcohol and drug use and related harm using population-based datasets available in Victoria. The staff

in the Population Health Research team currently include: Belinda Lloyd, Mohajer Abbass Hameed,

Cass Connor, Annie Haines, Caroline Gao, Cathie Garrard, Cherie Heilbronn, Jessica Killian, Liliana

Laskaris, Heather Laurie, Elizabeth Le, Daniel Leung, Sharon Matthews, Lisa Meyenn, Elke Mitchell,

Rowan Ogeil, Melissa Reed, Andrew Rodsted, Adam Scott, Kay van Namen and Merran Waterfall.

The Population Health Research team aims is to examine patterns of drug use and harm in Victoria

and provide this information to policy makers, alcohol and drug workers, as well as other interested

groups and individuals. Current projects include the Victorian Alcohol and Drug Statistics Series.

Ambo Project: Alcohol and Drug related Ambulance Attendances - 2012/13 Annual Report Page xv

Acknowledgements

We would like to thank Cathie Garrard, Annie Haines, Alexa Hayley, Cherie Heilbronn, Liliana

Laskaris, Heather Laurie, Elizabeth Le, Daniel Leung, Josephine Mascaro, Lisa Meyenn, Elke

Mitchell, Melissa Reed, Andrew Rodsted, Lydia Soh, Julie Tennant, Qian Wang, Merran Waterfall and

Julie Wood, for their valuable contribution.

Ambo Project: Alcohol and Drug related Ambulance Attendances - 2012/13 Annual Report Page xvi

Acronyms

ABS Australian Bureau of Statistics

AOD Alcohol and Other Drug

ERP Estimated Resident Population

GHB Gamma-Hydroxy Butyrate

LGA Local Government Area

PCR Patient Care Record

PWID People Who Inject Drugs

Ambo Project: Alcohol and Drug related Ambulance Attendances – 2012/13 Annual Report Page 1

Summary

Table 1 provides a summary of drug- and alcohol-related events attended by ambulance in Victoria in

2012/13. Alcohol-related attendances were most common in both metropolitan Melbourne and

regional Victoria, with benzodiazepines the second most common drug category involved in

ambulance attendances across metropolitan Melbourne and regional Victoria. Non-opioid analgesics

also featured, with this category ranking third for regional Victorian alcohol- and drug-related

ambulance attendances, and fourth for metropolitan Melbourne attendances (with all heroin-related

attendances ranking third in metropolitan Melbourne). Attendances related to antidepressants,

antipsychotics and cannabis were also common across Victoria in 2012/13. In 2012/13, population

rates of attendances were higher for cannabis, anticonvulsants, antidepressants, antipsychotics,

opioid analgesics and other analgesics in regional Victoria than in metropolitan Melbourne.

Table 1: Alcohol- and drug-related attendances in metropolitan Melbourne, regional Victoria, and Victoria - 2012/13

Metropolitan Melbourne N (rate)**

Regional Victoria

N (rate)**

All Victoria

N* (rate)**

Alcohol 11159 (2665.9) 3692 (2559.9) 14902 (2650.0)

Cannabis 1416 (338.2) 554 (384.2) 1975 (351.2)

Ecstasy 306 (73.1) 54 (37.4) 360 (64.0)

All Amphetamines 1394 (333.1) 312 (216.6) 1708 (303.7)

Crystal Methamphetamine 1112 (265.7) 231 (159.8) 1344 (239.0)

Other Amphetamines 282 (67.4) 82 (56.8) 364 (64.7)

Benzodiazepines 3159 (754.6) 808 (560.0) 3979 (707.6)

Inhalants 122 (29.1) 31 (21.5) 153 (27.2)

All Heroin 1901 (454) 102 (70.9) 2003 (356.2)

Heroin (with response to naloxone) 960 (229.4) 38 (26.1) 998 (177.5)

Other Heroin 940 (224.6) 65 (44.8) 1005 (178.7)

GHB 578 (138.1) 42 (29.0) 620 (110.3)

Anticonvulsants 230 (54.9) 104 (72.1) 334 (59.4)

Antidepressants 1221 (291.6) 487 (337.6) 1710 (304.1)

Antipsychotics 1145 (273.5) 425 (294.7) 1574 (279.9)

Opioid Analgesics 711 (169.8) 350 (242.4) 1065 (189.4)

Other Analgesics 1584 (378.5) 603 (418.1) 2193 (390.0)

Cocaine 122 (29.1) 10 (6.9) 132 (23.5)

*Total N for Victoria may equal more than the sum of metropolitan and regional cases as some attendances may not contain location information ** per 1,000,000 population

Table 2 provides a summary of drug- and alcohol-related events attended by ambulance in

metropolitan Melbourne and regional Victoria in 2011/12 and 2012/13, and the change between

2011/12 and 2012/13. In metropolitan Melbourne, large increases (greater than ten per cent) were

noted in alcohol-, cannabis-, ecstasy-, all amphetamine-, crystal methamphetamine-,

benzodiazepine-, GHB-, anticonvulsant-, antidepressant-, antipsychotic-, opioid analgesic-, non-opioid

analgesic- and cocaine-related attendances. There was a smaller increase in other heroin-related

attendances. A large decrease (greater than ten per cent) was noted in attendances for heroin (with

response to naloxone). With the exception of inhalant- and GHB-related attendances, the change


patterns in regional Victoria were broadly the same as in metropolitan Melbourne.

Table 2: Numbers of metropolitan Melbourne and regional Victoria attendances by drug - 2012/13 compared with 2011/12

Metropolitan Melbourne Regional Victoria

2011/12 N

2012/13 N

% Change from 2011/12

2011/12 N

2012/13 N

% Change from 2011/12

Alcohol 8824 11159 +27% 2594 3692 +42%

Cannabis 936 1416 +51% 350 554 +58%

Ecstasy 191 306 +61% 33 54 +62%

All Amphetamines 880 1394 +59% 166 312 +89%

Crystal Methamphetamine 592 1112 +88% 77 231 +198%

Other Amphetamines 288 282 -2% 88 82 -7%

Benzodiazepines 2694 3159 +17% 727 808 +11%

Inhalants 135 122 -10% 14 31 +121%

All Heroin 1964 1901 -3% 106 102 -4%

Heroin (with response to naloxone)

1104 960 -13% 44 38 -15%

Other Heroin 860 940 +9% 62 65 +4%

GHB 407 578 +42% 41 42 +3%

Anticonvulsants 197 230 +17% 89 104 +18%

Antidepressants 1060 1221 +15% 435 487 +12%

Antipsychotics 964 1145 +19% 337 425 +26%

Opioid Analgesics 458 711 +55% 288 350 +21%

Other Analgesics 1149 1584 +38% 451 603 +34%

Cocaine 88 122 +39% 7 10 +47%

Note: Except where indicated, all figures in the proportions are weighted.

Alcohol: Daily numbers of alcohol-related attendances were significantly higher in 2012/13 than in

2011/12 in both metropolitan Melbourne and regional Victoria. The mean age of patients attended

increased in 2012/13 in metropolitan Melbourne and regional Victoria. In metropolitan Melbourne and

regional Victoria, the proportion of cases occurring in public spaces decreased when compared with

2011/12. In both metropolitan Melbourne and regional Victoria, the proportion of alcohol-related

attendances where the patient was transported to hospital increased significantly in 2012/13 when

compared with the previous year. Melbourne retained its ranking as the LGA with the highest

proportion of alcohol-related attendances in metropolitan Melbourne. In regional Victoria, Greater

Geelong was the LGA with the highest proportion of alcohol-related ambulance attendances in

2012/13, followed by Latrobe and Ballarat, while Yarriambiack and Warnambool had the highest rates

of attendances.

Alcohol involvement in other drug-related attendances: In metropolitan Melbourne, there was a

large decrease (ten percentage points or greater) in the proportion of ecstasy-related attendances

where alcohol was also involved when compared with the preceding year. For all other drug

categories, there were smaller decreases or increases in the proportions of attendances where

alcohol was also involved. In regional Victoria, large decreases were seen in the proportions of

cannabis-, ecstasy-, antidepressant- and cocaine-related attendances where alcohol was also

involved when compared with the preceding year, while a large increase was noted in the proportion

of inhalant-related attendances where alcohol was also involved. For all other drug categories, there


were smaller decreases or increases in the proportions of attendances where alcohol was also

involved.

Cannabis: Across metropolitan Melbourne and regional Victoria, the daily number of cannabis-related

attendances in 2012/13 increased significantly when compared with the preceding year. In both

metropolitan Melbourne and regional Victoria, the proportions of cannabis-related attendances where

alcohol was involved decreased while the proportion where the patient was transported to hospital

increased in 2012/13 when compared with the previous year. In metropolitan Melbourne, the three

LGAs with the highest rates for cannabis-related ambulance attendances in 2012/13 were Melbourne,

Frankston and Port Phillip. In regional Victoria, Latrobe and Greater Shepparton had the highest

population rates in 2012/13.

Ecstasy: In both metropolitan Melbourne and regional Victoria, there were significant increases in the

daily numbers of ecstasy-related attendances in 2012/13 when compared with 2011/12. The age of

patients attended decreased in metropolitan Melbourne while the age increased in regional Victoria in

2012/13 compared with 2011/12. In metropolitan Melbourne, the proportion of attendances where

alcohol was also involved decreased while the proportion of attendances where the patient was

transported to hospital increased. In metropolitan Melbourne, the three LGAs with the highest rates for

ecstasy-related ambulance attendances in 2012/13 were Melbourne, Stonnington and Port Phillip. In

regional Victoria, Greater Bendigo and Greater Geelong had the highest population rates in 2012/13.

All amphetamines: In both metropolitan Melbourne and regional Victoria, the daily number of all

amphetamine-related attendances and the proportion of events co-attended by police in 2012/13

increased significantly when compared with the preceding year. In metropolitan Melbourne, there was

a significant decrease in the proportion of cases where alcohol was also involved, while there was a

significant increase in the proportion of cases where the patient was transported to hospital in 2012/13

when compared with 2011/12. In regional Victoria, the proportion of events occurring in public spaces

increased significantly. In metropolitan Melbourne, the three LGAs with the highest rates for all

amphetamine-related ambulance attendances in 2012/13 were Melbourne, Port Phillip and Yarra. In

regional Victoria, Latrobe, Moorabool and Greater Shepparton had the highest population rates of all

amphetamine-related ambulance attendances in 2012/13.

Crystal methamphetamine: In 2012/13 across Victoria, the daily number of crystal

methamphetamine-related attendances was significantly higher than in 2011/12. In metropolitan

Melbourne, significant decreases were seen in the proportion of cases where alcohol was involved,

and where events occurred in public spaces, while significant increases were noted in the proportion

of events co-attended by police, and cases where the patient was transported to hospital. In regional

Victoria, there was a significant increase in the proportion of events co-attended by police. In

metropolitan Melbourne, the top three ranking LGAs in the proportion of crystal methamphetamine-

related ambulance attendances were Melbourne, Casey and Hume. In regional Victoria, Latrobe,

Moorabool and Horsham had the highest population rates of crystal methamphetamine-related

ambulance attendances in 2012/13.

Other amphetamines: In metropolitan Melbourne, the proportion of cases where the patient was

transported to hospital was significantly higher than in 2011/12. In metropolitan Melbourne, the three

LGAs with the highest rates for other amphetamine-related ambulance attendances in 2012/13 were

Melbourne, Port Phillip and Yarra. In regional Victoria, Greater Shepparton and Latrobe had the

highest population rates of other amphetamine-related ambulance attendances in 2012/13.


Benzodiazepines: Across metropolitan Melbourne and regional Victoria, the daily numbers of

benzodiazepine-related attendances were higher in 2012/13 than in 2011/12. Significant decreases

were seen in the proportions of events occurring in public spaces, while significant increases were

evident in the proportions of events co-attended by police and in cases where the patient was

transported to hospital. The mean age of patients increased significantly while the proportion of male

patients decreased significantly in metropolitan Melbourne. The proportion of cases involving alcohol

decreased significantly in regional Victoria In metropolitan Melbourne, the three LGAs with the highest

rates for benzodiazepine-related ambulance attendances in 2012/13 were Yarra, Frankston and

Melbourne. In regional Victoria, East Gippsland, Benalla and Bass Coast had the highest population

rates of benzodiazepine-related ambulance attendances in 2012/13.

Inhalants: The daily number of regional Victorian inhalant-related attendances in 2012/13 was

significantly higher than in 2011/12. In metropolitan Melbourne, the three LGAs with the highest rates

for inhalant-related ambulance attendances in 2012/13 were Maroondah, Melbourne and Greater

Dandenong. In regional Victoria, Mildura, Ballarat and Greater Bendigo were the LGAs with the

highest rates of inhalant-related ambulance attendances in 2012/13.

All heroin: In metropolitan Melbourne, the mean age of patients and the proportion of cases where

the patient was transported to hospital increased significantly in 2012/13 compared with the previous

year In metropolitan Melbourne, the three LGAs with the highest rates for all heroin-related

ambulance attendances in 2012/13 were Yarra, Melbourne and Maribyrnong. In regional Victoria,

Greater Geelong was the LGA with the highest population rate of heroin-related ambulance

attendances in 2012/13, followed by Ballarat.

Heroin with response to naloxone: The daily number of heroin overdose attendances in 2012/13

was significantly lower than in 2011/12. There was a significant increase in the mean age of patients

in 2012/13 when compared with 2011/12. In metropolitan Melbourne, the three LGAs with the highest

rates of heroin overdose ambulance attendances in 2012/13 were Yarra, Melbourne and Maribyrnong.

In regional Victoria, Greater Geelong was the LGA with the highest rate of heroin overdose


Other heroin: Across metropolitan Melbourne and regional Victoria, the proportions of cases where

the patient was transported to hospital increased significantly. In metropolitan Melbourne, the three

LGAs with the highest rates of other heroin-related ambulance attendances in 2012/13 were Yarra,

Melbourne and Maribyrnong. In regional Victoria, Wodonga and Baw Baw had the highest population

rates of other heroin-related ambulance attendances in 2012/13.

GHB: The daily number of GHB-related attendances in metropolitan Melbourne increased significantly

when compared with the preceding year. Significant increases were seen in the proportions of events

occurring in public and outdoor spaces, co-attended by police, and cases where the patient was

transported to hospital. In regional Victoria, the mean age of patients attended decreased significantly.

In metropolitan Melbourne, the three LGAs with the highest rates of GHB-related ambulance

attendances in 2012/13 were Melbourne, Port Phillip and Stonnington. In regional Victoria, Moorabool,

Wellington and Latrobe had the highest population rates of GHB-related ambulance attendances in

2012/13.

Anticonvulsants: In regional Victoria, the proportion of cases where the patient was transported to

hospital increased significantly when compared with the preceding year. In metropolitan Melbourne,


the three LGAs with the highest rates of anticonvulsant-related ambulance attendances in 2012/13

were Mornington Peninsula, Port Phillip and Frankston. In regional Victoria, although Greater Geelong

was the LGA with the highest proportion of anticonvulsant-related ambulance attendances in 2012/13,

while South Gippsland, Mitchell and Bass Coast had the highest population rates.

Antidepressants: In metropolitan Melbourne, the daily number of antidepressant-related attendances

was significantly higher in 2012/13 than in 2011/12, while the mean age was lower in 2012/13 than in

2011/12. In regional Victoria, there was a significant decrease in the proportion of cases involving

alcohol, while there was a significant increase in the proportion of cases where the patient was

transported to hospital. In metropolitan Melbourne, the three LGAs with the highest rates of

antidepressant-related ambulance attendances in 2012/13 were Frankston, Melbourne and Cardinia.

In regional Victoria, Benalla, East Gippsland and Horsham had the highest population rates of

antidepressant-related ambulance attendances in 2012/13.

Antipsychotics: The daily numbers of antipsychotic-related attendances increased significantly in

both metropolitan Melbourne and regional Victoria when compared with 2011/12. In regional Victoria,

there was a significant decrease in the proportion of attendances where alcohol was also involved in

2012/13 when compared with 2011/12. In metropolitan Melbourne, the three LGAs with the highest

rates of antipsychotic-related ambulance attendances in 2012/13 were Frankston, Port Phillip and

Melbourne. In regional Victoria, East Gippsland, Northern Grampians and Greater Bendigo had the

highest population rates of antipsychotic-related ambulance attendances in 2012/13.

Opioid analgesics: When compared with 2011/12, the daily number of opioid analgesic-related

attendances and the proportion of cases where the patient was transported to hospital increased

significantly in metropolitan Melbourne. In regional Victoria, when compared with 2011/12, the

proportion of attendances where alcohol was also involved decreased significantly, while the

proportion of events co-attended by police, the daily number of the attendances, and the mean age of

patients increased significantly. In metropolitan Melbourne, the three LGAs with the highest rates for

opioid analgesic-related ambulance attendances in 2012/13 were Frankston, Port Phillip and Yarra

Ranges. Horsham, East Gippsland and Mildura had the highest rates of opioid analgesic-related

attendances in regional Victoria.

Other analgesics: In 2012/13 the daily numbers of other analgesic-related attendances and the

proportion of cases where the patient was transported to hospital increased in both metropolitan

Melbourne and regional Victoria when compared with the preceding year. In metropolitan Melbourne,

there were significant decreases in the proportion of attendances where alcohol was also involved

and in the proportion of events occurring in public spaces. In metropolitan Melbourne, the three LGAs

with the highest rates for other analgesic-related ambulance attendances in 2012/13 were Melbourne,

Frankston and Moonee Valley. In regional Victoria, Benalla, East Gippsland and Campaspe had the

highest population rates.

Cocaine: There was a significant increase in the proportion of cases where the patient was

transported to hospital in metropolitan Melbourne compared with 2011/12. When compared with

2011/12, the proportion of attendances where alcohol was also involved remained unchanged in

metropolitan Melbourne. Due to the small number of cocaine-related attendances in regional Victoria,

most characteristics had too few cases to be reported.


Chapter 1: Introduction

This report is part of an ongoing project undertaken by Turning Point, and which commenced in 1998.

The rate of fatal heroin overdoses was increasing in Victoria in the late 1990s (Dietze, Fry, Rumbold,

& Gerostamoulos, 2001), and in response to increasing concern about the prevalence of overdose,

the current project was established to examine non-fatal heroin overdose in depth using ambulance

service records (Dietze, Cvetkovski, Rumbold, & Miller, 1998). The project is funded by the Victorian

Department of Health, formerly the Victorian Department of Human Services.

Non-fatal versus fatal heroin overdose

Surveys of people who inject drugs (PWID), along with anecdotal reports from users, suggest that the

experience of overdose is common amongst heroin users both in Australia (e.g., Darke, Ross, & Hall,

1996a; Loxley, Carruthers, & Bevan, 1995) and overseas (e.g., Gossop, Griffiths, Powis, Williamson,

& Strang, 1996). Darke et al. (1996a) found that 68% of respondents had experienced a heroin

’overdose’. A survey conducted in Victoria as part of the Illicit Drug Reporting System found that 64%

of regular heroin users reported having an experience of at least one overdose (Jenkinson & Quinn,

2007). Indeed, heroin users identify overdose as the heroin related harm with which they are most

concerned.

Most research on heroin related overdose has examined fatal overdoses (Dietze et al., 2001; Farrell,

Neeleman, Griffiths, & Strang, 1996). However, the examination of non-fatal heroin overdoses is likely

to be far more informative than the examination of fatal heroin overdoses. This is because fatal

overdoses represent only a small fraction of the total number of heroin overdoses; the majority of

heroin overdoses remain non-fatal. Recognition of this fact has seen an increase in the research effort

that has been directed at the examination of non-fatal overdoses (Darke et al., 1996a; Darke, Ross, &

Hall, 1996b). This research has been important in terms of identifying risk factors for overdose and

informing the development of strategies for the prevention of fatal overdose (Darke et al., 1996b;

Farrell et al., 1996; Gossop et al., 1996).

Ambulance service records

Examination of non-fatal overdose has been conducted through surveys of PWID (e.g., Darke et al.,

1996a). However, another potential source of information regarding these overdoses is records of

ambulance attendance (Bammer, Ostini, & Sengoz, 1995; Degenhardt, Hall, & Adelstein, 2001;

Dietze, Cvetkovski, Rumbold, & Miller, 2000; Dietze, Jolley, & Cvetkovski, 2003). The rate of

ambulance attendance at heroin overdose has been found to be as high as 56% of total overdoses

(Darke et al., 1996a). Recognition of this fact has seen an increase in the use of ambulance service

records to examine the nature and prevalence of heroin overdose (Bammer et al., 1995; Degenhardt

et al., 2001; Dietze et al., 2003). In this regard ambulance service records can provide rich information

on heroin related overdose and have significant advantages over one-off surveys of PWID. For

example, ambulance service records are not subject to the same sampling biases inherent in surveys

of PWID (see Hser, 1993). Moreover, in contrast to one-off surveys, ambulance records are routinely

collected and are thus sensitive to potential changes in heroin market characteristics such as changes

in drug purity, policing practices and user behaviour.

In Victoria, ambulance paramedics are required to complete an electronic patient care record (ePCR)

for every incident that they attend and for which they provide a service. These electronic records are


downloaded onto VACIS, which contains the details of incident location and incident result (hospital

journey etc.) along with additional details about the incident, such as the patient’s condition. This

method of data collection superseded an earlier paper-based recording of incident and patient details

(see previous periodic reports from this project). In early 1997 Turning Point commenced discussions

with the Metropolitan Ambulance Service, now Ambulance Victoria, with a view to establishing

whether their records could be used to examine non-fatal overdose in Melbourne. The resulting

project was designed to examine non-fatal heroin overdose using ambulance service records through

the establishment of a database of all ambulance attendances at overdose events in the Melbourne

metropolitan area. With enhanced data collection available from June 1998, attendances involving

drugs other than heroin can also be examined.

The current report

In this annual report, eighteen drug categories are examined:

1. Alcohol

2. Cannabis

3. Ecstasy

4. All amphetamine related attendances

5. Crystal methamphetamine

6. Other amphetamine

7. Benzodiazepines

8. Inhalants

9. All heroin related attendances

10. Heroin overdose (responding to naloxone)

11. Other heroin

12. GHB

13. Anticonvulsants

14. Antidepressants

15. Antipsychotics

16. Opioid analgesics

17. Other analgesics, and

18. Cocaine related attendances.

The appendix includes key maps of the Victorian LGAs included in the report.


Chapter 2: Methods

Data generated from VACIS®

The results presented in this report are generated from an analysis of electronic data extracted from

VACIS®. This system is used by Ambulance Victoria paramedics to record the details of all

emergency cases they attend, the endpoint being an electronic patient care record (ePCR). The

project team have developed a method for parsing the received VACIS® electronic data to correctly

identify relevant alcohol and drug related cases and extract the required information. However, due to

the structure of the data model in the VACIS® (point of care data collection), extracting alcohol- and

drug-related attendance information requires additional programming, manual data entry and clerical

validation so as to accurately extract the specific drugs or substances involved in the cases attended

by ambulance. As a consequence, a separate database was developed for the current project that

integrates and standardises information extracted from the VACIS® data supplied with the existing

Turning Point project database.

Victorian regional data became available from the system in 2011, hence the VACIS® data have now

included both the metropolitan Melbourne area and the regional Victorian area. The current database

contains information on:

the drugs or substances involved

geographic location

type of location (e.g., indoors/outdoors, public building/private residence)

time of day, day of week

demographic details of patient (sex, approximate age)

whether naloxone had been administered (yes/no) and response to naloxone administration

(effective/not effective)

outcome (e.g., taken to hospital/not transported)

whether police co-attended

other relevant clinical data (e.g., cyanisation, pupil size, respiratory rate).

The database has in excess of 385,000 records that have been collected for the period of 01/06/1998

to 30/06/2013. Analysis of some of the data collected for this period forms the basis of this report.

Data auditing and quality control

The data are internally validated when parsed for import and conversion from the VACIS® transfer

files provided by Ambulance Victoria to Turning Point. Variables and coding used in the VACIS® data

are compared to the Turning Point database model and any discrepancies are flagged for

investigation by project staff. When the VACIS® data have been parsed, converted and appended to

the Turning Point database, the electronic PCR records are collated for review by project staff in order

to manually code the various project-specific data required for reporting, including correctly coding the

drugs and substances involved in the event.

After the set of electronic PCR records is manually coded, the dataset is reviewed by senior project

staff and extracted for cleaning prior to analysis. Multiple electronic PCRs for the same patient are

aggregated and a random selection of cases is reviewed to ensure the manual coding was accurate


and consistent. Data are then converted to a format suitable for analysis and are merged with the

Turning Point master project dataset. Preliminary analyses are performed to identify any anomalous

trends in the data. Any unusual or unexpected results are then re-reviewed to ensure that data

accurately reflect the case details. Ongoing review and cleaning of historical data are undertaken to

maintain the quality of the core dataset. Accordingly, numbers may vary slightly between this report

and previous publications.

In addition to these formal quality control methods, throughout these processes, all project staff

involved - the data entry personnel and the Research Fellows responsible for analysis - communicate

to identify trends, anomalies or interesting patterns noticed in the current dataset.

Definition of drug involvement/overdose used in this report

The attribution of a drug or substance as being involved in the event is formed on the basis of

ambulance paramedic mention of the involvement of these substances, established through

paramedic clinical assessment, patient self-report or information provided by someone else at the

scene, such as family, friends or associates. The drug categories reported indicate the involvement of

these drugs however other drugs and alcohol may have also been ingested (with the exception of

Alcohol which is an exclusive category in this report).

The core criterion project staff use in determining the involvement of a drug or substance is: “Is it

reasonable to attribute the immediate or recent (not merely chronic) over- or inappropriate ingestion of

the substance or medication as significantly contributing to the reason for the Ambulance Victoria

attendance?”

Alcohol-related events

Alcohol-related cases are defined as those cases attended by ambulance where assessment of

causality is that only alcohol, as far as could be ascertained, was involved in causing the attendance.

These cases usually relate to alcohol intoxication and poisoning, but may include alcohol-related

injuries.

All amphetamine-related attendances

This category is an aggregation of the cases classified as either crystal methamphetamine- or other

amphetamine-related events.

Crystal methamphetamine-related attendances

These cases are selected on the basis of ambulance paramedic mention of the involvement of

“Crystal meth(amphetamine)”, “Ice”, etc., established through patient self-report or information

provided by someone else at the scene, such as family, friends or associates. Data on “crystal

methamphetamine/ice” as the type of amphetamine involved in events have been collected from

October 2002.

Other amphetamine-related attendances

These cases are selected on the basis of ambulance paramedic mention of the involvement of any

form of amphetamine excluding “crystal meth(amphetamine)”, “ice”, etc., established through patient

self-report or information provided by someone else at the scene, such as family, friends or

associates. It should be noted that crystal methamphetamine cases cannot be excluded from the


”other amphetamine” category with certainty. Therefore, the other amphetamine category should be

viewed as excluding crystal methamphetamine cases as far as could be ascertained.

All heroin-related attendances

This category is an aggregation of the cases classified as either heroin overdose or other heroin-

related events.

Heroin overdose

It is difficult to define heroin overdose (Darke & Zador, 1996). For the data presented in this report,

Heroin overdose refers to a positive response to the administration of naloxone (an opioid antagonist)

for those people attended by an ambulance and where there was no indication that the overdose

resulted from another opioid such as morphine or methadone. Other drugs and alcohol may also have

been ingested.

Other heroin-related attendances

These are cases where evidence of heroin use is established through the clinical assessment of the

ambulance paramedic and/or by the patient or his or her associates at the scene, but naloxone was

not administered. In these cases too, other drugs and alcohol may have also been ingested.

Ecstasy-, gamma-hydroxybutyrate (GHB)-, cannabis-, cocaine- and inhalant- related attendances

These cases are selected on the basis of ambulance paramedic mention of the involvement of these

substances, established through patient self-report or information provided by someone else at the

scene, such as family, friends or associates. Data on GHB as the drug involved in events have been

collected from March 2001.

Benzodiazepine-related attendances

This category includes drugs such as alprazolam, bromazepam, clobazam, clonazepam, diazepam,

flunitrazepam, lorazepam, midazolam, nitrazepam, oxazepam, temazepam and triazolam. This

category also includes the sedatives zolpidem and zopiclone.

Anticonvulsant-related attendances

Selected anticonvulsants include the drugs carbamazepine, gabapentin, lamotrigine, oxcarbazepine,

pregabalin, sodium valproate, tiagabine and topiramate. For the Ambo Project, the only

anticonvulsants coded are those that are used - on- or off-label - in treating psychiatric conditions,

primarily bipolar disorder. Data pertaining to anticonvulsant-related attendances were collected from

May 2000.

Antidepressant-related attendances

Included in this category are drugs such as amitriptyline, citalopram, clomipramine, desvenlafaxine,

dothiepin, doxepin, duloxetine, escitalopram, fluoxetine, fluvoxamine, imipramine, mianserin,

mirtazapine, moclobemide, nortriptyline, paroxetine, phenelzine, reboxetine, sertraline,

tranylcypromine, trimipramine and venlafaxine.

Antipsychotic-related attendances

These include drugs such as amisulpride, aripiprazole, chlorpromazine, clozapine, droperidol,

flupenthixol, fluphenazine, haloperidol, olanzapine, paliperidone, pericyazine, pimozide, quetiapine,


risperidone, thioridazine, trifluoperazine, ziprasidone, zuclopenthixol. This category also includes

lithium.

Opioid analgesic-related attendances

This category includes drugs such as dextropropoxyphene (with or without paracetamol), fentanyl,

hydromorphone, morphine, oxycodone, pethidine and tramadol, but excludes methadone and

buprenorphine.

Other analgesic-related attendances

Other analgesics includes drugs such as aspirin, ibuprofen and paracetamol, either alone or in

combination with other drugs (excluding dextropropoxyphene but including codeine).

Please note that for all categories, values of less than five cases are not reported.

Mapping of alcohol- and drug-related ambulance attendances

The ability to map ambulance attendances for alcohol- and drug-related harm provides unparalleled

opportunities to explore clustering of harms in local areas at the micro level for populations and sub-

populations of interest. The production of maps of patterns and clusters of alcohol- and other drug-

related harms requiring ambulance attendance addresses policy priorities and also the need to

develop strategic and timely responses to alcohol and drug related harms. For each of the main drug

groups included in this report, maps of concentrations of alcohol- and drug-related ambulance

attendances are provided for 2012/13. These maps are presented at two levels of geographic

specificity - by local government area (LGA) and by postcode of attendance for both metropolitan

Melbourne, and for Victoria. Please note that postal area may not specify which part of Victoria is

regional or Melbourne metropolitan area. Key maps of LGAs are provided in the Appendix.

Population estimates

This report uses Australian Bureau of Statistics Estimated Resident Population (ERP) data to

calculate population rates. These figures are estimated at June 30 each year. For the 2011/12

financial year, ERP data from 2011 has been used as the denominator, whilst for the 2012/13

financial year, 2012 ERP data has been used as the denominator.


Chapter 3: Alcohol-Related Attendances (Alcohol

Only)

Alcohol-related cases are defined as those cases attended by ambulance where assessment of

causality is that only alcohol, as far as could be ascertained, was involved in causing the attendance.

No other drugs or substances are known to be involved in these events. These cases usually relate to

alcohol intoxication and poisoning, but may include alcohol-related injuries.

Characteristics of alcohol-related attendances

The data displayed in Table 3 shows characteristics of alcohol-related ambulance attendances in

metropolitan Melbourne and regional Victoria for 2011/12 and 2012/13. The daily numbers of alcohol-

related attendances were significantly higher in 2012/13 than in 2011/12 (p<0.001) in both

metropolitan Melbourne and regional Victoria. The mean age of patients attended increased in

2012/13 (p<0.001) in metropolitan Melbourne and regional Victoria. In metropolitan Melbourne and

regional Victoria, the proportion of cases occurring in public spaces decreased (p<0.001) when

compared with 2011/12. In both metropolitan Melbourne and regional Victoria, the proportion of

alcohol-related attendances where the patient was transported to hospital increased significantly in

2012/13 when compared with the previous year (p<0.001).

Table 3: Characteristics of alcohol-related attendances - 2011/12 and 2012/13


2011/12 2012/13 P 2011/12 2012/13 P

N attendances (per 1m population)

8824 (2147.6)

11159 (2665.9)

2594

(1816.0) 3692

(2559.9)

Mean per day (SD) 24.11

(11.10) 30.57

(13.43) <0.001

7.09

(4.23) 10.12 (5.42)

<0.001

Daily range 5 - 82 6 - 109 0 - 28 2 - 48

Alcohol involved 8824

(100%) 11159

(100%) <0.001

2594

(100%) 3692

(100%)

<0.001

Age - Mean (SD) 38

(17.89) 40

(17.27)

38 (18.48)

41 (17.58)

Age - Median (range) 37

(<1 - 95) 40

(<1 - 95) <0.001

38

(<1 - 91) 41

(<1 - 94) <0.001

Male 5728

(65%) 7330

(66%) 0.246

1624

(63%) 2312

(63%) 0.981

Public space 4512

(52%) 5421

(49%) <0.001

1060

(42%) 1371

(38%) 0.002

Outdoor space 4271

(50%) 5334

(49%) 0.471

856

(83%) 1100

(82%) 0.668

Police co-attendance 1728

(20%) 2361

(21%) 0.005

356

(14%) 603

(16%) 0.004

Transported to hospital

6102 (70%)

7726 (86%)

<0.001

1868

(73%) 2544

(87%)

<0.001

Note: Except where indicated, all proportions are based on non-missing information.

Day of week and time of day of alcohol-related attendances

In both metropolitan Melbourne and regional Victoria, the distribution of alcohol-related ambulance

attendances across the days of the week was consistent in both 2011/12 and 2012/13, with the

highest proportion of attendances occurring on Saturdays and Sundays and lowest on Mondays. The

peak time for alcohol-related attendances in 2012/13 was between 12pm and 6am on Saturday and

Sunday. The distribution of alcohol-related attendances over times of day and days of week is


presented in Figure 1 and Figure 2, and indicates that the trend in temporal variation in attendances

was similar in 2011/12 and 2012/13.

Figure 1: Proportion of alcohol-related attendances by time of day of week, metropolitan Melbourne - 2011/12 and 2012/13

Figure 2: Proportion of alcohol-related attendances by time of day of week, regional Victoria - 2011/12 and 2012/13


Alcohol-related attendances in local government areas

Alcohol-related ambulance attendances are presented for 2012/13 (and 2011/12 for comparison) by

local government area for metropolitan Melbourne in Table 4 and for regional Victoria in Table 5. In

metropolitan Melbourne, the three LGAs with the highest rates for alcohol-related ambulance

attendances in 2012/13 were Melbourne, Port Phillip and Yarra (Table 4). Rates of attendances

increased across the majority of LGAs when compared with the previous year. The only exception

was Boroondara.

Melbourne retained its ranking as the LGA with the highest rate of alcohol-related attendances in

metropolitan Melbourne. Nillumbik remained the LGA with the lowest rate of alcohol-related

attendances in metropolitan Melbourne.

In regional Victoria, although Greater Geelong was the LGA with the highest proportion of alcohol-

related ambulance attendances in 2012/13, Yarriambiack and Warnambool had the highest

population rates, followed by Latrobe and Greater Shepparton (Table 5). Rates of attendances

increased across the majority of LGAs when compared with the previous year. The exceptions were

Murrindindi, Hepburn, Gannawarra and Buloke, showing decreases in population rates for alcohol-

related ambulance attendances.

Mapped alcohol-related attendances for 2012/13 are presented at LGA level (Map 1 and Map 2) and

postcode (Map 3) for metropolitan Melbourne and regional Victoria.


Table 4: Numbers of alcohol-related attendances by local government area in metropolitan Melbourne - 2011/12 and 2012/13

LGA 2011/12

LGA 2012/13

N (%*) Rate** N (%*) Rate**

Melbourne 1165 (13%) 1162.2 Melbourne 1418 (13%) 1345.6

Yarra 439 (5%) 556.4 Port Phillip 614 (6%) 614.7

Port Phillip 521 (6%) 535.6 Yarra 458 (4%) 568.2

Stonnington 342 (4%) 346.0 Frankston 543 (5%) 412.8

Frankston 400 (5%) 306.9 Greater Dandenong 575 (5%) 397.4

Greater Dandenong 435 (5%) 306.0 Stonnington 399 (4%) 396.3

Maribyrnong 219 (3%) 291.4 Maribyrnong 276 (3%) 360.4

Maroondah 262 (3%) 244.1 Mornington Peninsula 435 (4%) 288.5

Moreland 349 (4%) 226.3 Maroondah 311 (3%) 287.7

Kingston 332 (4%) 223.9 Darebin 403 (4%) 279.7

Darebin 311 (4%) 217.6 Kingston 385 (4%) 256.7

Hobsons Bay 186 (2%) 212.8 Hobsons Bay 221 (2%) 250.7

Mornington Peninsula 301 (3%) 201.6 Moonee Valley 279 (3%) 246.3

Moonee Valley 221 (3%) 197.0 Moreland 382 (3%) 244.6

Knox 250 (3%) 161.7 Whitehorse 354 (3%) 222.7

Boroondara 267 (3%) 159.8 Brimbank 430 (4%) 222.0

Banyule 190 (2%) 154.5 Hume 372 (3%) 209.0

Yarra Ranges 226 (3%) 151.8 Knox 295 (3%) 190.7

Brimbank 276 (3%) 144.1 Casey 477 (4%) 178.1

Melton 159 (2%) 141.2 Yarra Ranges 264 (2%) 177.1

Cardinia 107 (1%) 141.1 Bayside 168 (2%) 173.5

Bayside 134 (2%) 139.4 Glen Eira 236 (2%) 170.0

Hume 238 (3%) 136.6 Melton 198 (2%) 167.9

Whitehorse 207 (2%) 131.4 Cardinia 130 (1%) 162.3

Casey 335 (4%) 128.2 Banyule 196 (2%) 158.6

Glen Eira 174 (2%) 126.9 Boroondara 264 (2%) 156.9

Wyndham 208 (2%) 124.8 Monash 281 (3%) 156.3

Monash 211 (2%) 119.0 Whittlesea 257 (2%) 151.6

Whittlesea 180 (2%) 111.9 Manningham 170 (2%) 145.3

Manningham 124 (1%) 106.2 Wyndham 250 (2%) 139.3

Nillumbik 56 (1%) 89.3 Nillumbik 67 (1%) 106.9

Rest of Melbourne 0 (0%) - Rest of Melbourne 0 (0%) -

* % of metropolitan Melbourne ** per 100,000 population


Table 5: Numbers of alcohol-related attendances by local government area in regional Victoria - 2011/12 and 2012/13

LGA 2011/12

LGA 2012/13

N (%*) Rate** N (%*) Rate**

Warrnambool 87 (3%) 266.3 Yarriambiack 27 (1%) 379.5

Central Goldfields 33 (1%) 262.3 Warrnambool 125 (3%) 379.2

Latrobe 190 (7%) 257.5 Latrobe 280 (8%) 378.7

Mildura 129 (5%) 248.9 Greater Shepparton 229 (6%) 367.3

Greater Shepparton 153 (6%) 247.8 Wellington 146 (4%) 345.2

East Gippsland 105 (4%) 245.2 East Gippsland 148 (4%) 343.0

Murrindindi 32 (1%) 240.0 Mildura 169 (5%) 323.7

Greater Geelong 497 (19%) 230.3 Bass Coast 97 (3%) 317.1

Wellington 93 (4%) 221.1 Central Goldfields 38 (1%) 302.0

Mansfield 17 (1%) 214.1 Wangaratta 80 (2%) 293.7

Bass Coast 61 (2%) 201.8 Greater Geelong 640 (18%) 293.1

Southern Grampians 31 (1%) 187.1 Colac-Otway 56 (2%) 270.1

Ballarat 178 (7%) 187.0 Ballarat 242 (7%) 249.6

Buloke 12 (1%) 185.6 Horsham 49 (1%) 249.3

Wodonga 65 (3%) 180.4 Strathbogie 24 (1%) 248.4

Moira 51 (2%) 179.5 Glenelg 48 (1%) 242.7

Glenelg 35 (1%) 176.3 Mount Alexander 43 (1%) 240.7

Mitchell 61 (2%) 173.8 Wodonga 88 (2%) 240.3

Surf Coast 46 (2%) 172.5 Ararat 27 (1%) 237.8

Campaspe 63 (2%) 170.9 Campaspe 87 (2%) 235.4

Wangaratta 46 (2%) 169.0 Swan Hill 49 (1%) 233.6

Benalla 23 (1%) 166.4 Mansfield 18 (0.5%) 223.1

Strathbogie 15 (1%) 156.3 Greater Bendigo 228 (6%) 219.8

Swan Hill 32 (1%) 153.4 Surf Coast 57 (2%) 208.4

Greater Bendigo 148 (6%) 145.1 Pyrenees 14 (0.4%) 207.2

Colac-Otway 30 (1%) 144.2 Benalla 28 (1%) 203.9

Hepburn 21 (1%) 143.6 Corangamite 33 (1%) 201.4

Baw Baw 60 (2%) 138.3 Moira 57 (2%) 198.8

Gannawarra 14 (1%) 133.9 Mitchell 71 (2%) 195.9

Horsham 26 (1%) 133.2 Southern Grampians 32 (1%) 195.1

Corangamite 21 (1%) 127.1 Baw Baw 82 (2%) 184.8

Moyne 20 (1%) 123.7 Moorabool 54 (2%) 184.0

Northern Grampians 14 (1%) 116.1 Macedon Ranges 75 (2%) 172.4

Mount Alexander 20 (1%) 111.9 Alpine 19 (1%) 156.5

Yarriambiack 8 (0.3%) 111.4 Hindmarsh 9 (0.2%) 155.3

Ararat 12 (1%) 106.0 South Gippsland 40 (1%) 143.8

South Gippsland 29 (1%) 105.4 Murrindindi 19 (0.5%) 141.4

Pyrenees 7 (0.3%) 103.6 Buloke 9 (0.2%) 141.4

Alpine 11 (0.4%) 91.2 Northern Grampians 16 (0.4%) 133.7

Moorabool 26 (1%) 90.7 Loddon 10 (0.3%) 132.9

Macedon Ranges 38 (2%) 88.6 Moyne 21 (1%) 129.5

Hindmarsh 5 (0.2%) 85.4 Hepburn 18 (0.5%) 122.0

Loddon 5 (0.2%) 66.3 Gannawarra 12 (0.3%) 115.5

Golden Plains 10 (0.4%) 52.7 Indigo 14 (0.4%) 91.0

Indigo 8 (0.3%) 52.2 Golden Plains 16 (0.4%) 82.4

Rest of Regional Victoria 8 (0.4%) - Rest of Regional Victoria 8 (0.3%) -

*% of regional Victoria ** per 100,000 population


Map 1: Alcohol-related attendances by Victorian LGA, numbers of attendances - 2012/13


Map 2: Alcohol-related attendances by Victorian LGA, rates per 100,000 ERP - 2012/13


Map 3: Alcohol-related attendances by Victorian postcode, numbers of attendances - 2012/13


Trends over time in alcohol-related attendances

As shown in Figure 3, numbers and rates of alcohol-related attendances have fluctuated with overall

upward trends across metropolitan Melbourne and regional Victoria over the past two years.

December 2012 had the highest number and rate of attendances across Victoria. Over the past 10

years, there has been a pronounced upward trend in alcohol-related attendances across metropolitan

Melbourne, with more than a threefold increase in attendances occurring during this period (Figure 4).

Figure 3: Alcohol-related attendances by month - 2011/12 and 2012/13


Figure 4: Alcohol-related attendances by year - 2003/04 to 2012/13


Chapter 4: Cannabis-Related Attendances

Characteristics of cannabis-related attendances

As displayed in Table 6, across metropolitan Melbourne and regional Victoria, the daily rate of

cannabis-related attendances in 2012/13 increased significantly when compared with the preceding

year (p<0.001). In both metropolitan Melbourne and regional Victoria, the proportions of cannabis-

related attendances where alcohol was involved decreased while the proportion where the patient

was transported to hospital increased in 2012/13 when compared with the previous year; both

changes were statistically significant (p<0.001).

Table 6: Characteristics of cannabis-related attendances - 2011/12 and 2012/13


2011/12 2012/13 p 2011/12 2012/13 P


936 (227.8)

1416 (338.2)

350

(244.9) 554

(384.2)


(1.80) 3.88

(2.20)

<0.001

0.96

(1.01) 1.52

(1.30)

<0.001

Daily range 0 - 10 0 - 11 0 - 4 0 - 7


(57%) 699

(49%)

<0.001

219 (63%)

286 (52%)

0.001

Age - Mean (SD) 29

(11.77) 30

(11.84)

0.089

30 (11.75)

30 (12.29)

0.506


(<1 - 69) 27

(<1 - 79)

28 (<1 - 66)

27 (13 - 63)

Male 604

(64%) 962

(68%)

0.066

234 (67%)

358 (65%)

0.494

Public space 318

(34%) 447

(32%)

0.195

90 (26%)

118 (22%)

0.130

Outdoor space 313

(34%) 458

(33%)

0.596

68 (71%)

81 (69%)

0.675


(18%) 287

(20%)

0.222

59 (17%)

89 (16%)

0.782

Transported to hospital 715

(76%) 996

(86%)

<0.001

278 (80%)

419 (91%)

<0.001

Note: Except where indicated, all figures in the proportions are based on non-missing information.

Day of week and time of day of cannabis-related attendances

The distribution of attendances across the times of the day and days of the week in metropolitan

Melbourne and regional Victoria in 2011/12 and 2012/13 are shown in Figure 5 and Figure 6. In

2012/13, the distribution of attendances clustered around the weekend, with a similar pattern as

shown in the preceding year. The peak days (aggregating all times) in both 2011/12 and 2012/13

were Friday and Saturday. The peak times (aggregating all days) in 2012/13 were between 6pm and

midnight, which was consistent with 2011/12.


Figure 5: Proportion of cannabis-related attendances by time of day of week, metropolitan Melbourne - 2011/12 and 2012/13

Figure 6: Proportion of cannabis-related attendances by time of day of week, regional Victoria - 2011/12 and 2012/13


Cannabis-related attendances in local government areas

Cannabis-related ambulance attendances are presented for 2012/13 (and 2011/12 for comparison) by


metropolitan Melbourne, the three LGAs with the highest rates for cannabis-related ambulance

attendances in 2012/13 were Melbourne, Frankston and Port Phillip (Table 7). Rates of attendances

increased across the majority of LGAs when compared with the previous year.

Melbourne retained its ranking as the LGA with the highest rate of cannabis-related attendances in

metropolitan Melbourne. Boroondara remained the LGA with the lowest rate of cannabis-related

attendances in metropolitan Melbourne.

In regional Victoria, although Greater Geelong was the LGA with the highest proportion of cannabis-

related ambulance attendances in 2012/13, Latrobe and Greater Shepparton had the highest

population rates, followed by Mildura and East Gippsland (Table 8). Rates of attendances increased

across the majority of LGAs when compared with the previous year.

Mapped cannabis-related attendances for 2012/13 are presented at LGA (Map 4 and Map 5) and

postcode (Map 6) levels for metropolitan Melbourne and regional Victoria.


Table 7: Numbers of cannabis-related attendances by local government area in metropolitan Melbourne - 2011/12 and 2012/13

LGA 2011/12

LGA 2012/13

N (%*) Rate** N (%*) Rate**


Yarra 46 (5%) 58.3 Frankston 74 (5%) 56.3

Greater Dandenong 60 (6%) 42.2 Port Phillip 56 (4%) 56.1


Port Phillip 35 (4%) 36.0 Greater Dandenong 67 (5%) 46.3

Maroondah 36 (4%) 33.5 Darebin 66 (5%) 45.8

Frankston 42 (5%) 32.2 Yarra 32 (2%) 39.7

Hobsons Bay 27 (3%) 30.9 Casey 105 (7%) 39.2

Darebin 44 (5%) 30.8 Mornington Peninsula 56 (4%) 37.1

Mornington Peninsula 37 (4%) 24.8 Stonnington 37 (3%) 36.7

Knox 38 (4%) 24.6 Moreland 57 (4%) 36.5

Kingston 35 (4%) 23.6 Maroondah 39 (3%) 36.1

Hume 41 (4%) 23.5 Hume 64 (5%) 35.9

Stonnington 20 (2%) 20.2 Brimbank 68 (5%) 35.1

Moreland 31 (3%) 20.1 Moonee Valley 38 (3%) 33.6

Brimbank 38 (4%) 19.8 Knox 52 (4%) 33.6

Whitehorse 30 (3%) 19.0 Yarra Ranges 49 (4%) 32.9

Moonee Valley 21 (2%) 18.7 Banyule 36 (3%) 29.1

Monash 32 (3%) 18.0 Kingston 43 (3%) 28.7

Bayside 17 (2%) 17.7 Melton 33 (2%) 28.0

Casey 46 (5%) 17.6 Hobsons Bay 24 (2%) 27.2

Banyule 20 (2%) 16.3 Whitehorse 40 (3%) 25.2

Wyndham 27 (3%) 16.2 Cardinia 20 (1%) 25.0

Yarra Ranges 24 (3%) 16.1 Whittlesea 41 (3%) 24.2

Cardinia 12 (1%) 15.8 Glen Eira 31 (2%) 22.3

Glen Eira 18 (2%) 13.1 Wyndham 39 (3%) 21.7

Whittlesea 18 (2%) 11.2 Manningham 25 (2%) 21.4

Melton 12 (1%) 10.7 Nillumbik 12 (1%) 19.2

Boroondara 17 (2%) 10.2 Monash 33 (2%) 18.4

Bayside 15 (1%) 15.5

Boroondara 24 (2%) 14.3


*% of metropolitan Melbourne ** per 100,000 population


Table 8: Numbers of cannabis-related attendances by local government area in regional Victoria - 2011/12 and 2012/13

LGA 2011/12

LGA 2012/13

N (%*) Rate** N (%*) Rate**

Mildura 26 (8%) 50.2 Latrobe 62 (11%) 83.9

Horsham 9 (3%) 46.1 Greater Shepparton 42 (8%) 67.4

East Gippsland 18 (5%) 42.0 Mildura 33 (6%) 63.2

Greater Shepparton 25 (7%) 40.5 East Gippsland 24 (4%) 55.6

Latrobe 29 (8%) 39.3 Wangaratta 15 (3%) 55.1

Moorabool 10 (3%) 34.9 Ararat 6 (1%) 52.8

Greater Geelong 75 (22%) 34.7 Murrindindi 7 (1%) 52.1

Warrnambool 11 (3%) 33.7 Wellington 22 (4%) 52.0

Bass Coast 10 (3%) 33.1 Warrnambool 17 (3%) 51.6

Campaspe 9 (3%) 24.4 Bass Coast 14 (3%) 45.8

Ballarat 22 (6%) 23.1 Greater Geelong 95 (17%) 43.5

Mitchell 8 (2%) 22.8 Southern Grampians 7 (1%) 42.7

Wodonga 8 (2%) 22.2 Ballarat 36 (7%) 37.1

Moira 6 (2%) 21.1 Macedon Ranges 16 (3%) 36.8

Baw Baw 7 (2%) 16.1 Mitchell 13 (2%) 35.9

Wellington 6 (2%) 14.3 South Gippsland 10 (2%) 35.9

Greater Bendigo 14 (4%) 13.7 Horsham 7 (1%) 35.6

Corangamite 5 (1%) 30.5

Glenelg 6 (1%) 30.3

Campaspe 11 (2%) 29.8

Wodonga 10 (2%) 27.3

Baw Baw 11 (2%) 24.8

Moorabool 7 (1%) 23.9

Surf Coast 6 (1%) 21.9

Greater Bendigo 21 (4%) 20.2

Rest of Regional Victoria 55 (17%) - Rest of Regional Victoria 45 (8%) -



Map 4: Cannabis-related attendances by Victorian LGA, numbers of attendances - 2012/13


Map 5: Cannabis-related attendances by Victorian LGA, rates per 100,000 ERP - 2012/13


Map 6: Cannabis-related attendances by Victorian postcodes, numbers of attendances - 2012/13


Trends over time in cannabis-related attendances

Figure 7 shows the numbers and rates of cannabis-related attendances have fluctuated with overall

upward trends across metropolitan Melbourne and regional Victoria over the past two years, with the

lowest rate of attendances occurring in June 2012. The increase in attendances over the last decade

has been significant, with more than double the number of cannabis-related attendances in 2012/13

than in 2003/04 in metropolitan Melbourne (Figure 8).

Figure 7: Cannabis-related attendances by month - 2011/12 and 2012/13


Figure 8: Cannabis-related attendances by year - 2003/04 to 2012/13


Chapter 5: Ecstasy-Related Attendances

Characteristics of ecstasy-related attendances

As shown in Table 9, in both metropolitan Melbourne and regional Victoria, there were significant

increases in the daily numbers of ecstasy-related attendances in 2012/13 when compared with

2011/12. The age of patients attended decreased in metropolitan Melbourne while the age increased

in regional Victoria in 2012/13 compared with 2011/12. Both changes were significant (p<0.05). In

metropolitan Melbourne only, the proportion of attendances where alcohol was also involved

decreased while the proportion of attendances where the patient was transported to hospital

increased, both changes were statistically significant (p<0.001; p<0.05, respectively).

Table 9: Characteristics of ecstasy-related attendances - 2011/12 and 2012/13


2011/12 2012/13 p 2011/12 2012/13 p


191 (46.4)

306 (73.1)

33

(23.4) 54

(37.4)


(1.03) 0.84

(1.27)

<0.001

0.09

(0.30) 0.15

(0.42) 0.035

Daily range 0 - 12 0 - 8 0 - 2 0 - 3


(67%) 168

(55%) 0.006

22

(67%) 27

(50%) 0.115

Age - Mean (SD) 24

(8.22) 23

(6.54) 0.034

22

(7.46) 25

(7.12) 0.031


(<1 - 60) 21

(15 - 55)

22 (<1 - 44)

23 (18 -49)

Male 124

(65%) 199

(65%) 0.971

17

(52%) 35

(65%) 0.229

Public space 94

(51%) 158

(53%) 0.559

14

(45%) 28

(56%) 0.332

Outdoor space 96

(52%) 161

(56%) 0.487

12

(86%) 22

(79%) 0.537


(13%) 50

(16%) 0.242

<5

5

(9%)


(79%) 238

(87%) 0.030

29

(88%) 41

(93%) 0.403


Day of week and time of day of ecstasy-related attendances


Melbourne was similar for 2012/13 and the previous year (Figure 9 and Figure 10), with few cases in

regional Victoria indicating a broadly similar trend in 2012/13. The peak days (aggregating all times) in

2011/12 and in 2012/13 in metropolitan Melbourne and regional Victoria were Sundays. The peak

times (aggregating all days) in 2011/12 and in 2012/13 were between midnight and 6am in

metropolitan Melbourne and regional Victoria.


Figure 9: Proportion of ecstasy-related attendances by time of day of week, metropolitan Melbourne - 2011/12 and 2012/13

Figure 10: Proportion of ecstasy-related attendances by time of day of week, regional Victoria - 2011/12 and 2012/13


Ecstasy-related attendances in local government areas

Ecstasy-related ambulance attendances are presented for 2012/13 (and 2011/12 for comparison) by


metropolitan Melbourne, the three LGAs with the highest rates for ecstasy-related ambulance

attendances in 2012/13 were Melbourne, Stonnington and Port Phillip (Table 10). Rates of

attendances increased across the majority of LGAs when compared with the previous year.

Melbourne retained its ranking as the LGA with the highest rate of ecstasy-related attendances in

metropolitan Melbourne. In regional Victoria, Greater Bendigo and Greater Geelong had the highest

population rates in 2012/13 (Table 11).

Mapped ecstasy-related attendances for 2012/13 are presented at LGA (Map 7 and Map 8) and

postcode (Map 9) levels.

Table 10: Numbers of ecstasy-related attendances by local government area in metropolitan Melbourne - 2011/12 and 2012/13

LGA 2011/12

LGA 2012/13

N (%*) Rate** N (%*) Rate**


Stonnington 19 (10%) 19.2 Stonnington 24 (8%) 23.8

Port Phillip 14 (8%) 14.4 Port Phillip 17 (6%) 17.0

Yarra 8 (4%) 10.1 Yarra 9 (3%) 11.2

Maribyrnong 6 (3%) 8.0 Frankston 14 (5%) 10.6

Moonee Valley 7 (4%) 6.2 Moreland 13 (4%) 8.3

Frankston 8 (4%) 6.1 Banyule 9 (3%) 7.3

Boroondara 9 (5%) 5.4 Darebin 10 (3%) 6.9

Bayside 5 (3%) 5.2 Maroondah 7 (2%) 6.5

Hume 7 (4%) 4.0 Yarra Ranges 9 (3%) 6.0

Knox 6 (3%) 3.9 Boroondara 10 (3%) 5.9

Yarra Ranges 5 (3%) 3.4 Hume 10 (3%) 5.6

Wyndham 5 (3%) 3.0 Moonee Valley 6 (2%) 5.3

Casey 7 (4%) 2.7 Glen Eira 6 (2%) 4.3

Whittlesea 7 (2%) 4.1

Mornington Peninsula 6 (2%) 4.0

Monash 7 (2%) 3.9

Kingston 5 (2%) 3.3

Knox 5 (2%) 3.2

Whitehorse 5 (2%) 3.1

Casey 8 (3%) 3.0


*% of metropolitan Melbourne. ** per 100,000 population

Table 11: Numbers of ecstasy-related attendances by local government area in regional Victoria - 2011/12 and 2012/13

LGA 2011/12

LGA 2012/13

N (%*) Rate** N (%*) Rate**

Greater Geelong 10 (30%) 4.6 Greater Bendigo 7 (13%) 6.7

Greater Geelong 9 (17%) 4.1


*% of regional Victoria. ** per 100,000 population


Map 7: Ecstasy -related attendances by Victorian LGA, numbers of attendances - 2012/13


Map 8: Ecstasy -related attendances by Victorian LGA, rates per 100,000 ERP - 2012/13


Map 9: Ecstasy -related attendances by Victorian postcode, numbers of attendances - 2012/13


Trends over time in ecstasy-related attendances

Figure 11 shows an upward trend in ecstasy-related attendances across metropolitan Melbourne over

the past two years, with some fluctuations. Over the last ten years there has been a slight upward

trend in ecstasy-related ambulance attendances in metropolitan Melbourne, with a peak in 2008/09

followed by a decline in 2009/10, 2010/11 and 2011/12 and a rise again in 2012/13 (Figure 12).

Figure 11: Ecstasy-related attendances by month - 2011/12 and 2012/13


Figure 12: Ecstasy-related attendances by year - 2003/04 to 2012/13


Chapter 6 All Amphetamine-Related Attendances

This chapter provides analysis of all amphetamine-related attendances, combining crystal

methamphetamine-related attendances, as reported in Chapter 7, with other amphetamine-related

attendances, as reported in Chapter 8. Alcohol and other drugs may have also been ingested.

Characteristics of all amphetamine-related attendances

As shown in Table 12, in both metropolitan Melbourne and regional Victoria, the daily rate of all

amphetamine-related attendances and the proportion of events co-attended by police in 2012/13

increased significantly when compared with the preceding year (p<0.01). In metropolitan Melbourne,

there was a significant decrease (p<0.01) in the proportion of cases where alcohol was also involved,

while there was a significant increase (p<0.001) in the proportion of cases where the patient was

transported to hospital in 2012/13 when compared with 2011/12. In regional Victoria, the proportion of

events occurring in public spaces increased significantly (p<0.01).

Table 12: Characteristics of all amphetamine-related attendances - 2011/12 and 2012/13


2011/12 2012/13 p 2011/12 2012/13 p


880 (214.1)

1394 (333.1)

166 (115.9)

312 (216.6)


(1.95) 3.82

(2.30)

<0.001 0.45 (0.68)

0.86 (1.07)

<0.001

Daily range 0 - 12 0 - 14 0 - 3 0 - 6


(33%) 375

(27%) 0.001

66

(40%) 98

(31%) 0.046

Age - Mean (SD) 28

(9.41) 28

(8.59) 0.202

27

(9.55) 28

(8.59) 0.335


(<1 - 64) 27

(12 - 70)

26 (<1 - 68)

26 (13 - 60)

Male 570

(65%) 914

(66%) 0.710

106

(64%) 201

(64%) 0.897

Public space 380

(44%) 563

(41%) 0.145

44

(27%) 111

(37%) 0.030

Outdoor space 347

(41%) 534

(39%) 0.528

26

(59%) 76

(64%) 0.545


(20%) 366

(26%) 0.001

16

(10%) 64

(21%) 0.002


(76%) 1085 (87%)

<0.001

139

(84%) 243

(89%) 0.113



Day of week and time of day of all amphetamine-related attendances

As displayed in Figure 13 the distribution of attendances across the times of the day and days of the

week was similar for 2012/13 and the previous year in metropolitan Melbourne, while patterns were

variable in regional Victoria in 2012/13 (Figure 14). The peak day (aggregating all times) in 2012/13

was Saturday in metropolitan Melbourne and Sunday in regional Victoria. The peak times

(aggregating all days) in 2012/13 in both metropolitan Melbourne and regional Victoria were between

midnight and 6am.

Figure 13: Proportion of all amphetamine-related attendances by time of day of week, metropolitan Melbourne - 2011/12 and 2012/13


Figure 14: Proportion of all amphetamine-related attendances by time of day of week - 2011/12 and 2012/13

All amphetamine-related attendances in local government areas

All amphetamine-related ambulance attendances are presented for 2012/13 (and 2011/12 for

comparison) by local government area for metropolitan Melbourne in Table 13 and for regional

Victoria in Table 14. In metropolitan Melbourne, the three LGAs with the highest rates for all

amphetamine-related ambulance attendances in 2012/13 were Melbourne, Port Phillip and Yarra

(Table 13). Rates of attendances increased across the majority of LGAs when compared with the

previous year. The two exceptions were Yarra and Maribyrnong. Melbourne retained its ranking as the

LGA with the highest rate of alcohol-related attendances in metropolitan Melbourne. Manningham was

the LGA with the lowest rate of all amphetamine-related attendances in metropolitan Melbourne.

In regional Victoria, although Greater Geelong was the LGA with the highest proportion of all

amphetamine-related ambulance attendances in 2012/13, Latrobe, Moorabool and Greater

Shepparton had the highest population rates, followed by Horsham and Warnambool (Table 14).

Rates of attendances increased across the majority of LGAs when compared with the previous year.

The exceptions were East Gippsland and Bass Coast, showing decreases in population rates for all

amphetamine-related ambulance attendances.

Mapped all amphetamine-related attendances for 2012/13 are presented at LGA (Map 10 and Map

11) and postcode (Map 12).


Table 13: Numbers of all amphetamine-related attendances by local government area in metropolitan Melbourne - 2011/12 and 2012/13

LGA 2011/12

LGA 2012/13

N (%*) Rate** N (%*) Rate**




Frankston 48 (5%) 36.8 Frankston 64 (5%) 48.7

Greater Dandenong 42 (5%) 29.5 Greater Dandenong 62 (5%) 42.9

Maribyrnong 22 (3%) 29.3 Darebin 58 (4%) 40.3

Hobsons Bay 25 (3%) 28.6 Hume 70 (5%) 39.3

Stonnington 26 (3%) 26.3 Moreland 60 (4%) 38.4

Darebin 35 (4%) 24.5 Brimbank 74 (5%) 38.2

Moreland 37 (4%) 24.0 Stonnington 38 (3%) 37.7

Maroondah 24 (3%) 22.4 Banyule 42 (3%) 34.0

Banyule 27 (3%) 22.0 Melton 40 (3%) 33.9

Hume 35 (4%) 20.1 Casey 86 (6%) 32.1

Yarra Ranges 28 (3%) 18.8 Hobsons Bay 28 (2%) 31.8

Brimbank 35 (4%) 18.3 Moonee Valley 35 (3%) 30.9

Moonee Valley 20 (2%) 17.8 Maroondah 33 (2%) 30.5

Whittlesea 27 (3%) 16.8 Kingston 40 (3%) 26.7

Wyndham 27 (3%) 16.2 Whittlesea 44 (3%) 26.0

Kingston 24 (3%) 16.2 Mornington Peninsula 39 (3%) 25.9

Melton 18 (2%) 16.0 Knox 38 (3%) 24.6

Knox 24 (3%) 15.5 Whitehorse 39 (3%) 24.5

Casey 39 (4%) 14.9 Cardinia 19 (1%) 23.7

Mornington Peninsula 22 (3%) 14.7 Glen Eira 30 (2%) 21.6

Whitehorse 23 (3%) 14.6 Nillumbik 13 (1%) 20.7

Nillumbik 8 (1%) 12.8 Yarra Ranges 30 (2%) 20.1

Glen Eira 14 (2%) 10.2 Maribyrnong 15 (1%) 19.6

Manningham 11 (1%) 9.4 Wyndham 34 (2%) 18.9

Boroondara 15 (2%) 9.0 Boroondara 28 (2%) 16.6

Monash 13 (3%) 7.3 Bayside 16 (1%) 16.5

Monash 29 (2%) 16.1

Manningham 17 (1%) 14.5




Table 14: Numbers of all amphetamine-related attendances by local government area in regional Victoria - 2011/12 and 2012/13

LGA 2011/12

LGA 2012/13

N (%*) Rate** N (%*) Rate**

East Gippsland 10 (6%) 23.4 Latrobe 35 (11%) 47.3

Bass Coast 7 (4%) 23.2 Moorabool 12 (4%) 40.9

Latrobe 16 (10%) 21.7 Greater Shepparton 21 (7%) 33.7

Mildura 10 (6%) 19.3 Horsham 6 (2%) 30.5

Greater Geelong 34 (20%) 15.8 Warrnambool 10 (3%) 30.3


Greater Shepparton 9 (6%) 14.6 Greater Bendigo 29 (9%) 28.0

Wellington 6 (4%) 14.3 Campaspe 9 (3%) 24.4

Mitchell 5 (3%) 14.2 Mildura 12 (4%) 23.0

Baw Baw 5 (3%) 11.5 Wodonga 8 (3%) 21.8

Greater Bendigo 10 (6%) 9.8 Moira 6 (2%) 20.9

Ballarat 20 (7%) 20.6

Bass Coast 6 (2%) 19.6

East Gippsland 8 (3%) 18.5


Baw Baw 8 (3%) 18.0

Macedon Ranges 6 (2%) 13.8




Map 10: Amphetamine-related attendances by Victorian LGA, numbers of attendances - 2012/13


Map 11: Amphetamine-related attendances by Victorian LGA, rates per 100,000 ERP - 2012/13


Map 12: Amphetamine-related attendances by Victorian postcode, numbers of attendances - 2012/13


Trends over time in all amphetamine-related attendances

Over the past two years, upward trends in all amphetamine-related attendances across metropolitan

Melbourne and regional Victoria were evident, with some fluctuations (Figure 15).

As shown in Figure 16, there has been an upward trend in all amphetamine-related attendances in

metropolitan Melbourne over the first four years shown, with a peak in 2006/07 followed by a decline

in 2007/08, beginning to rise again from 2010/11, and peaking in 2012/13.

Figure 15: All amphetamine-related attendances by month - 2011/12 and 2012/13


Figure 16: All amphetamine-related attendances by year - 2003/04 and 2012/13


Chapter 7 Crystal Methamphetamine-Related

Attendances

These cases are selected on the basis of ambulance paramedic mention of the involvement of “crystal

meth(amphetamine)”, “ice”, etc., established through patient self-report or information provided by

someone else at the scene, such as family, friends or associates. Data on “crystal

methamphetamine/ice” as the type of amphetamine involved in events have been collected from

October 2002.

Characteristics of crystal methamphetamine-related attendances

As shown in Table 15, in 2012/13 across Victoria, the daily rate of crystal methamphetamine-related

attendances was significantly higher than in 2011/12 (p<0.001). In metropolitan Melbourne, significant

decreases were seen in the proportion of cases where alcohol was involved, and where events

occurred in public spaces (p<0.05), while significant increases were noted in the proportion of events

co-attended by police, and cases where the patient was transported to hospital (p<0.01). In regional

Victoria, there was a significant increase in the proportion of events co-attended by police (p<0.001).

Table 15: Characteristics of crystal methamphetamine-related attendances - 2011/12 and 2012/13


2011/12 2012/13 p 2011/12 2012/13 p


592 (144.1)

1112 (265.7)

77 (54.2)

231 (159.8)


(1.45) 3.05

(1.92)

<0.001 0.21 (0.44)

0.63 (0.84)

<0.001

Daily range 0 - 7 0 - 10 0 - 2 0 - 4


(27%) 243

(22%)

0.022 25 (32%)

63 (27%)

0.377

Age - Mean (SD) 28

(8.80) 28

(8.41)

0.136 26 (9.06)

28 (8.83)

0.136


(<1 - 53) 27

(12 - 70)

25 (<1 - 68)

26 (13 - 60)

Male 386

(65%) 724

(65%)

0.975 46 (59%)

150 (65%)

0.313

Public space 256

(44%) 424

(39%)

0.028 18 (23%)

78 (34%)

0.062

Outdoor space 226

(40%) 405

(38%)

0.407 10 (56%)

54 (63%)

0.559


(21%) 306

(27%)

0.002 5 (6%)

51 (22%)

0.002


(78%) 858

(87%)

<0.001 65 (84%)

182 (90%)

0.136



Day of week and time of day of crystal methamphetamine-related attendances

As displayed in Figure 17 the distribution of attendances across the times of the day and days of the

week was similar for 2012/13 and the previous year in metropolitan Melbourne, while patterns were

variable in regional Victoria in 2012/13 (Figure 18). The peak day (aggregating all times) in 2012/13

was Saturday in metropolitan Melbourne and Friday in regional Victoria. The peak times (aggregating

all days) in 2012/13 were between 6pm and midnight in both metropolitan Melbourne and regional

Victoria.

Figure 17: Proportion of crystal methamphetamine-related attendances by time of day of week, metropolitan Melbourne - 2011/12 and 2012/13


Figure 18: Proportion of crystal methamphetamine-related attendances by time of day of week, regional Victoria - 2011/12 and 2012/13

Crystal methamphetamine-related attendances in local government areas

Crystal methamphetamine-related ambulance attendances are presented for 2012/13 (and 2011/12

for comparison) by local government area for metropolitan Melbourne in Table 16 and for regional

Victoria in Table 17. In metropolitan Melbourne, the three LGAs with the highest rates for crystal

methamphetaminel-related ambulance attendances in 2012/13 were Melbourne, Port Phillip and

Yarra (Table 16). Rates of attendances increased across the majority of LGAs when compared with

the previous year. The only exception was Maribyrnong.

Melbourne retained its ranking as the LGA with the highest rate of crystal methamphetamine-related

attendances in metropolitan Melbourne. Bayside was the LGA with the lowest rate of crystal

methamphetamine-related attendances in metropolitan Melbourne.

In regional Victoria, although Greater Geelong was the LGA with the highest proportion of crystal

methamphetamine-related ambulance attendances in 2012/13, Latrobe, Moorabool and Horsham had

the highest population rates, followed by Greater Bendigo and Greater Geelong (Table 17). Rates of

attendances increased across all LGAs when compared with the previous year (where numbers

allowed for comparison).

Mapped crystal methamphetamine-related attendances for 2012/13 are presented at LGA level (Map

1 and Map 2) and postcode (Map 3) for metropolitan Melbourne and regional Victoria.


Table 16: Numbers of crystal methamphetamine-related attendances by local government area in metropolitan Melbourne - 2011/12 and 2012/13

LGA 2011/12

LGA 2012/13

N (%*) Rate** N (%*) Rate**






Hobsons Bay 18 (3%) 20.6 Darebin 50 (5%) 34.7

Maribyrnong 15 (3%) 20.0 Moreland 53 (5%) 33.9

Stonnington 19 (3%) 19.2 Hume 59 (5%) 33.1

Moreland 29 (5%) 18.8 Melton 38 (3%) 32.2

Hume 29 (5%) 16.6 Brimbank 60 (5%) 31.0

Darebin 22 (4%) 15.4 Stonnington 31 (3%) 30.8

Brimbank 27 (5%) 14.1 Casey 72 (7%) 26.9

Maroondah 15 (3%) 14.0 Banyule 33 (3%) 26.7

Melton 15 (3%) 13.3 Moonee Valley 28 (3%) 24.7

Banyule 16 (3%) 13.0 Kingston 37 (3%) 24.7

Knox 19 (3%) 12.3 Maroondah 26 (2%) 24.1

Kingston 17 (3%) 11.5 Whittlesea 39 (4%) 23.0

Wyndham 19 (3%) 11.4 Whitehorse 36 (3%) 22.6

Whittlesea 18 (3%) 11.2 Hobsons Bay 19 (2%) 21.6

Yarra Ranges 16 (3%) 10.7 Mornington Peninsula 32 (3%) 21.2

Moonee Valley 12 (2%) 10.7 Cardinia 17 (2%) 21.2

Casey 25 (4%) 9.6 Maribyrnong 14 (1%) 18.3

Glen Eira 13 (2%) 9.5 Knox 28 (3%) 18.1

Mornington Peninsula 11 (2%) 7.4 Nillumbik 11 (1%) 17.6

Whitehorse 11 (2%) 7.0 Wyndham 28 (3%) 15.6

Manningham 8 (1%) 6.9 Glen Eira 20 (2%) 14.4

Monash 10 (2%) 5.6 Monash 23 (2%) 12.8

Boroondara 9 (2%) 5.4 Yarra Ranges 19 (2%) 12.7

Manningham 14 (1%) 12.0

Boroondara 20 (2%) 11.9

Bayside 10 (0.9%) 10.3




Table 17: Numbers of crystal methamphetamine-related attendances by local government area in regional Victoria - 2011/12 and 2012/13

LGA

2011/12

LGA

2012/13

N (%*) Rate** N (%*) Rate**

Latrobe 10 (13%) 13.6 Latrobe 30 (13%) 40.6

Ballarat 8 (10%) 8.4 Moorabool 9 (4%) 30.7

Greater Geelong 18 (23%) 8.3 Horsham 5 (2%) 25.4


Greater Bendigo 7 (9%) 6.9 Greater Geelong 50 (22%) 22.9

Greater Shepparton 14 (6%) 22.5

Campaspe 8 (4%) 21.6


Warrnambool 6 (3%) 18.2

Moira 5 (2%) 17.4

Ballarat 15 (7%) 15.5

Mildura 8 (4%) 15.3

East Gippsland 5 (2%) 11.6



Trends over time in crystal methamphetamine-related attendances

Figure 19 shows a pronounced upward trend in crystal methamphetamine-related attendances over

the past two years in metropolitan Melbourne, while a slow rise was seen for regional Victorian

attendances. As shown in Figure 20 an upward trend in crystal methamphetamine-related

attendances in metropolitan Melbourne is evident, with the peak for attendances occurring in 2012/13.


Figure 19: Crystal methamphetamine-related attendances by month - 2011/12 and 2012/13

Figure 20: Crystal methamphetamine-related attendances by year - 2003/04 to 2012/13


Chapter 8: Other Amphetamine-Related Attendances

This chapter excludes analysis of crystal methamphetamine-related attendances, the results of which

were presented in the previous chapter. However, it should be noted that crystal methamphetamine

involved cases cannot be excluded, with certainty, from the other amphetamine category, but only in

so far as could be ascertained.

Characteristics of other amphetamine-related attendances

As shown in Table 18, across metropolitan Melbourne and regional Victoria, the daily rate of other

amphetamine-related attendances decreased non-significantly. In metropolitan Melbourne only, the

proportion of cases where the patient was transported to hospital was significantly higher than in

2011/12 (p<0.001).

Table 18: Characteristics of other amphetamine attendances - 2011/12 and 2012/13


2011/12 2012/13 p 2011/12 2012/13 p


288 (70.0)

282 (67.4)

88 (61.7)

82 (56.8)


(1.04) 0.77 (1.03)

0.865 0.24 (0.49)

0.22 (0.52)

0.658

Daily range 0 - 6 0 - 6 0 - 2 0 - 3


(47%) 132

(47%)

0.992 41 (47%)

35 (43%)

0.552

Age - Mean (SD) 28

(10.56) 29

(9.30)

0.694 28 (9.92)

29 (7.89)

0.823


(<1 - 64) 26

(13 - 58) 27

(<1 - 64) 27

(17 - 50)

Male 184

(64%) 190

(67%)

0.398 60 (68%)

51 (62%)

0.408

Public space 124

(44%) 139

(50%)

0.149 26 (30%)

33 (43%)

0.082

Outdoor space 121

(43%) 129

(47%) 0.380 16

(60%) 22

(65%)

0.731


(19%) 60

(21%)

0.512 11 (12%)

13 (16%)

0.522


(74%) 227

(89%)

<0.001 74 (84%)

62 (86%)

0.698

Note: Except where indicated, all figures in the proportions are based on non-missing information

Day of week and time of day of other amphetamine-related attendances


Melbourne were similar in 2012/13 and the previous year, and broadly similar to the pattern in

regional Victoria in 2011/12 (Figure 21, Figure 22). The peak days (aggregating all times) in both

metropolitan Melbourne and regional Victoria were Saturday and Sunday. The peak time (aggregating

all days) in 2012/13 in metropolitan Melbourne was between midnight and 6am.


Figure 21: Proportion of other amphetamine-related attendances by time of day of week, metropolitan Melbourne - 2011/12 and 2012/13

Figure 22: Proportion of other amphetamine-related attendances by time of day of week, regional Victoria - 2011/12 and 2012/13


Other amphetamine-related attendances in local government areas

Other amphetamine-related ambulance attendances are presented for 2012/13 (and 2011/12 for


Victoria in Table 20. In metropolitan Melbourne, the three LGAs with the highest rates for other

amphetamine-related ambulance attendances in 2012/13 were Melbourne, Port Phillip and Yarra

(Table 19). Rates of attendances varied across the majority of LGAs when compared with the

previous year. Melbourne retained its ranking as the LGA with the highest rate of other amphetamine-

related attendances in metropolitan Melbourne.

In regional Victoria, although Greater Geelong was the LGA with the highest proportion of other

amphetamine-related ambulance attendances in 2012/13, Greater Shepparton and Latrobe had the

highest population rates (Table 19)

Table 19: Numbers of other amphetamine-related attendances by local government area in metropolitan Melbourne - 2011/12 and 2012/13

LGA 2011/12

LGA 2012/13

N (%*) Rate** N (%*) Rate**




Frankston 20 (7%) 15.3 Hobsons Bay 9 (3%) 10.2

Maribyrnong 8 (3%) 10.6 Frankston 13 (5%) 9.9

Darebin 13 (5%) 9.1 Yarra Ranges 11 (4%) 7.4

Greater Dandenong 13 (4%) 9.1 Banyule 9 (3%) 7.3

Banyule 11 (4%) 8.9 Brimbank 14 (5%) 7.2

Maroondah 9 (3%) 8.4 Glen Eira 10 (4%) 7.2

Yarra Ranges 12 (4%) 8.1 Stonnington 7 (3%) 7.0

Hobsons Bay 7 (3%) 8.0 Maroondah 7 (3%) 6.5

Whitehorse 12 (4%) 7.6 Knox 10 (4%) 6.5

Mornington Peninsula 11 (4%) 7.4 Hume 11 (4%) 6.2

Moonee Valley 8 (3%) 7.1 Moonee Valley 7 (3%) 6.2

Stonnington 7 (2%) 7.1 Bayside 6 (2%) 6.2

Whittlesea 9 (3%) 5.6 Darebin 8 (3%) 5.6

Casey 14 (5%) 5.4 Greater Dandenong 8 (3%) 5.5

Wyndham 8 (3%) 4.8 Casey 14 (5%) 5.2

Kingston 7 (2%) 4.7 Boroondara 8 (3%) 4.8

Moreland 7 (3%) 4.5 Mornington Peninsula 7 (3%) 4.6

Brimbank 7 (3%) 3.7 Moreland 7 (3%) 4.5

Boroondara 6 (2%) 3.6 Wyndham 6 (2%) 3.3

Hume 6 (2%) 3.4 Monash 6 (2%) 3.3

Knox 5 (2%) 3.2 Whittlesea 5 (2%) 3.0




Table 20: Numbers of other amphetamine-related attendances by local government area in regional Victoria - 2011/12 and 2012/13

LGA 2011/12

LGA 2012/13

N (%*) Rate** N (%*) Rate**

East Gippsland 8 (9%) 18.7 Greater Shepparton 7 (9%) 11.2

Wellington 6 (7%) 14.3 Latrobe 5 (6%) 6.8

Mildura 6 (7%) 11.6 Greater Geelong 14 (17%) 6.4

Latrobe 7 (8%) 9.5 Ballarat 5 (6%) 5.2

Greater Geelong 16 (18%) 7.4 Greater Bendigo 5 (6%) 4.8

Ballarat 7 (7%) 7.4



Trends over time in other amphetamine-related attendances

As shown in Figure 23, there has been a downward trend in other amphetamine-related attendances

across metropolitan Melbourne n the past two years. Due to the small numbers of regional Victorian

attendances, the trend was not immediately apparent. Figure 24 shows a gradual downward trend

across metropolitan Melbourne over the past ten years.

Figure 23: Other amphetamine-related attendances by month - 2011/12 and 2012/13


Figure 24: Other amphetamine-related attendances by year - 2003/04 to 2012/13


Chapter 9: Benzodiazepine-Related Attendances

Characteristics of benzodiazepine-related attendances

Characteristics of benzodiazepine-related attendances in metropolitan Melbourne and regional

Victoria are displayed in Table 21. As shown, across metropolitan Melbourne and regional Victoria,

the daily numbers of benzodiazepine-related attendances were higher in 2012/13 than in 2011/12

(p<0.001; p<0.05, respectively). Significant decreases were seen in the proportions of events

occurring in public spaces, while significant increases were evident in the proportions of events co-

attended by police and in cases where the patient was transported to hospital. The mean age of

patients increased while the proportion of male patients decreased in metropolitan Melbourne. Both

changes were significant (p<0.01; p<0.001). The proportion of cases involving alcohol decreased

significantly (p<0.01) in regional Victoria.

Table 21: Characteristics of benzodiazepine-related attendances - 2011/12 and 2012/13


2011/12 2012/13 p 2011/12 2012/13 p


2694 (655.6)

3159 (754.6)

727

(508.9) 808

(560.0)


(2.88) 8.65

(3.10)

<0.001

1.99 (1.54)

2.21 (1.43)

0.039

Daily range 1 – 15 2 - 20 0 - 7 0 - 7

Alcohol involved 1193 (44%)

1338 (42%)

0.123

351 (48%)

333 (41%)

0.004

Age - Mean (SD) 37

(14.55) 38

(14.31)

0.004

39 (15.91)

40 (15.46)

0.119


(<1 - 95) 37

(<1 - 100)

40 (<1 - 95)

40 (1 - 92)

Male 1226 (46%)

1295 (41%)

<0.001

280 (39%)

323 (40%)

0.548

Public space 733

(28%) 767

(25%)

0.008

156 (22%)

136 (17%)

0.016

Outdoor space 606

(23%) 677

(22%)

0.311

86 (53%)

88 (60%)

0.158


(17%) 653

(21%)

0.001

96 (13%)

136 (17%)

0.046

Transported to hospital 2389 (89%)

2793 (93%)

<0.001

664 (92%)

735 (97%)

<0.001


Day of week and time of day of benzodiazepine-related attendances

The distributions of attendances across the times of the day and days of the week in metropolitan

Melbourne and regional Victoria were similar in 2012/13 and 2011/12 (Figure 25, Figure 26). The

peak days (aggregating all times) in 2012/13 were Monday and Tuesday in metropolitan Melbourne,

and Saturday in regional Victoria, although the difference between days was small. The peak times of

attendances (aggregating all days) in 2012/13 were between 6pm and midnight in metropolitan

Melbourne and in regional Victoria.


Figure 25: Proportion of benzodiazepine-related attendances by time of day of week, metropolitan Melbourne - 2011/12 and 2012/13

Figure 26: Proportion of benzodiazepine-related attendances by time of day of week, regional Victoria - 2011/12 and 2012/13


Benzodiazepine-related attendances in local government areas

Benzodiazepine-related ambulance attendances are presented for 2012/13 (and 2011/12 for


Victoria in Table 23. In metropolitan Melbourne, the three LGAs with the highest rates for

benzodiazepine-related ambulance attendances in 2012/13 were Yarra, Frankston and Melbourne

(Table 22). Rates of attendances increased across the majority of LGAs when compared with the

previous year. The exceptions included: Yarra, Melbourne, Maribyrnong, Greater Dandenong and

Bayside.

Melbourne did not retain its ranking as the LGA with the highest rate of benzodiazepine-related

attendances in metropolitan Melbourne. Rather Yarra had the highest rate. Manningham remained the

LGA with the lowest rate of benzodiazepine-related attendances in metropolitan Melbourne.

In regional Victoria, although Greater Geelong was the LGA with the highest proportion of

benzodiazepine-related ambulance attendances in 2012/13, East Gippsland, Benalla and Bass Coast

had the highest population rates, followed by Greater Shepparton and Mount Alexander (Table 23).

Rates of attendances increased across the majority of LGAs when compared with the previous year.

The exceptions were Greater Shepparton, Latrobe, Horsham, Ballarat, Central Goldfields, Baw Baw,

Wodonga, Wangaratta, Northern Grampians and Murrindindi, showing decreases in population rates

for benzodiazepine-related ambulance attendances.

Mapped benzodiazepine-related attendances for 2012/13 are presented at LGA (Map 13 and Map 14)

and postcode (Map 15) levels.


Table 22: Numbers of benzodiazepine-related attendances by local government area in metropolitan Melbourne - 2011/12 and 2012/13

LGA 2011/12

LGA 2012/13

N (%*) Rate** N (%*) Rate**

Melbourne 174 (7%) 173.6 Yarra 118 (4%) 146.4

Yarra 128 (5%) 162.2 Frankston 176 (6%) 133.8

Frankston 152 (6%) 116.6 Melbourne 132 (4%) 125.3


Maribyrnong 80 (3%) 106.4 Maroondah 110 (4%) 101.8

Greater Dandenong 117 (4%) 82.3 Maribyrnong 77 (2%) 100.5


Mornington Peninsula 116 (4%) 77.7 Stonnington 87 (3%) 86.4

Darebin 103 (4%) 72.1 Darebin 121 (4%) 84.0

Stonnington 71 (3%) 71.8 Whitehorse 128 (4%) 80.5

Moreland 101 (4%) 65.5 Greater Dandenong 112 (4%) 77.4


Hobsons Bay 55 (2%) 62.9 Moonee Valley 87 (3%) 76.8

Banyule 77 (3%) 62.6 Brimbank 145 (5%) 74.9

Knox 96 (4%) 62.1 Moreland 116 (4%) 74.3

Kingston 90 (3%) 60.7 Kingston 106 (3%) 70.7

Bayside 58 (2%) 60.3 Hume 124 (4%) 69.7

Moonee Valley 66 (3%) 58.8 Banyule 86 (3%) 69.6

Brimbank 107 (4%) 55.9 Melton 82 (3%) 69.5

Melton 63 (2%) 55.9 Knox 107 (3%) 69.2

Whittlesea 88 (3%) 54.7 Hobsons Bay 60 (2%) 68.1

Whitehorse 83 (3%) 52.7 Whittlesea 113 (4%) 66.7

Yarra Ranges 78 (3%) 52.4 Monash 109 (4%) 60.6

Wyndham 83 (3%) 49.8 Casey 153 (5%) 57.1

Cardinia 37 (1%) 48.8 Wyndham 101 (3%) 56.3

Casey 126 (5%) 48.2 Bayside 54 (2%) 55.8

Monash 77 (3%) 43.4 Cardinia 43 (1%) 53.7

Nillumbik 27 (1%) 43.1 Glen Eira 67 (2%) 48.3


Boroondara 51 (2%) 30.5 Nillumbik 28 (1%) 44.7

Manningham 30 (1%) 25.7 Manningham 48 (2%) 41.0




Table 23: Numbers of benzodiazepine-related attendances by local government area in regional Victoria - 2011/12 and 2012/13

LGA 2011/12

LGA 2012/13

N (%*) Rate** N (%*) Rate**

Mansfield 12 (2%) 151.1 East Gippsland 43 (5%) 99.6

Northern Grampians 12 (2%) 99.6 Benalla 11 (1%) 80.1

Latrobe 67 (9%) 90.8 Bass Coast 21 (3%) 68.6

Murrindindi 12 (2%) 90.0 Greater Shepparton 42 (5%) 67.4

East Gippsland 38 (5%) 88.7 Mount Alexander 12 (2%) 67.2

Horsham 17 (2%) 87.1 Latrobe 49 (6%) 66.3

Central Goldfields 9 (1%) 71.5 Moira 19 (2%) 66.3

Greater Shepparton 44 (6%) 71.3 Horsham 13 (2%) 66.1

Benalla 9 (1%) 65.1 Mildura 34 (4%) 65.1

Ararat 7 (1%) 61.8 Campaspe 24 (3%) 64.9

Baw Baw 26 (4%) 59.9 Mitchell 23 (3%) 63.5


Wangaratta 16 (2%) 58.8 Strathbogie 6 (1%) 62.1

Moira 16 (2%) 56.3 Corangamite 10 (1%) 61.0

Mildura 29 (4%) 56.0 Moorabool 17 (2%) 57.9

Bass Coast 16 (2%) 52.9 Ballarat 56 (7%) 57.7

Wodonga 19 (3%) 52.7 Swan Hill 12 (2%) 57.2

Greater Geelong 108 (15%) 50.0 Central Goldfields 7 (1%) 55.6

Wellington 20 (3%) 47.5 Baw Baw 24 (3%) 54.1

Mount Alexander 8 (1%) 44.8 Greater Bendigo 55 (7%) 53.0

Corangamite 7 (1%) 42.4 Wellington 21 (3%) 49.7

Macedon Ranges 18 (2%) 42.0 Wodonga 18 (2%) 49.1

Glenelg 8 (1%) 40.3 Warrnambool 16 (2%) 48.5

Mitchell 14 (2%) 39.9 Wangaratta 13 (2%) 47.7

Greater Bendigo 39 (5%) 38.2 Hepburn 7 (1%) 47.5

Campaspe 14 (2%) 38.0 Golden Plains 9 (1%) 46.3

Moorabool 10 (1%) 34.9 Macedon Ranges 20 (3%) 46.0

Hepburn 5 (1%) 34.2 Glenelg 9 (1%) 45.5

Swan Hill 7 (1%) 33.5 Northern Grampians 5 (1%) 41.8

Warrnambool 10 (1%) 30.6 Murrindindi 5 (1%) 37.2

Southern Grampians 5 (1%) 30.2 Southern Grampians 6 (1%) 36.6

Colac-Otway 5 (1%) 24.0 Moyne 5 (1%) 30.8

South Gippsland 5 (1%) 18.2 Surf Coast 7 (1%) 25.6

Colac- Otway 5 (1%) 24.1

South Gippsland 6 (1%) 21.6




Map 13: Benzodiazepine-related attendances by Victorian LGA, numbers of attendances - 2012/13


Map 14: Benzodiazepine-related attendances by Victoria LGA, rates per 100,000 ERP - 2012/13


Map 15: Benzodiazepine-related attendances by Victorian postcode, numbers of attendances - 2012/13


Trends over time in benzodiazepine-related attendances

The data displayed in Figure 27 indicates a slight upward trend in month-to-month benzodiazepine-

related attendances over the past two years in metropolitan Melbourne and regional Victoria, with

some fluctuations. The pattern over the longer period indicates a slight upward trend in

benzodiazepine-related attendances in metropolitan Melbourne over time (Figure 28).

Figure 27: Benzodiazepine-related attendances by month - 2011/12 and 2012/13


Figure 28: Benzodiazepine-related attendances by year - 2003/04 and 2012/13


Chapter 10: Inhalant-Related Attendances

Characteristics of inhalant-related attendances

Characteristics of inhalant-related attendances in metropolitan Melbourne and regional Victoria are

shown in Table 24. The daily rate of regional Victorian inhalant-related attendances in 2012/13 was

significantly higher than in 2011/12 (p<0.05). When compared with the preceding year, the proportion

of cases where the patient was transported to hospital increased in metropolitan Melbourne while the

proportion decreased in regional Victoria; neither change was statistically significant.

Table 24: Characteristics of inhalant-related attendances - 2011/12 and 2012/13


2011/12 2012/13 p 2011/12 2012/13 p


135 (32.9)

122 (29.1)

14

(9.8) 31

(21.5)


(0.66) 0.33 (0.58)

0.451

0.04 (0.22)

0.08 (0.36)

0.033

Daily range 0 - 4 0 - 3 0 - 2 0 - 4

Alcohol involved 43

(32%) 29

(24%) 0.140

<5

6

(19%)

Age - Mean (SD) 24

(11.64) 23

(11.22) 0.488

37

(19.05) 28

(17.86) 0.071


(<1 - 70) 18

(14 - 81)

33 (3 - 80)

24 (13 - 76)

Male 78

(58%) 62

(53%) 0.352

11

(79%) 20

(65%) 0.328

Public space 79

(60%) 80

(69%) 0.123

5

(36%) 10

(34%) 0.934

Outdoor space 57

(45%) 54

(49%) 0.469

<5

<5


(34%) 46

(38%) 0.532

<5

5

(16%)


(74%) 76

(80%) 0.254

13

(93%) 20

(80%) 0.283


Day of week and time of day of inhalant-related attendances

As displayed in Figure 29 and Figure 30, the distribution of attendances in metropolitan Melbourne

across the times of the day and days of the week in 2012/13 and 2011/12 was variable due to the low

numbers of cases. The peak days (aggregating all times) in 2012/13 were Tuesday, Wednesday and

Friday in metropolitan Melbourne, and Thursday in regional Victoria. The peak times (aggregating all

days) in 2012/13 were between 6pm and 6am in metropolitan Melbourne, and between 12pm and

6pm in regional Victoria.


Figure 29: Proportion of inhalant-related attendances by time of day of week, metropolitan Melbourne - 2011/12 and 2012/13

Figure 30: Proportion of inhalant-related attendances by time of day of week, regional Victoria - 2011/12 and 2012/13


Inhalant-related attendances in local government areas

Inhalant-related ambulance attendances are presented for 2012/13 (and 2011/12 for comparison) by


metropolitan Melbourne, the three LGAs with the highest rates for inhalant-related ambulance

attendances in 2012/13 were Maroondah, Melbourne and Greater Dandenong (Table 25). Rates of

attendances decreased in Melbourne and Frankston LGAs when compared with the previous year.

Greater Dandenong, Whitehorse and Casey showed increases in rates. Maroondah replaced

Melbourne as the LGA with the highest rate of inhalant-related attendances in metropolitan

Melbourne. In regional Victoria, although numbers are small Mildura, Ballarat and Greater Bendigo

were the LGAs with the highest rates of inhalant-related ambulance attendances in 2012/13 (Table

26).

Mapped inhalant-related attendances for 2012/13 are presented at LGA (Map 16 and Map 17) and


Table 25: Numbers of inhalant-related attendances by local government area in metropolitan Melbourne - 2011/12 and 2012/13

LGA 2011/12

LGA 2012/13

N (%*) Rate** N (%*) Rate**

Melbourne 19 (14%) 19.0 Maroondah 14 (12%) 13.0

Maribyrnong 9 (7%) 12.0 Melbourne 11 (9%) 10.4

Yarra 7 (5%) 8.9 Greater Dandenong 12 (10%) 8.3


Hobsons Bay 6 (5%) 6.9 Whitehorse 10 (8%) 6.3

Monash 10 (7%) 5.6 Brimbank 7 (6%) 3.6

Port Phillip 5 (4%) 5.1 Casey 9 (7%) 3.4

Wyndham 7 (5%) 4.2 Kingston 5 (4%) 3.3

Brimbank 7 (5%) 3.7 Monash 5 (4%) 2.8

Glen Eira 5 (4%) 3.6

Greater Dandenong 5 (4%) 3.5

Whitehorse 5 (4%) 3.2

Casey 6 (4%) 2.3



Table 26: Numbers of inhalant-related attendances by local government area in regional Victoria - 2011/12 and 2012/13

LGA 2011/12

LGA 2012/13

N (%*) Rate** N (%*) Rate**

Mildura 5 (16%) 9.6

Ballarat 6 (19%) 6.2






Map 16: Inhalant-related attendances by Victorian LGA, numbers of attendances - 2012/13


Map 17: Inhalant-related attendances by Victorian LGA, rates per 100,000 ERP - 2012/13


Map 18: Inhalant-related attendances by Victorian postcode, numbers of attendances - 2012/13


Trends over time in inhalant-related attendances

Figure 31 shows a slight upward trend in inhalant-related attendances across metropolitan Melbourne

in the past two years, peaking in March 2012. There were only a few months in 2012/13 where there

were more than four inhalant-related attendances in regional Victoria. An overall downward trend in

numbers of inhalant-related attendances is shown in metropolitan Melbourne over the last decade

(Figure 32).

Figure 31: Inhalant-related attendances by month - 2011/12 and 2012/13


Figure 32: Inhalant-related attendances by year - 2003/04 to 2012/13


Chapter 11: All Heroin-Related Attendances

This section provides analysis of all heroin-related attendances, combining heroin overdose

attendances, as reported in Chapter 12, with other heroin-related attendances, as reported in Chapter

13. Other drugs and alcohol may have also been ingested.

Characteristics of all heroin-related attendances

The characteristics of all heroin-related attendances in metropolitan Melbourne and regional Victoria

are shown in Table 27. In metropolitan Melbourne, the mean age of patients and the proportion of

cases where the patient was transported to hospital increased significantly in 2012/13 compared with

the previous year (p<0.001). No statistically significant changes were found for characteristics of

interest in regional Victoria.

Table 27: Characteristics of heroin-related attendances - 2011/12 and 2012/13


2011/12 2012/13 p 2011/12 2012/13 p


1964 (478.0)

1901 (454.0)

106

(74.2) 102

(70.9)

Mean per day (SD) 5.37 (2.8)

5.21 (2.9)

0.446

0.29 (0.6)

0.28 (0.6)

0.817

Daily range 0 - 17 0 - 17 0 - 3 0 - 3


(18%) 348

(18%) 0.902

25

(24%) 19

(18%) 0.340

Age - Mean (SD) 32

(12.67) 35

(9.53) <0.001

34

(12.50) 35

(9.38) 0.546


(<1 - 70) 34

(<1 - 85)

35 (<1 - 69)

35 (18 - 62)

Male 1361 (69%)

1325 (70%)

0.820

73 (69%)

69 (68%)

0.854

Public space 1220 (63%)

1168 (62%)

0.616

26 (26%)

28 (29%)

0.596

Outdoor space 1116 (58%)

1037 (56%)

0.125

22 (78%)

24 (82%)

0.742


(16%) 337

(18%) 0.147

10

(9%) 15

(14%) 0.267


(35%) 706

(43%) <0.001

51

(50%) 51

(62%) 0.111


Day of week and time of day of all heroin-related attendances

The distribution of attendances across the times of the day and days of the week were similar for

2012/13 and 2011/12 for metropolitan Melbourne (Figure 33), while the pattern changed in 2012/13 in

regional Victoria, with different peak days and times (Figure 34). The peak days (aggregating all

times) in 2012/13 were Wednesday and Friday in metropolitan Melbourne, and Tuesday in regional

Victoria. The peak times (aggregating all days) in 2012/13 were between 12pm and 6pm in

metropolitan Melbourne, and between 6pm and midnight in regional Victoria.


Figure 33: Proportion of heroin-related attendances by time of day of week, metropolitan Melbourne - 2011/12 and 2012/13

Figure 34: Proportion of heroin-related attendances by time of day of week, regional Victoria - 2011/12 and 2012/13


All heroin-related attendances in local government areas

All heroin-related ambulance attendances are presented for 2012/13 (and 2011/12 for comparison) by


metropolitan Melbourne, the three LGAs with the highest rates for all heroin-related ambulance

attendances in 2012/13 were Yarra, Melbourne and Maribyrnong (Table 28). Rates of attendances

decreased across most LGAs when compared with the previous year. Those that increased included:

Yarra, Port Phillip, Greater Dandenong, Stonnington, Frankston, Whitehorse, Moonee Valley,

Banyule, Kingston, Bayside and Hume. Yarra retained its ranking as the LGA with the highest rate of

all heroin-related attendances in metropolitan Melbourne.

In regional Victoria, Greater Geelong was the LGA with the highest proportion of all heroin-related

ambulance attendances in 2012/13 and the highest population rates, followed by Ballarat and

Wodonga (Table 28). Rates of attendances decreased for most the LGAs shown in Table 28 when

compared with the previous year.

Mapped all heroin-related attendances for 2012/13 are presented at LGA (Map 19 and Map 20) and



Table 28: Numbers of all heroin-related attendances by local government area in metropolitan Melbourne - 2011/12 and 2012/13

LGA 2011/12

LGA 2012/13

N (%*) Rate** N (%*) Rate**

Yarra 336 (17%) 425.8 Yarra 352 (19%) 436.7


Melbourne 231 (12%) 230.4 Maribyrnong 138 (7%) 180.2


Brimbank 178 (9%) 93.0 Greater Dandenong 134 (7%) 92.6

Greater Dandenong 118 (6%) 83.0 Brimbank 166 (9%) 85.7


Stonnington 48 (2%) 48.6 Frankston 59 (3%) 44.9

Hobsons Bay 37 (2%) 42.3 Whitehorse 67 (4%) 42.1

Moonee Valley 43 (2%) 38.3 Darebin 60 (3%) 41.6

Maroondah 37 (2%) 34.5 Moonee Valley 45 (2%) 39.7

Moreland 51 (3%) 33.1 Hobsons Bay 34 (2%) 38.6

Monash 57 (3%) 32.1 Maroondah 34 (2%) 31.5

Frankston 40 (2%) 30.7 Moreland 47 (3%) 30.1

Whitehorse 47 (2%) 29.8 Banyule 34 (2%) 27.5


Banyule 30 (2%) 24.4 Monash 42 (2%) 23.4

Glen Eira 32 (2%) 23.3 Whittlesea 36 (2%) 21.2

Kingston 34 (2%) 22.9 Knox 30 (2%) 19.4

Melton 25 (1%) 22.2 Bayside 17 (1%) 17.6

Knox 32 (2%) 20.7 Hume 30 (2%) 16.9

Boroondara 26 (1%) 15.6 Wyndham 27 (1%) 15.0

Wyndham 26 (1%) 15.6 Glen Eira 20 (1%) 14.4

Yarra Ranges 21 (1%) 14.1 Boroondara 24 (1%) 14.3

Casey 35 (2%) 13.4 Yarra Ranges 20 (1%) 13.4

Hume 21 (1%) 12.0 Melton 15 (1%) 12.7

Bayside 11 (0.5%) 11.4 Casey 33 (2%) 12.3

Manningham 12 (1%) 10.3 Manningham 9 (0.5%) 7.7

Mornington Peninsula 6 (0.3%) 4.0 Cardinia 5 (0.3%) 6.2

Rest of Melbourne 6 (0.4%) - Rest of Melbourne 6 (0.3%) -


Table 29: Numbers of all heroin-related attendances by local government area in regional Victoria - 2011/12 and 2012/13

LGA 2011/12

LGA 2012/13

N (%*) Rate** N (%*) Rate**

Greater Geelong 39 (37%) 18.1 Greater Geelong 36 (35%) 16.5

East Gippsland 7 (7%) 16.3 Ballarat 15 (15%) 15.5

Greater Bendigo 11 (10%) 10.8 Wodonga 5 (5%) 13.7

Ballarat 9 (9%) 9.5 Baw Baw 6 (6%) 13.5



* % of regional Victoria ** per 100,000 population


Map 19: Heroin-related attendances by metropolitan Victorian LGA, numbers of attendances - 2012/13


Map 20: Heroin-related attendances by regional Victorian LGA, rates per 100,000 ERP - 2012/13


Map 21: Heroin-related attendances by Victorian postcode, numbers of attendances - 2012/13


Trends over time in all heroin-related attendances

As can be seen from Figure 35, there was a slight decline in all heroin-related attendances over the

two years July 2011 to June 2013 in metropolitan Melbourne, and a stable trend between July 2011

and June 2013 in regional Victoria (Figure 35). After an initial drop, there was a rapid increase from

2005/06 to over approximately 2,000 attendances in 2009/10 in metropolitan Melbourne followed by a

slight drop from 2010/11 to 2012/13 (Figure 36).

Figure 35: Heroin-related attendances by month - 2011/12 and 2012/13


Figure 36: Heroin-related attendances by year - 2003/04 to 2012/13


Chapter 12: Heroin Overdose (Responding to

Naloxone) Attendances

Heroin overdose attendances are included in this section where there is a positive response to the

administration of naloxone (an opioid antagonist) for those people attended by an ambulance and

where there was no indication that the overdose resulted from another opioid such as morphine or

methadone. Other drugs and alcohol may also have been ingested.

Characteristics of heroin overdose attendances (responding to naloxone)

The data displayed in Table 30 shows the characteristics of heroin overdose ambulance attendances

in metropolitan Melbourne and regional Victoria in 2011/12 and 2012/13. The daily rate of heroin

overdose attendances in metropolitan Melbourne in 2012/13 was significantly lower than in 2011/12

(p<0.01). There was a significant increase in the mean age of patients in 2012/13 when compared

with 2011/12 (p<0.001). In regional Victoria, the proportion of cases where the patient was

transported to hospital decreased non-significantly.

Table 30: Characteristics of heroin overdose attendances (responding to naloxone) - 2011/12 and 2012/13


2011/12 2012/13 p 2011/12 2012/13 p


1104 (268.7)

960 (229.4)

44

(30.8) 38

(26.1)


(2.01) 2.63

(1.90) 0.008

0.12

(0.35) 0.10 (0.33)

0.496

Daily range 0 - 9 0 - 12 0 - 2 0 - 2


(17%) 166

(17%) 0.830

9

(20%) 5

(13%) 0.390

Age - Mean (SD) 33

(13.43) 36

(9.62) <0.001

34

(14.14) 35

(10.25) 0.489


(<1 - 70) 35

(<1 - 85)

34 (<1 - 69)

35 (19 - 62)

Male 792

(72%) 700

(73%) 0.584

34

(77%) 27

(72%) 0.602

Public space 674

(62%) 587

(61%) 0.946

8

(19%) 9

(26%) 0.444

Outdoor space 633

(58%) 540

(57%) 0.499

7

(88%) 9

(87%) 0.977


(12%) 129

(13%) 0.222

<5

<5


(23%) 202

(24%) 0.355

12

(30%) 9

(28%) 0.822


Day of week and time of day of heroin overdose attendances (responding to naloxone)

As shown in Figure 37 and Figure 38, the distribution of attendances across the times of the day and

days of the week were similar for both 2012/13 and 2011/12 in metropolitan Melbourne, while the

pattern changed from 2011/12 in regional Victoria. The peak days (aggregating all times) were

Thursday and Friday in metropolitan Melbourne, and Tuesday in regional Victoria in 2012/13. In

2012/13, the peak times (aggregating all days) were between 12pm and 6pm in metropolitan

Melbourne, and between 6pm and midnight in regional Victoria.


Figure 37: Proportion of heroin overdose attendances (responding to naloxone) by time of day of week, metropolitan Melbourne - 2011/12 and 2012/13

Figure 38: Proportion of heroin overdose attendances (responding to naloxone) by time of day of week, regional Victoria - 2011/12 and 2012/13


Heroin overdose attendances (responding to naloxone) in local government areas

Heroin overdose attendances are presented for 2012/13 (and 2011/12 for comparison) by local

government area for metropolitan Melbourne in Table 31 and for regional Victoria in Table 32. In

metropolitan Melbourne, the three LGAs with the highest rates for heroin overdose ambulance


decreased across the majority of LGAs when compared with the previous year. Exceptions included:

Yarra, Stonnington, Frankston, Whitehorse, Wyndham, and Hume. Yarra retained its ranking as the

LGA with the highest rate of heroin overdose attendances in metropolitan Melbourne.

In regional Victoria, Greater Geelong was the LGA with the highest proportion of heroin overdose

ambulance attendances in 2012/13 and the highest population rate (Table 32).

Table 31: Numbers of heroin overdose attendances (responding to naloxone) by local government area in metropolitan Melbourne - 2011/12 and 2012/13

LGA

2011/12

LGA

2012/13

N (%*) Rate** N (%*) Rate**

Yarra 195 (18%) 247.1 Yarra 206 (21.6%) 255.6

Maribyrnong 112 (10%) 149.0 Melbourne 101 (10.6%) 95.8

Melbourne 133 (12%) 132.7 Maribyrnong 73 (7.6%) 95.3

Port Phillip 61 (6%) 62.7 Port Phillip 54 (5.7%) 54.1

Greater Dandenong 75 (7%) 52.8 Greater Dandenong 70 (7.3%) 48.4

Brimbank 101 (9%) 52.7 Brimbank 79 (8.3%) 40.8

Darebin 50 (5%) 35.0 Stonnington 33 (3.5%) 32.8

Hobsons Bay 21 (2%) 24.0 Frankston 32 (3.4%) 24.3

Stonnington 22 (2%) 22.3 Whitehorse 34 (3.6%) 21.4

Maroondah 23 (2%) 21.4 Darebin 28 (2.9%) 19.4

Moonee Valley 22 (2%) 19.6 Moonee Valley 20 (2.1%) 17.7

Moreland 28 (3%) 18.2 Hobsons Bay 15 (1.6%) 17.0

Whitehorse 28 (3%) 17.8 Moreland 25 (2.6%) 16.0

Banyule 20 (2%) 16.3 Maroondah 16 (1.7%) 14.8

Monash 28 (3%) 15.8 Banyule 17 (1.8%) 13.8

Whittlesea 21 (2%) 13.1 Monash 21 (2.2%) 11.7

Frankston 17 (2%) 13.0 Kingston 16 (1.7%) 10.7

Knox 19 (2%) 12.3 Whittlesea 18 (1.9%) 10.6

Kingston 18 (2%) 12.1 Wyndham 15 (1.6%) 8.4

Melton 13 (1%) 11.5 Knox 13 (1.4%) 8.4

Glen Eira 15 (1%) 10.9 Glen Eira 10 (1.0%) 7.2

Wyndham 13 (1%) 7.8 Casey 18 (1.9%) 6.7

Manningham 9 (1%) 7.7 Bayside 6 (0.6%) 6.2

Yarra Ranges 11 (1%) 7.4 Melton 7 (0.7%) 5.9

Casey 18 (2%) 6.9 Hume 10 (1.0%) 5.6

Boroondara 10 (1%) 6.0 Boroondara 8 (0.8%) 4.8

Hume 8 (1%) 4.6

Rest of Melbourne 10 (1%) - Rest of Melbourne 10 (1.0%) -



Table 32: Numbers of heroin overdose attendances (responding to naloxone) by local government area in regional Victoria - 2011/12 and 2012/13

LGA 2011/12

LGA 2012/13

N (%*) Rate** N (%*) Rate**


Ballarat 7 (18%) 7.2



Trends over time in heroin overdose attendances (responding to naloxone)

The data displayed in Figure 39 shows that heroin overdose attendances have followed a slightly

downward trend over the period July 2011 to June 2013 in metropolitan Melbourne. There were only a

few months with more than four heroin overdose attendances in regional Victoria during the same

time period. After an initial drop, there was a rapid increase from 2005/06 to over 1,200 attendances

in 2009/10 in metropolitan Melbourne followed by a slight drop from 2010/11 to 2012/13 (Figure 40).

Figure 39: Heroin overdose attendances (responding to naloxone) by month - 2011/12 and 2012/13


Figure 40: Heroin overdose attendances (responding to naloxone) by year - 2003/04 and 2012/13


Chapter 13: Other Heroin-Related Attendances

This section excludes analysis of heroin overdose attendances with response to naloxone, the results

of which were presented in the previous chapter. ‘Other heroin’ events are included in this section and

are attendances where evidence of heroin use is established through the clinical assessment of the

ambulance paramedic and/or by the patient or his or her associates at the scene, but naloxone was

not administered. In these cases, other drugs and alcohol may have also been ingested.

Characteristics of other heroin-related attendances

As shown in Table 33, across metropolitan Melbourne and regional Victoria, the proportions of cases

where the patient was transported to hospital increased significantly (p<0.001; p<0.05, respectively).

In metropolitan Melbourne, the mean age of patients increased significantly (p<0.001).

Table 33: Characteristics of other heroin-related attendances - 2011/12 and 2012/13


2011/12 2012/13 p 2011/12 2012/13 p


860 (209.3)

940 (224.6)

62

(43.4) 65

(44.8)


(1.66) 2.58

(1.89) 0.085

0.17

(0.44) 0.18 (0.42)

0.807

Daily range 0 - 9 0 - 11 0 - 3 0 - 2


(20%) 182

(19%) 0.834

16

(26%) 14

(21%) 0.533

Age - Mean (SD) 32

(<1 - 61) 33

(<1 - 70) <0.001

35

(<1 - 55) 35

(18 - 53) 0.837


(<1 - 70) 35

(<1 - 85)

34 (<1 - 69)

35 (19 - 62)

Male 569

(66%) 625

(66%) 0.917

39

(63%) 42

(65%) 0.804

Public space 546

(65%) 581

(63%) 0.427

18

(31%) 19

(31%) 0.988

Outdoor space 483

(58%) 497

(54%) 0.152

15

(75%) 15

(79%) 0.765


(22%) 208

(22%) 0.782

9

(15%) 11

(16%) 0.762


(50%) 504

(63%) <0.001

39

(63%) 42

(84%) 0.013


Day of week and time of day of other heroin-related attendances

As shown in Figure 41, the distribution of attendances across the times of the day and days of the

week were similar for both 2012/13 and 2011/12 in metropolitan Melbourne, while the pattern

changed from 2011/12 in regional Victoria (Figure 42). The peak day (aggregating all times) was

Wednesday in metropolitan Melbourne, and Saturday in regional Victoria in 2012/13. In 2012/13, the

peak times (aggregating all days) were between 12pm and 6pm in metropolitan Melbourne, and

between 6pm and midnight in regional Victoria.


Figure 41: Proportion of other heroin-related attendances by time of day of week, metropolitan Melbourne - 2011/12 and 2012/13

Figure 42: Proportion of other heroin-related attendances by time of day of week, regional Victoria - 2011/12 and 2012/13


Other heroin-related attendances in local government areas

Other heroin-related ambulance attendances are presented for 2012/13 (and 2011/12 for comparison)

by local government area for metropolitan Melbourne in Table 34 and for regional Victoria in Table 35. In

metropolitan Melbourne, the three LGAs with the highest rates for other heroin-related ambulance


increased across the majority of LGAs when compared with the previous year. The exceptions included

Melbourne, Maribyrnong, Stonnington, Darebin and Moreland among others. Yarra retained its ranking

as the LGA with the highest rate of other heroin-related attendances in metropolitan Melbourne.

Melbourne and Maribyrnong remained in the top three however reversing their order.

In regional Victoria, although Greater Geelong was the LGA with the highest proportion of other heroin-

related ambulance attendances in 2012/13, Wodonga and Baw Baw had the highest population rates,

followed by Ballarat and Greater Geelong (Table 35).

Table 34: Numbers of other heroin-related attendances by local government area in metropolitan Melbourne - 2011/12 and 2012/13

LGA

2011/12

LGA

2012/13

N (%*) Rate** N (%*) Rate**

Yarra 141 (16%) 178.7 Yarra 146 (16%) 181.1


Melbourne 98 (11%) 97.8 Maribyrnong 65 (7%) 84.9


Brimbank 77 (9%) 40.2 Brimbank 87 (9%) 44.9



Stonnington 25 (3%) 25.3 Darebin 32 (3%) 22.2

Moonee Valley 21 (2%) 18.7 Moonee Valley 25 (3%) 22.1

Hobsons Bay 16 (2%) 18.3 Hobsons Bay 19 (2%) 21.6

Frankston 23 (3%) 17.6 Whitehorse 33 (4%) 20.8

Monash 29 (3%) 16.4 Frankston 27 (3%) 20.5

Moreland 23 (3%) 14.9 Maroondah 18 (2%) 16.7


Maroondah 14 (2%) 13.0 Moreland 22 (2%) 14.1

Glen Eira 16 (2%) 11.7 Banyule 17 (2%) 13.8

Melton 13 (2%) 11.5 Monash 21 (2%) 11.7

Whitehorse 18 (2%) 11.4 Bayside 11 (1%) 11.4

Kingston 16 (2%) 10.8 Hume 20 (2%) 11.2

Boroondara 16 (2%) 9.6 Knox 17 (2%) 11.0

Wyndham 14 (2%) 8.4 Whittlesea 18 (2%) 10.6

Knox 13 (2%) 8.4 Boroondara 16 (2%) 9.5


Banyule 9 (1%) 7.3 Glen Eira 10 (1%) 7.2

Yarra Ranges 10 (1%) 6.7 Melton 8 (1%) 6.8

Casey 17 (2%) 6.5 Wyndham 12 (1%) 6.7

Bayside 5 (0.5%) 5.2 Casey 15 (2%) 5.6

Mornington Peninsula 5 (1%) 3.3 Manningham 6 (1%) 5.1




Table 35: Numbers of other heroin-related attendances by local government area in regional Victoria - 2011/12 and 2012/13

LGA

2011/12

LGA

2012/13

N (%*) Rate** N (%*) Rate**

East Gippsland 6 (10%) 14.0 Wodonga 5 (8%) 13.7

Greater Geelong 21 (34%) 9.7 Baw Baw 5 (8%) 11.3

Greater Bendigo 7 (11%) 6.9 Ballarat 8 (12%) 8.2



* % of regional Victoria ** per 100,000 population

Trends over time in other heroin-related attendances

As shown in Figure 43, the number and rate of other heroin-related attendances in metropolitan

Melbourne fluctuated with an overall stable trend between July 2011 and June 2013. Similar to heroin

overdose data presented in the previous chapter, the numbers of other heroin-related attendances in

metropolitan Melbourne have been increasing since 2005/06 (Figure 44).

Figure 43: Other heroin-related attendances by month - 2011/12 and 2012/13


Figure 44: Other heroin-related attendances by year - 2003/04 to 2012/13


Chapter 14: GHB-Related Attendances

Data on GHB have been collected since March 2001.

Characteristics of GHB-related attendances

The daily rate of GHB-related attendances in metropolitan Melbourne increased significantly when

compared with the preceding year (p<0.001) (Table 36). Significant increases were seen in the

proportions of events occurring in public and outdoor spaces, co-attended by police, cases where the

patient was transported to hospital, while there was a significant decrease in cases where alcohol was

also involved (all p<0.01). In regional Victoria, the mean age of patients attended decreased

significantly (p<0.05).

Table 36: Characteristics of GHB-related attendances - 2011/12 and 2012/13


2011/12 2012/13 p 2011/12 2012/13 p


407 (99.0)

578 (138.1)

41

(28.4) 42

(29.0)


(1.27) 1.58 (1.73)

<0.001

0.11 (0.33)

0.11 (0.36)

0.879

Daily range 0 - 7 0 - 13 0 - 2 0 - 2


(32%) 135

(23%) 0.001

16

(39%) 14

(33%) 0.578

Age - Mean (SD) 26

(10.22) 25

(6.56) 0.046

31

(13.77) 26

(7.79) 0.016


(<1 - 66) 23

(4 - 58)

27 (14 - 73)

24 (15 - 47)

Male 242

(59%) 341

(59%) 0.883

23

(56%) 26

(62%) 0.595

Public space 240

(61%) 391

(69%) 0.004

14

(35%) 18

(44%) 0.404

Outdoor space 219

(57%) 375

(67%) 0.001

9

(69%) 14

(70%) 0.951


(19%) 158

(27%) 0.002

5

(12%) 8

(19%) 0.363


(82%) 490

(92%) <0.001

35

(86%) 35

(97%) 0.082


Day of week and time of day of GHB-related attendances

As shown in Figure 45 and Figure 46, the distributions of attendances across the times of the day and

days of the week were different from the previous year. The peak day (aggregating all times) in

metropolitan Melbourne in 2012/13 was Sunday, while in regional Victoria the peak day was Friday.

The peak times (aggregating all days) in 2012/13 were between 6pm and midnight in metropolitan

Melbourne and regional Victoria.


Figure 45: Proportion of GHB-related attendances by time of day of week, metropolitan Melbourne - 2011/12 and 2012/13

Figure 46: Proportion of GHB-related attendances by time of day of week, regional Victoria - 2011/12 and 2012/13


GHB-related attendances in local government areas

GHB-related ambulance attendances are presented for 2012/13 (and 2011/12 for comparison) by

local government area for metropolitan Melbourne in (Table 37) and for regional Victoria in (Table 38).

In metropolitan Melbourne, the three LGAs with the highest rates for GHB-related ambulance

attendances in 2012/13 were Melbourne, Port Phillip and Stonnington (Table 37). Rates of


Melbourne retained its ranking as the LGA with the highest rate of GHB-related attendances in

metropolitan Melbourne. Port Phillip and Stonnington remained in the top three however reversing

their order.

In regional Victoria, although Greater Geelong was the LGA with the highest proportion of GHB-

related ambulance attendances in 2012/13, Moorabool, Wellington and Latrobe had the highest

population rates, followed by Greater Geelong (Table 38).

Mapped GHB-related attendances for 2012/13 are presented at LGA (Map 22 and Map 23) and



Table 37: Numbers of GHB-related attendances by local government area in metropolitan Melbourne - 2011/12 and 2012/13

LGA 2011/12

LGA 2012/13

N (%*) Rate** N (%*) Rate**


Stonnington 29 (7%) 29.3 Port Phillip 29 (5%) 29.0

Port Phillip 23 (6%) 23.6 Stonnington 25 (4%) 24.8

Yarra 14 (4%) 17.7 Frankston 26 (5%) 19.8

Moonee Valley 17 (4%) 15.2 Yarra 16 (3%) 19.8

Maribyrnong 11 (3%) 14.6 Kingston 22 (4%) 14.7

Moreland 19 (5%) 12.3 Mornington Peninsula 20 (3%) 13.3

Frankston 15 (4%) 11.5 Maribyrnong 10 (2%) 13.1

Nillumbik 7 (2%) 11.2 Hume 21 (4%) 11.8

Knox 17 (4%) 11.0 Knox 17 (3%) 11.0

Whitehorse 13 (3%) 8.3 Greater Dandenong 15 (3%) 10.4

Darebin 11 (3%) 7.7 Melton 12 (2%) 10.2

Mornington Peninsula 11 (3%) 7.4 Cardinia 8 (1%) 10.0

Boroondara 12 (3%) 7.2 Darebin 13 (2%) 9.0

Greater Dandenong 10 (3%) 7.0 Boroondara 15 (3%) 8.9

Hume 12 (3%) 6.9 Maroondah 9 (2%) 8.3

Whittlesea 11 (3%) 6.8 Moonee Valley 9 (2%) 7.9

Kingston 10 (2%) 6.7 Glen Eira 11 (2%) 7.9

Brimbank 12 (3%) 6.3 Moreland 12 (2%) 7.7

Monash 11 (3%) 6.2 Casey 19 (3%) 7.1

Melton 7 (2%) 6.2 Manningham 8 (1%) 6.8

Casey 16 (4%) 6.1 Whittlesea 9 (2%) 5.3

Hobsons Bay 5 (1%) 5.7 Brimbank 10 (2%) 5.2

Banyule 5 (1%) 4.1 Banyule 6 (1%) 4.9

Wyndham 6 (1%) 3.6 Whitehorse 6 (1%) 3.8

Glen Eira 5 (1%) 3.6 Monash 5 (1%) 2.8

Yarra Ranges 5 (1%) 3.4



Table 38: Numbers of GHB-related attendances by local government area in regional Victoria - 2011/12 and 2012/13

LGA 2011/12

LGA 2012/13

N (%*) Rate** N (%*) Rate**

Latrobe 7 (17%) 9.5 Moorabool 5 (12%) 17.0

Greater Geelong 10 (24%) 4.6 Wellington 5 (12%) 11.8

Latrobe 7 (17%) 9.5





Map 22: GHB-related attendances by Victorian LGA, numbers of attendances - 2012/13


Map 23: GHB-related attendances by Victorian LGA, rates per 100,000 ERP - 2012/13


Map 24: GHB-related attendances by Victorian postcode, numbers of attendances - 2012/13


Trends over time in GHB-related attendances

The data displayed in Figure 47 shows that the number and rate of GHB-related attendances across

metropolitan Melbourne fluctuated with an overall upward trend over the past two years. As shown,

there were only a few months where there were more than four attendances in regional Victoria. As

can be seen from Figure 48, with the exception of 2007/08 which recorded a drop, there was a

marked increase in the number of attendances over time to approximately 600 in 2012/13.

Figure 47: GHB-related attendances by month - 2011/12 and 2012/13


Figure 48: GHB-related attendances by year - 2003/04 to 2012/13


Chapter 15: Anticonvulsant-Related Attendances

This section includes attendances related to selected anticonvulsants that are used for treatment of

psychiatric conditions. Data pertaining to anticonvulsant-related attendances were collected from May

2000.

Characteristics of anticonvulsant-related attendances

The data displayed in Table 39 details the characteristics of anticonvulsant-related ambulance

attendances in 2011/12 and 2012/13 in metropolitan Melbourne and regional Victoria. In regional

Victoria, the proportion of cases where the patient was transported to hospital increased significantly

when compared with the preceding year (p<0.01).

Table 39: Characteristics of anticonvulsant-related attendances - 2011/12 and 2012/13


2011/12 2012/13 p 2011/12 2012/13 p


197 (48.0)

230 (54.9)

89

(62.0) 104

(72.1)


(0.74) 0.63

(0.81)

0.110

0.24 (0.53)

0.28 (0.52)

0.268

Daily range 0 - 5 0 - 5 0 - 3 0 - 2

Alcohol involved 69

(35%) 64

(28%)

0.100

26 (29%)

34 (33%)

0.587

Age - Mean (SD) 38

(13.64) 39

(15.59)

0.387

38 (15.20)

38 (14.97)

0.857


(2 - 79) 38

(1 - 100)

38 (3 - 91)

39 (1 - 89)

Male 95

(48%) 94

(41%)

0.135

37 (42%)

51 (49%)

0.287

Public space 36

(18%) 57

(25%)

0.084

15 (17%)

14 (14%)

0.580

Outdoor space 28

(15%) 37

(16%)

0.588

9 (61%)

5 (31%)

0.094


(17%) 29

(13%)

0.215

6 (7%)

14 (13%)

0.118


(96%) 218

(98%)

0.271

78 (88%)

99 (99%)

0.001


Day of week and time of day of anticonvulsant-related attendances

As shown in Figure 49 and Figure 50, the distributions of anticonvulsant-related attendances across

times of the day and days of the week in both metropolitan Melbourne and regional Victoria in

2012/13 were different from the previous year. The peak day (aggregating all times) in metropolitan

Melbourne in 2012/13 was Wednesday, while the peak day in regional Victoria was Tuesday. The

peak time (aggregating all days) was between 6pm and midnight in both metropolitan Melbourne and

regional Victoria.


Figure 49: Proportion of anticonvulsant-related attendances by time of day of week, metropolitan Melbourne - 2011/12 and 2012/13

Figure 50: Proportion of anticonvulsant-related attendances by time of day of week, regional Victoria - 2011/12 and 2012/13


Anticonvulsant-related attendances in local government areas

Anticonvulsant-related ambulance attendances are presented for 2012/13 (and 2011/12 for


Victoria in Table 41. In metropolitan Melbourne, the three LGAs with the highest rates for

anticonvulsant-related ambulance attendances in 2012/13 were Mornington Peninsula, Port Phillip

and Frankston (Table 40). Only Frankston featured in the top three in consecutive years.


anticonvulsant-related ambulance attendances in 2012/13, South Gippsland, Mitchell and Bass Coast

had the highest population rates, followed by Latrobe and Greater Shepparton (Table 41).

Mapped anticonvulsant-related attendances for 2012/13 are presented at LGA (Map 25 and Map 26)


Table 40: Numbers of anticonvulsant-related attendances by local government area in metropolitan Melbourne - 2011/12 and 2012/13

LGA

2011/12

LGA

2012/13

N (%*) Rate** N (%*) Rate*

*

Frankston 16 (8%) 12.3 Mornington Peninsula 20 (9%) 13.3

Greater Dandenong 14 (7%) 9.8 Port Phillip 11 (5%) 11.0

Banyule 9 (4%) 7.3 Frankston 14 (6%) 10.6

Knox 11 (6%) 7.1 Greater Dandenong 13 (6%) 9.0

Whitehorse 11 (6%) 7.0 Yarra 7 (3%) 8.7


Maroondah 7 (4%) 6.5 Cardinia 6 (3%) 7.5

Melton 7 (3%) 6.2 Hume 13 (6%) 7.3

Kingston 9 (5%) 6.1 Casey 19 (8%) 7.1

Casey 15 (8%) 5.7 Whitehorse 11 (5%) 6.9

Moonee Valley 6 (3%) 5.3 Hobsons Bay 6 (3%) 6.8

Hume 9 (5%) 5.2 Maroondah 7 (3%) 6.5

Moreland 8 (4%) 5.2 Maribyrnong 5 (2%) 6.5

Darebin 7 (4%) 4.9 Melton 6 (3%) 5.1

Wyndham 8 (4%) 4.8 Banyule 6 (3%) 4.9

Mornington Peninsula 6 (3%) 4.0 Yarra Ranges 7 (3%) 4.7

Brimbank 7 (3%) 3.7 Knox 7 (3%) 4.5

Monash 5 (3%) 2.8 Moreland 7 (3%) 4.5

Moonee Valley 5 (2%) 4.4

Brimbank 8 (4%) 4.1

Whittlesea 6 (3%) 3.5

Monash 6 (3%) 3.3

Wyndham 6 (3%) 3.3




Table 41: Numbers of anticonvulsant-related attendances by local government area in regional Victoria - 2011/12 and 2012/13

LGA 2011/12

LGA 2012/13

N (%*) Rate** N (%*) Rate**

Warrnambool 7 (8%) 21.4 South Gippsland 7 (7%) 25.2

Bass Coast 6 (7%) 19.8 Mitchell 6 (6%) 16.6

Mildura 6 (7%) 11.6 Bass Coast 5 (5%) 16.3

Ballarat 9 (10%) 9.5 Latrobe 11 (11%) 14.9

Latrobe 7 (8%) 9.5 Greater Shepparton 5 (5%) 8.0


Greater Geelong 14 (16%) 6.5 Ballarat 6 (6%) 6.2





Map 25: Anticonvulsant-related attendances by Victorian LGA, numbers of attendances - 2012/13


Map 26: Anticonvulsant-related attendances by Victorian LGA, rates per 100,000 ERP - 2012/13


Map 27: Anticonvulsant-related attendances by Victorian LGA, postcode, numbers of attendances - 2012/13


Trends over time in anticonvulsant-related attendances

The data displayed in Figure 51 shows that the number and rate of anticonvulsant-related

attendances across metropolitan Melbourne fluctuated with an overall upward trend over the past two

years, while an overall downward trend was noted across regional Victoria. As can be seen from

Figure 52, the rate of attendances dropped dramatically with some fluctuations to below 5 per 100,000

population in 2011/12.

Figure 51: Anticonvulsant-related attendances by month - 2011/12 and 2012/13


Figure 52: Anticonvulsant-related attendances by year - 2003/04 to 2012/13


Chapter 16: Antidepressant-Related Attendances

Characteristics of antidepressant-related attendances

The data displayed in Table 42 detail the characteristics of antidepressant-related ambulance

attendances in 2011/12 and 2012/13 across metropolitan Melbourne and regional Victoria. In

metropolitan Melbourne, the daily number of antidepressant-related attendances was significantly higher

in 2012/13 than in 2011/12 (p<0.001), while the mean age was lower in 2012/13 than in 2011/12

(p<0.05). In regional Victoria, there was a significant decrease (p<0.001) in the proportion of cases

involving alcohol, while there was a significant increase (p<0.05) in the proportion of cases where the

patient was transported to hospital.

Table 42: Characteristics of antidepressant-related attendances - 2011/12 and 2012/13


2011/12 2012/13 p 2011/12 2012/13 p


1060 (257.9)

1221 (291.6)

435

(304.8) 487

(337.56)


(1.63) 3.34 (1.72)

<0.001

1.19 (1.05)

1.33 (1.18)

0.081

Daily range 0 - 9 0 - 10 0 - 5 0 - 6


(39%) 426

(35%) 0.052

196

(45%) 159

(33%) <0.001

Age - Mean (SD) 36

(14.36) 35

(15.36) 0.038

36

(15.92) 34

(15.81) 0.092


(<1 - 91) 33

(1 - 97)

35 (<1 - 91)

31 (2 - 92)

Male 388

(37%) 403

(33%) 0.066

133

(31%) 167

(34%) 0.233

Public space 188

(18%) 223

(18%) 0.779

86

(20%) 93

(19%) 0.737

Outdoor space 158

(15%) 195

(16%) 0.492

51

(56%) 45

(49%) 0.310


(13%) 187

(15%) 0.201

48

(11%) 62

(13%) 0.413


1151 (97%)

0.066

417 (96%)

450 (98%)

0.033


Day of week and time of day of antidepressant-related attendances


days of the week in 2012/13 was similar to the previous year in metropolitan Melbourne and in regional

Victoria. The peak day (aggregating all times) in 2012/13 was Monday in metropolitan Melbourne, and

Saturday and Sunday in regional Victoria. The peak time (aggregating all days) in 2012/13 was between

6pm and midnight in metropolitan Melbourne and in regional Victoria.


Figure 53: Proportion of antidepressant-related attendances by time of day of week, metropolitan Melbourne - 2011/12 and 2012/13

Figure 54: Proportion of antidepressant-related attendances by time of day of week, regional Victoria - 2011/12 and 2012/13


Antidepressant-related attendances in local government areas

Antidepressant-related ambulance attendances are presented for 2012/13 (and 2011/12 for comparison)


metropolitan Melbourne, the three LGAs with the highest rates for antidepressant-related ambulance

attendances in 2012/13 were Frankston, Melbourne and Cardinia (Table 43). Frankston retained its

ranking as the LGA with the highest rate of antidepressant-related attendances in metropolitan

Melbourne.


antidepressant-related ambulance attendances in 2012/13, Benalla, East Gippsland and Horsham had

the highest population rates, followed by Latrobe and Wellington (Table 44).

Mapped antidepressant-related attendances for 2012/13 are presented at LGA (Map 28 and Map 29)



Table 43: Numbers of antidepressant-related attendances by local government area in metropolitan Melbourne - 2011/12 and 2012/13

LGA

2011/12 LGA

2012/13

N (%*) Rate** N (%*) Rate**



Greater Dandenong 55 (5%) 38.7 Cardinia 33 (3%) 41.2

Hume 62 (6%) 35.6 Maroondah 44 (4%) 40.7

Melton 37 (4%) 32.8 Melton 47 (4%) 39.8

Maribyrnong 24 (2%) 31.9 Mornington Peninsula 55 (5%) 36.5

Casey 78 (7%) 29.9 Greater Dandenong 52 (4%) 35.9

Maroondah 32 (3%) 29.8 Yarra Ranges 49 (4%) 32.9

Hobsons Bay 26 (2%) 29.7 Knox 50 (4%) 32.3

Mornington Peninsula 44 (4%) 29.5 Moonee Valley 36 (3%) 31.8

Knox 45 (4%) 29.1 Casey 85 (7%) 31.7

Yarra 23 (2%) 29.1 Moreland 49 (4%) 31.4

Wyndham 47 (4%) 28.2 Hobsons Bay 26 (2%) 29.5

Cardinia 21 (2%) 27.7 Hume 52 (4%) 29.2

Stonnington 27 (3%) 27.3 Darebin 42 (4%) 29.1

Darebin 38 (4%) 26.6 Maribyrnong 22 (2%) 28.7

Banyule 32 (3%) 26.0 Yarra 23 (2%) 28.5

Port Phillip 25 (2%) 25.7 Brimbank 54 (4%) 27.9

Yarra Ranges 36 (3%) 24.2 Wyndham 49 (4%) 27.3

Moreland 33 (3%) 21.4 Monash 49 (4%) 27.3

Nillumbik 13 (1%) 20.7 Nillumbik 16 (1%) 25.5

Whittlesea 33 (3%) 20.5 Port Phillip 25 (2%) 25.0


Brimbank 37 (4%) 19.3 Stonnington 22 (2%) 21.9

Whitehorse 28 (3%) 17.8 Whitehorse 33 (3%) 20.8

Glen Eira 24 (2%) 17.5 Whittlesea 34 (3%) 20.1

Moonee Valley 19 (2%) 16.9 Boroondara 33 (3%) 19.6

Bayside 15 (1%) 15.6 Banyule 23 (2%) 18.6

Manningham 17 (2%) 14.6 Bayside 18 (2%) 18.6

Monash 25 (2%) 14.1 Manningham 18 (2%) 15.4

Boroondara 19 (2%) 11.4 Glen Eira 21 (2%) 15.1




Table 44: Numbers of antidepressant-related attendances by local government area in regional Victoria - 2011/12 and 2012/13

LGA

2011/12

LGA

2012/13

N (%*) Rate** N (%*) Rate**

Horsham 20 (5%) 102.4 Benalla 10 (2%) 72.8

Mansfield 6 (1%) 75.5 East Gippsland 28 (6%) 64.9

Northern Grampians 7 (2%) 58.1 Horsham 12 (3%) 61.0

Central Goldfields 7 (2%) 55.6 Latrobe 39 (8%) 52.8

East Gippsland 21 (5%) 49.0 Wellington 22 (5%) 52.0

Latrobe 33 (8%) 44.7 Southern Grampians 8 (2%) 48.8

Mildura 21 (5%) 40.5 Greater Shepparton 29 (6%) 46.5

Bass Coast 11 (3%) 36.4 Glenelg 8 (2%) 40.5

Greater Geelong 78 (18%) 36.1 Mitchell 14 (3%) 38.6

Wodonga 13 (3%) 36.1 Wangaratta 10 (2%) 36.7

Glenelg 7 (2%) 35.3 Bass Coast 11 (2%) 36.0

Swan Hill 7 (2%) 33.5 Wodonga 13 (3%) 35.5

Wangaratta 9 (2%) 33.1 Moira 10 (2%) 34.9

Greater Shepparton 20 (5%) 32.4 Swan Hill 7 (2%) 33.4

Moira 9 (2%) 31.7 Greater Bendigo 34 (7%) 32.8

Baw Baw 13 (3%) 30.0 Campaspe 12 (3%) 32.5


Wellington 11 (3%) 26.1 Indigo 5 (1%) 32.5

Mitchell 9 (2%) 25.6 Ballarat 30 (6%) 30.9

Warrnambool 8 (2%) 24.5 Corangamite 5 (1%) 30.5

Macedon Ranges 9 (2%) 21.0 Mildura 15 (3%) 28.7

Moorabool 6 (1%) 20.9 Mount Alexander 5 (1%) 28.0

Ballarat 19 (4%) 20.0 Moorabool 8 (2%) 27.3

Campaspe 7 (2%) 19.0 South Gippsland 7 (2%) 25.2

Baw Baw 10 (2%) 22.5


Warrnambool 5 (1%) 15.2




Map 28: Antidepressant-related attendances by Victorian LGA, numbers of attendances - 2012/13


Map 29: Antidepressant -related attendances by Victorian LGA, rates per 100,000 ERP - 2012/13


Map 30: Antidepressant-related attendances Victorian postcode, numbers of attendances - 2012/13


Trends over time in antidepressant-related attendances

The trends in the numbers and the rates of antidepressant-related attendances fluctuated in

metropolitan Melbourne and regional Victoria over the past two years (Figure 55). As can be seen

from Figure 56, trends in antidepressant-related attendance numbers and rates fluctuated in

metropolitan Melbourne over the past decade; 2011/12 had the lowest rate of attendances during the

period examined.

Figure 55: Antidepressant-related attendances by month - 2011/12 and 2012/13


Figure 56: Antidepressant-related attendances by year - 2003/04 to 2012/13


Chapter 17 Antipsychotic-Related Attendances

Characteristics of antipsychotic-related attendances

As shown in Table 45, the daily rate of antipsychotic-related attendances increased significantly in

both metropolitan Melbourne and regional Victoria when compared with 2011/12 (p<0.01). In regional

Victoria, there was a significant decrease in the proportion of attendances where alcohol was also

involved in 2012/13 when compared with 2011/12 (p<0.01).

Table 45: Characteristics of antipsychotic-related attendances - 2011/12 and 2012/13


2011/12 2012/13 p 2011/12 2012/13 p


964 (234.5)

1145 (273.5)

337

(236.0) 425

(294.7)


(1.65) 3.14 (1.79)

<0.001

0.92 (1.02)

1.16 (1.19)

0.003

Daily range 0 - 9 0 - 9 0 - 6 0 - 6


(32%) 365

(32%) 0.778

119

(35%) 111

(26%) 0.006

Age - Mean (SD) 35

(13.48) 36

(13.80) 0.593

36

(14.86) 34

(13.93) 0.066


(<1 - 89) 35

(1 - 100)

33 (<1 - 95)

32 (1 - 89)

Male 369

(38%) 405

(35%) 0.166

112

(33%) 164

(39%) 0.112

Public space 213

(22%) 263

(23%) 0.626

64

(19%) 66

(16%) 0.252

Outdoor space 159

(17%) 213

(19%) 0.185

35

(51%) 29

(42%) 0.294


(15%) 194

(17%) 0.304

40

(12%) 70

(16%) 0.069


(96%) 1066 (97%)

0.268

318 (95%)

387 (97%)

0.481


Day of week and time of day of antipsychotic-related attendances

As shown in Figure 57 and Figure 58, the distribution of metropolitan Melbourne and regional

Victorian antipsychotic-related attendances across the times of the day and days of the week in

2012/13 was slightly different when compared with the previous year. The peak days (aggregating all

times) in 2012/13 were Saturday in metropolitan Melbourne, and Saturday and Sunday in regional

Victoria. The peak times (aggregating all days) in 2012/13 were between 6pm and midnight in both

metropolitan Melbourne and regional Victoria.


Figure 57: Proportion of antipsychotic-related attendances by time of day of week, metropolitan Melbourne - 2011/12 and 2012/13

Figure 58: Proportion of antipsychotic-related attendances by time of day of week, regional Victoria - 2011/12 and 2012/13


Antipsychotic-related attendances in local government areas

Antipsychotic-related ambulance attendances are presented for 2012/13 (and 2011/12 for comparison)


metropolitan Melbourne, the three LGAs with the highest rates for antipsychotic-related ambulance

attendances in 2012/13 were Frankston, Port Phillip and Melbourne (Table 46). Yarra rates substantially

reduced from the previous year where it had been in the top three.

Frankston retained its ranking as the LGA with the highest rate and number of antipsychotic-related

attendances in metropolitan Melbourne. Frankston rates and numbers of attendances increased

substantially over the two years presented.

In regional Victoria, although Greater Geelong was the LGA with the highest proportion of antipsychotic-

related ambulance attendances in 2012/13, East Gippsland, Northern Grampians and Greater Bendigo

had the highest population rates, followed by Gannawarra and Latrobe (Table 47).

Mapped antipsychotic-related attendances for 2012/13 are presented at LGA (Map 31 and Map 32) and



Table 46: Numbers of antipsychotic-related attendances by local government area in metropolitan Melbourne - 2011/12 and 2012/13

LGA

2011/12

LGA

2012/13

N (%*) Rate** N (%*) Rate**




Port Phillip 34 (4%) 35.0 Maroondah 42 (4%) 38.9



Knox 51 (5%) 33.0 Stonnington 33 (3%) 32.8

Stonnington 31 (3%) 31.4 Hume 57 (5%) 32.0

Mornington Peninsula 43 (4%) 28.8 Yarra Ranges 47 (4%) 31.5

Hobsons Bay 25 (3%) 28.6 Nillumbik 19 (2%) 30.3

Greater Dandenong 40 (4%) 28.1 Cardinia 24 (2%) 30.0

Wyndham 46 (5%) 27.6 Moreland 46 (4%) 29.5

Yarra Ranges 36 (4%) 24.2 Greater Dandenong 42 (4%) 29.0

Banyule 29 (3%) 23.6 Darebin 41 (4%) 28.5

Moonee Valley 26 (3%) 23.2 Yarra 23 (2%) 28.5

Cardinia 16 (2%) 21.1 Knox 43 (4%) 27.8

Hume 36 (4%) 20.7 Whitehorse 43 (4%) 27.0

Darebin 29 (3%) 20.3 Melton 31 (3%) 26.3

Casey 51 (5%) 19.5 Hobsons Bay 23 (2%) 26.1

Melton 22 (2%) 19.5 Banyule 32 (3%) 25.9

Whitehorse 29 (3%) 18.4 Wyndham 44 (4%) 24.5

Bayside 17 (2%) 17.7 Monash 43 (4%) 23.9

Boroondara 27 (3%) 16.2 Brimbank 45 (4%) 23.2


Monash 28 (3%) 15.8 Moonee Valley 25 (2%) 22.1

Brimbank 30 (3%) 15.7 Casey 45 (4%) 16.8

Moreland 24 (3%) 15.6 Bayside 16 (1%) 16.5


Manningham 18 (2%) 15.4 Glen Eira 20 (2%) 14.4

Whittlesea 22 (2%) 13.7 Whittlesea 24 (2%) 14.2

Nillumbik 7 (0.7%) 11.2 Manningham 12 (1%) 10.3




Table 47: Numbers of antipsychotic-related attendances by local government area in regional Victoria - 2011/12 and 2012/13

LGA 2011/12

LGA 2012/13

N (%*) Rate** N (%*) Rate**

Horsham 11 (3%) 56.3 East Gippsland 28 (7%) 64.9

Latrobe 32 (10%) 43.4 Northern Grampians 7 (2%) 58.5

Moira 12 (4%) 42.2 Greater Bendigo 53 (13%) 51.1

East Gippsland 16 (5%) 37.4 Gannawarra 5 (1%) 48.1

Greater Shepparton 21 (6%) 34.0 Latrobe 34 (8%) 46.0

Wangaratta 9 (3%) 33.1 Mildura 24 (6%) 46.0

Baw Baw 14 (4%) 32.3 Greater Shepparton 26 (6%) 41.7


Mildura 15 (5%) 28.9 Corangamite 5 (1%) 30.5

Mount Alexander 5 (2%) 28.0 Warrnambool 10 (2%) 30.3

Wodonga 9 (3%) 25.0 Wodonga 11 (3%) 30.0

Wellington 9 (3%) 21.4 Wangaratta 8 (2%) 29.4

Greater Bendigo 21 (6%) 20.6 Colac- Otway 6 (1%) 28.9

Campaspe 7 (2%) 19.0 Mount Alexander 5 (1%) 28.0

Warrnambool 6 (2%) 18.4 Wellington 11 (3%) 26.0

Moorabool 5 (2%) 17.4 Glenelg 5 (1%) 25.3

Bass Coast 5 (2%) 16.5 Moorabool 7 (2%) 23.9

Ballarat 14 (4%) 14.7 Swan Hill 5 (1%) 23.8

Baw Baw 10 (2%) 22.5

South Gippsland 6 (1%) 21.6

Moira 6 (1%) 20.9



Mitchell 6 (1%) 16.6


Campaspe 5 (1%) 13.5

Ballarat 10 (2%) 10.3




Map 31: Antipsychotic-related attendances by Victorian LGA, numbers of attendances - 2012/13


Map 32: Antipsychotic-related attendances by Victorian LGA, rates per 100,000 ERP - 2012/13


Map 33: Antipsychotic-related attendances by Victorian postcode, numbers of attendances - 2012/13


Trends over time in antipsychotic-related attendances

Figure 59 shows that trends in numbers and rates of antipsychotic-related attendances fluctuated

across metropolitan Melbourne and regional Victoria over the past two years, with a slight upward

overall trend in metropolitan Melbourne. The pattern over the longer period, as can be seen from

Figure 60, indicates that antipsychotic-related attendance numbers have been increasing over time in

metropolitan Melbourne.

Figure 59: Antipsychotic-related attendances by month - 2011/12 and 2012/13


Figure 60: Antipsychotic-related attendances by year - 2003/04 to 2012/13


Chapter 18 Opioid Analgesic-Related Attendances

Characteristics of opioid analgesic-related attendances

The data displayed in Table 48 shows the characteristics of opioid analgesic-related ambulance

attendances in metropolitan Melbourne and regional Victoria for the 2011/12 and 2012/13 financial

years. When compared with 2011/12, the daily number of opioid analgesic-related attendances and

the proportion of cases where the patient was transported to hospital increased significantly in

metropolitan Melbourne (p<= 0.001). In regional Victoria, when compared with 2011/12, the proportion

of attendances where alcohol was also involved decreased significantly (p<0.05), while the proportion

of events co-attended by police, the daily number of attendances and the mean age of attendees

increased significantly (p<0.05).

Table 48: Characteristics of opioid analgesic-related attendances - 2011/12 and 2012/13


2011/12 2012/13 p 2011/12 2012/13 p


458 (111.4)

711 (169.8)

288

(201.9) 350

(242.4)


(1.22) 1.95

(1.39) <0.001

0.79

(0.86) 0.96

(0.96) 0.012

Daily range 0 - 7 0 – 7 0 - 4 0 - 5


(32%) 222

(31%) 0.676

99

(34%) 88

(25%) 0.012

Age - Mean (SD) 41

(17.68) 42

(17.37) 0.322

41

(17.54) 44

(17.48) 0.021


(<1 - 98) 40

(1 - 96)

39 (<1 - 96)

41 (1 - 99)

Male 220

(48%) 341

(48%) 0.964

146

(51%) 179

(51%) 0.905

Public space 107

(23%) 142

(20%) 0.165

57

(20%) 60

(17%) 0.352

Outdoor space 74

(16%) 105

(15%) 0.521

24

(43%) 32

(52%) 0.307


(14%) 102

(14%) 0.769

15

(5%) 40

(11%) 0.005


(85%) 617

(92%) 0.001

255

(89%) 279

(88%) 0.916


Day of week and time of day of opioid analgesic-related attendances


days of the week in 2012/13 was similar to the previous year, with a higher peak in attendances noted

for Wednesday evening in metropolitan Melbourne and a higher peak in attendances on Sunday

evening in regional Victoria in 2012/13. Attendances were fairly evenly distributed across times of day

and days of the week in 2012/13. The peak day (aggregating all times) in 2012/13 was Wednesday in

metropolitan Melbourne, while the peak day in regional Victoria was Sunday. The peak times

(aggregating all days) in metropolitan Melbourne and regional Victoria in 2012/13 were between 6pm

and 12pm.


Figure 61: Proportion of opioid analgesic-related attendances by time of day of week, metropolitan Melbourne - 2011/12 and 2012/13

Figure 62: Proportion of opioid analgesic-related attendances by time of day of week, regional Victoria - 2011/12 and 2012/13


Opioid analgesic-related attendances in local government areas

Opioid analgesic-related ambulance attendances are presented for 2012/13 (and 2011/12 for


Victoria in Table 50. In metropolitan Melbourne, the three LGAs with the highest rates for opioid

analgesic-related ambulance attendances in 2012/13 were Frankston, Port Phillip and Yarra Ranges

(Table 49). Rates of attendances varied across many LGAs when compared with the previous year.

Melbourne did not retain ranking as the LGA with the highest rate of opioid-related attendances in

metropolitan Melbourne.

In regional Victoria, Greater Geelong was the LGA with the highest proportion of opioid analgesic-

related ambulance attendances in 2012/13 (Table 50). However Horsham, East Gippsland and

Mildura had the highest rates of opioid analgesic-related attendances in regional Victoria.

Mapped opioid analgesic-related attendances for 2012/13 are presented at LGA (Map 34 and Map

35) and postcode (Map 36) levels.


Table 49: Numbers of opioid analgesic-related attendances by local government area in metropolitan Melbourne - 2011/12 and 2012/13 up to here

LGA

2011/12

LGA

2012/13

N (%*) Rate** N (%*) Rate**

Melbourne 26 (5.8%) 25.9 Frankston 46 (6.5%) 35.0

Frankston 32 (7.0%) 24.5 Port Phillip 27 (3.8%) 27.0

Mornington Peninsula 31 (6.7%) 20.8 Yarra Ranges 38 (5.4%) 25.5

Yarra 16 (3.5%) 20.3 Melton 28 (4.0%) 23.7

Casey 40 (8.8%) 15.3 Melbourne 25 (3.5%) 23.7

Hume 24 (5.3%) 13.8 Cardinia 19 (2.7%) 23.7

Moonee Valley 15 (3.3%) 13.4 Moonee Valley 25 (3.5%) 22.1

Melton 15 (3.3%) 13.3 Mornington Peninsula 33 (4.7%) 21.9

Banyule 15 (3.2%) 12.2 Yarra 17 (2.4%) 21.1

Maroondah 13 (2.8%) 12.1 Kingston 31 (4.4%) 20.7

Stonnington 12 (2.7%) 12.1 Maribyrnong 15 (2.1%) 19.6

Maribyrnong 9 (1.9%) 12.0 Darebin 28 (4.0%) 19.4

Port Phillip 11 (2.3%) 11.3 Hume 33 (4.7%) 18.5

Darebin 16 (3.5%) 11.2 Banyule 22 (3.1%) 17.8

Kingston 16 (3.5%) 10.8 Casey 47 (6.6%) 17.5

Glen Eira 14 (3.0%) 10.2 Greater Dandenong 25 (3.5%) 17.3

Knox 15 (3.2%) 9.7 Wyndham 28 (4.0%) 15.6

Nillumbik 6 (1.4%) 9.6 Whittlesea 26 (3.7%) 15.3

Greater Dandenong 13 (2.7%) 9.1 Maroondah 16 (2.3%) 14.8

Monash 15 (3.2%) 8.5 Bayside 14 (2.0%) 14.5

Moreland 13 (2.8%) 8.4 Nillumbik 9 (1.3%) 14.4

Whitehorse 13 (2.9%) 8.3 Stonnington 4 (2.0%) 13.9

Yarra Ranges 12 (2.7%) 8.1 Brimbank 26 (3.7%) 13.4

Wyndham 13 (2.8%) 7.8 Moreland 21 (3.0%) 13.4

Whittlesea 12 (2.7%) 7.5 Whitehorse 21 (3.0%) 13.2

Brimbank 14 (3.1%) 7.3 Knox 17 (2.4%) 11.0

Hobsons Bay 6 (1.4%) 6.9 Glen Eira 15 (2.1%) 10.8

Bayside 6 (1.4%) 6.2 Manningham 12 (1.7%) 10.3

Boroondara 9 (2.0%) 5.4 Monash 15 (2.1%) 8.3

Hobsons Bay 6 (0.8%) 6.8

Boroondara 9 (1.3%) 5.3

Rest of Melbourne 5 (1.1%) - Rest of Melbourne 0 (0%) -



Table 50: Numbers of opioid analgesic-related attendances by local government area in regional Victoria - 2011/12 and 2012/13

LGA 2011/12

LGA 2012/13

N (%*) Rate** N (%*) Rate**

East Gippsland 22 (8%) 51.4 Horsham 12 (4%) 61.0

Wodonga 18 (6%) 50.0 East Gippsland 20 (6%) 46.3

Northern Grampians 6 (2%) 49.8 Mildura 22 (6%) 42.1

Latrobe 26 (9%) 35.2 Northern Grampians 5 (1%) 41.8

Wellington 14 (5%) 33.3 Warrnambool 12 (4%) 36.4

Mildura 17 (6%) 32.8 Baw Baw 16 (5%) 36.1

Horsham 5 (2%) 25.6 Glenelg 7 (2%) 35.4

Glenelg 5 (2%) 25.2 Greater Shepparton 22 (6%) 35.3

Moira 7 (2%) 24.6 Latrobe 25 (7%) 33.8

Warrnambool 8 (3%) 24.5 Wodonga 12 (4%) 32.8

Greater Geelong 43 (15%) 19.9 Campaspe 12 (4%) 32.5

Mitchell 7 (2%) 19.9 Wellington 13 (4%) 30.7

Campaspe 7 (2%) 19.0 Moira 7 (2%) 24.4

Baw Baw 8 (3%) 18.4 Swan Hill 5 (1%) 23.8



Macedon Ranges 5 (2%) 11.7 Bass Coast 6 (2%) 19.6

Greater Bendigo 11 (4%) 10.8 Wangaratta 5 (1%) 18.4


Ballarat 17 (5%) 17.5


Mitchell 5 (1%) 13.8




Map 34: Opioid analgesic-related attendances by Victorian LGA, numbers of attendances - 2012/13


Map 35: Opioid analgesic -related attendances by Victorian LGA, rates per 100,000 ERP - 2012/13


Map 36: Opioid analgesic-related attendances by Victorian postcode, numbers of attendances - 2012/13


Trends over time in opioid analgesic-related attendances

As shown in Figure 63, there were upward trends in opioid analgesic-related attendance numbers and

rates in metropolitan Melbourne and regional Victoria from July 2011 to June 2013. June 2012 had

the lowest rate during the past two years. Upward trends were evident in opioid analgesic-related

attendances in metropolitan Melbourne over the period 2003/04 to 2012/13 and in regional Victoria

over the period 2011/12 to 2012/13 (Figure 64).

Figure 63: Opioid analgesic-related attendances by month - 2011/12 and 2012/13


Figure 64: Opioid analgesic-related attendances by year - 2003/04 to 2012/13


Chapter 19: Other Analgesic-Related Attendances

The analyses presented in this section exclude the involvement of opioid analgesic related-cases as

far as could be ascertained, as these results were presented in the previous section. For examples of

the drugs categorised as “other analgesic”, please refer to the Methods section of the report.

Characteristics of other analgesic-related attendances

As shown in Table 51, in 2012/13 the daily number of other analgesic-related attendances and the

proportion of cases where the patient was transported to hospital increased in both metropolitan

Melbourne and regional Victoria when compared with the preceding year (p<0.01). In metropolitan

Melbourne only, there were significant decreases in the proportion of attendances where alcohol was

also involved and in the proportion of events occurring in public spaces (p<0.01).

Table 51: Characteristics of other analgesic-related attendances - 2011/12 and 2012/13


2011/12 2012/13 p 2011/12 2012/13 p


1149 (279.57)

1584 (378.49)

451

(315.47) 603

(418.14)


(1.82) 4.34

(1.98) <0.001

1.23

(1.12) 1.65

(1.30) <0.001

Daily range 0 - 10 0 - 11 0 - 6 0 - 6


(37%) 514

(32%) 0.007

144

(32%) 173

(29%) 0.228

Age - Mean (SD) 33

(15.71) 33

(16.30) 0.984

33

(17.19) 33

(16.99) 0.550


(<1 - 93) 29

(<1 - 100)

31 (<1 - 95)

28 (1 - 94)

Male 327

(28%) 451

(29%) 0.984

139

(31%) 180

(30%) 0.730

Public space 255

(22%) 296

(19%) 0.019

111

(26%) 131

(22%) 0.184

Outdoor space 169

(15%) 232

(15%) 0.997

57

(52%) 69

(54%) 0.750


(11%) 208

(13%) 0.106

40

(9%) 76

(13%) 0.053


1506 (98%)

<0.001

427 (95%)

562 (98%)

0.006


Day of week and time of day of other analgesic-related attendances

The distribution of metropolitan Melbourne and regional Victorian attendances across the times of the

day and days of the week in 2012/13 as shown in Figure 65 and Figure 66 was similar to the previous

year. In 2012/13, the peak days (aggregating all times) in metropolitan Melbourne were Monday and

Wednesday, whilst the peak days in regional Victoria were Tuesday and Sunday. In both metropolitan

Melbourne and regional Victoria, the peak time (aggregating all days) in 2012/13 was between 6pm

and midnight.


Figure 65: Proportion of other analgesic-related attendances by time of day of week, metropolitan Melbourne - 2011/12 and 2012/13

Figure 66: Proportion of other analgesic-related attendances by time of day of week, regional Victoria - 2011/12 and 2012/13


Other analgesic-related attendances in local government areas

Other analgesic-related ambulance attendances are presented for 2012/13 (and 2011/12 for

comparison) by local government area for metropolitan Melbourne in Table 52 and for regional Victoria

in Table 53. In metropolitan Melbourne, the three LGAs with the highest rates for other analgesic-related

ambulance attendances in 2012/13 were Melbourne, Frankston and Moonee Valley (Table 52). Rates of


In regional Victoria, although Greater Geelong was the LGA with the highest proportion of other

analgesic-related ambulance attendances in 2012/13, Benalla, East Gippsland and Campaspe had the

highest population rates, followed by Mildura and Gannawarra (Table 53). Rates of attendances varied

across the majority of LGAs when compared with the previous year.

Mapped other analgesic-related attendances for 2012/13 are presented at LGA (Map 37 and Map 38 )



Table 52: Numbers of other analgesic-related attendances by local government area in metropolitan Melbourne - 2011/12 and 2012/13

LGA 2011/12

LGA 2012/13

N (%*) Rate** N (%*) Rate**

Frankston 67 (5.8%) 51.4 Melbourne 65 (4.1%) 61.7

Yarra 37 (3.2%) 46.9 Frankston 77 (4.9%) 58.5

Melbourne 43 (3.8%) 42.9 Moonee Valley 61 (3.9%) 53.9

Hume 64 (5.5%) 36.7 Moreland 77 (4.9%) 49.3

Mornington Peninsula 52 (4.5%) 34.8 Mornington Peninsula 73 (4.6%) 48.4

Hobsons Bay 30 (2.6%) 34.3 Hume 83 (5.3%) 46.6

Maroondah 35 (3.0%) 32.6 Yarra Ranges 67 (4.2%) 45.0

Greater Dandenong 45 (3.9%) 31.7 Knox 67 (4.2%) 43.3

Cardinia 24 (2.1%) 31.6 Maroondah 46 (2.9%) 42.6

Bayside 30 (2.6%) 31.2 Greater Dandenong 60 (3.8%) 41.5

Darebin 44 (3.8%) 30.8 Yarra 32 (2.0%) 39.7

Casey 80 (7.0%) 30.6 Maribyrnong 30 (1.9%) 39.2

Melton 34 (3.0%) 30.2 Wyndham 70 (4.4%) 39.0

Port Phillip 29 (2.5%) 29.8 Port Phillip 39 (2.5%) 39.0

Maribyrnong 22 (1.9%) 29.3 Melton 44 (2.8%) 37.3

Knox 44 (3.9%) 28.5 Banyule 46 (2.9%) 37.2

Wyndham 46 (4.0%) 27.6 Nillumbik 23 (1.5%) 36.7

Moreland 42 (3.6%) 27.2 Hobsons Bay 32 (2.0%) 36.3

Yarra Ranges 40 (3.5%) 26.9 Brimbank 67 (4.2%) 34.6

Brimbank 50 (4.3%) 26.1 Whittlesea 57 (3.6%) 33.6

Banyule 31 (2.7%) 25.2 Kingston 50 (3.2%) 33.3

Whittlesea 38 (3.3%) 23.6 Casey 87 (5.5%) 32.5

Moonee Valley 26 (2.3%) 23.2 Cardinia 26 (1.6%) 32.5

Kingston 34 (3.0%) 22.9 Darebin 46 (2.9%) 31.9

Glen Eira 31 (2.7%) 22.6 Monash 55 (3.5%) 30.6

Boroondara 32 (2.8%) 19.2 Whitehorse 46 (2.9%) 28.9

Stonnington 18 (1.6%) 18.2 Stonnington 28 (1.8%) 27.8

Nillumbik 11 (0.9%) 17.5 Bayside 24 (1.5%) 24.8

Whitehorse 27 (2.3%) 17.1 Glen Eira 34 (2.2%) 24.5

Monash 30 (2.6%) 16.9 Manningham 28 (1.8%) 23.9

Manningham 10 (0.9%) 8.6 Boroondara 38 (2.4%) 22.6




Table 53: Numbers of other analgesic-related attendances by local government area in regional Victoria - 2011/12 and 2012/13

LGA 2011/12

LGA 2012/13

N (%*) Rate** N (%*) Rate**

Horsham 16 (3.6%) 82.0 Benalla 10 (1.7%) 72.8

Latrobe 41 (9.1%) 55.6 East Gippsland 27 (4.5%) 62.6

Greater Shepparton 29 (6.5%) 47.0 Campaspe 23 (3.9%) 62.2

Bass Coast 13 (2.8%) 43.0 Mildura 31 (5.2%) 59.4

Warrnambool 14 (3.1%) 42.9 Gannawarra 6 (1.0%) 57.7

Moira 12 (2.6%) 42.2 Horsham 11 (1.8%) 56.0

Moorabool 12 (2.7%) 41.9 Corangamite 9 (1.5%) 54.9

East Gippsland 17 (3.8%) 39.7 Wellington 23 (3.9%) 54.4

Mildura 19 (4.3%) 36.7 Greater Bendigo 54 (9.1%) 52.1

Wangaratta 10 (2.2%) 36.7 Murrindindi 7 (1.2%) 52.1

Greater Geelong 79 (17.4%) 36.6 Greater Shepparton 32 (5.4%) 51.3

Benalla 5 (1.2%) 36.2 Moira 14 (2.3%) 48.8

Moyne 5 (1.1%) 30.9 Ballarat 47 (7.9%) 48.5

Corangamite 5 (1.2%) 30.3 Latrobe 34 (5.7%) 46.0

Wodonga 10 (2.3%) 27.8 Mitchell 16 (2.7%) 44.1

Greater Bendigo 27 (6.0%) 26.5 Baw Baw 19 (3.2%) 42.8

Golden Plains 5 (1.1%) 26.4 Greater Geelong 93 (15.6%) 42.6

Wellington 11 (2.3%) 26.1 Hepburn 6 (1.0%) 40.7

Macedon Ranges 11 (2.5%) 25.7 Glenelg 8 (1.3%) 40.5

Baw Baw 11 (2.5%) 25.4 Wangaratta 11 (1.8%) 40.4

Ballarat 22 (4.8%) 23.1 Mount Alexander 7 (1.2%) 39.2

Mitchell 8 (1.7%) 22.8 Wodonga 14 (2.3%) 38.2

Campaspe 8 (1.7%) 21.7 Warrnambool 12 (2.0%) 36.4

Bass Coast 10 (1.7%) 32.7

Moorabool 9 (1.5%) 30.7

Swan Hill 6 (1.0%) 28.6

Colac- Otway 5 (0.8%) 24.1

Macedon Ranges 9 (1.5%) 20.7

South Gippsland 5 (0.8%) 18.0

Rest of Regional Victoria 61 (13.5%) - Rest of Regional Victoria 38 (6.4%) -



Map 37: Other analgesic-related attendances by Victorian LGA, numbers of attendances - 2012/13


Map 38: Other analgesic-related attendances by Victorian LGA, rates per 100,000 ERP - 2012/13


Map 39: Other analgesic-related attendances by Victorian postcode, numbers of attendances - 2012/13


Trends over time in other analgesic-related attendances

As can be seen in Figure 67, there were upward trends in other analgesic-related attendances for

both metropolitan Melbourne and regional Victoria over the past two years. Over the longer period,

upward trends are evident despite the numbers and the rates fluctuating in metropolitan Melbourne

over the last two years (Figure 68).

Figure 67: Other analgesic-related attendances by month - 2011/12 and 2012/13


Figure 68: Other analgesic-related attendances by year - 2003/04 to 2012/13


Chapter 20: Cocaine-Related Attendances

Characteristics of cocaine-related attendances

The data displayed in Table 54 shows the characteristics of cocaine-related ambulance attendances for

2011/12 and 2012/13. There was a significant increase (p<0.05) in the proportion of cases where the

patient was transported to hospital in metropolitan Melbourne compared with 2011/12. When compared

with 2011/12, the proportion of attendances where alcohol was also involved remained unchanged in

metropolitan Melbourne. Due to the small number of cocaine-related attendances in regional Victoria,

most characteristics had too few cases to be reported.

Table 54: Characteristics of cocaine-related attendances - 2011/12 and 2012/13


2011/12 2012/13 p 2011/12 2012/13 p


88 (21.4)

122 (29.1)

7

(4.8) 10

(6.9)


(0.52) 0.33

(0.69) 0.038

0.02

(0.13) 0.03 (0.16)

0.428

Daily range 0 - 3 0 - 4 0 - 1 0 - 1

Alcohol involved 56

(64%) 78

(64%) 0.963

<5

<5

Age - Mean (SD) 30

(10.01) 30

(8.78) 0.689

25

(12.76) 34

(9.34) 0.086


(<1 - 61) 28

(15 - 56)

28 (<1 - 38)

35 (19 - 45)

Male 55

(63%) 82

(67%) 0.538

* *

0.656

Public space 34

(40%) 53

(45%) 0.429

<5

<5

Outdoor space 36

(42%) 45

(39%) 0.672

<5

<5


(14%) 24

(20%) 0.234

<5

<5


(76%) 89

(87%) 0.036

<5

10

(100%)

Note: Except where indicated, all figures in the proportions are based on non-missing information. *Data not presented due to small numbers.

Day of week and time of day of cocaine-related attendances

As shown in Figure 69 and Figure 70, the distribution of metropolitan Melbourne and regional Victoria

cocaine-related attendances across the times of the day and days of the week in 2011/12 and 2012/13

were highly variable - which is due to the small numbers of attendances. The peak day (aggregating all

times) in 2012/13 in metropolitan Melbourne was Sunday, while the peak days in regional Victoria were

Friday and Sunday. The peak time (aggregating all days) in 2012/13 in metropolitan Melbourne was

between midnight and noon, while the peak time in regional Victoria was either between noon and 6pm

or between midnight and 6am.


Figure 69: Proportion of cocaine-related attendances by time of day of week, metropolitan Melbourne - 2011/12 and 2012/13

Figure 70: Proportion of cocaine-related attendances by time of day of week - 2011/12 and 2012/13


Cocaine-related attendances in local government areas

Cocaine-related ambulance attendances are presented for 2012/13 (and 2011/12 for comparison) by

local government area for metropolitan Melbourne in Table 55. In metropolitan Melbourne, the three

LGAs with the highest rates for cocaine-related ambulance attendances in 2012/13 were Melbourne,

Yarra and Port Phillip. Melbourne also had the highest proportion of attendances.

Due to the small numbers of cocaine-related attendances, small changes may result in apparently

large differences in proportions presented. In 2012/13 there were no LGAs in regional Victoria where

more than four cocaine-related attendances occurred.

Mapped cocaine-related attendances for 2012/13 are presented at LGA (Map 40 and Map 41) and


Table 55: Numbers of cocaine-related attendances by local government area in metropolitan Melbourne - 2011/12 and 2012/13

LGA 2011/12

LGA 2012/13

N (%*) Rate** N (%*) Rate**

Melbourne 12 (13.4%) 12.0 Melbourne 17 (14.0%) 16.1

Port Phillip 11 (12.8%) 11.3 Yarra 11 (9.1%) 13.6

Yarra 6 (6.8%) 7.6 Port Phillip 11 (9.1%) 11.0

Darebin 7 (8.0%) 4.9 Stonnington 9 (7.4%) 8.9

Maroondah 5 (5.5%) 4.7 Maribyrnong 6 (5.0%) 7.8

Banyule 7 (5.8%) 5.7

Moreland 6 (5.0%) 3.8

Darebin 5 (4.1%) 3.5

Hume 5 (4.1%) 2.8

Brimbank 5 (4.1%) 2.6

Rest of Melbourne 47 (53.5%) - Rest of Melbourne 39 (32.4%) -



Map 40: Cocaine-related attendances by Victorian LGA, numbers of attendances - 2012/13


Map 41: Cocaine-related attendances by Victorian LGA, rates per 100,000 ERP - 2012/13


Map 42: Cocaine-related attendances by Victorian postcode, numbers of attendances - 2012/13


Trends over time in cocaine-related attendances

Figure 71 shows overall upward trends in the numbers and the rates of cocaine-related attendances

across metropolitan Melbourne in the past two years, with some fluctuations. No month had more

than four cases in regional Victoria over the last 24 months. Over the past decade, there has been a

rise in cocaine-related attendances in metropolitan Melbourne while there has been a slight increase

in attendances in regional Victoria as shown in Figure 72.

Figure 71: Cocaine-related attendances by month - 2011/12 and 2012/13


Figure 72: Cocaine-related attendances by year - 2003/04 to 2012/13


Chapter 21: Summary of findings

Alcohol-related attendances were most common in both metropolitan Melbourne and regional Victoria,

with benzodiazepines the second most common drug category involved in ambulance attendances

across metropolitan Melbourne and regional Victoria. Non-opioid analgesics also featured, with this

category ranking third for regional Victorian alcohol- and drug-related ambulance attendances, and

fourth for metropolitan Melbourne attendances (with all heroin-related attendances ranking third in

metropolitan Melbourne). Attendances related to antidepressants, antipsychotics and cannabis were

also common across Victoria in 2012/13. In 2012/13, population rates of attendances were higher for

cannabis, anticonvulsants, antidepressants, antipsychotics, opioid analgesics and other analgesics in

regional Victoria than in metropolitan Melbourne.

In metropolitan Melbourne, large increases (greater than ten per cent) were noted in alcohol-, cannabis-,

ecstasy-, all amphetamine-, crystal methamphetamine-, benzodiazepine-, GHB-, anticonvulsant-,

antidepressant-, antipsychotic-, opioid analgesic-, non-opioid analgesic- and cocaine-related

attendances. There was a smaller increase in other heroin-related attendances. A large decrease

(greater than ten per cent) was noted in attendances for heroin (with response to naloxone). With the

exception of inhalant- and GHB-related attendances, the change patterns in regional Victoria were

broadly the same as in metropolitan Melbourne.

Daily numbers of alcohol-related attendances were significantly higher in 2012/13 than in 2011/12 in

both metropolitan Melbourne and regional Victoria. The mean age of patients attended increased in

2012/13 in metropolitan Melbourne and regional Victoria. In metropolitan Melbourne and regional

Victoria, the proportion of cases occurring in public spaces decreased when compared with 2011/12. In

both metropolitan Melbourne and regional Victoria, the proportion of alcohol-related attendances where

the patient was transported to hospital increased significantly in 2012/13 when compared with the

previous year. Melbourne retained its ranking as the LGA with the highest proportion of alcohol-related

attendances in metropolitan Melbourne. In regional Victoria, Greater Geelong was the LGA with the

highest proportion of alcohol-related ambulance attendances in 2012/13, followed by Latrobe and

Ballarat, while Yarriambiack and Warnambool had the highest rates of attendances.

In metropolitan Melbourne, there was a large decrease (ten percentage points or greater) in the

proportion of ecstasy-related attendances where alcohol was also involved when compared with the

preceding year. For all other drug categories, there were smaller decreases or increases in the

proportions of attendances where alcohol was also involved. In regional Victoria, large decreases were

seen in the proportions of cannabis-, ecstasy-, antidepressant- and cocaine-related attendances where

alcohol was also involved when compared with the preceding year, while a large increase was noted in

the proportion of inhalant-related attendances where alcohol was also involved. For all other drug

categories, there were smaller decreases or increases in the proportions of attendances where alcohol

was also involved.

Across metropolitan Melbourne and regional Victoria, the daily number of cannabis-related attendances

in 2012/13 increased significantly when compared with the preceding year. In both metropolitan

Melbourne and regional Victoria, the proportions of cannabis-related attendances where alcohol was

involved decreased while the proportion where the patient was transported to hospital increased in

2012/13 when compared with the previous year. In metropolitan Melbourne, the three LGAs with the


highest rates for cannabis-related ambulance attendances in 2012/13 were Melbourne, Frankston and

Port Phillip. In regional Victoria, Latrobe and Greater Shepparton had the highest population rates in

2012/13.

In both metropolitan Melbourne and regional Victoria, there were significant increases in the daily

numbers of ecstasy-related attendances in 2012/13 when compared with 2011/12. The age of patients

attended decreased in metropolitan Melbourne while the age increased in regional Victoria in 2012/13

compared with 2011/12. In metropolitan Melbourne, the proportion of attendances where alcohol was

also involved decreased while the proportion of attendances where the patient was transported to

hospital increased. In metropolitan Melbourne, the three LGAs with the highest rates for ecstasy-related

ambulance attendances in 2012/13 were Melbourne, Stonnington and Port Phillip. In regional Victoria,

Greater Bendigo and Greater Geelong had the highest population rates in 2012/13.

In both metropolitan Melbourne and regional Victoria, the daily number of all amphetamine-related

attendances and the proportion of events co-attended by police in 2012/13 increased significantly when

compared with the preceding year. In metropolitan Melbourne, there was a significant decrease in the

proportion of cases where alcohol was also involved, while there was a significant increase in the

proportion of cases where the patient was transported to hospital in 2012/13 when compared with

2011/12. In regional Victoria, the proportion of events occurring in public spaces increased significantly.

In metropolitan Melbourne, the three LGAs with the highest rates for all amphetamine-related ambulance

attendances in 2012/13 were Melbourne, Port Phillip and Yarra. In regional Victoria, Latrobe, Moorabool

and Greater Shepparton had the highest population rates of all amphetamine-related ambulance

attendances in 2012/13.

In 2012/13 across Victoria, the daily number of crystal methamphetamine-related attendances was

significantly higher than in 2011/12. In metropolitan Melbourne, significant decreases were seen in the

proportion of cases where alcohol was involved, and where events occurred in public spaces, while

significant increases were noted in the proportion of events co-attended by police, and cases where the

patient was transported to hospital. In regional Victoria, there was a significant increase in the proportion

of events co-attended by police. In metropolitan Melbourne, the top three ranking LGAs in the proportion

of crystal methamphetamine-related ambulance attendances were Melbourne, Casey and Hume. In

regional Victoria, Latrobe, Moorabool and Horsham had the highest population rates of crystal

methamphetamine-related ambulance attendances in 2012/13.

In metropolitan Melbourne, the proportion of other amphetamine-related cases where the patient was

transported to hospital was significantly higher than in 2011/12. In metropolitan Melbourne, the three

LGAs with the highest rates for other amphetamine-related ambulance attendances in 2012/13 were

Melbourne, Port Phillip and Yarra. In regional Victoria, Greater Shepparton and Latrobe had the highest

population rates of other amphetamine-related ambulance attendances in 2012/13.

Across metropolitan Melbourne and regional Victoria, the daily numbers of benzodiazepine-related

attendances were higher in 2012/13 than in 2011/12. Significant decreases were seen in the proportions

of events occurring in public spaces, while significant increases were evident in the proportions of events

co-attended by police and in cases where the patient was transported to hospital. The mean age of

patients increased significantly while the proportion of male patients decreased significantly in

metropolitan Melbourne. The proportion of cases involving alcohol decreased significantly in regional

Victoria In metropolitan Melbourne, the three LGAs with the highest rates for benzodiazepine-related


ambulance attendances in 2012/13 were Yarra, Frankston and Melbourne. In regional Victoria, East

Gippsland, Benalla and Bass Coast had the highest population rates of benzodiazepine-related


The daily number of regional Victorian inhalant-related attendances in 2012/13 was significantly higher

than in 2011/12. In metropolitan Melbourne, the three LGAs with the highest rates for inhalant-related

ambulance attendances in 2012/13 were Maroondah, Melbourne and Greater Dandenong. In regional

Victoria, Mildura, Ballarat and Greater Bendigo were the LGAs with the highest rates of inhalant-related


In metropolitan Melbourne, the mean age of patients and the proportion of cases where the patient was

transported to hospital for all heroin-related attendances increased significantly in 2012/13 compared

with the previous year In metropolitan Melbourne, the three LGAs with the highest rates for all heroin-

related ambulance attendances in 2012/13 were Yarra, Melbourne and Maribyrnong. In regional Victoria,

Greater Geelong was the LGA with the highest population rate of heroin-related ambulance attendances

in 2012/13, followed by Ballarat.

The daily number of heroin overdose attendances in 2012/13 was significantly lower than in 2011/12.

There was a significant increase in the mean age of patients in 2012/13 when compared with 2011/12.

In metropolitan Melbourne, the three LGAs with the highest rates of heroin overdose ambulance

attendances in 2012/13 were Yarra, Melbourne and Maribyrnong. In regional Victoria, Greater Geelong

was the LGA with the highest rate of heroin overdose ambulance attendances in 2012/13.

Across metropolitan Melbourne and regional Victoria, the proportions of other heroin-related cases

where the patient was transported to hospital increased significantly. In metropolitan Melbourne, the

three LGAs with the highest rates of other heroin-related ambulance attendances in 2012/13 were Yarra,

Melbourne and Maribyrnong. In regional Victoria, Wodonga and Baw Baw had the highest population

rates of other heroin-related ambulance attendances in 2012/13.

The daily number of GHB-related attendances in metropolitan Melbourne increased significantly when

compared with the preceding year. Significant increases were seen in the proportions of events

occurring in public and outdoor spaces, co-attended by police, and cases where the patient was

transported to hospital. In regional Victoria, the mean age of patients attended decreased significantly.

In metropolitan Melbourne, the three LGAs with the highest rates of GHB-related ambulance

attendances in 2012/13 were Melbourne, Port Phillip and Stonnington. In regional Victoria, Moorabool,

Wellington and Latrobe had the highest population rates of GHB-related ambulance attendances in

2012/13.

In regional Victoria, the proportion of anticonvulsant-related cases where the patient was transported to

hospital increased significantly when compared with the preceding year. In metropolitan Melbourne, the

three LGAs with the highest rates of anticonvulsant-related ambulance attendances in 2012/13 were

Mornington Peninsula, Port Phillip and Frankston. In regional Victoria, although Greater Geelong was

the LGA with the highest proportion of anticonvulsant-related ambulance attendances in 2012/13, while

South Gippsland, Mitchell and Bass Coast had the highest population rates.

In metropolitan Melbourne, the daily number of antidepressant-related attendances was significantly

higher in 2012/13 than in 2011/12, while the mean age was lower in 2012/13 than in 2011/12. In regional

Victoria, there was a significant decrease in the proportion of cases involving alcohol, while there was a


significant increase in the proportion of cases where the patient was transported to hospital. In

metropolitan Melbourne, the three LGAs with the highest rates of antidepressant-related ambulance

attendances in 2012/13 were Frankston, Melbourne and Cardinia. In regional Victoria, Benalla, East

Gippsland and Horsham had the highest population rates of antidepressant-related ambulance

attendances in 2012/13.

The daily numbers of antipsychotic-related attendances increased significantly in both metropolitan

Melbourne and regional Victoria when compared with 2011/12. In regional Victoria, there was a

significant decrease in the proportion of attendances where alcohol was also involved in 2012/13 when

compared with 2011/12. In metropolitan Melbourne, the three LGAs with the highest rates of

antipsychotic-related ambulance attendances in 2012/13 were Frankston, Port Phillip and Melbourne. In

regional Victoria, East Gippsland, Northern Grampians and Greater Bendigo had the highest population

rates of antipsychotic-related ambulance attendances in 2012/13.

When compared with 2011/12, the daily number of opioid analgesic-related attendances and the

proportion of cases where the patient was transported to hospital increased significantly in metropolitan

Melbourne. In regional Victoria, when compared with 2011/12, the proportion of attendances where

alcohol was also involved decreased significantly, while the proportion of events co-attended by police,

the daily number of the attendances, and the mean age of patients increased significantly. In

metropolitan Melbourne, the three LGAs with the highest rates for opioid analgesic-related ambulance

attendances in 2012/13 were Frankston, Port Phillip and Yarra Ranges. Horsham, East Gippsland and

Mildura had the highest rates of opioid analgesic-related attendances in regional Victoria.

In 2012/13 the daily numbers of other analgesic-related attendances and the proportion of cases where

the patient was transported to hospital increased in both metropolitan Melbourne and regional Victoria

when compared with the preceding year. In metropolitan Melbourne, there were significant decreases in

the proportion of attendances where alcohol was also involved and in the proportion of events occurring

in public spaces. In metropolitan Melbourne, the three LGAs with the highest rates for other analgesic-

related ambulance attendances in 2012/13 were Melbourne, Frankston and Moonee Valley. In regional

Victoria, Benalla, East Gippsland and Campaspe had the highest population rates.

There was a significant increase in the proportion of cases where the patient was transported to hospital

in metropolitan Melbourne compared with 2011/12. When compared with 2011/12, the proportion of

attendances where alcohol was also involved remained unchanged in metropolitan Melbourne. Due to

the small number of cocaine-related attendances in regional Victoria, most characteristics had too few

cases to be reported.


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Appendix

Map 43: LGAs of outer metropolitan Melbourne

Brimbank (C)

Maroondah (C)

Kingston (C)

Greater Dandenong (C)

Cardinia (S)Casey (C)

Frankston (C)

Hume (C)

Knox (C)

Melton (S)

Mornington Peninsula (S)

Nillumbik (S)

Whittlesea (C)

Wyndham (C)

Yarra Ranges (S)


Map 44: LGAs of inner metropolitan Melbourne

Port Phillip (C)

Maribyrnong (C)

Melbourne (C)

Hobsons Bay (C)

Yarra (C)

Boroondara (C)

Stonnington (C)

Glen Eira (C)

Bayside (C)

Monash (C)

Manningham (C)

Moreland (C) Darebin (C) Banyule (C)

Casey (C)

Hume (C)

Moonee Valley (C)

Nillumbik (S)

Whitehorse (C)

Whittlesea (C)

Wyndham (C)

Yarra Ranges (S)


Map 45: LGAs of regional Victoria

Documents

trends in alcohol and drug related ambulance attendances in