No abstract

The use of illicit and misuse of licit drugs is a global public health problem, with illicit drug use being responsible for 1.8% of the total disease burden in Australia in 2011. Oral adverse effects associated with illicit drug use are well-established, with aggressive caries, periodontitis, bruxism, poor oral hygiene and general neglect documented. Other factors such as a high cariogenic diet and lifestyle, social and psychological factors compound the poorer oral health in illicit drug users. Literature has shown that the oral health-related quality of life among injecting drug users is poorer compared with the Australian general population and the overall quality of life of addicted people correlates with caries experience. Thus, the role of the dentist is imperative in managing the oral health of these individuals. Given their widespread recreational use, it is likely that dental practitioners will encounter patients who are regular or past users of illicit drugs. The aim of this article is to describe the prevalence and mechanism of action of commonly used illicit drugs in Australia, including cannabis, methamphetamine, cocaine and heroin and to inform dentists about the common orofacial presentations of their side effects to help with patient management.Abbreviations and acronyms: CBD = cannabidiol; CNS = central nervous system; MA = methamphetamine; ONJ = osteonecrosis of the jaw; THC = delta-9 tetrahydrocannabinol.

Health professionals are expected to be familiar with common and clinically significant complementary medicine interactions or at least know where to look them up. Knowing the dynamic and kinetic interactions associated with commonly used complementary medicines helps to identify the risk of drug interactions. Although information on complementary medicine interactions is not readily provided by the manufacturers, evidence is available by way of case reports, independent research and webbased resources, which have increased in recent years. Collectively, these data make interactions with complementary medicines largely predictable and therefore preventable.

Recent surveys suggest that the elderly are more frequent users of complementary and alternative medicines (CAMs) than the general population-up to 80% have reported using at least one CAM on a regular basis in the past year. Although many reasons are cited for their interest in CAMs, the elderly commonly state that CAMs are not used as 'alternatives', but rather as 'supplements' to compensate for aspects perceived to be lacking in conventional care. Although high-level evidence supports the use of some CAMs in specific conditions, their use in the elderly presents significant challenges as this population is burdened by polypharmacy, decreased functional reserve and chronic disease. Preventing adverse reactions and drug interactions associated with CAM use is complicated by the fact that fewer than 50% of older patients disclose CAM use to their doctor or pharmacist. This article is a guide for health professionals who wish to advise the elderly consumer on the rational use of CAMs. J Pharm Pract Res 2005; 35: 63-8.