The ATOP is a psychometrically valid instrument for the measurement of treatment outcomes in Australian opioid treatment populations and can feasibly be implemented as part of routine clinical practice in specialist opioid treatment program clinics. The role of the ATOP to measure outcomes in other drug and alcohol treatment modalities requires exploration.

Introduction In early 2020, many services modified their delivery of opioid treatment in response to the COVID‐19 pandemic, to limit viral spread and maintain treatment continuity. We describe the changes to treatment and preliminary analysis of the association with patients' substance use and well‐being. Methods A pre‐post comparison of treatment conditions and patient self‐reported outcomes using data extracted from electronic medical records in the 5 months before (December 2019–April 2020) and after (May 2020–September 2020) changes were implemented in three public treatment services in South Eastern Sydney Local Health District. Results Data are available for 429/460 (93%) patients. Few (21, 5%) dropped out of treatment. In the ‘post’ period there was significantly more use of depot buprenorphine (12–24%), access to any take‐away doses (TAD; 24–69%), access to ≥6 TAD per week (7–31%), pharmacy dosing (24–52%) and telehealth services. There were significant reductions in average opioid and benzodiazepine use, increases in cannabis use, with limited group changes in social conditions, or quality of life, psychological and physical health. At an individual level, 22% of patients reported increases in their use of either alcohol, opioids, benzodiazepines or stimulants of ≥4 days in the past 4 weeks. Regression analysis indicates increases in substance use were associated with higher levels of supervised dosing. Discussion and Conclusions These preliminary findings suggest that the modified model of care continued to provide safe and effective treatment, during the pandemic. Notably, there was no association between more TAD and significant increases in substance use. Limitations are discussed and further evaluation is needed.

The addition of naloxone does not appear to affect the efficacy of buprenorphine as a maintenance drug. While offering some deterrence of injection through precipitated withdrawal, there are many circumstances where injecting of buprenorphine-naloxone is reinforcing rather than aversive. The combination will reduce, but not eliminate, intravenous misuse; clinicians therefore need to monitor patients in OST, and be selective in providing patients with medication to be taken without observation.

Background and Aims The Australian Treatment Outcomes Profile (ATOP) is a brief instrument measuring recent substance use, risk profile and general health and wellbeing among clients attending alcohol and other drug (AoD) treatment services. This study evaluates the ATOP for concurrent validity, inter‐rater and test–re‐test reliability among alcohol and opioid treatment groups. Design For concurrent validity and inter‐rater reliability, participants completed an ATOP with a clinician and an ATOP plus standardized questionnaires (time‐line follow‐back, Opiate Treatment Index, Kessler‐10, 12‐item Short Form Survey, World Health Organization Quality of Life‐BREF, Personal Wellbeing Index) with a researcher within 3 days. For test–re‐test reliability, participants completed two ATOPs with a researcher within a 3‐day interval. Setting Outpatient AoD treatment centres in Australia. Participants For testing concurrent validity and inter‐rater reliability, 278 participants were recruited by advertisements in waiting‐rooms or clinician invitation during 2016 to 2018. A further 94 participants were recruited to examine test–re‐test reliability. Measurements Statistical tests used for concurrent validity and test–re‐test reliability were Pearson’s and Spearman’s rank order correlations for continuous variables, and Cohen’s κ for nominal variables. Inter‐rater reliability was assessed using Krippendorf’s α. Findings Most Australian Treatment Outcomes Profile items returned excellent or moderate validity and reliability. For the main substances used—alcohol, cannabis and benzodiazepines—concurrent validity, inter‐rater reliability and test–re‐test reliability all reached excellent or good agreement (0.72–0.96). Psychological health, physical health and quality of life showed fair to strong agreement with their comparator scales (0.47–0.85). Conclusions The Australian Treatment Outcomes Profile is a validated and reliable instrument for assessing recent substance use and clinical risk, health and welfare among alcohol and opioid clients in alcohol and other drug treatment settings. Its ability to reliably measure complex constructs, such as psychological and physical health, against longer scales makes it suitable for integration into routine clinical care, enabling regular monitoring of patient outcomes and safety parameters.

Introduction and AimsThe Australian Treatment Outcomes Profile (ATOP) is a brief clinical tool measuring recent substance use, health and wellbeing among clients attending alcohol and other drug (AOD) treatment services. It has previously been assessed for concurrent validity and inter‐rater reliability. In this study we examine whether it is suitable for administration over the telephone.Design and MethodsWe recruited a sample of 107 AOD clients across public sector specialist AOD treatment services in New South Wales, Australia between 2016 and 2018. Participants had a mean age of 47 years and 46% were female. Participants completed a face‐to‐face ATOP and a phone ATOP with a researcher within 5 days. Comparisons between the two administration modes were undertaken using Spearman's rank correlation coefficient for continuous or ordinal variables, and Cohen's Kappa for nominal variables.ResultsAmong 107 participants, 59% were attending for alcohol treatment and 41% for opioid treatment. Most ATOP items (76%) reached above 0.7 (good) or 0.9 (excellent) agreement between face‐to‐face and telephone use.Discussion and ConclusionsOur findings suggest that the ATOP is a suitable instrument for telephone monitoring of recent substance use, health and social functioning among AOD clients. Its validation for remote use over the telephone will support staff to monitor clients' risks and outcomes—of particular relevance in response to the COVID‐19 pandemic in which services are increasingly relying on telework approaches to client monitoring.