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DSU Bulletins

The Statements of Principles Monitoring, Aetiology and CCPS Commentary Unit

4th floor AMP Place, 10 Eagle St Brisbane Qld 4000.

Facsimile: 07 3223 8722.

Bob Connolly

07 3223 8325  (Manager, Brisbane)

Dr Bev Grehan

07 3223 8376

Maureen Anderson

08 8290 0365  (Manager, Adelaide)

Dr Jon Kelley

07 3223 8412

Duncan Cape

07 3223 8757

Sue Lee

08 8290 0227

Gaynor Cavanagh

07 3223 8331

Bernadette McCabe

07 3223 8393

SOP BULLETIN 17

4 December, 1998

THE FOLLOWING RMA SOPS ARE TO BE GAZETTED ON 9 December, 1998

New SOPs

Nil

Revocations & Determinations

Alcohol Dependence or Alcohol Abuse (determination)

Drug Dependence or Drug Abuse (determination)

(together replacing Psychoactive substance Abuse or Dependence)

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Ischaemic Heart Disease

Amendments

Nil

IMPORTANT OPERATIONAL FEATURES

ALCOHOL DEPENDENCE OR ALCOHOL ABUSE

Revocation - 76 & 77 of 1998 (replaces Psychoactive Substance Abuse or Dependence 5 & 6 of 1994)

There are significant changes to the stress factor.  A severe stressor must now be experienced within 2 years (RH) and 1 year (BOP) before clinical onset or clinical worsening of alcohol dependence or alcohol abuse.

DRUG DEPENDENCE OR DRUG ABUSE

New - 78 & 79 of 1998  (replaces Psychoactive Substance Abuse or Dependence 5 & 6 of 1994)

There is now a definitive list of drugs to which the SoP applies, and it does not include nicotine/tobacco.

There are significant changes to the stress factor.  A severe stressor must now be experienced within 2 years (RH) and 1 year (BOP) before clinical onset or clinical worsening of drug dependence or drug abuse.

There is an additional factor for drug dependence or drug abuse as a result of being medically prescribed drugs for medical/surgical/psychiatric conditions.

ISCHAEMIC HEART DISEASE

Revocation - 80 & 81 of 1998 (replaces 140 & 141 of 1996 as amended by 77 & 78 of 1997 & 37 & 38 of 1998)

The definition has been altered such that this SOP now covers only Ischaemic Heart Disease (IHD) which results from coronary atheroma or coronary vasospasm.  IHD due to other factors, such as anaemia, should either be coded to the condition causing the IHD or to 414.9 (IHD unspecified) and treated as a non SOP condition.  Cases of coronary atheroma without cardiac disability should be NIF.

It is now necessary to have smoked at least five cigarettes a day for one year immediately before the clinical onset of IHD.  There are also three new sub clauses dealing with IHD if smoking has ceased before onset - see both the RH and BOP SoPs for full details.

Immersion in an atmosphere of visible tobacco smoke has been reduced from 5200 hours to 1000 hours.  See the SoP for the periods over which this must occur, and if smoking has ceased the relevant time periods involved.

Experiencing a severe stressor is now an onset factor as well as a worsening factor for IHD.

OTHER SoP INFORMATION NOT PREVIOUSLY ADVISED

HYPERTENSION (gazetted 9 September 1998)

Revocation - 64 & 65 of 1998 (replaces 83 & 84 of 1995)

There are significant changes to the alcohol factor which now refers to “alcohol dependence or alcohol abuse” instead of PSA.  Alcohol consumption of at least 200 grams (RH) and 300 grams (BOP) before clinical onset and clinical worsening is now required.

A single factor, “chronic renal parenchymal disease or injury”, now replaces several separate factors referring to specific diseases.

The salt factor has been redefined “salt supplementation” and has been extended to the BOP SoP.  Consumption levels required are 12 grams (RH) and 15 grams (BOP).

If you are having any problems with SOPs, including if you think a SOP needs to be changed, talk to us!