Aust Fam Physician
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There is a pressing need to improve alcohol treatment services for Aboriginal and Torre Strait Islander peoples with alcohol dependence. One component of treatment is the use of medicines including naltrexone and acamprosate. Access to these medicines among the general drinking population is poor and, anecdotally, even worse for Aboriginal and Torre Strait Islander peoples who drink. ⋯ The major effect of naltrexone is reducing episodic heavy drinking, a pattern often seen in Aboriginal and Torre Strait Islander peoples with alcohol dependence. Possible genetic and epigenetic factors, and practical considerations including once-daily dosing also make naltrexone an appealing agent in this population.
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Adults with autism spectrum disorder (ASD) may require medical assessment and care, especially for mental health conditions. Although substantial knowledge and resources are available regarding the management of mental ill health in children with ASD, substantial gaps remain for adults with ASD. Diagnostic overshadowing, limitations of communication skills and the heterogeneous nature of this patient population can make practice in this area more challenging, and can contribute to poorer outcomes, including overprescribing of psychotropic medications. ⋯ The incorporation of specific knowledge and adaptations in the areas of communication, awareness of physical health comorbidities, management of challenging behaviour, impact of the environment, role of carers and an approach that values neurodiversity has the potential to positively influence mental health outcomes of adults with ASD.