Longitudinal Treatment Outcomes For Methamphetamine Dependence: A Treatment Cohort Study
Funder
National Health and Medical Research Council
Funding Amount
$720,500.00
Summary
Australia has a substantial and growing population of problematic stimulant users, namely dependent or injecting methamphetamine users, with methamphetamine injection accounting for one-third of all injecting drug use. Methamphetamine dependence has been associated with serious physical and mental health problems, including psychosis, depression, stroke and general poor health and wellbeing. Increasing numbers of people are presenting for treatment of methamphetamine dependence and many are expe ....Australia has a substantial and growing population of problematic stimulant users, namely dependent or injecting methamphetamine users, with methamphetamine injection accounting for one-third of all injecting drug use. Methamphetamine dependence has been associated with serious physical and mental health problems, including psychosis, depression, stroke and general poor health and wellbeing. Increasing numbers of people are presenting for treatment of methamphetamine dependence and many are experiencing other psychiatric problems like drug-induced psychosis and depression. Currently little is known about people who present for treatment of methamphetamine dependence, including how many have other serious mental health problems that need treatment in their own right. Nor is it known whether the treatment they receive for their methamphetamine use is effective in reducing their drug use or improving their mental health status. The current study will provide much needed information on people seeking treatment for methamphetamine dependence in Australia, including their psychiatric status, and whether the treatment they receive for methamphetamine dependence is effective in reducing their drug use and related health problems or improving their mental health status. These aims will be met by assessing drug use, psychiatric status, treatment experience as well as general health and well being among a cohort of people entering treatment for methamphetamine use in Sydney. Responses to treatment will be assessed at 3 months and 12 months following treatment entry and outcomes will be compared to a group of methamphetamine users not receiving treatment. This is the first study in Australia to assess the effectiveness of treatment that is provided to methamphetamine users in an everyday treatment setting. It is also the first study internationally to focus on treatment outcome for methamphetamine dependence in a community setting.Read moreRead less
Mental Health And Substance Use: Understanding, Preventing And Treating
Funder
National Health and Medical Research Council
Funding Amount
$268,065.00
Summary
Mental & substance use disorders account for more years of disability than any other disorder. In young adults the top 10 causes of burden of disease are dominated by mental and substance use disorders. I lead an international program of research in the combined areas of mental health & substance abuse, and am recognised as a leading international expert. My research aims to increase our understanding of drug & alcohol and mental disorders, prevent where possible and improve treatment responses.
A Double Blind Placebo Randomised Controlled Trial Of Sativex In The Management Of Cannabis Withdrawal
Funder
National Health and Medical Research Council
Funding Amount
$245,626.00
Summary
Cannabis is the most commonly used illicit drug in Australia with an estimated 300,000 individuals with cannabis use disorder in Australia. Treatment presentations for cannabis have more than doubled over the last 10 years, yet there is still no medication to help with withdrawal. This proposal will test pure active ingredients in cannabis in a preparation sprayed in the mouth, to wean individuals from cannabis. This will assist them to complete cannabis withdrawal.
Exploring The Efficacy And Biobehavioural Basis Of Baclofen In The Treatment Of Alcoholic Liver Disease.
Funder
National Health and Medical Research Council
Funding Amount
$661,197.00
Summary
Alcoholic liver disease (ALD) is the main cause of death from alcohol consumption. Early detection of the disease and subsequent abstinence from alcohol can prevent death and disability. Current medications to help control alcohol consumption are not suitable for use in this patient population owing to the risk of liver side-effects. This study investigates the novel use of an existing medication, baclofen, to safely help maintain abstinence from alcohol in patients suffering from ALD.
Australian Longitudinal Study Of Heroin Dependence: An 18-20yr Prospective Cohort Study Of Mortality, Abstinence, And Psychiatric And Physical Health Comorbidity
Funder
National Health and Medical Research Council
Funding Amount
$1,210,319.00
Summary
The burden associated with heroin dependence is undeniable. But little is known about the natural history and long-term course of heroin dependence; knowledge that is critical for informing the development of new treatment interventions, health care planning and service delivery. We propose to extend our study of 615 Australians with heroin dependence, recruited in 2001-2002, to 18-20 years follow-up to answer critical questions about the long-term impact of this condition.
Assessing Naltrexone Implant Or Methadone Maintenance Treatment On Mental And Physical Health Outcomes In Heroin Users
Funder
National Health and Medical Research Council
Funding Amount
$216,200.00
Summary
The WA hospital data linkage system (DLS) will be used to assess differences in the mental and physical health of dependent heroin users prior to and post naltrexone implant or methadone maintenance treatment (MMT). MMT is the best established pharmacotherapy for the management of heroin dependence but oral naltrexone is gaining some acceptance. Currently funded by NHMRC, we are looking at outcomes with oral naltrexone using DLS data. Although effective in blocking heroin, management via oral na ....The WA hospital data linkage system (DLS) will be used to assess differences in the mental and physical health of dependent heroin users prior to and post naltrexone implant or methadone maintenance treatment (MMT). MMT is the best established pharmacotherapy for the management of heroin dependence but oral naltrexone is gaining some acceptance. Currently funded by NHMRC, we are looking at outcomes with oral naltrexone using DLS data. Although effective in blocking heroin, management via oral naltrexone has proved problematic, with medicine non compliance and relapse common. Surgical insertion of subcutaneous implants is an alternative method of naltrexone delivery. 441 heroin users have received naltrexone implants (3.4g) under Special Access in WA. Although naltrexone implants have yet to be comprehensively assessed, early results are encouraging. Pilot study data has shown a significant reduction in hospital emergency department (ED) attendance for accidental overdose, and mental health events following implant. The aim of this study is to more rigorously assess outcomes associated with implants compared to heroin dependent persons treated by MMT . The DLS collates general hospital and mental health admissions plus mortality data for individuals. This allows the health of an individual to be monitored over time. An electronic version of hospital ED data has recently become available. The study will validate these records by comparing the electronic data against hospital ED records for the implant group. We will then combine the electronic ED and DLS data. Morbidity and mortality rates for heroin users are significantly greater than those for the general population. If the preliminary findings are replicated, naltrexone implants may offer significant benefits over current pharmacotherapies in reducing general and psychiatric morbidity in dependent heroin users.Read moreRead less
Australian Longitudinal Study Of Heroin Dependence: A 11 Year Prospective Cohort Study Of Mortality, Abstinence, Criminality And Psychiatric Comorbidity Among Heroin Users
Funder
National Health and Medical Research Council
Funding Amount
$372,295.00
Summary
To conduct the longest and most comprehensive prospective follow-up of Australian heroin users. A 11 year follow-up presents the unique opportunity to examine: Mortality rates, remission rates, criminal histories and levels of psychopathology ; Predictive factors of long term remission, mortality, criminality and the health service utilisation associated with heroin use careers.
The Efficacy Of Behavioural Activation Therapy In Treating Depression Among Individuals With Opioid Dependence
Funder
National Health and Medical Research Council
Funding Amount
$733,908.00
Summary
Heroin dependence is a chronic relapsing condition, associated with high levels of psychopathology. On entry to treatment at least one quarter of heroin users meet criteria for Major Depression. The co-occurrence of heroin dependence and depression is associated with a range of harms and has been linked to poorer treatment outcomes. Despite this, practical and effective treatment options are scarce. The proposed international collaboration will contribute significantly to understanding of the tr ....Heroin dependence is a chronic relapsing condition, associated with high levels of psychopathology. On entry to treatment at least one quarter of heroin users meet criteria for Major Depression. The co-occurrence of heroin dependence and depression is associated with a range of harms and has been linked to poorer treatment outcomes. Despite this, practical and effective treatment options are scarce. The proposed international collaboration will contribute significantly to understanding of the treatment of this comorbidity.Read moreRead less
Integrating Treatment For Alcohol Use Problems And Comorbid PTSD
Funder
National Health and Medical Research Council
Funding Amount
$658,073.00
Summary
Comorbid alcohol use problems and posttraumatic stress disorder (PTSD) are common mental health problems that cause disability and distress. Despite this, there are few randomized controlled trials of interventions. The proposed study is the first Australian randomised controlled trial in this field to address the question of whether treating PTSD and alcohol use problems is superior to treating alcohol use problems alone. The study compares the relative efficacy of a manual guided treatment for ....Comorbid alcohol use problems and posttraumatic stress disorder (PTSD) are common mental health problems that cause disability and distress. Despite this, there are few randomized controlled trials of interventions. The proposed study is the first Australian randomised controlled trial in this field to address the question of whether treating PTSD and alcohol use problems is superior to treating alcohol use problems alone. The study compares the relative efficacy of a manual guided treatment for alcohol use disorder alone with a simultaneous treatment for alcohol use and PTSD. This study improves on the methodological limitations described in the two existing studies reported in the published literature. Two-hundred and sixty four participants will be recruited from mutiple sites (media, GPs, specialist clinics) and treated in the community at two sites in Sydney. Participants will be eligible if they consume harmful levels of alcohol (NHMRC risky or high risk levels) and have a concurrent diagnosis of PTSD based on recognised diagnostic criteria. Treatment will consist of 16 sessions of manual guided individual psychological therapy that has been found to be very efficacious with each problem alone. The efficacy of treatment will be determined on the basis of reductions in harmful drinking (above NHMRC low risk levels) and in symptoms of PTSD. Participants will be followed up by an independent, blind, clinician three and six months after treatment completion. The findings of this study have the potential to provide valuable information regarding the treatment needs of people with these complex presentations to clinicians and policy developers alike.Read moreRead less